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  • Gambling-harm prevention workshop: Woodbridge High School

    Woodbridge High School, what can I say? A truly amazing experience from start to finish. From the first point of call to the end of the day, Woodbridge High School welcomed us with open arms, which set the scene perfectly for us to deliver our Preventing Gambling Harm in Diverse Communities project. We were given centre stage (quite literally, as the venue was changed to the drama hall). Each sixth form student truly did themselves proud in engaging, listening and soaking in all discussions held today. I would like to thank Mr Graham Samuels and every other member of staff throughout the day who helped us to get our programme to run as smoothly as possible.

  • Gambling-harm prevention workshop at Royal Docks Academy: coeducational secondary school

    We took another step today on our mission to eradicate Gambling Harm and reach as many young people as possible and I would like to send a big thank you to Mr Robert Potterton and the Year 10’s and 11’s at Royal Docks Academy as they welcomed us in with open arms and listened attentively throughout.

  • Gambling-harm in Adults (Infographics)

    Prevalence of gambling harm in Adults Significance of gambling harm in Adults (Quality of Life Impacts and Mortality related to gambling harm) Significance of gambling harm on society Miscellaneous

  • Gambling-harm in Young People (Infographics)

    Prevalence of gambling in Young People (11-16 year olds) Prevalence of gambling harm in Young People (11-16 year olds) Miscellaneous

  • What A Ball Ache Podcast

    Gary and Ant are two great guys who like me love football. They love it so much they decided to talk about it a lot and started their podcast What A Ball Ache. It's a podcast I have enjoyed listening to regularly. So when Ant got in touch and asked me to come on and talk about gambling harm and it's relationship with sport, particularly football, amongst other things I was really excited. What I didn't realise was that Ant was going to use the podcast to share his own experiences of gambling harm. I feel incredibly privileged to have been part of this recording. Well done Ant, top man! https://open.spotify.com/episode/5tvu77BMxqnHtAwzpCCNCn?si=1OMblgYpRSewCv7wmQEB-g

  • Affected Other Harms in 11-16 year old School Students

    Young People and Gambling 2020 The findings are taken from the data tables of the annual Young People and Gambling Survey, conducted in 2020 by Ipsos Mori on behalf of the Gambling Commission. These statistics seemed significantly noteworthy to us but have been omitted from discussion within the overall report. In 11-16 year old school students in England and Scotland: Lost sleep at night because of worrying about a family member’s gambling rarely or sometimes or often or all the time: 4.9% often or all the time: 1.3% Not had enough food (food at home or money on school canteen card/account) rarely or sometimes or often or all the time: 1.8% often or all the time: 1.1% Stopped you from belonging to clubs or doing activities you like doing rarely or sometimes or often or all the time: 1.3% often or all the time: 1.0% Stopped you from going on trips (e.g. family holidays or school outings) rarely or sometimes or often or all the time: 1.8% often or all the time: 0.9% Parent’s or guardians have less time to spend with you rarely or sometimes or often or all the time: 1.6% often or all the time: 1.0% More arguments or tension at home rarely or sometimes or often or all the time: 2.1% often or all the time: 1.2% Has made you feel sad rarely or sometimes or often or all the time: 2.4% often or all the time: 0.6% Has made you feel worried rarely or sometimes or often or all the time: 2.9% often or all the time: 0.7%

  • NICE Guidance: Gambling: Identification, diagnosis and management

    One of our priorities at Gambling Harm UK is to see gambling harm appropriately considered and prioritised within the health context. Consequently, as well as Gambling Harm UK's Medical Education efforts, Gambling Harm UK have been one of the earliest and most committed campaigners that wish to see NICE guidelines for gambling. In April 2020, a UK Parliament committee launched a call for evidence for gambling-harm with an inquiry: "Gambling can have significant adverse effects on people which can include addiction, mental health problems, financial loss, and in some cases crime or suicide. Excluding the National Lottery, gambling operators earned £11.3bn in 2018-19. All gambling in Britain is regulated by the Gambling Commission with the aim to “ensure gambling is fair and safe”. It is funded by licence fees from industry, which amounted to £19 million in the same period. Overall responsibility for the policy and regulatory framework lies the Department for Digital, Culture, Media & Sport (DCMS), which has an objective to ensure gambling is socially responsible. The industry is increasingly complex, with new risks emerging from online and mobile gambling and games that share features with gambling but are not regulated as such. The NAO’s report ‘Gambling regulation: problem gambling and protecting vulnerable people’ examines how well gambling regulation protects people from gambling-related harms and addresses new risks from social and technological developments. The report finds that there are an estimated 395,000 problem gamblers in Great Britain, with 1.8 million more gamblers at risk who may also be experiencing harm. The report finds that the Gambling Commission is improving its regulation but has more to do including taking a more strategic approach to influencing gambling operators to raise standards. The NAO concludes that even with improvements, the Commission’s ability to protect gamblers faces constraints in the regulatory framework, including inflexible funding and gaps in redress arrangements, and that the Commission is unlikely to be fully effective in addressing risks and harms to consumers within the current arrangements. This will be the first time the Committee has examined gambling regulation in recent years. The Committee will question officials from the Department for Digital, Culture, Media and Sport and the Gambling Commission, on how well the current regulatory framework protects gamblers. The Committee will also ask officials about how current restrictions imposed in response to the COVID-19 pandemic could affect those susceptible to the negative impacts of gambling. The Committee is inviting views from any interested parties on the issues raised by the NAO report – please submit your evidence by Wednesday 22 April." In May 2020, Gambling Harm UK's Kishan Patel responded to this call for evidence with a short synthesis of salient points which included the lack of guidelines on gambling-harm: "There are currently no NICE guidelines on gambling. As of 24th July 2018, gambling has been referred to NICE, but it has not yet been scheduled into the work programme." The timeline for NICE guidelines on gambling has now been updated which also signifies a significant watershed moment from inaction to action. 20 October 2021 - Scoping workshop 12 July 2021 - Stakeholder list updated 01 June 2021 - 15 June 2021 - Topic expert committee member recruitment 01 June 2021 - 15 June 2021 - Committee chair recruitment 16 November 2021 - 14 December 2021 - Committee member recruitment 16 November 2021 - 14 December 2021 - Draft scope consultation 07 February 2024 - Expected publication We would like to encourage individuals with lived experience to join us, to engage and support efforts towards a robust, appropriate, and impactful set of NICE guidelines. For more information, see here.

  • BBC News: Online gambling: 'I stole £70,000 to feed my addiction'

    Extract from the article Danielle's met other gamblers in recovery through a network called TalkGEN, which wants to improve education and understanding of gambling harm. It was set up in 2020 by Kishan Patel, a fifth year medical student. "Growing up I was massively affected by my dad's addiction," he says. "There were times when my family really struggled for money and there was a big cultural stigma in my community too, where people wouldn't want to talk to us because of it." Kishan's dad died eight years ago and he has seen the emotional and mental impact of gambling first hand. But he says it isn't thought of as a health concern in the same way as drugs or alcohol addiction is: "There are guidelines for health professionals around these issues, but gambling is neglected when it shouldn't be." He would like it to become something GPs consider asking vulnerable patients about, in the same way they might do with other addictions: "Just a simple question like, 'Do you gamble?' could help open up the conversation. It's a really serious health issue we need to be addressing."

