Substance Use

Why this pillar is included

Substance use can affect appetite regulation, sleep quality, inflammation, blood pressure, and adherence to nutrition and activity plans.

Alcohol

Even moderate intake can increase sleep fragmentation and make metabolic goals harder to sustain in some patients.

Nicotine and tobacco

Smoking and vaping have significant cardiometabolic harms. Cessation is one of the highest-value risk-reduction steps.

Practical support

• Set a clear reduction or cessation target.
• Track triggers and high-risk times.
• Use social and clinical supports early instead of waiting for setbacks.

Clinical coordination

Discuss medications, withdrawal planning, and relapse-prevention options with your healthcare team.