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Health Promotion Board

Understanding addictions

In today's fast-paced world, we face an array of stresses and challenges which is exacerbated from having to possibly transition into different roles in life such as embarking on a new course of study, a new job or starting new relationships. 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.

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 alcohol use disorder

As we enter adulthood, we might start to venture into new experiences and one such activity could be experimenting with drinking. Many of us drink in social settings such as parties and bars, possibly to enjoy the feeling of euphoria (e.g. intense excitement or happiness) that alcohol brings us.

Feelings of euphoria are often linked to a sense of relaxation and make it easier to let go of self-control. Consequently, some of us may develop a dependence on alcohol to recreate these pleasurable feelings and to cope with our life stresses. Without proper control of our intake, consuming alcohol can become an addiction. Excessive and prolonged alcohol use is associated with negative consequences on our physical and mental health.

What is alcohol use disorder?

Alcohol use disorder, or alcohol addiction, is an addictive condition that leads to impaired control, psychological dependence and physiological changes associated with the problematic excessive usage of alcohol.

When we drink excessively, our bodies struggle to process the alcohol, leading to a buildup of harmful substances. Beyond the physical effects, alcohol addiction can land us in risky situations, like drunk driving or engaging in risky behaviours, putting our safety and the safety of those around us in danger.

How does alcohol use disorder affect our bodies?

Those of us living with alcohol addiction may face severe health problems over time, including liver failure, various cancers, long-lasting brain damage, or memory issues.

Moreover, since the brain continues to develop as we enter our mid-twenties, drinking alcohol may pose increased risks for us. For example, parts of the brain that undergo the most changes during development are our hippocampus and frontal lobe. Both of which are associated with impulse control, motivation and addiction.

Alcohol also works as a depressant to our brain, which means it slows down the brain functions and hence, could result in poor memory or poor decision-making. With these two factors combined, those of us who consume alcohol are at an even greater risk for committing risky and reckless behaviours.

As our brain adapts to regular alcohol consumption, it takes more alcohol to achieve the same euphoric effect (e.g. feelings of intense excitement or happiness), leading to a dangerous cycle of increased drinking over time. When we try to stop, withdrawal symptoms can set in, ranging from mild discomfort like hand tremors or poor sleep, to more severe reactions such as confusion, hallucinations, and seizures. In some cases, withdrawal can be life-threatening.

What puts us at risk?

Our genetics, psychological state, social environment, and personal experiences can affect how alcohol impacts us. Some signs that we might be developing an alcohol addiction include:

Binge drinking (e.g. 5 or more standard drinks* for men, or 4 or more drinks for women in one drinking session) * A standard alcoholic drink is defined as a can (330 ml) of regular beer, half a glass (100 ml) of wine or 1 nip (30 ml) of spirit

Other factors:

Drinking at an early age
Family history of alcohol use
Co-occurring mental health conditions

Common
misconceptions

01 We can control ourselves and stop ourselves from getting addicted to drinking alcohol.

What people may think:

We can control ourselves and stop ourselves from getting addicted to drinking alcohol.

Did you know?
Alcohol is chemical and with regular use of alcohol, our brain nerves work differently and demands for more alcohol.

Later, when alcohol use is suddenly stopped, alcohol withdrawal symptoms develop. When withdrawal occurs, people initially consume more alcohol to cope and then gradually lose their self-control over the amount of alcohol consumed. This gradually turns into an addiction.

02 It’s totally okay to consume alcohol during social gatherings to loosen up or as for liquid courage.

What people may think:

It’s totally okay to consume alcohol during social gatherings to loosen up or as for liquid courage.

Did you know?
Alcohol does help some people to socialise more, but this can come with a price. The key here is the dose (e.g. the daily amount of alcohol consumed and duration of its use).

Most people, with regular use of alcohol, gradually lose self-control over the amount of alcohol consumed and develop alcohol use disorder with major physical complications.

