Gambling Related Harm

Gambling involves risking something of value, usually money, to predict the outcome of a game involving chance, such as a lottery or horse race. It can also involve betting on sports events or using the pokies (Australian slot machines). Often people gamble without realising it, and they may start to bet more frequently and with greater amounts of money, and the behaviour may escalate over time. When a person’s gambling becomes problematic, it can lead to serious harm. In some cases, it can even cause death.

Problem gambling is an addictive behaviour that has a variety of negative impacts on a person’s health, relationships and family life, work, education and wellbeing. It can affect all ages and both males and females, and may start during adolescence or early adulthood. Problem gambling can cause a variety of problems, including loss of income and property, substance use disorders and mental illness. It can also have a significant impact on society, such as increased social isolation, increased domestic violence and family break-ups.

A key issue is that some people do not realise they have a problem, and those who recognise it find it difficult to seek help. This can be due to culture, where some communities consider gambling as a ‘normal’ pastime, or it may be because of the beliefs and values that a person has about what is appropriate behaviour. It can also be a result of the way they perceive the risks involved in gambling.

In recent times, there has been a move toward more consistent definitions and measures of gambling related harm across treatment providers, researchers and policy makers. This is to increase consistency in the conceptualisation of the breadth and experience of harms, and to enable comparisons between different jurisdictions and across sectors.

Despite this, there are still differences in the interpretation and measurement of gambling related harm. In part this is due to a confusion between the concept of harm and that of the underlying behaviour, which has led to the conflation of the terms in screening instruments such as the Problem Gambling Inventory (PGI) [1].

It is also due to the fact that many of the consequences of gambling are not directly associated with the gambling activity itself. In this context, we propose a new definition of gambling related harm that aligns with public health approaches to harm minimisation and is consistent with the national definition of problem gambling [2].

It allows for all instances of harm from gambling to be included, from any point in a person’s lifetime, through to legacy and intergenerational harms, and is consistent with standard measures used in other public health fields. It also allows for a more holistic approach to harm, which is inclusive of the effects of comorbidities. Finally, it is grounded in a health equity perspective to allow for the inclusion of issues that impact on people from disadvantaged backgrounds. This is a significant expansion on the current conceptualisation of harm in the gambling literature.