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Osmosis empowers over one million learners around the world with a better understanding of medicine and health topics. Although gambling-harm is increasingly recognised as a public health issue by experts, wider awareness and understanding have been limited for many reasons. One of the most significant issues facing gambling-harm awareness is the lack of education, training, and healthcare professionals' guidelines. Despite gambling-harm having such a profound impact on the quality of life of individuals (both gamblers and non-gamblers who are affected by someone else's gambling) and the burden of gambling-harm, on a population-level, being as significant as the harm that is attributable to alcohol or even tobacco, we've heard many times that Doctors don't have a clue. Gambling Harm UK has been working hard to change this, and we're pleased to say that our first piece of work with Osmosis has reached fruition. We hope that this builds a foundation for more work in this incredibly neglected area of health. To see the article, click here: Osmosis - Gambling Addiction: What Is It, Causes, Signs, Prevention, Support, and More. Additionally, Gambling Harm UK has also worked with Geeky Medics to further understanding of gambling-harm. Geeky Medics is a platform that receives over 2 million views each month from a global community of medical students, doctors, paramedics, nurses, pharmacists, physician associates and educators. Gambling now features as part of the social history for many different medical education articles on the Geeky Medics platform. These include: Alcohol history Cardiovascular history Chest pain history Depression history Gastrointestinal history Respiratory history Gambling also now features on the OSCE checklists for Medical Students: OSCEs or Objective Structured Clinical Exams are the ‘practical’ exam of medical school. It aims to prepare students for the clinical and communication aspects of becoming a doctor. Alcohol history Cardiovascular history Chest Pain history Depression history Gastrointestinal history Respiratory history At the time of writing, NICE has not yet scheduled work on guidelines on Gambling. We hope this changes soon! We'd like to give our thanks to everyone at the Osmosis and Geeky Medics teams who have worked with us in bringing about this step change. And also a special thanks to Shiv Gaglani (CEO of Osmosis) and Dr Lewis Potter (CEO of Geeky Medics) for encouraging the work on gambling-harm education.

Matt Zarb-Cousin writes in the Independent A video by Coalition Against Gambling Ads

On the evening of Wednesday 23rd December, I was invited onto the Talking Balls programme on BBC Radio Manchester hosted by Kyle Walker and Gaz Drinkwater. This discussion came about following the news that Atlético Madrid and England footballer Kieran Trippier had been suspended for 10 weeks and fine £70,000 for breaching betting rules. Despite this being very much a last-minute request, I was more than happy to come on and talk about the manifestation of gambling in football. A combination of topics that I am ever so passionate about. Play the video below to listen to the discussion.

It's not often I get invited onto podcasts to discuss my story in great length, and so I jumped at the chance when ALL IN host and good friend Brian Hatch dropped me a message. Brian and Jeff are doing a superb job of raising awareness of gambling-related harm in America, and are right to be deeply concerned at what could transpire over in America now that the online gambling market has well and truly opened-up to consumers. In this programme we talked about the demons from my childhood, how I got into gambling, the formation of the All Bets Are Off podcast and Gambling Harm UK, and much more... Massive thanks to Brian and Jeff for having me on. Click here to listen to the episode.

On Thursday 17th December, the ‘TalkBanStop’ initiative went live. This is a partnership between GamCare, Gamban, and GAMSTOP to help anyone experiencing gambling harms start their recovery journey. As part of the marketing campaign, I was invited to appear on a video alongside former Premier League football Michael Chopra to talk about our personal experience of gambling harms and why it’s so important to get the right support and barriers in place to help (check out the video and poster below). On a personal note, I think it’s wonderful to see these three organisations collaborating because I know through my own lived experience that this will help and, quite possibly, save many lives. For support and more information, please visit www.TalkBanStop.com.