  • Gambling and health

    Publicly the industry denied and continues to deny the significance of gambling harm on a population level. This refusal to accept the reality is compounded by the industry's lack of funding in public health research, despite the WHO commenting on the need to prioritise gambling-harm on agendas due to the magnitude of harm from gambling being comparable to the harm accrued by alcohol-use disorder or major depressive disorder. Harms in affected others challenge the industry in two ways. First, measures to raise awareness and prevent gambling harms in individuals who do not gamble will reduce the appeal of gambling and contribute to its social unacceptability. Second, the 'freedom to gamble' argument is confounded if individuals who do not gamble are harmed. The industry has largely refused to acknowledge the significance of harms in affected others, individuals who gamble and suffer low-risk harms, moderate-risk harms, and legacy harms due to previous gambling. This situation has not been helped by the chronic underfunding and lack of independence in research, education, and treatment. Summary “The gambling-related burden of harm appears to be of similar magnitude to harm attributed to major depressive disorder and alcohol misuse and dependence. It is substantially higher than harm attributed to drug dependence disorder.” WHO: The epidemiology and impact of gambling disorder and other gambling-related harm 2017 1 Gambling addiction was first formally recognised as a mental disorder by professionals in the US through the Diagnostic and Statistical Manual of Mental Disorders-III in 1980. Over the past two decades, gambling harm has emerged as a pressing public health issue globally. Domestic and international studies have reported statistical links between gambling harm in adults and suicide, mortality, and poor health. When faced with evidence of the links of gambling and harm to health, industry lobbyists have commonly steered away from admitting any responsibility; instead, they have promised research, reform, or reiterated commitments to safer gambling standards. Moreover, the industry has worked to associate itself with the NHS and other health organisations. Gambling harm may be experienced by individuals that gamble, affected others of people who gamble, and by communities. Research from Australia in 2016 reported a taxonomy of harms over eight domains: financial, relationship, emotional, health, cultural, work or study, criminal activity, life course and intergenerational harms. Responsible gambling mantras have largely replaced public health messaging in Great Britain. Meanwhile, ideas of risk-free gambling and safer gambling have been furthered. Current safer gambling ads seldom reflect the significance of gambling harm, especially on affected others, due to them being industry-supported. Similarly, specialist treatment options and awareness among health care workers remain challenges and are limited by such efforts being primarily managed with voluntary donations. Moreover, public health research in New Zealand and Australia have explored the significance of gambling harm on quality of life by reporting disability weights. These disability weights allow researchers and public health stakeholders to understand the significance of gambling harm on the individual and the population through comparison to other health states. Based on this research, a WHO report found an "urgent need to place gambling on national and international public health agendas", among other things. At the time of writing, little is known about the significance of harm in young people, individuals who previously gambled, and former affected others (legacy harm). Whereas gambling-harm has featured in Australia's Monash guidelines for healthcare professionals for over a decade, the UK's National Institute for Health and Care Excellence (NICE) is yet to begin reviewing the evidence on gambling harm. What is known? Taxonomy of gambling harm Gambling-harm can manifest both in individuals that gamble and individuals that are affected by other people’s gambling, as general, crisis, and legacy harms, across the domains of 2 Financial harm Relationship disruption, conflict or breakdown Emotional or Psychological Distress Decrements to Health Cultural Harm Reduced Performance at Work or Study Criminal Activity Lifecourse and Intergenerational Harms Prevalence of harms in Family Member's affected by gambling disorder (Affected Others) 3 93% reported that their loved one's disordered gambling impacted their financial security (64% stating that the impact was significant) 89% reported a reduction in available spending money and a 88% reduction in savings 23% reported losing a major asset such as a car, home, or business, and 12% had become bankrupt 82% reported that their loved one's disordered gambling impacted their work and/or education (37% stating that the impact was significant) 76% reported reduced performance at work or study due to tiredness or distraction 55% and 50% reported being late and absent, respectively 99% reported that their loved one's gambling compulsion had harmed their health (46% stating that the impact was significant, 38% moderate, 15% slight) 95% reported loss of sleep due to stress or worry 64% reported reduced physical activity, 30% increased alcohol use, 33% increased tobacco consumption, 56% eating too much, and 44% eating too little 29% reported neglecting their medical needs, 36% reported increased use of health services, and 21% reported requiring emergency treatment for health issues caused or exacerbated by their loved one's gambling 16% reported committing acts of self-harm, and 8% had attempted suicide 96% reported experiencing relationship harms (67% stating that the impact was significant) 89% and 82% reported greater tension and conflict, respectively 71% reported feeling excluded from others 68% reported threatening separation or ending the relationship 33% reported separating or ending the relationship with the family member who gambles and potentially related others Other harms 21% reported incidents of violence 21% reported feelings of shame within their religious or cultural community 7% reported engaging in petty theft or dishonesty as a consequence of their family member's gambling Other addictions Family members of individuals with gambling disorder reported elevated rates of problematic use of substances Alcohol: 34.6% Drugs: 21.2% Legal highs: 3.2% Prescription drugs: 5.0% Severity of gambling-harm on quality of life in Adults 4.5 Disability Weights (where 0 = perfect health and 1 = death) Schizophrenia: acute state: 0.76 Heroin and other opioid dependence: 0.64 Gambling disorder harm (PGSI 8 or more): 0.54 (NZ 18) Manic episode of Bipolar Disorder: 0.48 Gambling disorder harm (PGSI 8 or more): 0.44 (AUS 17) Migraine: 0.43 Moderate alcohol use disorder: 0.39 Moderate-risk harm gambling (PGSI 2-7): 0.37 (NZ 18) Affected others at gambling disorder harms: 0.36 (AUS 17) Affected others at moderate-risk harms: 0.33 (AUS 17) Stroke: long-term consequences, moderate plus cognition problems: 0.31 Moderate-risk harm gambling (PGSI 2-7): 0.29 (AUS 17) Mild alcohol use disorder: 0.26 Low-risk harm gambling (PGSI 1-2): 0.18 (NZ 18) Urinary incontinence: 0.15 Affected others at low-risk harms: 0.17 (AUS 17) Low-risk harm gambling (PGSI 1-2): 0.13 (AUS 17) Hearing loss: complete, with ringing: 0.09 Significance of gambling-harm on the population in Years of Life Lost due to Disability (YLD) New Zealand (Adult population: 3.6m) 6 Combined total of years lost with gambling-harm related quality of life effects in the New Zealand Adult population: 162, 000 years Anxiety and depressive disorders: 106, 000 years Harms from someone else's gambling in adults: 94, 700 years (prevalence: 13.6%) Alcohol – Hazardous drinking (>8 AUDIT): 87, 600 years Harms from own gambling in adults: 67, 200 years (prevalence: 7.3%) Diabetes: 26, 000 years Drug use disorders: 22, 400 years Stroke: 12, 900 years Eating disorders: 3, 980 years Victoria, Australia (Adult population 4.4m) 7 Major depressive disorder: 148, 000 years Alcohol use and dependence: 148, 000 years Combined total of years lost with gambling-harm related quality of life effects in the Victorian Adult population: 118, 000 years Harms from own gambling in adults: 102, 000 years (past-year prevalence: 12.5%) Diabetes Mellitus: 22, 700 years Harms from someone else's gambling in adults: 16, 300 years (past-year prevalence: 2.8%) Cannabis dependence: 5, 780 England 2013 (Adult population: 53.9m) Gambling harm in adults: 1.62m Dietary risks: 1.47m Tobacco smoke: 1.46m Harms from own gambling in adults: 0.90m (prevalence: 8.5%) Harms from someone else's gambling in adults: 0.77m (prevalence: 6.0%) Alcohol use: 0.55m Drug use: 0.27m Significance of gambling-harm on the population in Years of Life Lost due to Mortality (YLL) Research from the UK involving bank data from over 100, 000 customers found that high levels of gambling were associated with a 37% increase in mortality 8 The last Adult Psychiatry Morbidity Survey 2007 that considered gambling-harm reported that individuals with gambling disorder were more likely to have thoughts about suicide (19.2% vs 4.1%) and to have made a suicidal attempt in the past year (4.7% vs 0.6%) compared to individuals who do not suffer gambling-harm. 9 A study of 16-24 year olds living in Great Britain found that