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Over the past decades, there has been a significant migration of Sikhs, a religious group originating from Punjab, to Western countries, including Canada and England. Concurrently, while Sikhi maintains a prohibition of psychoactive substance use, Sikh immigrants face elevated alcohol abuse rates. Further convoluting this relationship with alcohol, alcohol abuse rates in Sikh communities continue to grow and negatively affect health outcomes despite the increased availability, recognition, and efficacy of current substance abuse models rooted in health promotion. While health promotion encourages individuals to take control of their health, there exist structural determinants that hinder an individual’s decision-making capabilities and resultingly, their health outcomes. Thus, this paper aims to centre the lived reality of Sikhs who migrate to Western countries to understand how the structural determinants associated with acculturative pressures contribute to an increasing tendency to use alcohol. This paper bases itself on a literature review that used the findings of previous studies that constructed both quantitative and qualitative data, with the latter drawing on individual responses to evaluate the lived experiences of Sikh immigrants who faced alcohol problems. It was found that two major structural determinants associated with newcomer health are contributing to alcohol problems in migrant Sikh communities, which are work stress and cultural barriers. Newcomer underemployment and migration from a collectivist to an individualistic culture were found to have contributed to the use of alcohol as a coping mechanism. Furthermore, analyzing existing health promotion models, including the transtheoretical model, supported that a lack of cultural competency led to an inefficacy for Sikhs seeking treatment. Finally, the review highlighted a need for a culturally integrative model and adopted various Sikh elements, including selfless service and the Gurdwara, the Sikh place of worship, to outline tools for a culturally integrative health promotion model for substance use problems. Overall, the limited available research related to Sikh-specific alcohol problems highlighted that it requires future research to effectively analyze the efficacy of overcoming cultural barriers through culturally-specific programming.