Issues: Individuals with substance use problems are at greater risk of chronic diseases due to their unhealthy lifestyle behaviours (e.g. alcohol use, smoking, physical inactivity, poor nutrition). There is increasing evidence that health risk communication is crucial in improving risk perception and knowledge of chronic diseases, and both factors are associated with health behaviour change. The aim of this systematic review is to provide a comprehensive overview of the current state of evidence on health risk communication on people with substance use problems. Approach: A systematic search identified peer reviewed studies from the databases MEDLINE, PsycINFO, CINAHL and Scopus. Data were extracted from the included studies and a narrative synthesis of the results was conducted. Key Findings: Eight articles, representing five unique studies, were included in the review. The overall risk of bias of the included studies was considered to be low. The studies evaluated the use of message framing and personalised/customised recommendations across smoking cessation and patient engagement with methadone maintenance treatment. Results revealed that message framing, specifically gain-framed messages, had a positive impact on smoking cessation. Risk perception, sex and level of nicotine dependence were also found to be associated with smoking cessation. Implications and Conclusions: The limited number of studies provides preliminary evidence that health risk communication promotes smoking cessation. However, studies included in the review were characterised by heterogeneous methods and measures. Further investigation of health risk communication using adequately powered randomised controlled trial is warranted.