03 Beer and wine are less intoxicating than liquor, so it is okay to drink more of them.

What people may think:

Beer and wine are less intoxicating than liquor, so it is okay to drink more of them.

Did you know?
A standard glass of wine, bottle of beer or a shot of whiskey contains equivalent amounts of alcohol. Thus, a 350ml can of beer, a 120ml glass of wine, or a normal mixed drink or cocktail are all equally intoxicating and give the same blood alcohol content (BAC).

Signs we may have alcohol use disorder

Alcohol use disorder can range from mild to severe, depending on the number of symptoms the individual experiences.

Signs we may have alcohol use disorder

Alcohol use disorder can range from mild to severe, depending on the number of symptoms the individual experiences.

Some of the common signs include:

Struggling to limit alcohol intake, even when we want to
Strong cravings for alcohol
Continued drinking despite it causing problems in our personal and/or professional life
Giving up activities we once enjoyed because of drinking
Drinking in risky situations (e.g. driving, swimming, handling machinery)
Needing more alcohol to feel the same effects
Experiencing withdrawal symptoms (e.g. nausea, sweating, hand tremors or craving alcohol to avoid withdrawal symptoms)
Spending a lot of time drinking alcohol or recovering from the last alcohol use
Spending large sums of money buying alcohol
Continued alcohol use despite experiencing physical (e.g. severe hangovers that affects their ability to function), social (e.g. getting into arguments or fights frequently when they drink), or interpersonal problems related to alcohol

Try this self-assessment to find out if you might have alcohol use disorder.

Diagnosis

Healthcare professionals can diagnose alcohol use disorder by discussing the individual’s medical and psychiatric history, family history, current symptoms, and how alcohol has affected the individual’s daily life. There must be a problematic usage of alcohol that has led to significant impairment over a 12‑month duration, exhibited by at least 2 of the following:

Increasing usage of alcohol, or over a longer period than originally intended
Repeated unsuccessful efforts to cut down or control usage, despite the desire to do so
Large amount of time spent on activities to obtain, use, or recover from the effects of alcohol
Presence of a strong desire or urge to use alcohol
Repeated alcohol usage resulting in a significant failure to fulfil major roles
Persistent alcohol use despite recurring social or interpersonal problems, with continued consumption despite awareness of the physical or psychological issues it causes
Giving up important activities due to alcohol use
Repeated usage despite significant impairments in physical health
Increased tolerance as defined by either:
- Need for increasing amounts of alcohol to achieve the same or desired effects, or
- Reduced effects with continued use of the same amount of alcohol
Withdrawal as defined by either:
- Characteristic withdrawal symptoms, or
- Alcohol being used to prevent or avoid withdrawal symptoms

A GUIDE TO

Preventing
alcohol addiction

Avoid using alcohol to cope with stress

Alcohol may seem like a quick fix for stress or insomnia, but it often worsens sleep and mood. Instead, try healthier coping strategies like exercise, hobbies, or time with loved ones. Consider placing reminders of these healthy activities—like running shoes or a yoga mat—in visible places at the living room to encourage you to choose them over alcohol.

Moderation is key

If there is a need to drink, remember that moderation is crucial: men should consume no more than 2 standard drinks a day, and women, no more than 1. A standard drink is typically a can (330 ml) of regular beer, half a glass (100 ml) of wine, or 1 nip (30 ml) of spirits.

Swapping alcohol for non-alcoholic beverages can help us stay within these limits and reduce the chances of over-consumption.

Avoid being pressured into alcohol consumption

Avoid binge drinking

Binge drinking, is defined as consuming 5 or more standard drinks for men and 4 or more for women, significantly raises the risk of developing Alcohol Use Disorder.

Eat before and during a drinking session

To prevent intoxication, eat before and during drinking to slow down alcohol absorption. Avoid salty foods, as they increase thirst and alcohol consumption.

When drinking, take small sips

Taking small sips instead of chugging your drink can help you pace yourself, maintain better control over your alcohol intake, and make it easier for your body to process the alcohol.