New research commissioned by GambleAware and delivered by YouGov has found that ethnic minority communities are disproportionately impacted by gambling harms and have a higher demand for treatment. Link to GambleAware Research published in December 2020 Gambling Harm UK summary Prevalence of gambling-harm In GHUK’s research on Gambling in BAME published in October 2020, we found that disproportionate harms in minority ethnic groups were reported in research from 2007, 2010, and 2012. The results we have from this 2020 study are in line with these older results and reflect an odds ratio for the most severe harm of around 3. Prevalence of gambling-harm due to own gambling among BAME adults: 1 in 5 (20%) Prevalence of gambling-harm due to another person's gambling among BAME adults: 1 in 10 (9%) Co-existing health conditions 50% of individuals suffering PG harm from White Ethnic groups have a co-existing long-term health condition 65% of individuals suffering PG harm from BAME Ethnic groups have a co-existing long-term health condition Prevalence of affected others in children 40% of individuals suffering PG harm from White Ethnic group have a child under 18 in the household 50% of individuals suffering PG harm from BAME Ethnic groups have a child under 18 in the household Sources of treatment, advice, and support Individuals suffering gambling-harm reported accessing support from their GP; however, this contrasts with expectations as there are no guidelines or medical curriculums that cover gambling-harm BAME individuals were more likely to access specialist services. However, these results are in stark contrast with the official statistics published, which reflect that BAME individuals are disproportionately less likely to access services (National Treatment Statistics)

Yesterday my story was posted on Lucy Holmes’ website ‘Cost of Gambling.’ Lucy is a trainee journalist, and in February 2021, Cost of Gambling will launch its first radio documentary exploring gambling addictions. In the meantime, I believe that she is uploading stories and other content up onto the website. To read my story, click here.

The All Bets Are Off podcast was proud to match sponsors for Billericay Town U23’s Essex Senior League Reserve Division fixture against Hashtag United Reserves earlier today. Over the past week-and-a-half, Billericay Town Football Club has been raising awareness of gambling-related harm across their social media channels. This campaign has included sharing information about the podcast and several specially selected partners. ABAO were due to be match sponsors for the fixture between Billericay’s first-team and Chelmsford City earlier in the week, but, unfortunately, due to a positive coronavirus test, the game was postponed. On the plus side, this meant that Chris and I were able to attend the match that we later became sponsors of. The Ricky ran out 6-1 winners, and we awarded our Man of the Match to Louis Dunwell (as pictured below). The central-midfielder was a deserved winner scoring an exquisite 35-yard lob and assisting two further goals in what turned into a drubbing by the home side. Both Chris and I would like to thank Billericay Town for their hospitality. With special praise going to co-owner Nick Hutt and club photographer Nicky Hayes.

