• Gambling

    Gambling-A Public Health Priority Area

    Is the State of Origin the gambling industry’s trojan horse? Read the article here: https://dailyreview.com.au/gambling-industrys-trojan-horse/62212/

    Read Dr Melissa Stoneham’s article on the effect of Gambling on Young Minds as published on The Medical Hub here: http://www.medicalhub.com.au/wa-news/guest-opinion-editorial/5134-gambling-on-young-minds

    Here is a report about the uses of social media in marketing by wagering and sports betting companies in Australia.

    https://www.responsiblegambling.vic.gov.au/information-and-resources/research/recent-research/the-marketing-of-wagering-on-social-media

    Here is an article about ex AFL star Chris Judd’s about face on gambling in sports.

    http://www.perthnow.com.au/news/opinion/liam-bartlett/liam-bartlett-why-chris-judd-endorsing-betting-reeks-of-hypocrisy/news-story/03a39d5e2c524a22fa7759350ee26276

    PHAIWA’s Gambling Position Statement and key advocacy targets is below. Gambling is an emerging public health issue which impacts on the wider community, at an individual, family and community level. Australia has the highest expenditure per capita on gambling, with 70% of Australians reporting participating in some form of gambling annually. The proliferation of online gambling has changed the gambling landscape over the last decade, making it much more accessible, with the marketing of various forms of gambling such as sports betting on the rise. Preliminary research recently presented by Dr Melissa Stoneham at the PHAA Annual Congress highlights a paucity in regulation within this field, suggesting the need for further review in this area. Key advocacy targets set by PHAIWA include reducing and regulating the availability of gambling products, developing health promotion strategies to counteract the pervasive marketing techniques of the gambling industry, and the ongoing implementation of harm minimisation strategies and treatment accessibility.

    Gambling position statement

    Gambling has been identified as one of PHAIWA’s priority areas, given its impact on the health of Australia’s population, and the wider effects that gambling has on Australian society.

    Key facts

      • Gambling is a public health issue with significant health and social impacts, at both the individual, family and community level 1
      • 70% of Australians report participating in some form of gambling annually 3
      • 80% of adolescents engage in a form of gambling by the age of 18
      • Gambling has been shown to be of higher prevalence in Indigenous populations compared to the general population. 20
      • Problem gambling is associated with mental health and substance abuse disorders, resulting in relationship breakdowns including family conflict and intimate partner violence, financial stress with high rates of bankruptcy, and reduced quality of life.11, 12
      • Online gambling in sport is becoming more prevalent with increasing user strategies that appeal to young people and in particular young males. 35

    Literature Review

    Problem Gambling Overview

    Gambling is a recognised public health issue, with both individual and social impacts. With the diversification of gambling methods in Australia over recent decades, and its associated range of marketing strategies to promote gambling products, it is appropriate that public health policies address this area.

    The literature recognises the importance of incorporating public health measures through the development of a public health framework to address these concerns. 1 Problem gambling has been identified as an emerging public health issue, 2 with significant health and social impacts, at the individual, family and community level. Many Australians gamble each year, with 70% of Australians reporting participating in some form of gambling. 3 Problem gambling is estimated to affect 0.7% of the Australian adult population, and a further 1.7% is estimated to be at moderate risk for problem gambling. 3 It has also been estimated that up to 80% of adolescents engage in a form of gambling by the age of 18, 4 and the effects on young people are of particular concern. 2 Problem gambling has been defined as being “…characterised by difficulties in limiting money and/or time spent on gambling which leads to adverse consequences for the gambler, others, or for the community.” 5

    The modern gambling environment has been heavily influenced by the gambling industry which has greatly increased gambling consumption. Factors promoting this include:

      • the move to large commercial operations,
      • the development of sophisticated technologies to attract players, and
      • the adaptation across the global sector to attract vulnerable populations, all of which have eventuated in gambling practices becoming omnipresent within communities. 1

