Keynote Speech by Adj Prof (Dr) Raymond Chua at the Society of Behavioural Health’s Annual Scientific Meeting on 30 January 2026

Ms Susan Tan, President, The Society of Behavioural Health, Singapore

Good afternoon, fellow healthcare professionals, social workers, community partners and the leadership and members of the Society of Behavioural Health, Singapore. Many thanks for inviting me to join your Society’s Annual Scientific Meeting in this important conversation on how we can do better as a community to curb substance abuse, specifically vaping, and care for those who have fallen prey to it.

2. As some of you may know, I wear several hats. As the Deputy Director-General of Health (Health Regulation) at MOH, I oversee the regulation of healthcare services. In my capacity as CEO of HSA, I am in charge of three distinct professional groups, namely the Applied Sciences Group, the Blood Services Group and the Health Products Regulation Group.  In particular for the Health Products Regulation Group, I am now leading the Group in strengthening the regulations and enhancing the enforcement against vaping and drug-laced vapes. I am also working with my colleagues at the Applied Sciences Group to enhance our testing capabilities and capacities for substances of abuse, including those psychoactive substances now found in e-vaporisers.  At the same time, as a public health doctor, I bring both regulatory and clinical insight to the fight, working with fellow medical colleagues to ensure that enforcement works hand-in-hand with interventions shaped by behavioural science. This will allow us to better address the complex behavioural challenges we face in substance abuse. Today, I will share why our approach has evolved — and how behavioural health professionals like all of you are indispensable partners in building a truly caring and resilient Singapore.

The Reality We Face

3. Let me begin with a sobering reality check. Since e-vaporisers started to emerge in Singapore in 2018, we have unfortunately been seeing a sharp rise in those who have been using it.  This is despite it being illegal all this while. This has led to more e-vaporiser seizures. From just over $2 million in 2021 to more than $18 million in 2024. To some relief, seizures in 2025 dropped to less than $5 million. The emergence of etomidate-laced vapes is particularly alarming, especially among our youth. This crisis is not just about individual health, it erodes family bonds and destabilises communities, as we have seen from a lot of recent media reports. We knew that as a nation, we must now take a harder stance against vaping. 

4. Last year, Whole-of-Government measures were implemented to tackle this crisis. This included an enhanced enforcement regime, mandatory rehabilitation and increased public awareness and education. An inter-agency taskforce comprising multiple agencies was formed to coordinate upstream disruption, domestic proactive enforcement and public education. 

5. Since the step up of the enforcement measures four months ago in September 2025, while we have seen more than 3,500 persons caught and fined for the possession and use of e-vaporisers as you will have seen in the news yesterday, the number week on week has come down from the highs of 250-300 per week prior to September 2025 to about 180-200 per week currently. We have also seen more than 200 individuals being placed on rehabilitation programmes, with eight of them successfully completing them.

6. These are some encouraging numbers from our enhanced actions against vaping. But we remain concerned on a few fronts. One is how our analyses have shown that youths under 20 and young adults aged 21-30 are disproportionately affected. They are in fact the majority of regular vape cases. For etomidate-vapes, there's an even stronger skew towards younger offenders with most offenders being below 30 years old.

7. While the overall reoffence rate for all vape cases is low, concerning patterns continue to emerge among younger demographics. These patterns bring us to another key concern: the strong addictive hold etomidate-vape has on young adults. It’s made worse as those peddling etomidate-vape are targeting them where they are: social media.  Over the past months, HSA removed more than 1,000 online e-vaporiser-related listings on websites and Telegram groups. We also took action against individuals who posted content of themselves vaping or possessing e-vaporisers on social media. Another emerging trend is e-vaporisers with bluetooth connectivity and digital screens to entice the young to buy them. These devices can double as gaming machines or music players.

8. These concerning patterns highlight a fundamental truth: the root causes of offences are multi-faceted, with addiction being one key parameter. Understanding why young people are drawn to and hooked on substances, then struggle to quit, requires us to look beyond dismissing youths as simply making "poor choices". From a behavioural science perspective, vaping exploits a perfect storm of adolescent neurobiology, social identity formation, and highly engineered reward systems. In general, young people are neurologically more inclined to seek rewards and immediate gratification, are still developing impulse control abilities, and can be more susceptible to peer influence. When addictive substances are deliberately marketed as lifestyle accessories and their appeal is amplified by social media algorithms, quitting requires addressing complex behavioural factors beyond individual willpower.

