The Brazilian Society of Pediatrics, SBP, has been issuing alerts to pediatricians, parents and educators of children and adolescents about health issues, including mental and behavioral health related to access to the Internet and digital networks, since 2016. Recently, document 163 was published: Guidance Manual #Menos Telas #Mais Saúde – update 2024 and available at: https://www.sbp.com.br/fileadmin/user_upload/24604c-MO__MenosTelas__MaisSaude-Atualizacao.pdf

Online risks currently permeate video games and operators that offer websites and betting houses, known in English as bets, as a supposed entertainment activity, even using children and adolescents themselves as “influencers” as advertising models, in TV commercials and advertising on digital networks. “Welcome” “bonuses” are offered to beginners in sports betting, in football championships, volleyball, horse racing or other online gaming activities and promotions. Many operators are national or international and await the granting of a federal license, with security protocols, to come into effect in 2025.

It is important to emphasize that, according to the criteria of the International Classification of Diseases, ICD-11 of the World Health Organization, these activities are considered disorders of compulsion and impulsivity, as diagnostic of addictive behaviors, mainly in children and adolescents, with repercussions in adult life. # QE 21 hazardous gambling and betting and # QE 22 hazardous gaming, in addition to # 6 C 50, gambling disorder online (internet) and # 6 C 51, digital gaming, online or offline, raise questions about violence, abuse, fatalities and consequences on physical and mental health, for oneself or others around. The increased risks may be due to the frequency of games or bets, time spent in these activities or failure to carry out school or work activities in the daily routine, with adverse consequences or some combination of these factors.

The “tiger game” or slot game is an example of this type of game, appealing to the curiosity and impulsiveness of children and adolescents and promoted on digital networks, such as Instagram. The promotion of these games and online betting are considered crimes against the rules of social protection of children and adolescents, according to CONANDA, the National Council for the Rights of Children and Adolescents, and CONAR, the National Council for Advertising Self-Regulation. It is worth noting that the Brazilian legal system, through the Statute of Children and Adolescents (ECA), especially in articles 4, 5, and 17, establishes full protection and absolute priority for children and adolescents, imposing clear limits on commercial practices that exploit the vulnerabilities of this age group. Exposing this public to environments that promote betting and gambling may also constitute a violation of the fundamental rights of these young people, and may even be subject to administrative and criminal sanctions as provided for in article 243 of the ECA.

Therefore, it is up to pediatricians to advise parents, during consultations, that early, prolonged and excessive use of online games of any kind, without explicit rules for safety and reliability, even in guesses, bets or tournaments, are addictive behaviors and harmful to health!

The Brazilian Society of Pediatrics reiterates that children and adolescents are not bargaining chips or profit and that the best bet is in social protection of health in childhood and adolescence, including online!