The future of gambling in the United Kingdom

For most people gambling is an enjoyable, if occasional, experience. For a minority, however, gambling leads to debilitating problems that harm the people close to them and the wider community. Problem gambling includes a range of behaviours that compromise, disrupt, or damage an individual's personal, family, or vocational pursuits, and, in its most severe forms, it has been recognised as a psychiatric disorder.1 A recent meta-analysis found that between 1% and 2% of adults aged 18 and over in the United States and Canada are pathological gamblers and an additional 2% to 4% of adults were classed as problem gamblers.2 Prevalence rates in Australia and New Zealand are similar.3 4 Problem gamblers and pathological gamblers are more likely than others in the general population to have been divorced, had physical and psychological problems, lost a job, been on welfare, been declared bankrupt, and been imprisoned.5

The availability of lotteries and casino gambling, as well as gaming machines, has expanded dramatically worldwide. The introduction of these tends to follow a predictable trajectory. Initial high participation is followed by stabilisation and then by the introduction of new games to revive interest and increase expenditure. Another common pattern is for established gaming operators (generally horseracing and casino concerns) to seek regulatory concessions to maintain a “level playing field” in the face of new competition.6 The availability of gambling thus expands further.

The recent evolution of gambling in the United Kingdom is no exception. Following three decades during which British gambling policy was shaped by the notion of “unstimulated demand,” the National Lottery was introduced in 1994 with a weekly draw for a large prize jackpot.7 This was followed in 1995 by the introduction of instant scratch tickets, in 1997 by a second weekly draw, and in 1999 by another weekly game that offers players more chances to win smaller prizes.8 Now that growth in revenues has stabilised, the next National Lottery licence is likely to include a daily lottery game as well as internet based services and interactive games. Furthermore, the introduction of the National Lottery led to strong pressures for deregulation from British casinos, betting shops, football pools, arcades, and charitable gambling industries.7 9

Research in several countries suggests that the “event frequency”—the number of opportunities to wager in a specified period of time—is tied to the development of gambling problems.4 10 For example, the prevalence rates of problem gambling are significantly higher among those who play daily and instant lottery games than among those who play weekly games.11 The prevalence of problem gambling among weekly players of video poker (in which there is a new game every 15 seconds) ranges from 3 to 16 times higher than the prevalence rate among other weekly (mostly lottery) gamblers.3 12 The introduction of even more rapid online and interactive games is likely to lead to an increase in the prevalence of problem gambling.

Another concern is the growing participation of women in gambling activities. Before the introduction of the National Lottery, gambling in the United Kingdom was largely restricted to betting shops, racecourses, and casinos, venues that appeal mostly to men. Recent studies in Australia, New Zealand, and the United States show that women are just as likely as men to play lottery games and to gamble at casinos, and it is likely that the introduction of a lottery sanctioned by the state has led more women in the United Kingdom to gamble.1 4 5 In the wake of changes in women's participation, other countries have all seen an increase in the proportion of problem gamblers who are women.

Although a recent Cochrane review indicates that treatment for gambling problems can be effective, there is a great deal that is not known about this disorder.13 Since there is no baseline information on the prevalence of problem gambling in the United Kingdom before the National Lottery, there is no way of knowing how these games have affected participation or the prevalence of problem gambling. As the British Gambling Review Board considers the future of gambling in the United Kingdom, those of us who are concerned about the adverse effects of gambling would suggest that steps be taken to monitor the impacts of gambling over time. Adequate funding of prevention and treatment programmes to minimise the harm that growing numbers of people may experience when they gamble is also of paramount importance.