    The gambling industry experienced substantial growth with liberalisation of gaming machines during the 1990s, followed by stabilisation and growth in keeping with other industries. 3 Since then, the gambling industry has created a pervasive online presence which is impacting on overall gambling involvement, with a recent study showing an increase in interactive gambling, with 64.3% of Australian adults reporting participation in online gambling over a 12 month period. 6 Problem gambling has become a product of the environment, with higher rates of problem gambling occurring in areas of increased facilities, and where ease of access to gambling products exists. 7

    This is intertwined with the conflicts of interest from financial benefits which governments and community organisations have with the gambling sector. 1 There is a strong financial connection with government, who are involved in industry regulation, delivery of treatment services and implementing public health strategies to combat gambling issues. 8 The risks of problem gambling are low for gambling forms relating to lotteries and scratchies, however these increase substantially with gambling on table games, wagering and particularly the use of electronic gaming machines. 3 Electronic gaming machines are available across all states and territories except for Western Australia, where they are not permitted outside of the casino, and have been associated with the highest gambling related problems. 7

    Gambling in Western Australia

    In comparison to the other States and Territories, Western Australia holds a unique position within the gambling landscape due to WA’s effective ban on electronic gaming machines outside the casino, and the support of this policy measure by successive governments. This has resulted in lower rates of problem gambling per capita when compared to Victoria and South Australia. 9 Whilst Western Australia has lower rates of both problem gambling and gambling generally, the Productivity Commission warns against direct comparison of statistics by state and jurisdiction given that data is derived from various sources. 3 These same findings were represented in data released by the ABS in 2000, for gambling expenditure per head of adult population between 1997-1998, with Western Australia having the lowest average expenditure ($528 per adult), next to Tasmania ($508 per adult), and New South Wales rating the highest ($963 per adult). 10 This lower expenditure on gambling products in Western Australia is not reflected in online gambling. There is substantial government involvement in, and revenue from, gambling in Western Australia, with the government owned TAB spread across the state.

    The health and social consequences of problem gambling

    The impact of gambling on public health is often under recognised despite the far reaching consequences of problem gambling, with implications for the individual, families and society. Problem gambling is associated with mental health and substance abuse disorders, resulting in relationship breakdowns including family conflict and intimate partner violence, financial stress with high rates of bankruptcy, and reduced quality of life.11, 12 The presence of comorbid disorders is substantial, with alcohol misuse, depression, anxiety, suicidal ideation, nicotine dependence, and substance use being higher in problem gamblers compared to the general population. 13 A systematic review and meta-analysis of problem and pathological gamblers has shown that this population has high rates of other comorbid disorders, with the highest prevalence seen for nicotine dependence, substance use disorder, any type of mood disorder, and any type of anxiety disorder. 14 Problem gambling is overrepresented in certain groups, including people who have experienced a significant relationship breakdown, are unemployed, of lower socioeconomic status, young people, or from an environment of drug or alcohol misuse or gambling problems. 7

    The Australian Medical Association has recommended that screening for problem gambling and other comorbidities are included as part of a lifestyle risk assessment by general practitioners, 15 with screening extended to include psychological impacts on family members also recommended by experts. 11 The impacts of gambling on family members is significant, with partners and children experiencing a range of emotional, physical and behavioural effects, 12 with a substantial number of people accessing gambling support services being family members of problem gamblers. 3 People who have a family member with problem gambling are more likely to develop gambling problems themselves, with children whose parents are problem gamblers being at 2 to 4 times greater risk of developing gambling problems than children to parents who do not gamble. 16

    Gambling and Young People

    Regulating the promotion of gambling to young people is difficult, given the wide range of media to which young people are exposed, and the powerful influence that advertising has on this group. 17 An Australian study identified gambling amongst young people aged 11-19 years old in the ACT, reported that 70% of adolescents had gambled in the previous 12 months, with 10% gambling at least weekly. 18 It estimated that 4% of adolescents could be categorised as problem gamblers according to DSM-IV criteria, with males and Indigenous young people overrepresented within this high risk group. This higher rate of problem gambling in young people has also been reflected in several studies overseas. 19 Gambling activities in this study were identified as private card games, scratchie tickets, and betting on racing and sporting events as the most popular forms to participate in, with the majority of participants who had gambled, taking part in two to four forms of gambling. 18 It has been shown that gambling in young people signifies a certain amount of risk taking, and has been linked to increased rates of risk taking activities including substance use and alcohol use, as well as physical and mental health disorders including depression, suicidal ideation and attempt, and anxiety. 2, 18

