By Charlotte Morris
The global health impact of commercial gambling is worse than previously understood and stronger regulatory controls are needed, a Lancet Public Health Commission on gambling has found.
- Gambling harms are far more substantial than previously understood, exacerbated by rapid global expansion and digital transformation of the gambling industry
- Harms from gambling include physical and mental health problems, relationship breakdown, heightened risk of suicide and domestic violence, increased crime, loss of employment and financial losses.
- An estimated 80 million adults globally experience gambling disorder or problematic gambling
- Effective and well-resourced regulatory controls and international leadership are urgently needed to reduce the impact of commercial gambling on public health and protect progress on UN Sustainable Development Goals.
The University of Glasgow’s Professor Heather Wardle, right, was Co-Chair of the Commission.
She was joined by University of Glasgow colleagues Professor Gerda Reith and Professor Chris Bunn, who are both Commissioners for the Lancet Public Health Commission, which combined international expertise on gambling studies, public health, global health policy, risk control and regulatory policy, with lived experience of gambling harms.
Professors Wardle, Reith and Bunn have all undertaken extensive research into the impact and severity of gambling harms, both in the UK and globally, as part of the Gambling Research Glasgow collective.
The Commission is published at a time when gambling reform in Great Britain continues to be debated. It recommends that governments prioritise protecting public health when developing gambling policy, and that governments should prohibit or substantially restrict gambling advertisement, sponsorship and marketing.
In addition, the Commission recommends that policy, research and treatment need to be protected from the distortionary effects of commercial influence. This involves a rapid transition away from industry funding for all of these activities.
Professor Gerda Reith said: “Gambling is associated with widespread harms, that affect many more people than just the person who gambles. The previous government recognised the need to reform gambling legislation to make it fit for the digital age. It is vital to continue and extend these reforms so that the policy priority is the protection of the public.”
She added: “Public health should always be prioritised over profit. The new Government’s ten-year plan for health and care put substantial focus on preventing ill-health. Enacting the Commission’s recommendations delivers this prevention activity for gambling and ensures that governments discharge their ethical duty to protect the health and wellbeing of their citizens.”
The Commission also calls for regulatory reform to tackle the health impacts of the rapid global expansion of commercial gambling. It estimated that approximately 448·7 million adults worldwide experience any risk gambling, where individuals occasionally experience at least one behavioural symptom or adverse personal, social or health consequence of gambling. Of these, an estimated 80 million adults experience gambling disorder or problematic gambling.
The new analysis also estimated that gambling disorder could affect 15.8 per cent of the adults and 26.4 per cent of the adolescents who gamble using online casino or slot products, and 8.9 per cent of adults and 16.3 per cent of adolescents who gamble using sports betting products.
Professor Heather Wardle said: “Most people think of a traditional Las Vegas casino or buying a lottery ticket when they think of gambling. They don’t think of large technology companies deploying a variety of techniques to get more people to engage more frequently with a commodity that can pose substantial risks to health, but this is the reality of gambling today.
“Anyone with a mobile phone now has access to what is essentially a casino in their pocket, 24 hours a day. Highly sophisticated marketing and technology make it easier to start, and harder to stop gambling, and many products now use design mechanics to encourage repeated and longer engagement. The global growth trajectory of this industry is phenomenal; collectively we need to wake up and take action. If we delay, gambling and gambling harms will become even more widely embedded as a global phenomenon and much harder to tackle.”
Access the Commission report and related content: www.thelancet.com/commissions/gambling
- The Lancet Public Health Commission involved 20 leading international experts in gambling studies, public health, global health policy, risk control and regulatory policy, including those with lived experience of gambling harms.
The University of Glasgow’s gambling experts recently created guidance for media and politicians to encourage more respectful and less stigmatising reporting and dialogue on gambling, to help protect lives. This was developed in consultation with those who have lived experience of gambling, and policy makers and journalists. Download Words Matter.
Gambling Research Glasgow is a collective of researchers based at the University of Glasgow who share a common interest in the social impacts of gambling, particularly its effects on vulnerable groups, and on the cultural and political context of the expansion of commercial gambling.
Key terms used in this story:
Gambling disorder: a recognised disorder in the two major classifications of mental and behavioural disorders—the ICD-11 and the American Psychiatric Association’s Diagnostic and Statistics Manual-5 (DSM-5). The DSM-5 states that gambling disorder is identified by a pattern of repeated and ongoing betting and wagering that continues despite creating multiple problems in several areas of an individual’s life. The ICD-11 states that gambling disorder is characterised by a pattern of persistent or recurrent gambling behaviour, manifested by impaired control over gambling (eg, onset, frequency, intensity, duration, termination, context), increasing priority given to gambling to the extent that gambling takes precedence over other life interests and daily activities, and continuation or escalation of gambling despite the occurrence of negative consequences. The pattern of gambling behaviour might be continuous or episodic and recurrent. The pattern of gambling behaviour results in substantial distress or impairments to personal, familial, social, educational, occupational, or other important areas of functioning.
Problem or problematic gambling: a commonly used term to describe gambling practices that create multiple problems that disrupt personal, family, financial, and employment circumstances; this term is sometimes used interchangeably with gambling disorder.
Any risk gambling: this term is used to include individuals who meet the thresholds for problematic or gambling disorder, but also includes individuals who, at a minimum, report sometimes or occasionally experiencing at least one behavioural symptom or adverse personal, social, or health-related consequence from gambling; this group represents the full range of risk severity.