Men and Women who indicated gambling disorder harms were 9.0 and 4.9 times more likely to attempt suicide, after adjusting for anxiety, impulsivity, life satisfaction, and other factors 10 Standardised mortality ratios 11 Men and Women in Sweden, aged 20-49 year olds and diagnosed with GD, were 19.3 times more likely to suffer from suicide when compared to the general Swedish population of the same ages Men and Women in Sweden, aged 20-49 years old and diagnosed with GD, were 6.2 more likely to suffer from any mortality when compared to the general Swedish population of the same ages What the industry said? Michael Dugher, CEO of the Betting Gaming Council 12 "The UK's addiction rate stands at 0.5% of the adult population, which is low compared to the international standard. The rates have also remained 'broadly steady around or below one percent for the past 20 years." Dugher frames the topic of gambling harm on the segment of adults suffering the most severe harms due to gambling in the past 12 months while omitting the experiences of affected others, individuals who previously had gambled, and individuals experiencing subclinical levels of gambling harm. Moreover, there are significant concerns with measuring gambling harm using self-completion forms included in health surveys, and as such, the stated 0.5% is expected to be a significant underestimate. The industry rarely comments on affected others as it recognises that this is likely to be the most damaging to their public relations strategies. Instead, the industry benefits from the fallacious societal stigma that gambling addiction is the individual's fault; however, the same cannot be easily argued for loved ones, especially the children who suffer harm. Gambling Commission in a briefing paper for Local Authorities and local Public Health providers February 2018 13 “The numbers of those who experience harm as a result of gambling by others will be considerably greater than the number of people who harm themselves.” “These are not small numbers. They suggest a significant public health issue which has received remarkably little attention relative to other population level concerns.” The Gambling Commission makes clear why gambling harm should be considered as a public health issue. Identifying gambling as a significant public health issue is in direct contrast to how the Gambling Commission falls under the remit of the Department of Culture, Media and Sport (DCMS) instead of the Department of Health and Social Care. Michael Dugher, CEO of the Betting Gaming Council 14 “NHS Charities said it wouldn't be possible for betting co's to make a direct donation, but they were happy for us to donate all the profits from this special fun virtual Grand National to help the NHS at this difficult time. Most people agree there's nothing wrong with this...” Dugher states that NHS Charities were not accepting a direct donation from the gambling industry. This quote demonstrates the BGC’s interest in associating with the NHS for the 4.8m viewers who tuned in to watch this virtual horse race which raised £2.6m. 15 “You don’t have to bet. If you don’t want to have a bet, please make a donation direct to NHS Charities. But millions of people do enjoy an occasional flutter & do so responsibly & safely.” Dugher argues that millions of people enjoy an occasional flutter while ignoring the millions that suffer gambling harm and the individuals who gamble frequently and make up significant amounts of the industry’s profit. Betting and Gaming Council 16 “Suicide is a complex issue and the examination of any links to gambling or disordered gambling requires great care and sensitivity. We suggest that a collaborative and careful approach to understanding linkages is required. The aim of research should be to explore what is clearly a difficult subject and provide pragmatic solutions.” The BGC creates an aura of doubt around gambling-suicide, despite evidence from studies across the world reflecting that individuals with gambling-disorder are many times more likely to suffer from suicidal harm. “Through continued funding by our industry over more than 20 years, these charitable services are able to provide free of charge treatment, support & advice services for anyone affected by gambling.” The BGC boasts of their voluntary funding for treatment services for harms caused by their industry. Thus, the industry demonstrates that treatment services are available due to the industry's generosity while ignoring issues with treatment access, awareness, and chronic underfunding. Mark Etches, CEO of GambleAware 17 [Britain was] “in great danger of sleepwalking into a future public health storm over gambling-related harm”. Etches reflects on the numbers of 11–16 year olds with a gambling disorder and signifies concern for the future. Contrastingly earlier that year, evidence reported on by the World Health Organisation (WHO) reflected a worryingly significant ongoing neglected public health crisis with an “urgent need to place gambling on national and international public health agendas”. 1 References 1. Abbott M. The epidemiology and impact of gambling disorder and other gambling-related harm. Geneva: World Health Organization; 2017. Available from: https://www.who.int/docs/default-source/substance-use/the-epidemiology-and-impact-of-gambling-disorder-and-other-gambling-relate-harm.pdf?sfvrsn=5901c849_2 [Accessed: 25th March 2020] 2. Langham E, Thorne H, Browne M, Donaldson P, Rose J, Rockloff M. Understanding gambling related harm: A proposed definition, conceptual framework, and taxonomy of harms. BMC Public Health. 2016;16(1): 80. Available from: doi:10.1186/s12889-016-2747-0 3. Banks J, Andersson C, Best D, Edwards M, Waters J. Families Living with Problem Gambling: Impacts, Coping Strategies and Help-Seeking. 2018. Available from: https://about.gambleaware.org/ [Accessed: 13th March 2021] 4. Rawat V, Browne M, Bellringer M, Greer N, Kolandai-Matchett K, Rockloff M, et al. A tale of two countries: comparing disability weights for gambling problems in New Zealand and Australia. Quality of Life Research. 2018;27(9): 2361–2371. Available from: doi:10.1007/s11136-018-1882-8 5. Rawat V, Greer N, Langham E, Rockloff M, Hanley C. What is the harm? Applying a public health methodology to measure the impact of gambling problems and harm on quality of life. Journal of Gambling Issues. 2017;36(36). Available from: doi:10.4309/jgi.2017.36.2 6. Browne M, Bellringer M, Greer N, Kolandai-Matchett K, Rawat V, Langham E, et al. Measuring the Burden of Gambling Harm in New Zealand. Central Queensland University and Auckland University of Technology. 2017. 7. Browne M, Langham E, Rawat V, Greer N, Li E, Rose J. Assessing gambling-related harm in Victoria: a public health perspective. Victorian Responsible Gambling Foundation. 2016. 8. Muggleton N, Parpart P, Newall P, Leake D, Gathergood J, Stewart N. The association between gambling and financial, social and health outcomes in big financial data. Nature Human Behaviour. 2021;5(3): 319–326. Available from: doi:10.1038/s41562-020-01045-w [Accessed: 22nd March 2021] 9. Wardle H, Dymond S, John A, McManus S. Problem gambling and suicidal thoughts, suicide attempts and non-suicidal self-harm in England: evidence from the Adult Psychiatric Morbidity Survey 2007. Gambling Commission. 2019. 10. Wardle H, McManus S. Suicidality and gambling among young adults in Great Britain: results from a cross-sectional online survey. The Lancet Public Health. 2021;6(1): e39–e49. Available from: doi:10.1016/S2468-2667(20)30232-2 11. Karlsson A, Håkansson A. Gambling disorder, increased mortality, suicidality, and associated comorbidity: A longitudinal nationwide register study. Journal of Behavioral Addictions. 2018;7(4): 1091–1099. Available from: doi:10.1556/2006.7.2018.112 12. Michael Dugher. It’s important that the Gambling Review tackles betting by under-18s – but let’s deal in facts, not fiction. Available from: https://www.politicshome.com/members/article/michael-dugher-its-important-that-the-gambling-review-tackles-betting-by-under18s-but-lets-deal-in-facts-not-fiction [Accessed: 28th March 2021] 13. Gambling Commission. Gambling-related harm as a public health issue. 2018. Available from: https://www.gamblingcommission.gov.uk/PDF/Gambling-related-harm-as-a-public-health-issue.pdf [Accessed: 1st February 2021] 14. @MichaelDugher. ‘1. NHS Charities said it wouldn’t be possible for betting co’s to make a direct donation, but they were happy for us to donate all the profits from this special fun virtual Grand National to help the NHS at this difficult time. Most people agree there’s nothing wrong with this...’. [cited 2020 April 3.] Available from: https://twitter.com/MichaelDugher/status/1246177242939559944 [Accessed: 28th March 2021] 15. BBC Sport. Virtual Grand National raises £2.6m for NHS Charities Together. BBC Sport. 5 April 2020. Available from: https://www.bbc.co.uk/sport/horse-racing/52175385 [Accessed: 29th March 2021] 16. UK Parliament – Betting and Gaming Council. Betting and Gaming Council – Written evidence (GAM0068). 2019. Available from: https://committees.parliament.uk/writtenevidence/154/html/ [Accessed: 29th March 2021] 17. Davies R. 25,000 children in Britain are problem gamblers, report finds. The Guardian. 12 December 2017. Available from: https://www.theguardian.com/society/2017/dec/12/children-britain-problem-gamblers-report [Accessed: 29th March 2021]