Ensure you are taking enough fluids

Staying hydrated is essential, especially when consuming alcohol, as it can cause dehydration, particularly in the brain, leading to headaches and more severe hangovers.

Avoid or refrain from buying or stocking up on alcohol at home

Limiting access to alcohol in our immediate environment creates a physical barrier that helps reduce temptation and prevent excessive drinking.

Avoid being pressured into alcohol consumption

Peer pressure is one of the biggest reasons why many youths drink excessively.

Be firm and direct when saying “No” to the invite/offer. Stand your ground and stick to your decision. Saying "No" can help you avoid the harmful effects of alcohol. Here are some examples of how to respond:

“Thanks, but I’m sitting this one out.”

“I’m good, sticking to my mocktail!”

“No thanks, I’ve got an early event tomorrow and can’t miss it.”

To feel less pressured at a social event, carry your own drink—whether it’s a mocktail or any non-alcoholic option.

Spread awareness about the dangers of alcohol and addiction. Remember, there are plenty of ways to have fun without drinking.

Build up your confidence by practising how to say “No” when faced with pressure to drink.

Treatment

Alcohol use disorder is a serious condition, but it is treatable. Treatment options range from counselling, medications, and support for any related health conditions. Youths and young adults are at higher risk of developing alcohol addiction due to early drinking and frequent binge drinking in social settings. That’s why it's important to seek help early. Some damage caused by excessive drinking, like harm to the brain or kidneys, may not be fully reversible, so getting treatment as soon as possible is crucial.

Most individuals can be treated on an outpatient basis, but some may need inpatient care, especially if there is a history of severe health problems, previous seizures or delirium.

Recovery is possible with the right support and commitment to change. The first step in treatment is often detoxification, which usually takes about a week. After detox, ongoing counselling and, if necessary, medications can help prevent relapse and support recovery.

Finding Support:
Mental health services

If you or someone you know is struggling with alcohol 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)

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.

Alcoholics Anonymous

This is a fellowship of men and women who share their experiences, strength and hope with each other, that they may solve their common problem and help others in recovery.

SobeRISE

This specialised programme offers support and assistance to individuals and families affected by issues associated with alcohol abuse.

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 gambling addiction

For many of us, gambling could be an occasional activity. But have you ever wondered when it crosses the line into something more serious? The excitement we feel may make it hard to stop, and before we know it, what started as a harmless pastime can evolve into something much harder to manage.

While we may think gambling is more common among older people, recent studies show that younger individuals are now at greater risk, mainly due to the easy access to gambling through online platforms and games.

Gambling is defined as risking something of value, like money, on an activity where the outcome is uncertain and based on chance. This includes activities like online or arcade games with elements of chance, betting on sports or e-sports, and in-game purchases like skins and loot boxes. These activities aren’t always regulated as gambling, which makes it easier for youths to get involved without understanding the risks. Without proper control, gambling can lead to addiction.

Read more about gambling and its common misconceptions.

What is gambling addiction?

What puts us at risk?

What is gambling addiction?

Gambling addiction occurs when one has an impaired ability to resist the impulse to gamble despite the harmful consequences of participation. These harmful consequences may include:

Risky behaviours, like borrowing money from illegal sources to fund the addiction
Struggling with financial problems such as spending monthly allowance on gambling and not having enough for daily expenses
Facing legal issues, like criminal charges for underage gambling, which may result in fines and community service
Failing to fulfil important life roles such as being a student, friend, romantic partner, family member, etc
Strained relationships with loved ones

Living with gambling addiction doesn’t just impact one’s finances—it can also increase stress, anxiety, and even lead to depression. These effects extend beyond the individual, impacting the people they care about most.

What puts us at risk?

