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

BMJ 2019; 365 doi: (Published 08 May 2019) Cite this as: BMJ 2019;365:l1807

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

Problem-gambling is one of the unidentified major public health issues that warrant immediate attention towards making policies and legislation that address the issue. The interest of governments and gamblers in increasing revenues and profits has played a significant part in the growth of the gambling industry over the past decades. Besides, it is rarely seen as a public health issue.

This continued growth in the gambling industry might be causing an increase in the prevalence of gambling problems that is affecting issues involving employment, personal relationships, financial burdens, and criminal pursuits. It was estimated that 3 million adults are problem gamblers, men more likely to be problem and at-risk gamblers than women. Moreover, the availability of a casino or other means of gambling within 50 miles (compared with 50 to 250 miles) is associated with approximately double the prevalence of problem and pathological gamblers. Gambling patterns of women, children and adolescents have grown to be more like patterns in men. Because of the global increase in gambling-related morbidity and harm, problem gambling is included in the DSM-V under ‘Addictions and Related Disorders’ category as Gambling disorder. It is the only non-substance addiction included in the category.

Because of this impact, Governments must focus on primary prevention of this condition using educational programs that target at-risk youth and adults to help establish a decrease in problem gambling and a culture of controlled, responsible gambling behaviours among adults and their children. To identify young men at risk and their gambling habits, start broad-ranging, precautionary, public health strategies to reduce harm. Furthermore, Governments must try for State supported assistance programs and insurance coverage for treatment and prevention of problem gambling as this seems to be limited in comparison to the problem.

A public health approach to control problem gambling should be taken from approaches used for dealing with tobacco availability and other forms of addiction.

Thus, there is an urgent need to include gambling in national and international public health goals and strengthen evidence-based policy and prevention strategies to reduce the morbidity and harm associated with problem gambling.

Competing interests: No competing interests

11 May 2019
Dr. Vishal Busa
Dr. Chaitra Janga
King George Hospital (KGH), Andhra Medical College.
Visakhapatnam, India.