Understanding addictions

As teenagers, we may experience a lot of big changes, like going through puberty, and moving from primary to secondary school. We may also be figuring out how to be more independent and handle new responsibilities. With so much going on, it’s normal to feel stressed and overwhelmed sometimes. But these stressors can lead some of us down a troublesome path of addiction to escape or cope with our problems.

As a result, addictions can pose significant risks to our well-being. They can often make us spiral into a destructive cycle that affects our health. 

Who is this for?

What are addictions?

Addictions are patterns of behaviour where a person becomes strongly attached or dependent on something to the point where it becomes difficult to control or stop that behaviour, even if it has negative consequences on their life.

Types of addictions

These addictions can involve substances like alcohol or activities such as gambling, smoking, or excessive internet or video game use. The effects reach far, impacting our physical and mental health, relationships, and overall well-being.

Reaching out for support and intervention is a natural and important step in overcoming addiction.  Curious about addictions and their common misconceptions? Read more.

Understanding gambling addiction

We might think that gambling is something only older people participate in, making them more likely to develop a gambling problem. However, young persons can also be at risk, as gambling can feel like a rite of passage, much like drinking or smoking. While teens with a gambling addiction may not face severe financial debts due to limited access to credit, they may be at a higher risk of borrowing money illegally.

What is gambling addiction?

What puts us at risk?

Common
misconceptions

01 Gambling isn’t as serious as substance use like alcohol and drugs.

02 Gambling only happens in physical venues.

03 Teens don’t have much money to gamble and lack access to financial resources.

04 I’m safe from gambling addiction since I don’t play games that require real money.

05 I can easily spot gambling—it’s obvious, like betting or slot machines.

Signs we may have gambling addiction

Behavioural Signs

Neglecting self-care, personal responsibilities, school or family tasks
Regularly late or absent for school
Missing family events and skipping out on outings with friends
Stop doing things that were previously enjoyed
Frequently thinking and talking about gambling
Cheat, steal or borrow to gamble or pay debts

Emotional Signs

Withdraws from family and friends
Distant, anxious, or has difficulty paying attention
Mood swings and sudden outbursts of anger
Boredom or restlessness

Financial Signs

Frequently borrowing money from friends and family but never repaying them
Alternating between being broke and flashing money

Health Signs

Headaches
Stomach issues
Difficulty sleeping
Changes in appetite

Diagnosis

Persistent and recurrent problematic gambling behaviour leading to clinically significant impairment or distress, as indicated by the individual exhibiting four (or more) of the following in a 12-month period:

Diagnosis

Persistent and recurrent problematic gambling behaviour leading to clinically significant impairment or distress, as indicated by the individual exhibiting four (or more) of the following in a 12-month period:

Problem gambling: 1-3 criteria met

Mild disordered gambling: 4–5 criteria met

Moderate disordered gambling: 6-7 criteria met

Severe disordered gambling: 8–9 criteria met

Needs to gamble with increasing amounts of money in order to achieve the desired excitement
Restless or irritable when attempting to cut down or stop gambling
Repeated unsuccessful efforts to control, cut back, or stop gambling
Often preoccupied with gambling (e.g. having constant thoughts of reliving past gambling experiences, hindering or planning the next venture, thinking of ways to get money to gamble with)
Often gambles when feeling distressed (e.g. helpless, guilty, anxious, depressed)
After losing money gambling, often returns another day to get even (“chasing” one’s losses)
Lies to conceal the extent of involvement with gambling
Has jeopardized or lost a significant relationship, job, or educational or career opportunity because of gambling
Relies on others to provide money to relieve desperate financial situations caused by gambling

Additionally, gambling behaviour can lead to significant mood changes such as feeling unusually happy or on the other hand, highly irritable. These mood shifts can last more than a day and may extend for weeks or longer.

Wonder if you might be experiencing gambling addiction? Try answering these questions.

Have you ever lied to prevent people from discovering your problem with gambling?
Do you gamble with money you can’t afford to lose (e.g. allowance for meals and personal expenses)?
Have you ever borrowed a large sum of money from a friend or loved one and lied about what it was for?
Have you ever traded your possessions or stolen things from others in exchange for gambling money?
Do you find yourself gambling more to win back losses?
Have you taken your gambling online in an attempt to hide your gambling activity?

If you answered yes to any of these questions, you should consider taking steps to help yourself or seeking help from trusted adults or professionals for your gambling problem.

FACING A GAMBLING
PROBLEM?

Here is what
to do next

Depending on the severity of the issue, individuals can consider trying these self‑help strategies:

Reduce access or frequency of gambling

Curb or gradually reduce the frequency of visiting physical or online gambling sites, games or venues and participation in gambling activities.