These factors can increase the risk of gambling addiction:

Family history of addiction or mental health issues
- Adolescents and older adults are most at risk for developing gambling disorder
- Males as¹ they are greater risk-takers as compared to females²
Individuals who are already dealing with a substance addiction like drugs and alcohol
Social environment where:
- Individuals who grew up with an over emphasis or importance placed on money
- Individuals who have lived or are living in an environment of extreme poverty
- Individuals who may be socially isolated or have little social connections³
- Individuals whose peers or family members frequently gamble
Personality factors⁴:
- Having higher levels of impulsivity
- Have a hard time in decision-making and planning
- Low self-directedness⁵
- Higher sensitivity to rejection
- Reduced resistance to peer influence

Common
misconceptions

01 Gambling only happens in physical spaces and venues.

What people may think:

Gambling only happens in physical spaces and venues.

Did you know?
Most gambling now takes place online, making virtual platforms the primary source of gambling. Activities like sports betting, card games, loot boxes, e-sports, and gambling on skins are all common and part of gaming culture.

With so many gambling sites online, youths and young adults have easier access, often without proper safeguards in place.

02 Stock investment is not gambling, it is a calculated risk.

What people may think:

Stock investment is not gambling, it is a calculated risk.

Did you know?
Stock investments can share similarities with gambling, especially when driven by the desire for quick wealth. High-risk stock options can lead to losses and financial instability, much like gambling.

03 Those who don’t play games with real money are safe from gambling addiction.

What people may think:

Those who don’t play games with real money are safe from gambling addiction.

Did you know?
Many games embed gambling elements in their gameplay, like slot machines or spinning wheels, to reward players with free items, in-game currency, or extra lives.

Additionally, social casino games that are free-to-play, offering in-game tokens without needing real money, can still increase the likelihood of future gambling with real money. Players who invest time or money into simulated gaming are at a higher risk of developing gambling problems.

Signs we may have gambling addiction

Behavioural Signs

Neglect self-care, personal responsibility, school or family duties
Regularly late or absent from 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

Emotional Signs

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

Financial Signs

Frequently borrows money from friends and family but never repaying them
Alternating between being broke and flashing money
Valuables or money disappearing (from a bank account or wallet)

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 or savings for meals, groceries, and school fees)?
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, you can consider trying these self‑help strategies:

Reduce access or frequency of gambling

Curb or gradually reduce visits to gambling venues or online sites, and schedule other activities to avoid gambling. This self exclusion order or visit limit form to the casino through the National Council on Problem Gambling (NCPG) website may be helpful.

Curbing the amount to gamble

You can consider leaving credit and ATM cards at home and bring only minimal cash. Once the money is lost, it is a sign to leave the venue.

Avoid alcohol or substances before gambling to avoid impulsive decisions.

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.

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.

If gambling is driven by peer pressure, it's important to recognise the influence of the social circle and take steps to distance oneself from situations where gambling is encouraged or normalised. Seeking support from trusted friends, family, or a mentor can provide the necessary encouragement and guidance to step away from such influences and make healthier choices.

If you are not sure where to turn to, reach out for help by calling the All Addictions Helpline at 6‑7326837 (6‑RECOVER) or visit the National Council on Problem Gambling (NCPG) website to look at the listed community resources to help you and your families. Remember, there is no shame in reaching out for help. With the right support, you can save your life, career and family.

Treatment

Treatment for gambling addiction typically involves both individual and group therapy. Cognitive Behavioural Therapy (CBT) is effective in managing the condition, and self-help models like SMART Recovery can provide additional support.

SMART Recovery is a 4-step programme that is designed to help individuals overcome their problems with gambling addiction, focusing on:

Enhancing and maintaining motivation to quit
Coping with urges
Managing problems
Lifestyle Balance

Find out more about SMART Recovery here.

Group therapy is another effective tactic that works great for many and individuals can go through WE CARE Community Services or National Addiction Management Services (NAMS) clinic. Many problem gamblers choose to partner with a behavioural services facility to find the right balance of inpatient and outpatient care.

