New research published by the Lancet Public Health Commission on gambling

A new report reveals the need for regulatory reform as the global expansion of gambling is causing widespread harm to public health.

The global health impact of commercial gambling is worse than previously understood and stronger regulatory controls are needed, a Lancet Public Health Commission on gambling has found.

Key messages from the report include:

• Commercial gambling is a rapidly growing global industry and is becoming increasingly digital.
• The harms to health and wellbeing that result from gambling are more substantial than previously understood, extending beyond gambling disorder to include a wide range of gambling harms, which affect many people in addition to individuals who gamble.
• Evolution of the gambling industry is at a crucial juncture; decisive action now can prevent or mitigate widespread harm to population health and wellbeing in the future. Thus far, globally, governments have paid too little attention to gambling harms and have not done enough to prevent or mitigate them.
• Stronger policy and regulatory controls focused on harm prevention and the protection of public health and wellbeing, and independent of industry or other competing influences, are now needed. Given the
increasingly global and boundary-spanning nature of the industry, international coordination on regulatory approaches will be necessary.

The Lancet Public Health Commission on gambling set out 7 key recommendations:

1. Gambling is a public health issue; in setting policy, governments should prioritise protecting health and wellbeing over competing economic motivations.
2. In all countries—irrespective of whether gambling is legally permitted—effective gambling regulation is needed, including;
   • Reductions in population exposure and the availability of gambling, through prohibitions or restrictions on access, promotion, marketing, and sponsorship.
   • Provision of affordable, universal support and treatment for gambling harms.
   • De-normalisation of gambling via well resourced social marketing and awareness campaigns.
3. Jurisdictions that permit gambling need a well resourced, independent, and adequately empowered regulator, focused on the protection of public health and wellbeing; at a minimum, regulatory protections must include:
   • Protection of children and adolescents from gambling, by enforcing minimum age requirements, backed by mandatory identification.
   • Provision of effective consumer protection measures, such as universal self-exclusion, and user registration systems.
   • Regulation of products proportionate to the risk of harms, based on their characteristics.
   • Enaction of mandatory measures limiting gambling consumption, such as enforceable deposit and bet limits, and universal precommitment systems
4. Gambling-related policy, regulation, treatment, and research must be protected from the distortionary effects of commercial influence; including a rapid transition away from industry-funded research and treatment, coupled with and enabled by increased levels of investment from independent sources.
5. At the international level, UN entities and intergovernmental organisations should incorporate a focus on gambling harms into their strategies and workplans for improving health and wellbeing broadly.
6. There is a need to develop an international alliance—including civil society, people with lived experience of harms related to gambling, researchers, and professional organisations—to provide thought leadership, advocacy, and convening of interested parties.
7. The instigation of the process to adopt a World Health Assembly resolution on the public health dimensions of gambling.

Professor Heather Wardle from University of Glasgow, who is co-chair of the Commission, stated: “Anyone with a mobile phone now has access to what is essentially a casino in their pocket, 24 hours a day. Highly sophisticated marketing and technology make it easier to start, and harder to stop gambling, and many products now use design mechanics to encourage repeated and longer engagement. The global growth trajectory of this industry is phenomenal; collectively we need to wake up and take action. If we delay, gambling and gambling harms will become even more widely embedded as a global phenomenon and much harder to tackle.”

These findings align with the vision of the ALLIANCE Scotland Reducing Gambling Harm programme, who advocate for a public health approach to reduce gambling harms in Scotland. You can find out more about our programme here.

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