Link to WIRED article It was late January when Google searches for “casinos” reached an all-time high in the UK. And that was before the coronavirus pandemic hit, and sent the gambling industry’s revenue spiralling downward. But as spending in casinos and betting sites dropped to zero during the first lockdown, online slots, poker, casino gaming, and virtual sports saw a significant increase. Data collected from the Gambling Commission (the British body responsible for gambling regulation) showed that in March, online virtual sports betting increased by 88 per cent and online poker by 53 per cent compared to the same month in 2019. The pandemic hit a country that was already home to big gamblers. A House of Lords report titled “Gambling Harm – Time for Action” published in July 2020 found that half the adults in the UK gamble at least once a month. A third of a million of UK citizens are “problem” or “disordered” gamblers. It is estimated that for each problem gambler, six other people – a total of two million – are harmed by the breakup of families, crime, loss of employment, loss of homes and, ultimately, loss of life. Kishan Patel, a fifth-year medical student at Imperial College and CEO of TalkGEN CIC, a non-profit focused on gambling harm, is one of them. “My dad was a gambler and passed away with it seven years ago. I still live with the effects of that and the effects this had on my mum, who is still paying for a mortgage that went up massively because of his addiction.” Patel wants the issue to be taken seriously. “We need to start seeing this gambling crisis as a health problem,” he says. Lockdowns, however, not only pushed gambling further into the online sphere. They also made people suffering from gambling addiction, those at risk of developing one, and those in recovery more vulnerable. Tony Parente, a 41-year-old British man, belongs to the latter group. He was nine years old when his grandfather asked him to pick a horse for him. Later, when he was a teenager, gambling became a social activity he would share with friends at betting shops – at least that’s what Parente told himself. Whenever he won, everyone – his grandfather, his friends – kept telling him that he was very lucky. But like most gambling stories, Parente’s lucky streak soon came to an end. “It quickly escalated from being a social activity to something that took over everything.” His relationship with gambling, Parente says, is the longest he ever had. But, it was also one that shattered his real-life ties with friends and family. He went from working hard and being good at his job as a manager for a car company to leaving for Dubai in 2010 in an attempt to escape gambling. After backsliding yet again, and coming back to England in 2016, Parente started to struggle with suicidal thoughts. “I asked my sister for £70 to get a train ticket to see my mum. I needed help. But instead I walked past a betting shop and spent the money there, even though I was in debt and had lost my family, my home, my business, and more importantly my sanity,” Parente recalls. “Looking back it was the best £70 I ever spent because losing them made me realise my addiction would kill me.” At the time when Parente needed help, he could still benefit from social support. But according to the psychologists, operators from gambling companies, and affected problem gamblers we talked to for this article, lockdown has made everyday life particularly dangerous for gamblers at risk. Working from home, constant access to the internet, readily available triggers like alcohol and drugs, and a feeling of isolation or helplessness contributed to an increasing number of people turning to and intensifying their presence on online casinos and betting websites. Today, three years later, Parente is in recovery and has become an outspoken activist on the issue. “If I was still gambling now, I would have gambled more and used it to escape,” Parente says. “I know that if I had been less secure in my recovery, this would have been a particularly risky time for me,” says Kerri Nicholls, another former gambler. On the GamCare Forum, an online message board providing a space for users to share experiences about problem gambling, a user expressed similar worries. “The Covid-19 and the work from home situation, I’ve basically hit a downward spiral again,” they wrote. “However, this time it’s on the online slots. They say it’s one of the worst forms of betting because it’s ultimately a game designed simply to rip us whilst enticing us with its dazzling game play and catchy music, yet those hooked still go back time and time again.” someone else replied: “I can totally relate, the last two months have been very stressful and I found myself chasing the bonus games on slots for the possible big win.” The Gordon Moody Association, a group that helps gambling addicts, told the BBC that in May the interactions on their helpline had more than tripled, and they had a 20-person waiting list for their residential treatment programme aimed at people with a gambling addiction – something unheard of in the organisation’s experience. Dominik Batthyany, a psychotherapist and head of the Institute for Behavioural Addiction at the Sigmund Freud University in Vienna, thinks gambling has become a coping mechanism. “Many people have lost their jobs, so they sit at home with nothing to do. Add anxiety or conflicts to that, and many will choose gambling as a way to cope,” he says. But it was not only by boredom, frustration and chance that gamblers took to betting sites during Britain’s spring lockdown, leading to the spikes in betting registered by the Gambling Commission. Although the Betting and Gaming Council (BGC), the UK industry association representing betting companies, vowed in April to suspend TV and radio ads in response to concerns over increased risk for vulnerable people during Covid-19 isolation, they were quickly called out for hypocrisy. Television advertising only accounts for 15 per cent of their advertising spendings, according to GambleAware, an independent organisation working with the Gambling Commission to reduce gambling harm. Online gambling marketing spending, however, is more than five times higher. According to the House of Lords report the gambling industry spends £1.5 billion a year on advertising. It says 60 per cent of profits come from the “five per cent who are already problem gamblers, or are at risk of becoming so.” It wasn’t long after the supposed ad suspension that several companies found a loophole and employed “safe gambling ads”, which were – as an all-party parliamentary group on gambling harm claimed in a letter to culture minister Nigel Huddleston in May this year – simply commercials disguised as social responsibility