9. Etomidate-laced vapes are particularly concerning because they significantly accelerate the development of dependency. Users likely experience a crucial transition from reward-seeking to relief-seeking behaviour—moving beyond just pleasure-seeking to actively avoiding withdrawal symptoms, anxiety, and emotional distress. This behavioural shift provides insight probably into the higher re-offence rates among young adults, even after enforcement action has been taken. These patterns mirror other addiction-related challenges similar to compulsive device/screen use, gambling disorders, and other substance abuse that exploit these identical neurological reward pathways.

Our Evolving Approach

10. At HSA, we have implemented a national enforcement framework that balances deterrence with rehabilitation. For first-time offenders caught with regular vapes, we impose composition fines rather than prosecution. Second-time offenders enter mandatory community-based rehabilitation, while third and subsequent time offenders will face prosecution.

11. When first-time offenders are caught using etomidate vapes, in addition to the fines, it will be coupled with mandatory community-based rehabilitation, with the Youth Enhanced Supervision Scheme (YESS) or Institute of Mental Health (IMH), depending on their age. Recognising that repeated etomidate abuse reflects deeper behavioural health challenges, second-time offenders undergo longer rehabilitation sessions, while third-time offenders enter residential rehabilitation, with both groups subject to six to ten months of close supervision that includes scheduled and surprise urine tests or hair tests in future.

12. This dual mandate of deterrence and rehabilitation reflects MOH and HSA's commitment: we are both a firm regulator that is tough on vaping and etomidate abuse, but we are also a caring one, who will partner the community in providing support and rehabilitation. Enforcement may halt the behaviour, but care and support need to be added in to better prevent its recurrence by healing root causes.

13. Let me briefly share two stories that show why support and care matter in the recovery of a person with substance addiction.  

14. The first involves a 16-year-old girl caught vaping etomidate. After our interview, she was released to her family—only to face rejection. Her family refused to take her home, despite our officers’ persuasion. HSA worked round the clock over the weekend connecting with relevant parties such as the Ministry of Social and Family Development (MSF) to ensure her well-being.  Social agencies intervened, uncovering her mental health struggles, and she was referred for immediate medical care. This case underscores the critical importance of family and community support in safeguarding resilience and long-term wellbeing.

15. The second story offers hope. Another first-time etomidate vape offender, also a 16-year-old youth, had a father who stood by her unwaveringly. He accompanied her at every step of the way, including at mandatory interviews with authorities, and even her urine testing appointments. He was with her at all her rehabilitation sessions. He became her anchor during a very challenging period of her life. His support was critical to her rehabilitation. The youth knew she was important to her father and family. Together, they are working towards recovery from the addiction, finding strength in renewed family unity.

The Behavioural Health Imperative

16. From these two stories, it's clear that family support can transform outcomes entirely. Substance abuse presents complex behavioural, mental, and emotional challenges that enforcement alone cannot solve. We are dealing with family dynamics, peer influence, misconceptions about vaping, social isolation, and questions of belonging.

17. Through coordinated Whole-of-Government efforts led by key agencies—including the Ministry of Health, Singapore Prisons Service, Ministry of Social and Family Development, Ministry of Education, Central Narcotics Bureau, HSA, and the Health Promotion Board (HPB), our rehabilitation and supervision programmes are meticulously designed and rigorously grounded in evidence-based behavioural interventions and clinical expertise from IMH,  HPB, MSF and social service agency specialist practitioners. These programmes are carefully tailored to the individual, depending on the severity of the addiction. Various proven therapeutic approaches are then offered, including (i) motivational interviewing to rebuild intrinsic motivation for change; (ii) family-based interventions to strengthen protective relationships and support networks; and (iii) structured supervision designed to disrupt harmful habit patterns. Our intention is not to punish, but to provide compassionate, clinical interventions that can help the person get back to life without drugs and addiction when individuals are most receptive to change.

