MindSG

Explore our suite of self-care tools and resources to help you better understand and manage your mental health.

CONTRIBUTED BY

Health Promotion Board

Understanding addictions

Most of us juggle multiple roles and responsibilities, balancing work, social life, not forgetting family commitments. Understandably, these pressures can feel overwhelming and 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.

Introduction

As children and teenagers grow, they experience significant changes like puberty and transitions (e.g. starting new schools or National Service). With these new experiences and responsibilities, they may begin to feel stressed or overwhelmed. In response, some may turn to unhealthy coping mechanisms that can harm their health and well-being, potentially leading to addiction.

Addictions can pose significant risks to our children’s well-being and can often make them spiral into a destructive cycle that affects their health.

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.

Addictions doesn’t just involve substances like alcohol, it can also relate to behaviours like gambling, smoking, or excessive use of the internet or video games. The effects reach far, impacting our physical and mental health, relationships, and overall well-being.

Read on to find out more about these addictions and how we can support our child/teen.

Understanding internet and gaming addiction

We grow up in a “wired world” where many of us practically “live” online. This is especially true for our children where most of them have access to the internet through their own devices. Social media, online gaming, and the internet are not necessarily bad for us and our children, but sometimes, what starts as a harmless habit can grow into something that disrupts their daily lives and even turns into an addiction.

What is internet and gaming addiction?

Excessive internet, gaming, or social media use can significantly impact our children, affecting their academic or work performance. It can strain relationships with family and loved ones and lead to poor sleep and reduction in appetite. Some children may also experience mood changes, becoming irritable or feeling low when they don’t have internet access, their gaming devices, or social media platforms.

What puts my child/teen at risk?

Our child might be at higher risk of this addiction due to:

Personality factors

Loneliness and introversion
Low self-esteem¹

Behavioural patterns – A child/teen's internet gaming characteristics

Spending large amounts of money on games²
Increasing gaming time
Actively involved in a gaming community that plays at odd hours
Subscribing to game passes for access to all publisher’s games

Psychological factors³

Having avoidant and schizoid personality disorders (e.g. a condition where an individual lacks interest and ability to form social relationships)
High in neuroticism (e.g. being prone to stress and have difficulty managing negative thoughts)⁴

Other factors

Poor parental competence and supervision
Inconsistent parental behaviour and care

Common
misconceptions

01 Spending a lot of time online means that my child is definitely addicted.

What people may think:

Spending a lot of time online means that my child is definitely addicted.

Did you know?
It’s not just about the time spent online. For a diagnosis of internet and gaming addiction, there must be negative impacts on other areas of their life, such as neglecting schoolwork, skipping meals or not getting enough sleep.

02 The internet helps my child cope when they are feeling down; it lets them shut out the world.

What people may think:

The internet helps my child cope when they are feeling down; it lets them shut out the world.

Did you know?
Using the internet as a coping mechanism can be unhealthy. It’s important to monitor your child’s usage, before it turns into an addiction, as excessive use can interfere with schoolwork and sleep.

03 Internet and gaming addiction isn’t as serious as addiction to alcohol and drugs.

What people may think:

Internet and gaming addiction isn’t as serious as addiction to alcohol and drugs.

Did you know?
Research shows that internet and gaming addiction can cause brain changes similar to those seen in alcohol and drug addiction.

Signs of internet and gaming addiction

Preoccupation with gaming or online activities
Becoming sad, irritable or violent if they are unable to access the internet or games
Increased time spent online to achieve satisfaction
Failed attempts to reduce usage
Neglecting responsibilities and personal care
Insufficient exercise and sleep, poor nutrition from skipping meals and disrupted sleep
Deterioration in their school performance
Deceiving others about time spent online
Using the internet or games to escape negative emotions (e.g. guilt and hopelessness)
Risking relationships or school/work opportunities due to excessive use

The signs and symptoms can be managed with early treatment.⁵

Diagnosis

If you are wondering whether your child may be struggling with excessive gaming and internet usage, it may be beneficial to seek help from a medical professional.