messages. Some even featured the often-criticised slogan “When the FUN stops, stop” with the word “fun” in all-caps. During the lockdowns, more time spent looking at a screen in order to work or kill time meant being exposed to more online gambling advertising. Online advertising for potentially addictive activities is particularly problematic because it’s targeting is based on the probability of someone clicking on a link. “And if someone is potentially vulnerable to gambling addiction, they are also more likely to click on the link,” says Julia Hörnle, professor of Internet Law at Queen Mary University of London. That is why it’s plausible that, during the worst of the pandemic, the people who were shown more gambling ads were exactly those who needed them the least – problem gamblers. And then there is social media. Even if services such as GamStop allow internet users to block access to gambling sites, spending time on social media still exposes them to risks. “Blocking yourself from gambling websites is not connected to Google or Facebook. That means the internet will keep advertising to you in terms of your past interests,” says Michael Auer, data scientist and founder of Neccton, a service provider for responsible gaming solutions. On social media you could also encounter sponsored posts and stories promoting gambling more or less subliminally. On social media, the distinction between editorial content and advertising no longer exists. “Among all the content, it is very difficult to distinguish whether an influencer is being paid, or whether he is just an enthusiastic young man bragging about his latest bets,” says Hörnle. Little protection of the most vulnerable users in the online sphere can be seen not only in advertising, but also in the way platforms seek to retain user attention once they’ve conquered it. Problem gamblers, for example, are often included in VIP schemes that give special treatment to those who gamble large sums. VIPs are a small, select group, representing not more than five per cent of customers but providing as much as half of a gambling operator’s deposits. Eight per cent of VIPs are estimated to be problem gamblers. Once customers are brought into the scheme they receive special offers like free bets, bonuses, and loyalty rewards. They will be assigned a personal manager who phones and emails them regularly – often even befriending them and inviting them to football matches. But when it comes to making sure their “friends” are okay, the companies seem to fail. They don’t usually carry out affordability checks on their VIP customers, so they can’t know if their VIPs are heading towards financial ruin. Additionally, VIPs are often kept in different databases and companies might still approach them even if they are in recovery and have blocked themselves from gambling websites – although this practice could be illegal and pursuable under the European General Data Protection Regulation (GDPR). Initiatives like these were always lurking online, and dangerous to vulnerable gamblers, but particularly so during the pandemic. The UK’s specific legal framework is partly to blame. The 2005 Gambling Act put the country firmly on the path of gambling liberalisation – as many more companies were allowed to compete to get and retain consumer attention. This decision demonstrated its shortcomings when the universal adoption of smartphones and other digital devices enabled gambling 24/7. “During work, I would go for walks or to the toilet to gamble,” says Nicholls. “When you’re gambling, your phone is an extension of you.” As regulators failed to keep up with the digital revolution, operators found ways to exploit outdated regulations. It does not help that the internet does not stop at the UK border, or necessarily adhere to national regulations. The way countries currently regulate gambling is through blocking websites of non-licensed and foreign companies. But anyone can now easily use VPNs to bypass the geoblocking of some websites. “If one country introduces extreme restrictions, players will stop playing there, but will pop up elsewhere. It’s like a balloon – you press it on one side and a bump will come up on the other side,” says Neccton’s Auer. In the online world, restricting regulations in one country is not enough. “Harmonising regulation in all European countries could help to make rules easier to enforce,” says Hörnle, “but I think politically we won’t see this happening.” Plus, with Brexit now a reality, it’s unclear how the UK could benefit from a similar development. People such as Tony Parente or Kerri Nicholls found a way out of their dire situations thanks to support organisations. But at a time when many more people are seeking help – as during a nation-wide lockdowns – support might come too late. For many, a regulatory solution would be a lifesaver. When asked about how to protect users in a better way during the pandemic, the experts we spoke to all pointed to one solution: much more detailed guidelines for how gambling companies must protect vulnerable users. Some gambling companies may think this will lead to decreased profits. “But in reality, they are actually harming their own business by allowing disordered gambling to thrive,” says Auer. Promoting healthy engagement from users is more likely to keep them loyal for longer periods of time. A Betting and Gaming Council spokesperson said that the “pledges” the industry signed at the start of the first lockdown resulted in the doubling of “safer gambling messages” on betting websites. “The number of direct interventions by operators where a player was spending more time or money betting than they did before went up by 25 per cent,” they added. They did not address direct questions on the kind of measures betting websites implemented to reduce problem gambling during the lockdown. Auer told us that current analytics technology and user profiling can help companies detect early signs of disordered play even before the user becomes a problematic player. Constantly informing users about their own behaviour is not yet compulsory for online gambling companies. But information should come with responsibility. The more companies know about their users, the larger their duty to protect them – especially during a pandemic. “I didn’t even think I was an addict until that last bet,” Parente told us about the time he was gambling so intensely that he couldn’t find a way to pull himself out. Perhaps the additional risks brought about by the Covid-19 crisis will help to focus attention on how to ensure that a potentially harmful tool such as user profiling is turned into an incredibly beneficial one. The authors of this investigation were supported by a grant from the IJ4EU fund

