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Increased accessibility leads to greater harm – including when it comes to gambling

  • Folkhälsa

The harm that occurs as a result of gambling can be regulated by reducing the accessibility of games, says Ingeborg Rossow, a researcher at the Norwegian Institute of Public Health.

Nearly 120 experts on gambling assembled in Helsinki in November to attend The 1st Gambling Policy Conference: Global Prospects, Nordic Perspectives. At one of the sessions, excerpts from the book Setting Limits: Gambling, Science and Public Policy were presented. The book will be published by Oxford University Press, next year.

Ingeborg Rossow is one of the authors. She points to the link between gambling game-related harm and the accessibility of such games.

According to Rossow, the scope of harm caused by gambling games is complex and complicated.

“Excessive gambling can lead to various economic problems. Those who gamble may borrow or embezzle money to pay for their gambling, or may turn to family members’ credit cards or similar sources to fund their habit. In the worst cases, the problem can become so extreme that the gambler must sell his or her home or declare private bankruptcy.

Problem gambling is also linked to criminal behaviour, such as in cases where the gambler embezzles money to pay off his or her gambling debts.”

“A variety of family problems also arise. The individual who has a gambling problem is focused on completely different things than their family and has less time for their children and partner. The partner may even express relief, when it turns out that a gambling problem, and not infidelity, was the reason for the gambler’s absence and lies. Gambling problems can occasionally lead to divorce. Frustration linked to problem gambling may also lead to both verbal and physical aggression.”

Mental health and substance use

 Those who play a lot of gambling games often have worse mental health; they are also more likely to use drugs and experience a greater degree of suicide-related problems.

“It’s impossible to know for sure if these issues are caused by gambling problems or by other conditions that may play a role in escalating a person’s gambling habit. It’s very difficult to use observational studies to investigate this question effectively, and that is, of course, the research method we are forced to apply in this field.”

The harm does not just occur on the individual level; it also affects the community at large.

"Society pays a price. Gambling is often discussed as a form of regressive taxation; it’s the poorest people who pay the greatest price, because they’re the ones who gamble the most, and when the gambling profits are used to benefit society, it becomes a vicious spiral. Those in the worst circumstances are hit the hardest.”

The effects interest researchers

In many studies, gambling researchers have based their investigations on the total consumption model. These studies show that there is a correlation between the total amount of gaming within a given population and the number of individuals who gamble very frequently or who have a gambling game problem. Thus, the studies support the theory that the harm caused by gambling games can be regulated by influencing the public’s overall consumption of such games.

What is interesting is to look at what has happened since the policy was changed, in order to see what impact the change has had.

“That’s what is most relevant for policymakers: what is a given society’s experience with having altered policy in one direction or the other. What happens when we increase or decrease gambling game accessibility? When it comes to that question, we don’t have much empirical research we can rely on, and most of the research that does exist, deals with increased accessibility, such as the uptick in availability that occurs when one or two casinos open.” Out of six studies, three of them found that an increase in the number of casinos was associated with more gambling problems. The other three studies were inconclusive.

“In a study conducted in the United Kingdom in 2000, researchers studied what occurred when a national lottery was introduced. The researchers found that the overall amount of money spent on gambling games doubled and that the number of people who gambled skyrocketed to four times the former level.

The Norwegian example

Rossow has also examined the opposite trend: what happens when gambling is regulated?

“In this case, there’s even less empirical evidence. We have only four empirical examples, two from the United States, which banned slot machines for a period of time, as well as one study from Norway and one from Switzerland. The one in Switzerland is difficult to interpret because the number of casinos was expanded in connection with the banning of slot machines.

In Norway, several adjustments were made over a two-year period. Norway wanted to establish a state monopoly on gambling, but due to litigation, it took time to implement.

“In 2006, slot machines became card-only. When cash could no longer be used, the number of individuals who sought help for gambling problems fell, especially among those for whom slot machines were the main problem. We also saw a decrease in the proportion of young people with gambling game problems.

Less aggressive machines

On 1 July 2007 slot machines were banned altogether, and for a year and a half, there were no legal slot machines in Norway. When the monopoly was eventually established, there were less machines and a new type of slot machine was introduced.

"They’re less aggressive. They require a personal gambling card and there is a maximum limit on how much money one can gamble away. Also, you can’t get the profits paid out in cash. The traditional sound and light features on such machines, which is said to be particularly stimulating, have been toned down.

After the slot machines disappeared, there was a decline in the extent of problem gambling and the number of people seeking help. In contrast, internet gambling increased, when the slot machines disappeared.

"But it’s difficult to say if the increase is greater than what would have been seen, if we hadn’t taken away the slot machines.

Research shows that control policy, and in particular major changes to the regulations, may have consequences for gambling, in precisely the same way as they can affect alcohol consumption.

"But policy isn’t the only thing that affects gambling, and if one forbids gambling altogether, a black market will probably emerge. Control policy also has to do with helping consumers to make easier choices. For example, making alcohol more expensive or more difficult to obtain, makes it easier for consumers to buy a little less of it.

Ingeborg Rossow

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