Curbing the amount to gamble

Reminding oneself that when they lose money, they should take conscious steps to stop gambling.

Focus on developing healthy coping mechanisms

Engage in activities you enjoy, explore ways to develop healthy coping mechanisms, or seek professional therapy to learn effective strategies tailored to your needs.

Set a cut-off date for these self-help strategies

You should set a cut-off date to try these self-help strategies. If these measures fail to reduce or curb your gambling problems by their stipulated cut-off date, seek professional help.

Treatment

National Addictions Management Service (NAMS)

Visit www.nams.sg
Call the All Addictions Helpline at 6‑7326837 (6‑RECOVER)
Operating hours: Everyday 8:30am‑9:00pm (inclusive of public holiday)
ReLive is a treatment programme at the National Addictions Management Service (NAMS) for adolescents aged 13-18 years old.

We Care

A Community-Based Addiction Recovery Centre that treats all forms of addictions including drugs, alcohol, and compulsive behaviours like problem gambling. They provide counselling, education and therapy groups and also has community-based drop-in centre.

National Council on Problem Gambling (NCPG)

Available daily from 8am to 11pm:

Helpline: 1800-666 8668*
*Airtime charges apply for mobile calls to 1800 service lines.
Webchat: https://go.gov.sg/ncpg-webchat

Understanding smoking addiction and vaping

While vaping and underage smoking are illegal in Singapore, some individuals may still engage in these activities. The real dangers of smoking come from tar and other carcinogens found in tobacco. These harmful substances can lead to various cancers, heart disease, and stroke. And it’s not just what smoking does to our bodies—loved ones who are exposed to second-hand smoke face health risks as well.

What is smoking addiction and vaping?

How does nicotine
affect you?

What puts us at risk?

Smoking addiction

Anyone who uses nicotine or tobacco-containing products, such as cigarettes or vapes, is at risk of developing an addiction. Here are some factors that might increase this risk:

Family history of smoking
Smoking at a young age—our brain continues to develop until the age of 25, thus, children and youths are more susceptible to nicotine addiction compared to adults.¹⁹

Vaping

Here are some reasons why individuals may engage in vaping:

Peer influence: Peer pressure is one of the main reasons people start vaping. When their friends vape, individuals may feel compelled to join in to fit into the group.
Concealability: Vapes come in discreet designs and don’t emit the strong smell of tobacco, making them easier to hide compared to traditional cigarettes.
Flavours: Vapes are available in a variety of appealing flavours like candy or fruit, making them attractive to users.
Belief that vaping is less harmful: Some people believe vaping is safer than smoking, but the long-term health effects are still unclear. Misleading marketing, like “nicotine-free” labels on products that may still contain nicotine, can further confuse consumers. Vaping also increases the likelihood of smoking cigarettes later in life.
Coping with stress: Individuals with anxiety or depression are more likely to vape, using it as a way to manage stress.

Hence, make informed decisions. Just because one's friends are vaping, doesn’t mean they have to do it too.

Common
misconceptions

01 It’s just harmless vapour!

02 I won’t get addicted to vaping!

03 Vaping isn’t as bad as smoking, so I’m fine!

04 Everyone vapes or smokes, so it’s okay.

Signs we may have smoking and vaping addiction

If you or someone you care about is experiencing these symptoms, it might be time to consider reaching out for help.

Signs we may have smoking and vaping addiction

If you or someone you care about is experiencing these symptoms, it might be time to consider reaching out for help:

Struggling to reduce or stop smoking and vaping.
Experiencing withdrawal symptoms like irritability, anxiety, or depression when trying to quit
Continuing to smoke despite health issues.
Giving up recreational activities, family time or socialising with others because of inability to smoke in certain situations.

E-cigarette, or vaping product, use associated lung injury (EVALI)

Vaping can lead to serious respiratory issues that mimic pneumonia or the flu. If you're unsure, consult a medical professional. Watch out for these symptoms:

Breathlessness
Chest discomfort
Coughing
Diarrhoea, vomiting, nausea, or abdominal pain
Shallow, rapid breathing
Fast heartbeat

Talk to a trusted adult, such as your parents, teachers, or school counsellors, to get the help you need. You don’t have to endure poor physical and mental health.

Diagnosis

A healthcare professional can diagnose nicotine dependence through a detailed clinical interview about the individual’s medical history, current symptoms, and how tobacco use is affecting their lives. The individual may also have to fill out a questionnaire to assess how dependent they are on nicotine.