Recently I spoke with journalist Joanna York of Welcome to the Jungle – a multi-channel media company that aims to inspire individuals to thrive in their professional lives. The article's title is ‘How remote work has impacted addiction…for better and for worse and having had spoken about this to a few people over the past eight months; I think I’ve got somewhat of a unique take on this particular subject. I came into recovery right at the beginning of the first lockdown, and for me personally, I found that disruption very helpful indeed. The article explains this in much more detail – click here to view.

I got a call asking me to appear on BBC 5 Live to talk about gambling-related harm. The Sunday night time slot didn't put me off. It's a subject that I would talk about any time, day or night, to raise awareness and help others. After I was Lisa, a guest on S1 EP5 - Women's Week - Raising Awareness of Female Gambling Addiction and Matthew Hickey from Gordon Moody.

We present a discussion on the process of GB self-exclusion methods across: Online gambling Betting shops Casino Adult Gaming Centres Bingo Background The Gambling Commission outlines three tools: setting limits, time-outs, and self-exclusion to help users 'gain control' as a part of 'safer gambling.' Literature has shown that self-exclusion programs are beneficial but under-utilised In 2019, 53% of gamblers were not aware of self-exclusion Gambling Commission code of practice for non-remote gambling: Individuals should be able to self-exclude without having to enter gambling premises (3.5.2:2) Results Online Gambling A free online form that takes a "few minutes" on gamstop.co.uk (Effective within 24 hours) Betting shops Phone the MOSES team (8 am to 12 am) & send documents by post or email Casino Visit a UK land-based casino Download & print form to be completed by hand and then emailed or posted Adult Gaming Centres Visit an Adult Gaming Centre Phone an Adult Gaming Centre Non-bacta members should contact bacta on e-mail or by phone Bingo Attend local bingo club or licensed bingo premises, explain and interview, take pictures, and assist in completing an online self-exclusion form. OR Contact licensed bingo premises by phone or website OR "Contact The Bingo Association, who will give them the telephone number of their club or licensed bingo premises. To start the process, a customer should complete the form below. Following receipt, a staff member from the Association will contact the customer (usually within 2 working days)." Summary of UK self-exclusion Two out of five self-exclusion groups are independent of contact with industry (online and betting shops) One out of five self-exclusion groups involve a method that is quick and available 24/7 (online) No self-exclusion method is clearly and easily advertised as available in multiple languages. Discussion A systematic review of 16 original studies published over 1997-2017 found that self-exclusion barriers need to be reduced. In line with the evidence, we also perceive industry-modifiable barriers to self-exclusion in availability and accessibility for the UK consumer, which we suggest are: Independence from gambling Perceived complexity Perceived chance of success Perceived time spent Language barriers Time restrictions (A lack of a 24/7 service) In particular, we note that the description for self-exclusion to Casino's states that the form must be printed and signed by hand (despite law on e-signatures) Conclusions We recommend that fit-for-purpose self-exclusion schemes be independent of gambling activity or representation, devoid of unnecessary verbosity and complexity, available at any time and in any language. Barriers in self-exclusion schemes, for all types of gambling except for online gambling, need to be urgently addressed using a simple online technology-based solution such as an online form (at minimal cost or specialist ability)