Public Health
Gambling – a Recognized Addictive Disorder
1. Gambling disorder is classified as a non-substance-related addictive disorder
Gambling disorder is classified as a non-substance-related disorder within “Substance-Related and Addictive Disorders” in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) (American Psychiatric Association, 2013).
In the Manual, Gambling as a Mental Illness is described as follows:
Gambling can cause low self-esteem, stress, anxiety and depression if gambling becomes a problem. Gambling can become an addiction, just like drugs or alcohol, if you use it compulsively or feel out of control. Gambling can affect the part of our brain that releases dopamine.
2. Gambling as a public health challenge
This article published on the website of the University of Bath on July 3, 2020 explains how “The ‘gamblification’ of sports over recent years poses significant challenges for individuals, families and community wellbeing according to new research”.
Impact of Advertising
1. What is the evidence that advertising policies could have an impact on gambling-related harms? A systematic umbrella review of the literature
E. McGrane , H. Wardle , M. Clowes , L. Blank , R. Pryce , M. Field , C. Sharpe , E. Goyder
https://www.sciencedirect.com/science/article/pii/S0033350622003420?via%3Dihub
This is an article in a highly respected journal of peer-reviewed articles focusing on scientific, technical and medical research, Science Direct. (Public Health, Volume 215, February 2023)
In summarizing the results of their review, the authors state that:
Included studies, using quantitative and qualitative methods, consistently support the existence of a causal relationship between exposure to advertising of gambling products/brands and more positive attitudes to gambling, greater intentions to gamble and increased gambling activity at both individual and population level. There is evidence of a ‘dose–response’ effect; greater advertising exposure increases participation which leads to a greater risk of harm. There was more evidence for the impact on children and young people and for those already at risk from current gambling activity with those most vulnerable more likely to be influenced.
The authors conclude:
Gambling advertising restrictions could reduce overall harm and mitigate the impact of advertising on gambling-related inequalities. Public health harm prevention strategies should include policies which limit exposure to advertising, particularly among children and vulnerable groups.
The article contains many reference and links to related studies and articles.
This article was published on February 13, 2023 in The Conversation and was written by marketing experts at the University of Bristol. The authors explain why they believe that a reform of gambling advertising is needed; they address the research that shows that certain types of advertising used by the sports betting companies are particularly appealing to children and young people; and they summarize the types of restrictions that have been imposed in other countries, including a complete ban on all gambling advertising in Italy and an upcoming (July 2023) almost complete ban in Belgium.
In a report published January 18, 2023, Ipsos polling finds that Canadians are experiencing fatigue from gambling advertising.
4. Protecting children and young people from contemporary marketing for gambling
Samantha Thomas, May C I van Schalkwyk, Mike Daube, Hannah Pitt, Darragh McGee, Martin McKee
https://doi.org/10.1093/heapro/daac194
This is an article in a highly resected journal published by Oxford University Press - Health Promotion International, Volume 38, Issue 2, April 2023.
The authors provide the following “Lay Summary”:
• Gambling marketing has become particularly pervasive and aligned with major cultural activities such as sport.
• Evidence clearly shows the normalizing impact of marketing on children and young people’s gambling attitudes and consumption intentions.
• Current regulatory efforts are inadequate and have not protected children and young people from exposure to a range of different forms of marketing.
• Young people and their parents support the implementation of significant restrictions on gambling marketing.
• The array of marketing mechanisms used by the gambling industry should be addressed as part of a comprehensive public health policy approach to protect children from gambling harms.
The article provides a comprehensive review of the research that has been done in several countries, including the UK, Australia and the United States, and includes links to many other papers.
The authors provide a comprehensive definition of “contemporary marketing”:
We define the contemporary marketing of gambling as:
The full range of direct and indirect advertising, promotion, sponsorship, incentives, public relations, lobbying, and donations that are strategically used by the gambling industry to promote its products, gain publicity, attract new customers, shape social and cultural attitudes, and build corporate and product image and support.
The authors conclude by providing recommendations for government action, saying:
while recognizing that the industry will work hard to circumvent it, the evidence in this paper justifies suggesting a total ban on commercial advertising for gambling, as occurs with tobacco in many jurisdictions, and this should at least be discussed. Primary responsibility for action to protect children and young people rests with governments. Applying the broad principles associated with the United Nations Convention on the Rights of the Child, we recommend the following [eight] principles to guide government action…
5. Submission by CAMH to the Alcohol and Gaming Commission of Ontario: Restricting athlete and celebrity participation in advertising for internet gaming
https://www.camh.ca/-/media/files/agco-submission-pdf.pdf
On May 9, 2023, CAMH responded to the Alcohol and Gaming Commission of Ontario’s invitation for comments on its proposal to impose restrictions on the participation of athletes and celebrities in gambling advertising. The Centre for Addiction and Mental Health (CAMH) describes itself as Canada's largest mental health and addiction teaching hospital and one of the world's leading research centres in this field.
In its introduction, CAMH states:
A recent review of the scientific literature found that there is a causal relationship between people’s exposure to gambling advertising and their intentions to gamble as well as increased gambling activity. Children and youth, as well as those already experiencing gambling problems, are especially susceptible to these effects. This is significant because the more a person gambles – measured by frequency, duration, and/or expenditure – the higher their likelihood of experiencing harm.
In addition to the AGCO’s proposed restrictions on participation by athletes and celebrities, CAMH encouraged the province:
to enact a whistle-to-whistle advertising ban that covers all gambling content and to adapt the abovementioned portions of the CRTC Code [provisions relating to alcohol advertising] for gambling ads. We also recommend that AGCO consider whether the Registrar’s Standards should be amended to allow gambling advertising only in media and venues, including on websites, and in digital or online media, directed primarily to adults.
CAMH summarized the sharp increase in calls to the Ontario Problem Gambling Hotline regarding problems with online gambling since June 2021 .
6. Article in The Guardian – “The Guardian bans all gambling advertising - Ban will apply worldwide to all of media group’s online and print outlets, including the Guardian, Observer, and Guardian Weekly”
https://www.theguardian.com/society/2023/jun/15/guardian-bans-all-gambling-advertising
On June 15, 2023, The Guardian announced a global ban on gambling advertising, arguing it is unethical to take money from services that can lead to “addiction and financial ruin”.
The article in The Guardian includes a link to recent studies which “highlight a clear correlation between exposure to gambling advertising and increased intentions to engage in regular gambling”. The principal study is referenced in item #1 above in this section “Impact of Advertising”:
What is the evidence that advertising policies could have an impact on gambling-related harms? A systematic umbrella review of the literature
E. McGrane , H. Wardle , M. Clowes , L. Blank , R. Pryce , M. Field , C. Sharpe , E. Goyder
https://www.sciencedirect.com/science/article/pii/S0033350622003420?via%3Dihub
The studies to which the article in The Guardian referred are summarized in a report on the website of the University of Sheffield https://www.sheffield.ac.uk/news/gambling-advertising-restrictions-could-reduce-harm:
Researchers from the University of Sheffield and Glasgow explored the relationship between exposure to gambling advertising and attitudes, intentions and behaviours which may be associated with an increased risk of gambling related harms
Evidence showed the impact on children, young people and those already at risk from current gambling activity are more likely to be influenced by gambling advertising
Gambling-related harms represent a significant potential driver of health inequalities, because those already experiencing financial, social and mental health disadvantage are also at increased risk of experiencing gambling-related harm
Photo by Vienna Reyes on Unsplash