Diagnosis

If you are wondering whether your child may be struggling with excessive gaming and internet usage, it may be beneficial to seek help from a medical professional. A healthcare professional can diagnose internet or gaming addiction through a detailed clinical interview. The assessment will explore your child’s internet and gaming habits, current symptoms, and how these behaviours impact daily life. Additionally, your child has to exhibit the above signs and symptoms for at least 12 months in order to fulfil the diagnostic criteria for internet and gaming disorder.

If you are concerned that your child may be struggling with excessive use of the internet or games, speak with a teacher or school counsellor. They will be able to help your child access counselling or therapy.

Supporting our child/teen with internet and gaming addiction

01 Rather than using methods like confiscation or total bans, it’s important for us to understand why our child is drawn to the internet and how it benefits them.

02 Help them manage their time and use the internet responsibly is key.

03 Work together with our child to understand their needs can reduce the risks of addiction.

04 Enlist the support of trusted adults, teachers, and school counsellors to guide them.

A GUIDE TO

Helping your child/teen
as parents & caregivers

Understand adolescents and their world

It’s easy to forget what it’s like to be an adolescent, seeking connection with peers. Just as we might spend hours on hobbies we enjoy, today’s teens may want to spend time online.

Adopt an engaging parenting style

Adolescence comes with challenges, so patience is key.

Instead of banning internet use, work with your child to set reasonable limits. Parents should agree on a unified approach to ensure consistency.

Pick your “battles”

While boundaries are important, it’s necessary to choose which issues to address.

Consider whether a disagreement is about a harmful behaviour or simply a difference of opinion. Is this a core family value, or could it strain your relationship unnecessarily?

Look out for danger

Stay informed about what your child is doing online but respect their privacy.

Instead of secretly checking their devices, be upfront and consider placing them in a common area for easy monitoring.

Set clear boundaries and realistic rules

It’s important to set clear, realistic limits.

Rules should be discussed and agreed upon together, with consequences for non-compliance. Gradually reducing online gaming, for instance, is more achievable than expecting immediate changes.

Behaviour modification

Behaviour modification is an approach used to change challenging behaviours through reinforcement (operant conditioning), which refers to how individuals learn and adapt their behaviour based on the consequences of their actions. It’s effective for both young children and adolescents but requires a trusting and respectful relationship—especially with teens.

Activity scheduling

Activity scheduling helps children manage their time by prioritising activities, introducing new ones, and controlling their internet use. It provides predictability and consistency to their day, while fostering independence in managing their time.

Internet to–do list

It easy to lose track of time on the internet. Encourage your child to create an internet to–do list, much like a shopping list. This helps them stay focused, prioritise tasks, and avoid exceeding agreed time limits. Once all tasks are done, they should log off.

Modelling

Children learn by example. One of the best ways to teach responsible internet use is to model it ourselves. If they see us using the internet, phone, or TV excessively, they’ll think it's ok to do the same.

Stay safe online

Support your child in navigating the digital world safely. Discover ways to encourage mindful screen use habits and avoid online harms.
Find out more here

Understand adolescents and their world

It’s easy to forget what it’s like to be an adolescent, seeking connection with peers. Just as we might spend hours on hobbies we enjoy, today’s teens may want to spend time online.

Negotiating realistic rules with your child, while respecting their growing independence, can encourage positive responses.

Parenting adolescents can be complex; it's beneficial to understand the needs and challenges they face.

Behaviour modification

Identify behaviours
- Start by identifying specific behaviours to change, like excessive internet use or skipping school.
- Focus on 1-2 behaviours for younger kids and 3-4 for older ones.
Be specific
- Clearly outline the behaviour you want to change. For example, if the goal is to reduce internet use, agree on set hours for internet time and make sure it’s balanced with schoolwork.
Plan a reward
- Choose rewards that motivate but aren't excessive. Avoid rewarding with the problem behaviour, like increasing gaming time beyond the agreed limit.
Be accountable
- If your child is younger, reward positive behaviour with tokens or stamps and set limits on how many can be earned per day. Acknowledge older children's progress with positive affirmation and let them know that we notice their change in behaviours through encouragement and affirmation.
Persevere on
- Behaviour change takes time. Some kids may respond quickly, while others need more time. Stay patient and persistent, and your child’s behaviour will improve over time.
Be consistent
- Stick to the agreement when your child achieves the desired behaviour.

