Gambling is a major activity that is widely practiced around the world and has significant social impacts. These can include harm to the gambler and to their significant others as well as to society. Several studies have looked at the costs and benefits of gambling, but a public health approach is needed.
Problematic gambling is a complex phenomenon with multiple risk factors, including: an early big win, boredom susceptibility, impulsivity, use of escape coping, lack of control, and stressful life experiences. Some people may also be predisposed to mental illness, which can make them more likely to develop a gambling addiction.
People who struggle with gambling addiction often find it difficult to stop despite recognizing the negative effects on their lives. They tend to have poorer relationships with family and friends, experience financial stress, feel shame and guilt, and can be at risk of suicide. They are influenced by a variety of social and environmental factors, including media coverage, advertising, peer influence, and family history. They are often isolated from their communities and do not seek support.
The causes of problematic gambling range from a lack of skills to deal with money, a misperception that gambling is an easy way to make money, and the false belief that they can control their behavior. They may also be influenced by cultural and social norms, and the availability of betting facilities in their homes or workplaces.
Problematic gambling can lead to serious health consequences, such as financial stress and debt, relationship breakdown, homelessness, suicide and depression. It can also have an impact on children and the wider family. The legacy of gambling harm can be transmitted intergenerationally, and the effect on quality of life can continue for a lifetime.
A public health approach to the impact of gambling is necessary, as it can assess costs and benefits across the entire severity spectrum of harm. This model identifies three classes of impacts: financial, labor, and health and well-being (figure 1). Financial impacts are those that affect the gambler themselves. Labor impacts relate to the gambler’s employment, and they can manifest as changes in income, work performance, absenteeism, job loss or unemployment, and job gains. Health and well-being impacts relate to the physical, mental and social aspects of a person’s health and can be measured using disability weights. The approach can identify the full spectrum of gambling impacts and allow policy makers to compare the health costs and benefits of different gambling policies. This can be a useful tool in identifying which gambling interventions are most cost-effective for the community.