  • Gambling and addiction

    The industry consistently emphasises that gambling addiction affects a small minority of individuals, benefitting from the fact that gold-standard prevalence surveys were stopped after 2010 due to funding cuts. The industry reflects on the estimates generated by data from self-completion forms included in health surveys or telephone surveys. On the other hand, more recent online studies have reported much higher gambling addiction rates, but the industry has dismissed these higher rates. Additionally, the industry fails to reflect that harmful gambling and gambling addiction should be viewed as a continuum. Moreover, more than half of the harm in individuals that gamble is expected to occur at the low-risk and moderate-risk harm levels. Summary The potential for addiction is influenced by intrinsic biological factors, extrinsic factors, and factors related to the addictive agent's ability to activate the brain's risk-reward areas. Like other addictions, dopamine has a crucial and well-documented role in developing and maintaining Gambling Disorder (GD). Gambling addiction is most prevalent among younger people. Other risk factors include a parent who suffered from a gambling disorder, poor mental health status, poor general health status, unemployment, and minority ethnic backgrounds. GD is a behavioural addiction characterised by compulsive involvement in gambling activities, despite severe adverse consequences. GD is defined in the Diagnostic and Statistical Manual of Mental Disorders as "persistent and recurrent problematic gambling behaviour leading to clinically significant impairment or distress". GD has been recently included in the disorder class of "substance-related and addictive disorders". It is essential to recognise that significant harms can occur in individuals who do not meet GD's clinical threshold as the diagnosis represents the most severe end of addiction and harm. According to research from Australia, gambling harm in individuals with GD makes up only 15% of the overall gambling harm suffered by those that gamble. Most of the harms on a population level are accrued by individuals who may be on the spectrum of addiction but not at GD's threshold. These findings are analogous to the scenario for alcohol harm, where harmful drinking in those without severe dependency is responsible for more significant amounts of harm. However, unlike alcohol harm, which is grouped into a single disorder on a continuum with mild, moderate, and severe sub-classifications, gambling-harm at mild and moderate levels are often treated with contempt. Industry lobbyists often comment on prevalence statistics of those suffering the most severe harms from their gambling. Through this narrative, the industry can hide behind the idea that gambling affects only a tiny minority of the overall population, neglecting that more than half of the gambling harm in individuals that gamble is attributable to low-risk harm and moderate-risk harm. Moreover, adult prevalence statistics following 2010 are primarily limited to self-completion forms in health surveys due to a funding cut instead of the gold-standard bespoke gambling prevalence surveys. What is known? Genetics of gambling disorder Twin studies investigating the genetics of pathological gambling have found that: 18 ‘heritability of pathological gambling is estimated to be 50–60%; pathological gambling and subclinical pathological gambling are a continuum of the same disorder; pathological gambling shares genetic vulnerability factors with antisocial behaviours, alcohol dependence and major depressive disorder; genetic factors underlie the association between exposure to traumatic life‐events and pathological gambling’ Risk factors for gambling disorder (Odds Ratio): 19, 20 Parents regularly gambled but did not have a problematic relationship with gambling: 1.58 Current cigarette smoker: 2.46 ‘Other’ ethnic minority groups: 2.86 Unmanaged hypertension: 3.10 Asian/Asian British: 3.55 Black/Black British: 3.80 Unemployed: 4.02 Bad/very bad general health status: 6.17 Parents regularly gambled and had a problematic relationship with gambling: 7.32 A low Warwick-Edinburgh Mental Wellbeing score: 7.65 Prevalence of gambling harm from own gambling in adults across the world (past 12 months) Great Britain British Gambling Prevalence Surveys 2007 and 2010 (Gold-standard) 19, 21 low-risk harm: 5.1 – 5.5%, moderate-risk harm: 1.4% - 1.8%, gambling disorder harm: 0.8% - 1.2% Self-completion forms included in health surveys 2012 – 2018 20, 22-24 low-risk harm: 2.5% - 3.9% moderate-risk harm: 0.8% - 1.1% gambling disorder harm: 0.5% - 0.9% Telephone surveys 2016 -2020 25 low-risk harm: 2.0% - 3.7% moderate-risk harm: 0.9% - 1.9% gambling disorder harm: 0.3% - 0.7% Online surveys 2019 – 2020 26 low-risk harm: 7.0% - 7.2% moderate-risk harm: 2.8% - 3.3% gambling disorder harm: 2.6% - 2.7% Isle of Man 27 Gambling Prevalence Survey 2017 7.0% low-risk harm 1.5% moderate-risk harm 0.8% gambling disorder harm Northern Ireland 28 Gambling Prevalence Survey 2010 8.2% low-risk harm 5.9% moderate-risk harm 2.6% gambling disorder harm 28 Gambling Prevalence Survey 2016 6.7% low-risk harm 4.9% moderate-risk harm 2.3% gambling disorder harm Scandinavia 29 Denmark Gambling Prevalence Survey 2016 3.6% low-risk harm 1.2% moderate-risk harm 0.4% gambling disorder harm Finland Gambling Prevalence Survey 2015 8.7% low-risk harm 2.8% moderate-risk harm 0.5% gambling disorder harm Norway Gambling Prevalence Survey 2015 7.7% low-risk harm 2.3% moderate-risk harm 0.9% gambling disorder harm Sweden Gambling Prevalence Survey 2015 4.2% low-risk harm 1.3% moderate-risk harm 0.4% gambling disorder harm 30 Italy Problem Gambling Survey 2018 4.1% low-risk harm 2.8% moderate-risk harm 3.0% gambling disorder harm 31 Victoria, Australia Gambling Prevalence Study 2014 8.9% low-risk harm 2.8% moderate-risk harm 0.8% gambling disorder harm 7 Gambling Prevalence Study 2019 6.7% low-risk harm 2.4% moderate-risk harm 0.7% gambling disorder harm 32 New Zealand Meta-analysis of survey results 2010 - 2016: 3.1% low-risk harm 1.5% moderate-risk harm 0.5% gambling disorder harm 33 Health Survey 2012: 2.0% low-risk harm 1.0% moderate-risk harm 0.2% gambling disorder harm 34 National Gambling Study 2012: 5.0% low-risk harm 1.8% moderate-risk harm 0.7% gambling disorder harm 35 What the industry said? Betting and Gaming Council 16 “Rates of problem gambling in Great Britain are stable and low by international standards and we are committed to doing more to ensure safer gambling” The BGC omits consideration for the vast majority of individuals who suffer gambling-harm and instead focuses on the smaller population who suffer the most severe forms of harm. Moreover, the BGC states that gambling disorder harm rates are stable despite the absence of a gold-standard prevalence study since 2010 due to a funding cut. Michael Dugher, CEO of the Betting Gaming Council 36 “I recognise the concerns people have when around 0.6 per cent of those who bet are classed as ’problem gamblers’.” Dugher demonstrates a lack of understanding of gambling harm by stating that 0.6% of those who bet suffer from a gambling disorder. Contrastingly, the most recent gold-standard study in 2010 reflected that approximately 1.6% of individuals that gambled in the past year suffer from the most severe form of addiction. After excluding individuals who exclusively play on the lottery and those who do not gamble regularly, this rate would be far higher. Moreover, the harms suffered by non-adults are entirely omitted. Notably, the gambling disorder harm rate is much higher in 11-16 year olds where 5.1% of individuals who gambled in the past year or 1.9% of the overall population affected by gambling disorder. “Of those problem gamblers, a smaller but still significant number are ‘disordered’ or addicted gamblers.” Dugher also demonstrates a confused understanding of addiction, as the most severe form of harm is at the gambling disorder level. As ever and despite the evidence, the industry refuses to embed an understanding of addiction and gambling-harm as being on a continuum and thus ignore the harms suffered by individuals who gamble and experience low-risk harms and moderate-risk harms. “That might be a tiny fraction – and we shouldn’t forget of course that millions of people gamble safely – but the effect of addiction on these individuals and their families can be devastating.” Here the CEO of the BGC, quite unusually, recognises that family members can suffer devastating harms but omits the statistic that between 6% to 7% of adults have reported suffering affected other harms in Great Britain. Michael Dugher, CEO of the Betting Gaming Council 37 “For millions of people, it is a carefree leisure activity, and they do so perfectly safely and perfectly responsibly.” Dugher uses the term “millions of people” to describe the number of individuals who gamble with no significant consequences while neglecting that millions of people suffer significant harm from gambling. “But we recognise, as do the Government, as do campaigners and others that there is a small group of people who can have a problem with this, and in some cases it can be very, very severe.” Dugher suggests that there is only a small group of people who suffer harm from gambling. Furthermore, Dugher and colleagues often implies that campaigners wanting reform are prohibitionists and have an issue with gambling as a leisure activity, despite evidence from lived experience campaigners showing that this claim is not valid. 