Treatment

Counselling and psychological interventions are often used to treat internet and gaming addiction In some cases, medications may be considered if the addiction leads to secondary mental health disorder.

While gaming addiction shares similarities with other addictions, the focus is to help individuals manage their gaming habits in a healthy way, rather than cutting it out completely. The initial assessment will determine how the problem started, what role gaming plays in the child/teen's life, and why the issue persists. The counsellor, parent and child/teen will then work together on strategies to manage gaming and device use.

Finding Support:
Mental health services

If you or someone you know is struggling with internet or gaming addiction, consider reaching out to one of the following resources:

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)
BRIDGE Family: is a support group for family members and caregivers who deal with someone struggling from addiction. The support group aims to empower them with coping skills and better understand how to manage an individual with an addiction
- Every Tuesday, 7:00pm – 8:30pm at NAMS Clinic (except eve of public holidays and public holidays)
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.

First Stop for Mental Health

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

National mindline
(24-hour)

1-771

6669-1771

In-person services

CREST

CHAT (for individuals aged 16-30)

Digital

mindline.sg

National mindline
(24-hour)

In-person services

Digital

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

References

Understanding smoking addiction and vaping

While vaping and underaged smoking are illegal in Singapore, many children/teens still engage in them. If you notice changes like secrecy, poor health, or mood swings, it could be a sign of vaping.

What is nicotine dependence?

Nicotine dependence, or tobacco use disorder, is an addictive condition that leads to impaired control, psychological dependence, and physical changes caused by nicotine or tobacco products. It develops when a person becomes reliant on nicotine. Although vaping isn’t officially classified as an addiction, it carries similar risks due to its nicotine content, and the long-term effects are still unknown.

How does nicotine
affect children?

What puts my child/teen at risk?

Smoking addiction

Anyone who uses nicotine or tobacco-containing products, such as cigarettes or vapes, is at risk of developing an addiction. The best way to prevent addiction is to avoid these products.

Other factors that increase risk of addiction include:

Family history – where individuals grow up in homes with tobacco users
Age of initiation – because the brain continues to develop until the age of 25, youths become addicted to nicotine more easily than older adults, creating a very real risk of them becoming nicotine dependent and long-term smokers/vapers¹⁹

Vaping

Here are some reasons why our child might be vaping:

Peer influence: Peer pressure is a strong motivator. If their friends are vaping, your child may feel pressured to join in to fit in
Concealability: Vapes are discreet, both in design and because they don’t emit the strong tobacco smell that gives away traditional smoking
Flavours: Vapes come in appealing flavours like candy or fruit, which makes them attractive to youths
Believe vaping is less harmful:
- Some believe vaping is safer than smoking, but the long-term health effects are still unclear. Misleading marketing, like "nicotine-free" claims, can also be deceptive, as these products may still contain nicotine
- Vaping increases the likelihood of smoking later in life
Cope with stress: Individuals with anxiety or depression are more likely to vape as a way to cope

Common
misconceptions

01 Vaping is healthier than smoking.

What people may think:

Vaping is healthier than smoking.

Did you know?
Vaping is illegal and harmful. It exposes users to toxic substances, keeps them addicted to nicotine, and can lead to severe lung diseases like "popcorn lung" (Bronchiolitis Obliterans).

Vapes may also contain illicit drugs, and due to lack of regulation, there’s no clear evidence that vaping is safer than smoking traditional cigarettes.

02 My child won’t get addicted—it’s not as serious as smoking.

What people may think:

My child won’t get addicted—it’s not as serious as smoking.

Did you know?
Both vaping and underage smoking are illegal in Singapore. Underage smoking can result in a fine of up to $300, while possessing or using electronic vaporisers can lead to fines up to $2,000.

Vapes deliver as much or more nicotine than cigarettes, making them highly addictive.

If a child uses vaping to cope or gain social acceptance, it can lead to reliance, making it difficult for them to handle stress or social situations without it. This dependency can interfere with developing healthy coping strategies and affect their confidence in navigating social interactions independently.

03 I’ll be able to tell if my child is vaping—it will be obvious.

What people may think:

I’ll be able to tell if my child is vaping—it will be obvious.