Finding Support:
Mental health services

If you or someone you know is struggling with gambling 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)

We Care

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

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

Understanding smoking and vaping addiction

Despite the well-known dangers of smoking, many people around the world still choose to smoke, even though it remains the leading cause of preventable death globally. 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.

Vaping has grown in popularity in recent years. It involves inhaling vapour produced by e-cigarettes, which heats a liquid often containing nicotine, flavourings, and chemicals. Vaping is often seen as socially acceptable and mistakenly considered safer than smoking, especially with its variety of flavours, discreet nature and lack of tobacco smell, which also adds to its appeal.

However, experts say there is insufficient evidence that vaping is safer than traditional smoking. Nicotine in both cigarettes and e-cigarettes is addictive, and all nicotine products are harmful, whether or not they contain tobacco. The best approach is to avoid both smoking and vaping.

Many people use vaping or smoking to manage stress, but research shows they can actually worsen stress, anxiety, and mental health conditions like depression. Protecting one's well-being involves learning about the risks of vaping and smoking, recognising signs of addiction, and seeking the right support to quit.

What is smoking addiction?

Have you ever felt like you just can’t quit, no matter how hard you try? That’s what smoking addiction —also known as Nicotine Dependence feels like. We find ourselves unable to stop using tobacco or nicotine products, even when we know they’re doing us harm. Simply put, this occurs when we develop a reliance on nicotine.

In comparison, while vaping isn’t officially classified as an addiction, it’s important to protect ourselves from potential risks. Vapes can contain nicotine, which is highly addictive and may lead to dependence. As vaping is still relatively new, the long-term effects remain unclear.

How does nicotine
affect you?

How does nicotine affect you?

When individuals struggle with nicotine addiction, they may experience cravings and withdrawal symptoms like restlessness, irritability, anxiety, depression, trouble concentrating, and difficulty sleeping. Over time, tolerance increases, leading to continued or heavier use despite the harm.

Since the brain develops until age 25, nicotine use during this period can impair memory, attention, and learning. It also increases the risk of anxiety, depression, and even suicidal thoughts.

Vaping produces hazardous chemicals like acetaldehyde (used in disinfectants) and formaldehyde (found in paints). Ingesting these substances can contribute to lung and heart diseases. People wouldn’t knowingly consume these chemicals, yet vaping leads to their inhalation.

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 adults¹⁹

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 l am a casual smoker, smoking one or two cigarettes a day is not very harmful.

What people may think:

I am a casual smoker, smoking one or two cigarettes a day is not very harmful.

Did you know?
Even light smoking can significantly increase our risk of serious health problems, including heart disease, stroke, and death.

02 Vaping (E-cigarettes) is safe because it doesnt have tar.

What people may think:

Vaping (E-cigarettes) is safe because it doesn’t have tar

Did you know?
Vape aerosols contain many harmful substances, including fine particulate matter, carcinogens, and metal nanoparticles.

Additionally, the nicotine content in vapes is often higher than that of traditional cigarettes, posing significant health risks.

03 Vaping isn’t as bad as smoking.

What people may think:

Vaping isn’t as bad as smoking.

Did you know?
Vaping still exposes us to toxic substances and maintains nicotine addiction. Furthermore, as these are relatively new products, its harms may only surface many years later.

Moreover, due to unregulated vape juice, vaping may be as harmful as smoking.

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

What people may think:

Everyone vapes or smokes, so it’s okay.

Did you know?
Both vaping and underaged smoking are illegal in Singapore. Underaged smokers can be fined up to $300, and vaping—illegal at any age—can lead to fines of up to $2,000.

05 I won’t get addicted to vaping!

What people may think:

I won’t get addicted to vaping!

Did you know?
Vapes can contain nicotine, an addictive substance also found in cigarettes, sometimes delivering as much or more nicotine than a tobacco cigarette. Vapes may also contain illicit drugs. Even short-term use can cause side effects like dry mouth or throat irritation, headaches, and coughing.