38 “What we're saying is you've got to get the regulation right because what we don't want is to drive customers away from safer gambling on the regulated high standard sites to the illegal black market offshore companies.” Paradoxically, Dugher highlights the concern of black market offshore companies while failing to recognise that before 2014, a large number of remote operators were not regulated, and the vast majority of companies continue to base offshore to avoid the UK’s corporation tax. Moreover, remote operators are global by nature and thus have customers in the black market in other countries. Brigid Simmonds, Chair of the Betting and Gaming Council 39 “Just as we intervene with our customers so banks should as well:” Simmonds deflects responsibility for safer gambling to banks, such that just like operators, banks should intervene to prevent gambling-harm. However, operator interventions are often limited to safer gambling messages as operators seldom close accounts that are profit-making for the industry. “We take our responsibility to our customers incredibly seriously and we are determined to raise standards and improve safer gambling,” Simmonds then repeats vague commitments to raising standards and improving safer gambling. Brigid Simmonds, Chair of the Betting and Gaming Council 40 … "we have worked together on BetRegret"… Simmonds comments on her role in developing the “BetRegret” campaign, which has been widely criticised for furthering stigma by placing responsibility on customers, potentially increasing self-blame, and for being drowned out by the sheer volume of contradictory betting advertisements. Michael Dugher, CEO of the Betting Gaming Council 41 “Place you bets now please… #RouletteBoy” "I thought you liked casinos, young Matt?" Dugher uses social media to mock someone who is now abstinent; in doing so, he demonstrates his contempt for those who have suffered gambling-harm, the legacy effects of those harms, and the chronic nature of addiction. References 7. Browne M, Langham E, Rawat V, Greer N, Li E, Rose J. Assessing gambling-related harm in Victoria: a public health perspective. Victorian Responsible Gambling Foundation. 2016. 16. UK Parliament – Betting and Gaming Council. Betting and Gaming Council – Written evidence (GAM0068). 2019. Available from: https://committees.parliament.uk/writtenevidence/154/html/ [Accessed: 29th March 2021] 17. Davies R. 25,000 children in Britain are problem gamblers, report finds. The Guardian. 12 December 2017. Available from: https://www.theguardian.com/society/2017/dec/12/children-britain-problem-gamblers-report [Accessed: 29th March 2021] 18. Lobo DSS, Kennedy JL. Genetic aspects of pathological gambling: a complex disorder with shared genetic vulnerabilities. Addiction. 2009;104(9): 1454–1465. Available from: doi:10.1111/j.1360-0443.2009.02671.x 19. Wardle H, Moody A, Spence S, Orford J, Volberg R, Jotangia D, et al. British Gambling Prevalence Survey 2010. The Gambling Commission. 2011. 20. Seabury C, Wardle H. Gambling behaviour in England & Scotland Headline findings from the Health Survey for England 2012 and Scottish Health Survey 2012. NatCen. 2014. 21. Wardle H, Sproston K, Orford J, Erens B, Griffiths M, Constantine R, et al. British Gambling Prevalence Survey 2007. NatCen. 2007 22. Gambling Commission. Participation in gambling and rates of problem gambling - England 2016 - Statistical report. Gambling Commission. 2016. 23. Barnfield-Tubb J, Francis C. Gambling participation in 2019: behaviour, awareness and attitudes. 2020. Available from: https://www.gamblingcommission.gov.uk/PDF/survey-data/Gambling-participation-in-2019-behaviour-awareness-and-attitudes.pdf [Accessed: 29th March 2020] 24. Conolly A, Fuller E, Jones H, Maplethorpe N, Sondaal A, Wardle H. Gambling behaviour in Great Britain in 2015: Evidence from England, Scotland and Wales. NatCen. 2017. 25. Gunstone B, Gosschalk K, Joyner O, Diaconu A, Sheikh M. The impact of the COVID-19 lockdown on gambling behaviour, harms and demand for treatment and support. Gambling Research Exchange Ontario. 2020. 26. Gambling Commission. Gambling behaviour in 2020: Findings from the quarterly telephone survey. Gambling Commission; 2021. Available from: https://beta.gamblingcommission.gov.uk/statistics-and-research/publication/year-to-december-2020 [Accessed: 30th March 2021] 27. Butler N, Quigg Z, Bates R, Sayle M, Ewart H. Isle of Man Gambling Survey 2017: Prevalence, methods, attitudes. Public Health Institute, Liverpool John Moores University. 2018. 28. Dunne S, Flynn C, Sholdis J. 2016 Northern Ireland Gambling Prevalence Survey. Northern Ireland Statistics and Research Agency. 2017. 29. Pallesen S. PREVALENCE OF GAMBLING PROBLEMS IN THE NORDIC COUNTRIES. [Presentation] University of Bergen. 30th May 2017. 30. Folkhälsomyndigheten. Published Material. Available from: www.folkhalsomyndigheten.se/publicerat-material [Accessed: 10th January 2021] 31. Stradbrooke S. Italy gambling survey casts doubt on effectiveness of advert ban. CalvinAyre.com. 19 October 2018. Available from: https://calvinayre.com/2018/10/19/business/italy-gambling-survey-advertising-effectiveness/ [Accessed: 28th February 2021] 32. Victorian Responsible Gambling Foundation. FACT SHEET 3: PROBLEM GAMBLING SEVERITY INDEX (PGSI) Victorian Population Gambling and Health Study (2018-2019). 2020. Available from: https://responsiblegambling.vic.gov.au/resources/publications/fact-sheet-3-problem-gambling-severity-index-pgsi-762/ [Accessed: 30th March 2021] 33. Ministry of Health New Zealand. Health and Lifestyle Survey – Monitoring gambling harm and knowledge. Available from: https://www.health.govt.nz/our-work/mental-health-and-addiction/addiction/gambling/gambling-research-and-evaluation/key-information-sources-gambling-harm-and-service-utilisation/health-and-lifestyle-survey-monitoring-gambling-harm-and-knowledge [Accessed: 28th February 2021] 34. Rossen F. Gambling And Problem Gambling: Results Of The 2011/12 New Zealand Health Survey Final Report. Ministry of Health New Zealand. 2015. 35. Bellringer M. New Zealand 2012 National Gambling Study: Gambling Harm And Problem Gambling. Ministry of Health New Zealand. Report number: 2, 2014. 36. Dugher M. We Need Big Changes And A Race To The Top On Standards In Gambling. Available from: https://bettingandgamingcouncil.com/news/michael-dugher [Accessed: 29th March 2021] 37. Hirst I. Government must tackle rates of gambling addiction which is a ‘crisis waiting to happen’, according to MP. Dewsbury Reporter. 7 January 2021. Available from: https://www.dewsburyreporter.co.uk/news/opinion/government-must-tackle-rates-gambling-addiction-which-crisis-waiting-happen-according-mp-3087969 [Accessed: 30th March 2021] 38. Gambling Harm UK. Lived Experience Community Respond to Remote Customer Interaction Call for Evidence. Available from: https://www.gamblingharm.com/post/lived-experience-community-respond-to-remote-customer-interaction-call-for-evidence [Accessed: 31st March 2021] 39. Hancock A. Betting industry body hits out at role of banks and tech in addiction. Financial Times. 3 February 2020. Available from: https://www.ft.com/content/4cc7cfa2-4692-11ea-aeb3-955839e06441 [Accessed: 30th March 2021] 40. @BrigidSimmonds. ‘Many congratulations Zoe, we have worked together on BetRegret & your knowledge & expertise in advertising, marketing & how charities can work with other partners & industry will be vital to your new role @GambleAware’. [cited 14 January 2021] Available from: https://twitter.com/BrigidSimmonds/status/1349755154640347137 [Accessed: 30th March 2021] ] 41. Boycott-Owen M. Gambling industry chief accused of mocking recovering addict on Twitter. The Telegraph. 5 February 2021. Available from: https://www.telegraph.co.uk/news/2021/02/05/gambling-industry-chief-accused-mocking-recovering-addict-twitter/ [Accessed: 30th March 2021]

