A pillar of lifestyle medicine

🚭 Risky Substances

Tobacco, alcohol and other addictive behaviors: what the data say and how to change habits. It is one of the six pillars of lifestyle medicine: avoiding risky substances.

Start here

Guide

Tobacco, alcohol and addiction: a guide to the risky substances pillar

Why avoiding risky substances is one of the six pillars of lifestyle medicine: what the data say about smoking and alcohol and where to start making changes.

4 min read · 3 scientific sources

All articles

Risky Substances

How to quit smoking: the methods with the best evidence

What Cochrane reviews show about nicotine replacement, varenicline and counseling, what the EAGLES safety trial found and a 5-step plan to quit.

Myth or fact

Is any amount of alcohol safe? The myth of the healthy glass of wine

Why newer research does not support the idea that moderate drinking is good for you, what the Global Burden of Disease found and how to cut back.

Risky Substances

E-cigarettes and vaping: what we know about harms and benefits

Are vapes safer than cigarettes? What a Cochrane review and a NEJM trial found about quitting smoking, why vaping is not safe and why teens should not start.

Risky Substances

Secondhand smoke: the harm to others and to children

Why there is no safe level of secondhand smoke, how many deaths it causes worldwide and what happened to heart attacks after a U.S. city went smoke-free.

Risky Substances

Alcohol and cancer: what the labels do not tell you

How alcohol causes cancer, what global estimates and a meta-analysis show about even light drinking, and what the U.S. Surgeon General has said.

Risky Substances

Smartphones and social media: when a habit becomes an addiction

How common problematic smartphone use is, how it is linked to anxiety, depression and sleep, and what experiments found when people limited social media.

Risky Substances

Energy drinks: how much caffeine is safe and who should avoid them

Safe caffeine limits for adults, teens and pregnancy, what a randomized trial found about energy drinks and heart rhythm, and why kids should skip them.

Risky Substances

Heated tobacco products: are they safer than cigarettes?

How heat-not-burn tobacco works, what a systematic review found about toxicant levels and industry funding, and what really helps people quit.

Risky Substances

Alcohol and blood pressure: what cutting back can do

How alcohol raises blood pressure, what a Lancet meta-analysis found about cutting back, and how the effect compares with blood pressure medication.

Risky Substances

Sleeping pills and sedatives: risks you should know

What a BMJ meta-analysis found about sleeping pills in older adults, why risks often outweigh benefits and what guidelines recommend instead.

Risky Substances

Gambling and sports betting: when play becomes addiction

What the Lancet Public Health Commission on gambling found, why online casinos and sports betting apps are especially risky and where to get help in the U.S.

Risky Substances

Cannabis: the risks, especially for teens

How often cannabis use leads to addiction, what a meta-analysis found about teen use, depression and suicidality, and how parents can talk about it.

Risky Substances

Alcohol and depression: a vicious circle

Why alcohol can relax you briefly but worsen mood over time, what research shows about alcohol use disorder and depression, and how to break the cycle.

Risky Substances

A month without alcohol: what happens to your body

What studies of Dry January and a month of abstinence found about blood pressure, weight, insulin resistance and drinking six months later.

Risky Substances

Over-the-counter painkillers: the risks of ibuprofen, naproxen and other NSAIDs

How common over-the-counter NSAIDs are linked to heart attack risk within the first week, other side effects and how to use pain relievers more safely.

Risky Substances

Weight gain after quitting smoking: what to expect and why quitting still pays off

How much weight people gain after quitting smoking, why heart disease risk still drops by about half and how to limit weight gain.

Risky Substances

Alcohol during pregnancy: no safe amount

What fetal alcohol spectrum disorders are, how common drinking in pregnancy is and why the CDC and ACOG say there is no safe amount or time.

Risky Substances

Hookah: why it is no safer than cigarettes

Why the water in a hookah does not filter out toxins, what a meta-analysis found about hookah and lung cancer, and why one session can equal many cigarettes.

Risky Substances

Alcohol and your liver: how alcohol-related liver disease develops

How heavy drinking progresses from fatty liver to hepatitis and cirrhosis, the rise of alcohol-related liver disease in the U.S. and how the liver can recover.

Risky Substances

Opioid painkillers: the risks of addiction and overdose

Why prescription opioids carry high risks of addiction and overdose, how they relate to heroin and fentanyl use, and how naloxone saves lives.

Risky Substances

Which drugs are most harmful? What a UK expert analysis found

How UK experts ranked 20 drugs on 16 measures of harm to users and others, why alcohol ranked most harmful overall and why legal status does not reflect harm.

Risky Substances

How to assess your drinking and why a short talk with a doctor helps

How the WHO AUDIT test works, what a Cochrane review found about brief alcohol interventions in primary care and why assessment is the first step.

Risky Substances

Gaming disorder: when video games become a problem

How common gaming disorder is, the WHO criteria in ICD-11, warning signs to watch for in teens and adults, and how it is treated.

Risky Substances

Holidays without alcohol: celebrate without regrets

Why heart attack risk rises during the holidays, what "holiday heart syndrome" is, how to turn down a drink politely and what to drink instead.

Quizzes and calculatorsAll quizzes →

Printables (PDF)All printables →