18. Our mandatory rehabilitation programme, implemented from September 2025, represents a crucial shift towards addressing these underlying factors. Early results are encouraging, with most of the offenders successfully enrolling in rehabilitation programmes. While the number who defaulted is small, we continue to try to enrol them for their rehabilitation programme.

19. Success stories from our community continue to emerge, including a recent Channel NewsAsia article published on 29 December 2025, demonstrating that rehabilitation can be genuinely transformative. 17-year-old Wei Qiang's journey exemplifies the "wake-up call" and transformation that effective intervention can provide. After being caught with etomidate, he underwent mandatory rehabilitation sessions focusing on key core areas such as emotion management, relapse prevention, and strategies to stay away from drugs. By the programme's completion, he had transformed his life around. He told CNA that previously, he was “mixing around with quite bad influence people". But now, he has become a young person demonstrating mature and responsible thinking in his choice of company and activities. We are heartened by individuals like Wei Qiang who, following rehabilitation, has successfully and positively changed their life trajectories.

20. Ultimately, quitting succeeds when individuals develop three core beliefs: first, that meaningful change is achievable. Second, that professional help and support are readily accessible, as quitting works better when you’re not alone. Last core belief, and this is critical for them to know, is that their identity and future potential will not be defined by past mistakes. Our job, collectively, is to design systems that make the “healthier choice” the easier choice—and the supported choice the default choice. These encouraging outcomes affirm that rehabilitation serves as a powerful tool for healing and recovery, rather than punishment.

21. As of 31 December 2025, as I have mentioned earlier, eight offenders have completed their rehabilitation programme. However, it is still too early to conclude that the rehabilitation programmes offer long-term effectiveness  and that’s why it requires sustained networks of support in our community if we want the rehabilitation programme to succeed.

22. This is where behavioural health becomes essential and an enabler. You provide what enforcement cannot:

    • Prevention through early intervention and education

    • Treatment that addresses the case specific root causes

    • Support for individuals and families navigating challenges

    • Sustained care that reduces reoffending

Building Healthier Communities Together

23. Together, we will not just be addressing individual cases. We can build healthier communities by fostering a culture of care that encompasses self, others, and community. HSA is committed to safe pathways for individuals to seek help without penalty. People need safe spaces to make hard choices, and we must ensure these avenues exist. We must move from punishment to include healing, from isolation to include connection, and from despair to include hope.

24. Users of e-vaporisers are strongly urged to quit immediately. Support is available under the QuitVape programme. Those using etomidate e-vaporisers can seek help from IMH, WE CARE Community Services, Singapore Anti-Narcotics Association, Thye Hua Kwan Moral Charities, and Fei Yue Community Services. The public can also access smoking and vaping cessation support through HPB’s QuitLine at 1800 438 2000. Those who voluntarily seek help will not face any penalties nor have an offence record.  (www.gov.sg/stopvaping-support-vapers ↗ (opens in new tab)) However, if the individual is separately caught for vaping, penalties under the various laws will be meted out and there will be an offence record.

A Call to Partnership

25. It is not a matter of whether we can eliminate substance abuse entirely. It is whether we can build systems of care that catch people when they fall. Support them as they recover and strengthen communities so fewer people fall in the first place.

26. And this will require coordinated efforts from enforcement agencies tackling illegal vaping products, healthcare providers offering addiction treatment and prevention programmes, social services supporting affected families, and community partners like you.

27. So I invite all of you to work with HSA and MOH. Share your insights, challenge our approaches, and help us co-create solutions that truly serve our community’s behavioural health needs, particularly supporting our youths and young adults.

28. As I close, let me leave you with two quotes that summarise my thoughts: While enforcement stops vaping. Support helps these people quit. Vapers are people who can recover—with help.

29. To our youth and individuals who may be struggling: You didn't choose addiction—but you can choose recovery. Getting help early is strength, not weakness.

30. Together, we can build a Singapore where care for self, others, and community is not just a conference theme—but the reality of how we live and work every day.

31. Thank you and we look forward to the continued partnership and collaboration.

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