  • Gambling in children and young people

    Evidence from Great Britain reflects that gambling is one of the more popular activities among 11–16 year olds. However, the industry comment that most of this gambling is done legally through private betting, significant numbers of young people enter licensed gambling venues illegally. Brain imaging studies have shown that brain development continues until the age of 25. The brain area related to decision-making and addictive behaviour is among the last to develop. Thus, it is not surprising that gambling harms, similar to other harmful behaviours, are most common in 16–24 year olds. As well as being vulnerable to harms from their gambling with potentially devastating life-long effects, young people are especially susceptible to harms from a family member’s gambling, which has not been considered in research until recently. The Gambling Act 2005 sets out three licensing objectives 42 “preventing gambling from being a source of crime or disorder, being associated with crime or disorder or being used to support crime ensuring that gambling is conducted in a fair and open way protecting children and other vulnerable persons from being harmed or exploited by gambling” Summary The third licensing objective in the Gambling Act 2005 specifically singles out children as a vulnerable group who should be protected from being harmed or exploited by gambling. Gambling-harms in young people are of particular significance; young people are more vulnerable to harm, and these harms can have a significant impact, both now and in the future. Moreover, as well as experiencing harm from their gambling, young people can also be susceptible to harm from an immediate family member's gambling through parental neglect or from other stresses, as detailed in the appendix. There is consistent and robust evidence from imaging studies that brain development continues through adolescence and does not complete until the age of 25 or later. Furthermore, the prefrontal cortex, an area of the brain tied to addictive behaviours due to its role in regulating reward regions of the brain and its involvement in higher-order executive function, is among the last to develop. Moreover, similar to other addictive products, such as alcohol and recreational drugs, the age of onset for first gambling is significantly associated with gambling disorder in later life. In Great Britain, the legal age for gambling varies by product. Some gambling products have no age-restrictions, others restricted for individuals 16 years and older, with traditional gambling products having the legal age of 18. Remarkably, loot boxes, although the most popular wagering activity among under 16s, are not yet considered a form of gambling and therefore unregulated. On top of games of chance where children can lose money, popular video games such as Grand Theft Auto 5 feature simulated gambling where players can gamble for virtual currencies. Despite all this, young people have profoundly limited access to appropriate treatment, help, or support. Notably, contrasting with the widespread recognition for substance-use harm, gambling-harm does not feature in competency-based curriculums for specialists in child and adolescent psychiatry (CAMHS). What is known? Legal definitions of youth and age of maturity 43 The age of majority is 18 years in all EU Member States except for Scotland, where children are considered to have full legal capacity from the age of 16 years. In EU Member States, the term ‘youth’ is the only term used to describe an age group that goes beyond 18 years. It is often used when States want to include young adults as well, sometimes up to the age of 30 years. The UN’s definition on the term ‘youth’ includes all persons between the ages of 15 and 24 years; UNESCO uses a wider and more flexible definition depending on the context. In the EU Strategy for Youth, the term ‘youth’ refers to teenagers and young adults aged between 13 and 30 years. EUROSTAT statistics consider the youth population to be aged between 15 and 29 years. Brain development during adolescence and youth 44 Brain maturation occurs during adolescence due to a surge in the synthesis of sex hormones. Types of studies that have provided evidence that structural and functional brain development is an active stage of maturation until at least the age of 25 neuromorphological, neurochemical, neurophysiological, neurobehavioral, neuropharmacological, and brain imaging studies Legal age of gambling by product 45 No age limit Private or Non-Commercial Betting Equal chance gaming Prize gaming at entertainment centre or travelling fair Category D gaming machines Games of chance in video-games (not considered gambling) 16 years old National lottery tickets and scratchcards in shops (18 from October 2021) National lottery tickets and scratchcards online (18 from April 2021) 18 years old Casino, betting shops or licensed premises Category A, B1, B2, B3, B3A, B4 and C gaming machines Football pool Gambling among secondary school students (11-16 year olds) >1 million 11-16 year olds gambled in the past-year 46 In 2018, gambling (14%) was more popular as a past-week activity among 11-16 year olds than alcohol use (13%), tobacco use (4%), and drug-taking (2%) 47 In 2019, gambling (11%) was less prevalent as a past-week activity among 11-16 year olds than alcohol use (16%), but more common than tobacco cigarettes (6%), e-cigarettes (7%), and drug-taking (5%) 46 In 2019, the most prevalent past-week gambling activity (excluding video game gambling) among 11-16 year olds was placing a private bet for money (e.g. with friends) at 5%, followed by: 46 Fruit or slot machines (e.g. at an arcade, pub or club): 4% National Lottery scratchcards which you bought in a shop: 3% Playing cards for money with friends: 3 Personally placing a bet at a betting shop: 3% Lotto (the main National Lottery draw): 2% National Lottery instant win games on the internet: 2% Any other National Lottery games (e.g. EuroMillions): 2% Other Lotteries: 2% Bingo at a bingo club: 2% Bingo at somewhere other than a bingo club: 2% Personally visiting a betting shop to play gaming machines: 2% Playing other gambling machines: 2% Personally visiting a casino to play casino games: 2% Gambling websites/apps where you can win real money: 2% Any other gambling: 3% The most popular form of games of chance with money are in video games Ever-played 46 Used in-game items to open loot boxes/crates/packs to get other in-game items within the game you were playing 11-16 year olds: 28% Paid money to open loot boxes/crates/packs to get other in-game items within the game you were playing 11-16 year olds: 23% Bet with in-game items on website outside of the game or privately (e.g. with friends)11-16 year olds: 3% Past-year 48 Paid money to open loot boxes 10-16 year olds: 20% Past-week 49 Paid money to open loot boxes 11-14 year olds: 27% 18+ year olds: 16% Investigations into under age gambling The Gambling Commission ran a test at the Royal Ascot in 2014, where all 20 bookmarkers served a 16-year old without asking for proof of age, and consequently received a written warning. In 2019, this test was repeated, with 7 out of 17 failing to ask for ID. 50,51 Gambling-harm among children and young people In 11-16 year old school students 46,52 Meta-analysis of prevalence in 2018 – 2020 46,47,52 By frequency Past week gambling: 9% - 14% Past year gambling: 36% - 39% By harm level Low-risk and moderate-risk harm gambling: 2.2% - 2.7% Gambling disorder harm gambling: 1.7% - 1.9 Other gambling: 32% - 33% DSM-IV-MR J harms: 46 Found yourself thinking about gambling or planning to gamble often: 1.7% Gambled to escape from problems or when you were feeling bad sometimes or often: 2.0% Felt bad or fed up when trying to cut down on gambling sometimes or often: 1.2% Needed to gamble with more and more money to get the amount of excitement you want sometimes or often: 1.9% Spent much more than you planned to on gambling sometimes or often: 1.6% Taken money without permission to spend on gambling (any one or more of the following: dinner money or fare money, money from family, money from things you’ve sold, money from outside the family, or somewhere else) Any one or more of the above: 3.8% Gambling led to risk relationships (any one or more of the following: arguments with family/friends or others, missing school): Any one or more of the above: 2.5% Gambling ever led to telling lies to family/friends or others once or twice or sometimes or often: 2.1% After losing money by gambling, have you returned another day to try to win back the money you lost more than half the time or every time: 1.6% Other harms 52 Lost sleep at night because you went to bed late because you were gambling rarely or sometimes or often or all the time: 2.5% often or all the time: 1.1% Lost sleep at night because you were worried about own gambling rarely or sometimes or often or all the time: 1.7% often or all the time: 0.3% Stopped you from buying things you wanted rarely or sometimes or often or all the time: 4.3% often or all the time: 1.3% Made it hard for you to concentrate at school rarely or sometimes or often or all the time: 3.8% often or all the time: 1.4% Made it hard for you to put effort into your homework or personal study rarely or sometimes or often or all the time: 3.4% often or all the time: 1.4% Made you not feel comfortable around your friends rarely or sometimes or often or all the time: 2.7% often or all the time: 0.9% In 11-16 year olds school students (statistics of harmed by an immediate family member(s) gambling) 52 Felt bad because of gambling among family members: 5.5% 46 Lost sleep at night because of worrying about a family member’s gambling rarely or sometimes or often or all the time: 4.9% often or all the time: 1.3% Not had enough food (food at home or money on school canteen card/account) rarely or sometimes or often or all the time: 1.8% often or all the time: 1.1% Stopped you from belonging to clubs or doing activities you like doing rarely or sometimes or often or all the time: 1.3% often or all the time: 1.0% Stopped you from going on trips (e.g. family holidays or school outings rarely or sometimes or often or all the time: 1.8% often or all the time: 0.9% Parent’s or guardians have less time to spend with you rarely or sometimes or often or all the time: 1.6% often or all the time: 1.0% More arguments or tension at home rarely or sometimes or often or all the time: 2.1% often or all the time: 1.2% Has made you feel sad rarely or sometimes or often or all the time: 2.4% often or all the time: 0.6% Has made you feel worried rarely or sometimes or often or all the time: 2.9% often or all the time: 0.7% In 18-24 year old university students 53 47% of students gambled in the past 12 months 8% of which suffer low-risk harm 8% of which suffer moderate-risk harms 8% of which suffer gambling disorder harms Overall, 11% of students suffer significant harm from their gambling, and 4% of students suffer the most severe level of harm from their gambling What the industry said? Matthew Hill, Director of the Gambling Commission 50 “This was a pretty poor result. Preventing under 18s from gambling is one of the most basic obligations every bookmaker has, on or off the course. The industry must do better or operators are likely to find themselves facing formal sanctions.” Hill warns operators of the possibility of sanctions for failing to protect children from gambling as all twenty operators tested allowed a 16 year old to gamble at the Royal Ascot 2014. Richard Watson, Executive Director of the Gambling Commission 51 “Every single gambling business must protect children from gambling but the on course bookmakers results have remained unacceptable. Despite various educational attempts to raise standards, by ourselves and the trade bodies, the on-course sector has historically performed poorly in both underage gambling test purchase exercises and Think 21 testing. Pass rates have failed to meet the standards expected and the sector has consistently performed to levels below those we see in other gambling and age restricted products. By way of example, over the past four years, the on-course sector has a pass rate of around 35% for Think 21 testing.” Watson reports that on-course bookmakers fail to meet the standards expected in preventing underage gambling following an investigation where 7 out of 17 operators allowed a 16 year old to gamble at the Royal Ascot 2019. Michael Dugher, CEO of the Betting Gaming Council 12 “We have already done a lot and we are ready to go even further to prevent underage gambling” Dugher refuses to accept responsibility for industry failings in meeting one of the three licensing objectives. Instead, he uses a vague statement and commitment to defend the prevalence of underage gambling. Michael Dugher, CEO of the Betting Gaming Council 12 "far from trying to entice children to gamble, regulated members of the BGC have a zero tolerance approach to betting by under-18s," and that they welcome the raising of the age limit from 16 to 18 for lottery products. Dugher suggests that regulated members of the BGC have a zero-tolerance approach to underage gambling, despite prevalence statistics and undercover investigations by the Gambling Commission reflecting the contrary. Michael Dugher, CEO of the Betting Gaming Council 36 "I'm also pleased to see that new age-verification and ID checks have resulted in literally hundreds of thousands of accounts being closed recently, where the customer was unable or unwilling to meet the new strict criteria" Dugher reports feeling pleased that the Gambling Commission set rules that mandate operators to verify customers age and identity before allowing them to gamble. Tim Miller, Executive Director of the Gambling Commission 54 “There's no doubt that today's figures on children and gambling should make people sit up and listen, he said. But while discussions about children gambling might conjure up images of kids sneaking into bookies or sitting alone on their iPad gambling on an online casino, our latest research paints a more complex picture. The most common activities that children gamble on are not licensed casinos, bingo providers or bookies. Instead we found children preferred to gamble in informal environments, out of sight of regulation - private bets between friends or playing cards with their mates for money.” Miller states that gambling figures for young people are worrying but argues that underage gambling is not happening mainly in betting shops or online. Although non-regulated forms of activity such as video game gambling and private betting may be more common among 11-16 year olds, staggering numbers of this population are able to enter licensed betting premises and gamble. Marc Etches, CEO of GambleAware 17 "Computer gaming with gambling presents real future challenges to the current regulatory framework. We've been saying for some time we have concern about the normalisation of gambling for young people..." Etches points to the regulatory gap in recognising games of chance in computer gaming as part of gambling. Michael Dugher, CEO of the Betting Gaming Council 55 “tackling betting by under 18s is a top priority. BGC members have a zero tolerance approach to underage betting - unlike the illegal, online black market - but are determined to do more to protect young people.” Dugher acknowledges that betting by under 18s is an issue and that it is a top priority. He also states that BGC members have a zero-tolerance approach to underage betting despite consistent statistics of 11-16 year olds entering licensed betting premises such as casinos and betting shops in the past week. References 12. Michael Dugher. It’s important that the Gambling Review tackles betting by under-18s – but let’s deal in facts, not fiction. Available from: https://www.politicshome.com/members/article/michael-dugher-its-important-that-the-gambling-review-tackles-betting-by-under18s-but-lets-deal-in-facts-not-fiction [Accessed: 28th March 2021] 17. Davies R. 25,000 children in Britain are problem gamblers, report finds. The Guardian. 12 December 2017. Available from: https://www.theguardian.com/society/2017/dec/12/children-britain-problem-gamblers-report [Accessed: 29th March 2021] 36. Dugher M. We Need Big Changes And A Race To The Top On Standards In Gambling. Available from: https://bettingandgamingcouncil.com/news/michael-dugher [Accessed: 29th March 2021] 42. Gambling Commission. Part 5: Principles to be applied by licensing authorities. Available from: https://www.gamblingcommission.gov.uk/for-licensing-authorities/GLA/Part-5-Principles-to-be-applied-by-licensing-authorities.aspx [Accessed: 30th March 2021] 43. European Union Agency for Fundamental Rights. Age of majority. Available from: https://fra.europa.eu/en/publication/2017/mapping-minimum-age-requirements/age-majority [Accessed: 22nd March 2021] 44. Arain M, Haque M, Johal L, Mathur P, Nel W, Rais A, et al. Maturation of the adolescent brain. Neuropsychiatric Disease and Treatment. 2013;449–461. Available from: doi:10.2147/NDT.S39776 45. Great Britain. Gambling Act 2005: Elizabeth II. Chapter 19. London: The Stationery Office; 2001. 46. The Gambling Commission. Young People and Gambling Survey 2019. The Gambling Commission. 2019. 47. Gambling Commission. Young People & Gambling 2018. Gambling Commission. 2018. 48. Parent Zone. The Rip-Off Games: How the new business model of online gaming exploits children. Parent Zone. 2019. 49. Royal Society for Public Health. Skins in the Game. Royal Society for Public Health. 2019. 50. Gambling Commission. Twenty bookmakers at Ascot allowed 16-year-old to bet: operators warned they must improve underage gambling controls. Gambling Commission. 2 July 2014. Available from: https://www.gamblingcommission.gov.uk/news-action-and-statistics/News/twenty-bookmakers-at-ascot-allowed-16-year-old-to-bet-operators-warned-they-must-improve-underage-gambling-controls [Accessed: 23rd March 2021] 51. Gambling Commission. On course bookies face licence reviews. Gambling Commission. 30 July 2019. Available from: https://www.gamblingcommission.gov.uk/news-action-and-statistics/news/2019/On-course-bookies-face-licence-reviews.aspx [Accessed: 23rd March 2021] 52. Gambling Commission. Young People and Gambling. Available from: https://www.gamblingcommission.gov.uk/news-action-and-statistics/Statistics-and-research/Levels-of-participation-and-problem-gambling/Young-persons-survey.aspx [Accessed: 28th February 2021] 53. Young Gamers and Gamblers Education Trust. How gaming & gambling affect student life. Young Gamers and Gamblers Education Trust. 2019. 54. BBC News. Number of child gamblers quadruples in just two years. BBC News. 21 November 2018. Available from: https://www.bbc.co.uk/news/business-46286945 [Accessed: 29th March 2021] 55. Betting and Gaming Council. BGC Chief Executive @MichaelDugher says tackling betting by under 18s is a top priority. BGC members have a zero tolerance approach to underage betting - unlike the illegal, online black market - but are determined to do more to protect young people. Available from: https://www.facebook.com/BettingAndGamingCouncil/photos/a.105106001278691/330551518734137/?type=3 [Accessed: 29th March 2021]