Signs we may have smoking 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 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 or vape in certain situations.

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. Here are some symptoms to look out for:

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

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

I Quit Programme

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.

The 4Ds

Individuals could also try the 4Ds, if they would like to try avoiding smoking or vaping on their own. Distract: Distract oneself from the desire to smoke or vape by engaging in enjoyable activities both at work and home. Conquer nicotine cravings by focusing on things that bring them joy and a sense of refreshment.

I Quit Programme

This tailored programme supports individuals through their quitting process by taking their lifestyle, habits, and level of smoking dependence into consideration. Tools available include daily SMS tips, weekly calls from trained QuitLine advisors or weekly face-to-face counselling sessions with health specialists.

For those who prefer to quit on their own without any programme support, there are resources available on the I Quit website where smokers and vapers can find out more tips on how to quit.

Smokers and vapers can also join I Quit club on Facebook featuring real-life testimonials from ex-smokers on their tips on quitting smoking to inspire others to start on their quit journey. featuring real-life testimonials from ex-smokers on their tips on quitting smoking to inspire others to start on their quit journey.

Smokers and vapers not on the I Quit programme may also contact HPB’s QuitLine advisors directly at 1800 438 2000* (Mon-Fri 8am-5pm) if they require additional adhoc support.

*Airtime charges apply for mobile calls to 1800 service lines.

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.

The 4Ds

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

Distract: Distract oneself from the desire to smoke or vape by engaging in enjoyable activities both at work and home. Conquer nicotine cravings by focusing on things that bring them joy and a sense of refreshment.
Delay: Delay the urge by watching a brief video or reaching out to a friend. The desire to smoke or vape typically fades away within a few minutes.
Deep Breathing: Focus on one’s body and breathing. Shift attention from vaping with a deep breathing break – this can be done anywhere, anytime!
Drink Water: Instead of reaching for a cigarette or a vape, occupy one’s hands and mouth with a glass of water, milk, or green tea.

Treatment

Typically, adults aged 18 years or older will be prescribed a mix of counselling and medication, like Nicotine Replacement Therapy (NRT). 3 NRT is available in forms such as patches, gum, or lozenges and helps manage the cravings with withdrawal symptoms we might face when trying to quit.

When undergoing NRT, it is important that individuals practice medical adherence as it can increase the likelihood of successful smoking cessation. Lastly, if their parent and other family members smoke or vape, encourage them to also seek help too.

Finding Support:
Mental health services

If you or someone you know is struggling with smoking 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)

We Care

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

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. But have you ever found yourself wondering if it’s becoming too much? Sometimes, 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?

An internet and gaming addiction is when we spend too much time on the internet or playing online games to the point it affects our daily life. This is not limited to computers—it includes any device with internet access like our phones or tablets.

Excessive use of the internet or games can have a life-changing impact on us. It could affect our school or work performance and strain relationships with our loved ones. Over time, this can lead to health issues like poor sleep, reduced physical activity, or neglecting personal care. We might also find ourselves missing out on important life events and activities as a result.

What puts us
at risk?

What puts us at risk?

Certain factors can increase the risk of developing an internet or gaming addiction:

Personality factors
- Loneliness and introversion
- Low self-esteem⁶
Behavioural patterns
- Spending large amounts of money on games⁷
- Increasing gaming time
- Being part of gaming communities that encourage one to play at odd hours (e.g. having friends who play after midnight or live overseas)
- Subscribing to a game pass where one can play all the games owned by the publisher
Psychological factors⁸
- High levels of anxiety
- Avoidant and schizoid personality disorders (e.g. a condition where individuals lack interest and ability to form social relationships)
- High in neuroticism⁹ (e.g. being prone to negative emotions, such as anxiety, depression and moodiness)
Other factors¹⁰
- Poor parental competence and supervision
- Inconsistent parental behaviour and care

Common
misconceptions

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

What people may think:

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

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

02 The internet is a great way to cope when feeling down— it’s always there for us, and we can shut the world out.

What people may think:

The internet is a great way to cope when feeling down— it’s always there for us, and we can shut the world out.