Meanwhile, e-cigarette, or vaping product, use associated lung injury (EVALI) is a diagnosis that involves excluding other diseases as vapes can cause respiratory issues that present as pneumonia or the seasonal flu. The healthcare professional assesses recent e-cigarette use, performs a physical exam, and uses tests like chest X-ray to identify lung abnormalities. Bloodwork may be ordered to eliminate alternative causes of illness.

A GUIDE TO

Additional support for quitting smoking and vaping

Hooked on Nicotine Checklist (HONC)

The HONC is designed to identify the point at which individuals may have lost full autonomy over their use of tobacco. Knowing this, you can reach out and seek help.

Remember, it’s okay to take more time off for yourself to manage this journey. Quitting smoking/vaping is a significant challenge, but with the right support and strategies, we can overcome it. Reach out to loved ones or professionals when you need help. You’re not alone in this.

Start to S.T.O.P.

Start to S.T.O.P. (Speak To Our Pharmacists) is a quit smoking programme championed by the Pharmaceutical Society of Singapore (PSS) Community Chapter. It is a nationwide collaborative effort by community pharmacy chains Guardian, Unity and Watsons to help you quit smoking and improve your health.

Learn more about this programme and select a location that is convenient for you.

Quit Plan

This online tool can be used to guide individuals through five steps to develop a personalised quit plan that will make it easier for them to stay on track to quit vaping.

The 4Ds

Individuals could also try the 4Ds, if they would like to try avoiding smoking or vaping on their own.

Treatment

National Addictions Management Service (NAMS)

Visit www.nams.sg
Call the All Addictions Helpline at 6‑7326837 (6‑RECOVER)
Operating hours: Everyday 8:30am‑9:00pm (inclusive of public holiday)
ReLive is a treatment programme at the National Addictions Management Service (NAMS) for adolescents aged 13-18 years old.

We Care

Understanding internet and gaming addiction

These days, it’s easy to feel like we’re always online. Whether we’re scrolling through social media, playing games, or just browsing. When used in moderation, the internet and online gaming can be fun and helpful.

For example, spending time on social media and playing games online can provide us the opportunity to connect with our friends outside of school. However, what starts as a harmless habit can grow into something that disrupts our daily lives and even turns into an addiction.  

What is internet and gaming addiction?

What puts us
at risk?

What puts us at risk?

Common
misconceptions

01 Being addicted to the internet and gaming isn’t as serious as being addicted to alcohol and drugs.

02 The internet is a great way to cope when I am feeling down and I can shut the world out.

03 I can be anyone I want to online—it’s totally safe.

Signs we may have internet and gaming addiction

Diagnosis

A healthcare professional can diagnose internet or gaming addiction through a detailed clinical interview. The assessment will explore the individual’s internet and gaming habits, current symptoms, and how these behaviours impact daily life. Additionally, the individual must exhibit the above signs and symptoms for at least 12 months in order to fulfil the diagnostic criteria for internet and gaming disorder.

A GUIDE TO

Preventing internet and
gaming addiction

Moderation is key

Set healthy limits for internet and gaming use.

Be self-aware

Track emotions, thoughts, and behaviours. Recognise when it’s time for a break.

Set time limits

Instead of eliminating internet use completely, schedule specific time slots for online activities. There are apps that can help manage screen time.

Explore alternatives

Engage in other activities like studying, hobbies, or exercise to shift focus away from excessive gaming or internet use.

Spend time with others

Being physically present with friends or family can help reduce the urge to go online or play games.

Understand their motivation

Identify why they spend time online or gaming and find substitute activities that meet similar needs (e.g. in-person activities like sports or board games with friends).

Substitute activities

Try in-person activities like sports or board games with friends as a healthy alternative to online gaming.

Treatment

National Addictions Management Service (NAMS)

Visit www.nams.sg
Call the All Addictions Helpline at 6‑7326837 (6‑RECOVER)
Operating hours: Everyday 8:30am‑9:00pm (inclusive of public holiday)
ReLive is a treatment programme at the National Addictions Management Service (NAMS) for adolescents aged 13-18 years old.

We Care

First-Stop Touchpoints

Not sure whom to reach out to? You can approach any of these First-Stop Touchpoints. They can help identify your mental health needs, provide brief support, and guide you to the most suitable services:

In-person services

CREST

CHAT (for individuals aged 16-30)

Digital

Mindline.sg

In-person services

Digital

Alternatively, you can click here to explore mental health resources and services located near you.

References

CONTRIBUTED BY

Health Promotion Board

MindSG

Understanding addictions

Who is this for?

What are addictions?

Types of addictions

Gambling

Smoking + Vaping

Internet + Gaming

Understanding gambling addiction