  • Gambling and advertising

    The industry maintains that advertising has no effect on consumption but instead helps operators differentiate product offerings and for customers to identify which brands are regulated and therefore can be trusted. Evidence from the Gambling Commission reflects the contrary. Younger adults, in particular, were more likely to be affected by advertising to spend money on gambling when they were not otherwise planning to. Worryingly, this phenomenon has been reported even among 11-16 year olds. The industry is keen to prevent meaningful reform on gambling advertising nationally and internationally because of its importance in driving gambling in the short-term and the long-term through a normalisation effect. The importance of advertising to the industry is highlighted by their lobbying against change and their expenditure. Summary Over the past decade, gambling advertising has grown exponentially. In the present day, gambling advertising is ubiquitous, with a distinct presence across various mediums, including online advertising, social media, affiliates, television, radio, newspapers, sponsorships, and physical ads in stores. The widespread nature of gambling advertising has meant inevitable exposure to vulnerable groups, such as young people and individuals with special educational needs and disabilities. Moreover, the volume of ads has led to a normalisation effect, such that young people are growing up in an era where gambling is seen as a normal part of everyday life. This phenomenon is particularly noticeable in sport. Advertising is vital to the gambling industry for one encompassing reason: increasing consumption and increasing yields. Increased gambling can be broken down into activity among new customers and returning customers. The importance of advertising to the industry is demonstrated by the sheer size of investments made and its fierce opposition to meaningful regulation in Great Britain and abroad. Like the tobacco industry, the gambling industry maintains the notion that advertising does not affect consumption but merely helps promote safer gambling by directing customers to regulated brands and helps customers differentiate offerings between brands. However, the industry would not spend as much on advertisements if it did not increase customers' gambling losses and increase industry profits. Online advertising is particularly significant for the gambling industry as it benefits from targeting and the accessibility of online gambling, where ads facilitate a more direct link to the product. According to the Advertising Standards Authority, there are several themes to the concerns around gambling advertising and these are: Links to problem gambling Children's exposure Online media Societal expectations Aggressive advertising Misleading advertising Some of the industry has recognised that there are significant issues with advertising, including the sheer volume of ads, their presence in sports, and ads' ability to reach young people in sports and online. However, despite these well-grounded concerns, little meaningful action has been taken. Instead, industry efforts have been self-heralded as successes demonstrating the industry's ability to self-regulate. Recent industry measures, which have been criticised for include the 'whistle-to-whistle’ advertising ban and the use of safer gambling messages during the pandemic, are discussed in more detail in the voluntary bans chapter. What is known? Advertising spend by the UK Gambling Industry According to the Advertising Association, the UK’s gambling industry advertising spend grew from £0.17bn to £0.24bn between 2010 and 2013 (after adjusting for inflation) at an increase of 40% or a year on year increase of 13.3% 56 2010 = £0.15bn (0.95% of total spend) TV: £0.07bn Press: £0.04bn Internet: £0.01bn 2011 = £0.17bn (1.07% of total spend) TV: £0.08bn Press: £0.04bn Internet: £0.03bn 2012 = £0.21bn (1.27% of total spend) TV: £0.12bn Press: £0.05bn Internet: £0.03bn 2013 = £0.24bn (1.36% of total spend) TV: £0.14bn Press: £0.05bn Internet: £0.02bn According to Regulus Partners, the UK’s gambling industry advertising spend grew from £1.07bn to £1.56bn between 2014 and 2017 (after adjusting for inflation) at an increase of 46% or a year on year increase of 15.3% 57 Prior to 2014, remote operators were not required to have a GB gambling license (discussed in more detail in chapter 9: gambling operators as multinational corporations) 2014 = £1.00bn (5.4% of total spend) 58 Internet: £0.72bn (9.9% of all online advertising spend) Online Marketing: £0.40bn Affiliates: £0.28bn Social Media: £0.04bn TV: £0.16bn (3.2% of all TV advertising spend) Sponsorship: £0.03bn Other Offline: £0.09bn 2017 = £1.56bn (7.0% of total spend) 59 Internet: £1.20bn (10.4% of all online advertising spend) Online Marketing: £0.75bn Affiliates: £0.30bn (54.3% of all affiliate advertising spend) 60 Social Media: £0.15bn (5.9% of all social media spend) TV: £0.23bn (4.6% of all TV advertising spend) Sponsorship: £0.06bn Other Offline: £0.07bn Gambling advertising exposure In young people 11-24 year olds in the past month 61 85% reported seeing gambling advertising on TV (including national lottery adverts) 70% noticed gambling adverts in betting shops on the high street, window displays as well as promotions on shop floors and near tills 66% reported seeing gambling promotions on their social media channels 11-16 year olds exposed at all in the past year (exposed at least once a week) 46 70% were exposed to gambling advertising or sponsorship at all in the past year 59% (33%) were exposed to ads on TV 52% (24%) were exposed to ads linked to sports events 50% (24%) were exposed to social media websites 45% (20%) were exposed to other websites (excluding social media) 43% (21%) were exposed to sponsorships on TV or radio 40% (18%) were exposed to sponsorships in sports venues 37% (13%) were exposed to ads on posters/billboards 31% (11%) were exposed to ads in newspapers 12% follow gambling companies on social media platforms like Facebook, YouTube and Instagram 11% had ever received direct marketing from gambling companies about gambling Mails: 4% Messages via Youtube: 3% Texts: 3% Messages via Instagram: 3% Messages on Facebook: 2% Messages via Snapchat: 2% Messages via Twitter: 2% Messages on another social media website: 1% In adults (16+ year olds) exposed at all in the past year (exposed at least once a week) 87% of adults (16+) has seen or heard gambling advertisements or sponsorships in the past year 23 79% (50%) were exposed to ads on TV 72% (45%) were exposed to gambling sponsorships on TV or radio 65% (33%) were exposed to gambling sponsorships on sports merchandise 64% (33%) were exposed to gambling sponsorships in sports venue 63% (31%) were exposed to gambling advertisements online (non-social media sites) 62% (23%) were exposed to gambling advertisements on posters/billboards 61% 27%) were exposed to gambling associations with sporting competitions 58% (31%) were exposed to gambling advertisements on social media 51% (23%) were exposed to gambling advertisements in newspapers 45% (18%) were exposed to gambling advertisements on the radio Online affiliates ODDSbible, an emerging affiliate brand that is part of the LADbible Group, boasts over 1m followers in under 1 year of operation, with 79% of these followers being between 18 and 34 years old and 96% being male 62 Significance of targeting and data analytics 63 A case-study of Sky Bet and companies used by Sky Bet and an individual with Gambling Disorder (Flutter Entertainment) What data? TransUnion: a large credit scoring agency that owns CallCredit, Signal, and Iovation CallCredit 34 page breakdown of financial history including information on: bank accounts, loan defaults, debts, mortgages and monthly payments Iovation A spreadsheet containing 19, 000 fields of data including device identification numbers network information about Signal A document containing personal characteristics including: history of playing slots favourite sports to bet on Interpretation of data by Sky Bet “win back” customer worth about $1, 500 if he started gambling again customer would be receptive to gambling promotions that featured Las Vegas Actions by Sky Bet sent emails to customer promoting a chance to win more than $40,000 by playing slot Effects of gambling advertising Spent money on gambling after seeing a gambling ad or marketing when they were otherwise not planning to 11-16 year olds: 5% (1 in 20) 46 16+ year olds who gamble online: 44% (1 in 2) 23 By age 18-24: 61% 25-34: 56% 35-44: 49% 45-54: 45% 55-64: 31% 65+: 26% By type Free bets and bonuses: 29% TV: 20% Online: 16% Social Media: 16% Newspaper: 11% Billboards: 9% What the industry said? William Hill PLC Annual Report and Accounts 2015 64 "[Gambling has] increased over time, with the National Lottery and TV advertising making gambling more socially acceptable as a leisure activity while mobile devices are making the product more accessible" William Hill recognises the role of advertising over the long-term in normalising gambling and the growing role of mobile devices in increasing accessibility of gambling products. Stephen van Rooyen, CEO of Sky in the UK and Ireland 65 "Yet again, the gambling industry are ignoring the fact they spend five times more on online marketing than they do on TV," van Rooyen said. "By cutting TV ads, they'll simply spend more online, bombarding people's smartphones, tablets and social media feeds with even more gambling ads." Van Rooyen recognises that the industry is keen to avoid meaningful change with online advertising as this is the most effective form of advertising. GVC Holdings PLC Annual Report 2019 66 “The Group also unilaterally ended all UK football shirt sponsorship and perimeter board advertising and has encouraged others in the industry to follow suit.” GVC Holdings recognises an issue with football sponsorships and takes steps to address it, leaving space for other operators to take their place. Betting and Gaming Council 16 "The fact that only companies licensed by the Gambling Commission may advertise in the UK provides an important means for customers to identify legal from illegal operators. It is also provides a means for companies to inform gambling consumers about the products that they enjoy." Like the Tobacco Industry in the past, the Betting and Gaming Council publicly denies or omits the role of advertising in increasing gambling-harm. In this statement, the BGC paraphrases Philip Morris, who in 1987 said that advertising ‘may influence the choice of one brand over another’. 