Did you know?
Using the internet as a way to escape from life’s stressors can be harmful. Excessive use can interfere with important aspects of life, like school, work and sleep, leading to addiction if not monitored.

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

What people may think:

We can be anyone we want to online—it’s totally safe.

Did you know?
The internet and gaming have risks. Digital footprints can reveal our identity, allowing others to track us and potentially exploit us in the real world. There have been numerous cases where one’s virtual identity was stolen and misused.

Signs we may have internet and gaming addiction

Preoccupation with gaming or online activities
Becoming sad, irritable or violent if the individual is unable to access the internet or games
Increased time spent online to achieve satisfaction
Failed attempts to reduce usage
Neglecting responsibilities and personal care
Deterioration in one’s school or work 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

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 your 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 your motivation

Identify why you spend time online or gaming and find substitute activities that meet similar needs.

Substitute activities

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

Treatment

Treatment for internet and gaming addiction often focuses on modifying behaviour rather than complete abstinence. During therapy, the individual and counsellor will work together to develop strategies to manage and reduce excessive online activity. This approach is different from other addictions, where stopping the behaviour entirely might be recommended.

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)

We Care

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

Who is this for?

What are addictions?

Types of addictions

Alcohol

Gambling

Smoking + Vaping

Internet + Gaming

Understanding alcohol use disorder

What is alcohol use disorder?

What is alcohol use disorder?

How does alcohol use disorder affect our bodies?

How does alcohol use disorder affect our bodies?

What puts us at risk?

What puts us at risk?

Common misconceptions

01

We can control ourselves and stop ourselves from getting addicted to drinking alcohol.

What people may think:

02

It’s totally okay to consume alcohol during social gatherings to loosen up or as for liquid courage.

What people may think:

03

Beer and wine are less intoxicating than liquor, so it is okay to drink more of them.

What people may think:

Signs we may have alcohol use disorder

Signs we may have alcohol use disorder

Diagnosis

Diagnosis

A GUIDE TO

Preventingalcohol addiction

Avoid using alcohol to cope with stress

Moderation is key

Avoid being pressured into alcohol consumption

Avoid binge drinking

Eat before and during a drinking session

When drinking, take small sips

Ensure you are taking enough fluids

Avoid or refrain from buying or stocking up on alcohol at home

Avoid being pressured into alcohol consumption

Treatment

Treatment

Finding Support: Mental health services

National Addictions Management Service (NAMS)

We Care

Alcoholics Anonymous

SobeRISE

First Stop for Mental Health

Understanding gambling addiction

Understanding gambling addiction

What is gambling addiction?

What puts us at risk?

What is gambling addiction?

What puts us at risk?

Common misconceptions

01

Gambling only happens in physical spaces and venues.

What people may think:

02

Stock investment is not gambling, it is a calculated risk.

What people may think:

03

Those who don’t play games with real money are safe from gambling addiction.

What people may think:

Signs we may have gambling addiction

Signs we may have gambling addiction

Diagnosis

Diagnosis

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

FACING A GAMBLING PROBLEM?

Here is what to do next

Reduce access or frequency of gambling

Curbing the amount to gamble

Avoid alcohol or substances before gambling to avoid impulsive decisions.

Focus on developing healthy coping mechanisms

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

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

Treatment

Treatment

Common
misconceptions

Preventing
alcohol addiction

Finding Support:
Mental health services

Common
misconceptions

FACING A GAMBLING
PROBLEM?

Here is what
to do next

Finding Support:
Mental health services

How does nicotine
affect you?

Common
misconceptions

Finding Support:
Mental health services

What puts us
at risk?

Common
misconceptions

The internet is a great way to cope when feeling down— it’s always there for us, and we can shut the world out.

Preventing internet and
gaming addiction