The gambling industry is at a ‘crucial juncture’, the recent Lancet Public Health Commission on Gambling reported, as it becomes more and more digital in nature and the lines between gambling and gaming become increasingly blurred (DDN, November, page 4). What’s more, the report adds, governments have so far paid too little attention to gambling-related harms – and are doing far too little to prevent them.
When the review of the 2005 Gambling Act was announced it was two and a half years before the gambling white paper finally saw the light of day, and even then it contained almost nothing about advertising or marketing (DDN, May 2023, page 5) – despite the fact that whenever the public is surveyed on the subject, most people are in favour of tighter regulations.
Vested interests
‘We know there are a lot of vested interests and a lot of lobbying in this space,’ says lead author of the Lancet Public Health commission report, Professor Heather Wardle of the University of Glasgow. ‘And it’s not just the gambling corporations, it’s also the broadcast media. So it’s a hotly contested space, but what’s really interesting is how other countries’ governments are taking the steps and saying, “You know what? We are going to ban this.”’
A recent report commissioned by GambleAware found that the UK had far more lenient rules than comparable countries like the Netherlands, Germany, Italy or Spain, many of which are taking action to crack down on marketing. And they’re doing so on a ‘similar, or even lesser, evidence base for their particular countries,’ Wardle points out. ‘Whereas our government is taking the line that there’s no evidence to say that advertising causes harm, although they do accept that advertising causes increased consumption. But of course we know that increased consumption is associated with the increased risk of harms.’
It was a Labour government that brought in the 2005 act, which controversially helped to liberalise the advertising and marketing regulations, but could the current government be the one that finally takes decisive action to address gambling-related harms?
‘It’s unclear as yet,’ she says. ‘There were some promising signs when they actually mentioned gambling reform in their manifesto under public health commitments – the first time it had actually been put under a public health or health improvement banner. But there were perhaps some more concerning signs when they then said, “We’re going to work with the industry to make sure these reforms are implemented in a responsible way,” which very much felt like a continuation of the status quo. Part of their policy commitment is a focus on prevention so if that’s then threaded through into gambling policy it could be very positive. But it’s a big if. We’re sitting tight and waiting to see what happens.’
Surveillance economy
Most people thinking about gambling are likely to picture a betting shop or a casino – not a highly sophisticated digital ecosystem with online products that are ‘designed to be rapid and intensive’, as the commission says. ‘Like any online commodity, this is driven by data and insight,’ she says. ‘It’s about how people can use and surveil the information that you as a consumer willingly give to these companies, because that’s the quid pro quo of them providing you with the products. So once you start situating this more within the kind of surveillance economy framework, you start thinking about it in a different way.’
Gambling is also becoming increasingly normalised at an early age, with ‘loot boxes’ in children’s games and so on. Is this something most parents are even aware of? ‘I think most parents will be aware that the gaming industry is rapacious in its ability to extract cash from kids,’ she says. ‘Anyone who’s got children who play games knows that they’re constantly coming to you going, “Can I just have some money to buy this?” That’s the way the gaming industry is now recouping its cash, based on what we call the ‘freemium’ model – upselling the purchase of items in the games.’
What parents are less likely to be aware of – ‘unless you’re actually sitting there playing the games yourself’ – is the mechanisms that underpin them, she points out. ‘And I know in the past the government has tried to shift the focus onto parents – that they should be much more involved in policing it themselves. But as a parent myself, you don’t always have the time to be constantly looking over their shoulder at what they’re doing. I’d rather have the responsibility placed on the corporations to not embed these things in products for my kids the first place.’
‘Problem’ cohorts
On the question of assigning responsibility, the gambling sector tends to push much the same narrative as the alcohol industry – shifting the focus and responsibility to a small cohort of ‘problem’ people. ‘It’s the common theme of corporate practice that runs throughout gambling, alcohol, tobacco, that there’s this small percentage of people who are disordered or don’t use the products properly, and if you just deal with them everybody else will be fine. Which is fundamentally at odds with the evidence base about how harms are distributed across the spectrums of behaviours. It’s big corporations who design and provide these products, and they have to bear responsibility for the consequences of the things they’re putting into the market.’
This public narrative of ‘a disordered few’ who can’t control themselves leads inexorably to the issue of stigma, something that’s just as pernicious in the gambling world as the drug and alcohol sector – perhaps even more so. ‘That narrative layers on the shame,’ she says. ‘People think, “Why can’t I just get control of myself? Everybody else can.” You can see how that builds and people feel ashamed in terms of seeking help, even when there’s help available – we don’t have long waiting lists for the NHS gambling treatment.’
For most people experiencing gambling harms it’s ‘very, very hidden,’ she says. ‘When you talk to people with lived experience, the partners often don’t know what’s the driver behind the difficulties they’re experiencing until it gets to crisis point. Because people who are experiencing that level of difficulty with gambling are very, very good at hiding it and they become very adept at lying to their loved ones. With alcohol or drugs there are going to be some physical cues that people would be picking up on which you just don’t have with gambling.’
Women’s stigma
And when it comes to stigma – again as with alcohol and drugs – it’s frequently women who are the most affected. While the stereotypical image of a gambler is probably still a man in a bookie’s or at a poker table, the ubiquity of online gambling hasn’t just made it possible to gamble 24 hours a day, it’s also made it far more accessible for women. As with many things, this was then exacerbated during lockdown, with a YouGov poll of almost 10,000 women using the Problem Gambling Severity Index finding that up to 1m women may now be at risk of gambling harm.
‘If you read a media article about a woman who’s experienced gambling harms it’s often framed in that kind of abrogation of duty to their family and children’ she says. ‘A comparative article for a man would tend to be “they stole this much money” or “they did this to their employers.” It doesn’t locate it in the same familial context, though of course the actions of a man will impact on the family just as much. There’s also this additional gendered aspect of what is and isn’t appropriate female behaviour, which exacerbates the shame that women can feel. And yet we know that many women experience gambling harms, need help, and should get that help – free from judgment and free from stigma.’
Conservative estimates
So what would she say to those commentators who maintain that the statistics on gambling harm are overblown and not realistic. ‘I would say that many of the statistics we’ve got are actually conservative,’ she states. ‘They’re not blown out of proportion at all, because what our statistics are not doing is measuring the impact on others. And we know that impact is wide reaching and can have hugely detrimental effects on people’s health and wellbeing. They’re not actually even measuring the full range of experiences and negative consequences that people can have from gambling.’
The most common tool – the Problem Gambling Severity Index – doesn’t include gambling’s impact on relationships, she points out. ‘And we know that getting information from marginalised communities is going to be difficult as well, so there are many reasons why these statistics should probably be considered as the most conservative basis, rather than a high-level basis.’
So if she could get the government to enact one piece of legislation, what would it be? She doesn’t hesitate. ‘Prohibition of the advertising, sponsorship and marketing,’ she states.