67 Philip Bowcock CEO of William Hill, Annual Report 2018 68 "This issue is one I have been speaking about for some time. I was on the record in 2016 saying I had concerns about the level of gambling advertising, for example, at 4 pm on a Sunday afternoon. The tone of the adverts, the number of them and the potential impact on young people have all been raised as concerns." Unusually for the industry, Bowcock recognises issues with advertising including the tone of the content, the volume, and the potential for impact on young people. Philip Bowcock CEO of William Hill, Annual Report 2018 68 "Most of our advertising is during live sport and it's then that we find young people are most likely to see gambling advertisements. The average under-18 audience of a Premier League match on Sky Sports is 96,000. Major events like the World Cup attract hundreds of thousands more young viewers. That is far too many young people seeing a product that isn’t appropriate for them." Hypocritically, Bowcock highlights an issue with advertising during live sports, while William Hill is the Scottish Cup's official sponsors. Moreover, William Hill also sponsored England and the FA Cup in 2014, through the FIFA World Cup in 2014, and secured the boxer Anthony Joshua as a brand ambassador in 2018. Bet365 69 "The business said it spent more in marketing as it tried to entice betters with offers linked to the 2018 World Cup, which was part of this period." Bet365 look to benefit from the exposure of events like the World Cup. Mr Green Annual Report 2017 70 "Digital communication gives us useful data for us to analyse which messages and channels are effective. In this way, we are constantly expanding our knowledge about what is relevant to the customer." Mr Green, a subsidiary of William Hill, recognise that digital targeted advertising can benefit from data analytics. William Hill PLC Annual Report and Accounts 2015 64 "Historically, affiliates drove a lot of traffic to our sites. Now, as we have increasingly focused on our core, regulated markets, TV advertising, search engine optimisation and PPC [pay-per-click] account are much more important. These channels accounted for [circa] 73% of our marketing spend and all drive a lower cost per acquisition." William Hill recognises the increasingly important role of digital advertising in lowering costs and increasing ad effectiveness to shareholders. Ladbrokes PLC Annual Report 2015 71 "We have helped to run a high impact TV and advertising campaign to educate people about the risks of gambling and how to stay in control. We are fully aligned with the GB Gambling Commission's objectives to ensure that gambling is crime free, fair and open and children and vulnerable people are protected and indeed commit to these objectives across the whole of our business wherever we operate" Ladbrokes reports their role in educating people about gambling-risks and their commitment to being fully aligned with the Gambling Commission’s objectives. Despite this commitment, Ladbrokes failed multiple customers between November 2014 and October 2017 and was fined £5.9m in 2019. Michael Dugher, CEO of Betting Gaming Council 72 “We welcome the Committee’s understanding of the role of advertising and the lack of real evidence of any link between gambling advertising and problem gambling.” Like the tobacco industry in the past, Dugher’s statement reflects the idea that advertising does not affect consumption. Moreover, Dugher fails to recognise evidence from the Gambling Commission that reflects approximately 1 in 20 11-16 years old go on to gamble when they were not otherwise planning to because of gambling advertising. Stewart Kenny - Founder of Paddy Power "That is dangerous, because it is promoted by well-known people, it's a constant barrage of advertising they see it before, during and after the match… It's become normal for children to think gambling and soccer are the same thing." Stewart Kenny, the Paddy Power founder who resigned in 2016 over what he saw as the failure to tackle problem gambling, says advertising is "normalising" gambling for children, and that it has become "nearly part of the game" when watching football. References 16. UK Parliament – Betting and Gaming Council. Betting and Gaming Council – Written evidence (GAM0068). 2019. Available from: https://committees.parliament.uk/writtenevidence/154/html/ [Accessed: 29th March 2021] 23. Barnfield-Tubb J, Francis C. Gambling participation in 2019: behaviour, awareness and attitudes. 2020. Available from: https://www.gamblingcommission.gov.uk/PDF/survey-data/Gambling-participation-in-2019-behaviour-awareness-and-attitudes.pdf [Accessed: 29th March 2020] 46. The Gambling Commission. Young People and Gambling Survey 2019. The Gambling Commission. 2019. 56. Community of Advertising Practice. CAP and BCAP Gambling Review: An assessment of the regulatory implications of new and emerging evidence for the UK Advertising Codes. Community of Advertising Practice. 57. REGULUS PARTNERS. Industry Advertising spend 2014-2017. Available from: https://www.begambleaware.org/media/1853/2018-11-24-rp-ga-gb-marketing-spend-infographic-final.pdf [Accessed: 28th February 2021] 58. IAB UK. UK advertising spend passes £20bn as growth hits five-year high. Available from: https://www.iabuk.com/press-release/uk-advertising-spend-passes-ps20bn-growth-hits-five-year-high [Accessed: 28th February 2021] 59. IAB UK. Full Year 2017 Digital Adspend Results. IAB UK. 2017. 60. IAB UK. IAB / PwC Affiliate Marketing Study 2017. Available from: https://www.iabuk.com/adspend/iab-pwc-affiliate-marketing-study-2017 [Accessed: 28th February 2021] 61. Ipsos Moir. Terms & Conditions. 2021. Available from: http://www.ipsos-mori.com/terms [Accessed: 31st March 2021] 62. LADbible Group. ODDSbible. Available from: https://ladbiblegroup.com/OurBrands/oddsbible/ [Accessed: 21st March 2021] 63. Satariano A. What Sky Bet, The Gambling App, Knows About You. The New York Times. 24 March 2021. Available from: https://www.nytimes.com/2021/03/24/technology/gambling-apps-tracking-sky-bet.html [Accessed: 28th March 2021] 64. William Hill. THE SCALE TO DELIVER OUTSTANDING CUSTOMER EXPERIENCES. 2015. Available from: http://files.williamhillplc.com/media/3612/williamhill_ar15.pdf [Accessed: 31st March 2021] 65. BBC Sport. Gambling chiefs confirm ‘whistle-to-whistle’ television sport advertising ban. BBC Sport. 13 December 2018. Available from: https://www.bbc.co.uk/sport/46550118 [Accessed: 29th March 2021] 66. GCV Holdings. FOR THE GOOD OF ENTERTAINMENT. 2019. Available from: https://www.annualreports.com/HostedData/AnnualReports/PDF/LSE_GVC_2019.pdf [Accessed 31st March 2021] 67. Bates C, Rowell A. Tobacco Explained: The truth about the tobacco industry …in its own words. World Health Organization. Available from: https://www.who.int/tobacco/media/en/TobaccoExplained.pdf [Accessed: 31st March 2021] 68. William Hill. Towards a digitally led, internationally diverse business. 2018. Available from: https://www.williamhillplc.com/media/12906/williamhill_ar18-01032019.pdf [Accessed 31st March 2021] 69. Andrews J. Bet365 chief exec takes home £58million pay rise as Britain’s top earning boss. Mirror Online. 18 December 2019. Available from: https://www.mirror.co.uk/money/denise-coates-handed-astonishing-320m-21119736 [Accessed: 29th March 2021] 70. MrGreen & Co AB. Annual Report. 2017. Available from: https://mb.cision.com/Main/8953/2473501/806461.pdf [Accessed 31st March 2021] 71. Ladbrokes. BUILDING A BETTER LADBROKES. 2015. Available from: http://ar2015.ladbrokesplc.html.investis.com/media/downloads/pdf/strategic-report-and-divisions/Ladbrokes_2_Strategic_Report_AW_160309.pdf [Accessed 31st March 2021] 72. Betting & Gaming Council. BGC statement on House of Lords Committee Report. Available from: https://bettingandgamingcouncil.com/news/bgc-statement-house-of-lords-committee [Accessed: 29th March 2021]

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