    Gambling in Indigenous people

    Gambling has been shown to be of higher prevalence in Indigenous populations compared to the general population. 20 An analysis of the 2002 National Aboriginal and Torres Strait Islander Social Survey, and the 2002 General Social Survey, identified that gambling-related problems were two to five times higher in non-remote areas in Indigenous populations when compared to the general population in Australia. 21 In remote areas, this was found to be significantly higher. 21, 22 As well as taking part in the usual forms of gambling, Indigenous Australian communities have historically undertaken card games, a form of unregulated gambling, which has been shown to have negative effects on communities. 21-23 Adequately addressing gambling problems through the use of mainstream interventions within Indigenous communities usually fails, due to the unique social, cultural and familial influences on gambling within these populations. 20

    Other issues PHAIWA is involved in in the gambling space

    Gambling Project

    PHAIWA investigates policy and advertising codes for sports wagering – in partnership with Deakin University

    The objectives of this project are to highlight progress in policy and advertising codes in the field of sports wagering marketing by comparing these to best practice recommendations, whilst simultaneously exposing gaps in these areas at a state, federal and industry level. The project also aims to examine lessons learnt in the regulation of advertising in tobacco, alcohol control and obesity at the policy level, and draw conclusions about how these approaches can be applied to gambling. In association with Assoc Professor Samantha Thomas, this project will approach sports wagering marketing and new forms of gambling as a public health issue and examine the capacity to respond to this harm through international expert opinions; and explore the role, development and practice of public health advocacy in the area of gambling, particularly in relation to the fields of tobacco, alcohol and obesity. The aim is to use this information to inform the development of a national Consensus Paper on Wagering Marketing to influence and inform policy in Australia.

    Peer reviewed journal articles and reports

    The following peer reviewed journal articles focusing on gambling, where PHAIWA staff have been authors have been published.

    Gambling with interests

    Mike Daube & Melissa Stoneham – in Addiction.

    Overview: Gambling researchers fall into three main categories in relation to industry funding: Accepters, Refusers and Excusers. Gambling companies fund research to support and promote their commercial interests. Gambling researchers should not accept any of this funding. As with tobacco and alcohol, government funding is legitimate and proper, so long as there is no prospect of industry involvement.

    Available at: http://onlinelibrary.wiley.com/doi/10.1111/add.13044/full

    Promoting harm? The responsibilities of sports administrators

    Mike Daube & Samantha Thomas – in ANZJPH

    Overview: Concerns about the association of professional sports and athletes with the promotion of unhealthy products such as alcohol and gambling to encourage normalisation are discussed.

    http://onlinelibrary.wiley.com/doi/10.1111/1753-6405.12534/full

    The following reports on gambling with input from PHAIWA staff members are available.

    Thomas, S. Pitt, H. Bestman, A. Randle, M. Daube, M. Stoneham, M. Pettigrew, S. (in press accepted January 2016) Child and parent recall of gambling sponsorship in Australian sport. A report for the Victorian Responsible Gambling Foundation.

    Thomas, S. Bestman, A. Pitt, H. Deans, E. Randle, M. Stoneham, M. Daube, M. The marketing of wagering on social media: An analysis of promotional content on YouTube, Twitter and Facebook. A report for the Victorian Responsible Gambling Foundation. October, 2015. Accessible on  https://www.responsiblegambling.vic.gov.au/information-and-resources/research/recent-research/the-marketing-of-wagering-on-social-media

    Read Professor Mike Daube’s latest article on problem gambling.

    http://www.insidegambling.com.au/editions/4/articles/the-problem-end-of-gambling-harm-is-just-the-tip-of-the-iceberg