Did you know?
Vaping is easier to hide than smoking. Vapours often smell fruity or minty, and vapes can be disguised as items like flash drives. Vaping can happen indoors, in places like bedrooms or bathrooms. It’s important to stay aware of the signs of vaping before it worsens.

Signs of smoking addiction or vaping

Nicotine dependence or tobacco use disorder is characterised by one or more of the following symptoms.

Signs of smoking addiction or vaping

Nicotine dependence or tobacco use disorder is characterised by one or more of the following symptoms:

Difficulty stopping or reducing smoking or vaping on their own.
Experiencing withdrawal symptoms like irritability, anxiety, or depression when trying to quit.
Continued smoking despite developing health problems due to smoking or vaping (e.g. lung disease, heart disease, stroke).
Giving up recreational activities, family time, or socialising to smoke.

E-cigarette, or vaping product, use associated lung injury (EVALI):
Vapes can cause respiratory issues that present as pneumonia or the seasonal flu. If in doubt, see a medical professional too. Watch out for these symptoms:

Breathlessness
Chest discomfort
Coughing
Diarrhoea, vomiting, nausea, and discomfort in the abdomen
Shallow, rapid breathing
Quick heartbeat

Additionally, here are some discreet signs your child may be vaping:

Unusual Scents: Vapes often emit fruity or minty smells. Look out for new scents at home as it might indicate vaping.
New Devices: Vapes can look like everyday items like thumb drives or pens, making them easy to hide.

Diagnosis

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

E-cigarette, or vaping product use-associated lung injury (EVALI), is diagnosed by ruling out other diseases since symptoms can resemble pneumonia or the flu. The doctor will ask about recent e-cigarette use, conduct a physical exam, and perform tests like chest X-rays to identify lung issues. Blood tests may be used to rule out other causes.

A GUIDE TO

Additional support for quitting smoking and vaping

Vaping Conversation Guide

A conversation guide for before, after, and while talking about the topic of vaping with our child.

Hooked on Nicotine Checklist (HONC)

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

Quit Plan

This online tool can help guide our child 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

If our child would like to try avoiding smoking or vaping on their own, encourage them to try the 4Ds:

The 4Ds

If our child would like to try avoiding smoking or vaping on their own, encourage them to try the 4 Ds:

Distract: Encourage them to engage in activities they enjoy to shift focus away from cravings.

Delay: Suggest delaying the urge by watching a video or chatting with a friend, as cravings usually pass within minutes.

Deep Breathing: Teach them to take a deep breathing break to calm themselves and reduce the urge.

Drink Water: Recommend sipping water, milk, or tea to keep their hands and mouth busy, helping them avoid cravings.

Treatment

If our child is under 18, treatment focuses on behavioural approaches, like counselling. In counselling, our child will learn strategies to quit smoking and manage cravings.

Once our child turns 18 years old, treatment may include a combination of behavioural approaches and pharmacological support, such as Nicotine Replacement Therapy (NRT). NRT provides low levels of nicotine without harmful chemicals from tobacco smoke, and it comes in forms like patches, gum, or tablets. Treatment usually lasts 8-12 weeks, gradually reducing the dose.

Before starting medication, consult with a doctor to determine the best options for our child. Following the treatment plan is key to successful cessation. If we also smoke or vape, consider quitting alongside our child to set a positive example.

It’s normal for our child to feel nervous about treatment. Sticking to the plan increases the chances of quitting successfully, and healthcare professionals are there to offer guidance and support.

Finding Support:
Mental health services

For mental health services related to addictions:

7-12yo

Child Guidance Clinic: 6389 2200

13-18yo

National Addictions Management Service Helpline (All Addictions Helpline):

Visit www.nams.sg
Call the All Addictions Helpline at 6‑7326837 (6‑RECOVER)
BRIDGE Family: is a support group for family members and caregivers who deal with someone struggling from addiction. The support group aims to empower them with coping skills and better understand how to manage an individual with an addiction
- Every Tuesday, 7:00pm – 8:30pm at NAMS Clinic (except eve of public holidays and public holidays)

First Stop for Mental Health

National mindline
(24-hour)

1-771

6669-1771

In-person services

CREST

CHAT (for individuals aged 16-30)

Digital

mindline.sg

National mindline
(24-hour)

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

Introduction

What are addictions?

Internet + Gaming

Smoking + Vaping