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Gambling and public health: we need policy action to prevent harm

BMJ 2019; 365 doi: https://doi.org/10.1136/bmj.l1807 (Published 08 May 2019) Cite this as: BMJ 2019;365:l1807
  1. Heather Wardle, assistant professor1,
  2. Gerda Reith, professor of social sciences2,
  3. Erika Langham, lecturer in health promotion3,
  4. Robert D Rogers, professor of psychology4
  1. 1London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place London, London WC1E 7HT, UK
  2. 2University of Glasgow College of Social Sciences, Glasgow, Glasgow, UK
  3. 3Central Queensland University School of Human Health and Social Sciences, Cairns, Queensland, Australia
  4. 4Bangor University College of Health and Behavioural Sciences, Bangor, Gwynedd, UK
  1. Correspondence to: H Wardle heather.wardle{at}lshtm.ac.uk

Prevention of harms related to gambling requires investment in population based approaches, say Heather Wardle and colleagues

Key messages

  • Current approaches targeting affected individuals substantially underestimate the harms of gambling

  • Gambling places a major burden of harm on individuals, communities, and society

  • Harms from gambling are generated through a range of political, legislative, commercial and interpersonal actions

  • Public health approaches to reduce harms related to gambling should encompass a range of population based approaches supported by regulation, legislation. and funding

In 2017 the gambling regulator for Great Britain, the Gambling Commission, described problem gambling as a public health concern (box 1)3 and emphasised the need to increase protection from harm.4 In 2018 the Faculty of Public Health released a position paper arguing for the introduction of harm prevention measures, underpinned by legislation, targeted at the whole population.5 The Labour Party recently shared plans for a radical overhaul of legislation to reduce the harms associated with “Britain’s hidden epidemic.”6

Box 1

Gambling behaviour in Great Britain12

  • Gambling encompasses a broad range of activities, ranging from the National Lottery to casino games, slot machines, and online betting

  • Around 58% of adults in Great Britain gambled on at least one of these activities in the past year

  • Approximately 0.7% of adults (about 340 000 people) in Great Britain are problem gamblers and a further 1.1% (about 550 000) are at moderate risk of harms related to gambling

  • Online gambling—on casino or slot style games and sports betting—is the largest growth area in the sector, accounting for over a third of the market. There are over 33 million active online gambling accounts in Great Britain

  • The prevalence of online gambling has increased from less than 1% in 1999 to 9% in 2016, with many online gamblers holding multiple accounts. This makes online gambling as popular as traditional betting on horses …

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