The use of substances such as alcohol and other drugs is common in various societies and cultures, often beginning in adolescence and young adulthood. Researchers and professionals, particularly from diverse health-related fields of knowledge, have devoted efforts to better understand the cognitive and social factors associated with the risk of harmful use, which results in adverse consequences at both individual and collective levels. Recently, there has been a growing focus on investigating social cognitive processes. Social cognition refers to a set of skills underlying the interpretation of emotions, intentions, and thoughts of others, which shape individuals’ behavior in social interaction contexts. It is understood that abilities such as empathy and perception of emotional cues in others can modulate behavior in environments where social pressure for substance use is intense. Depending on the implicit and explicit characteristics of the group, decisions may involve either engagement in excessive use as a means of acceptance or reducing use to avoid the risk of social exclusion. This chapter aims to discuss how cognitive processes may be linked to the risk of harmful substance use.