IIt is with a heavy heart that I have to inform you that a medical journal is once again writing about gambling. This time it is an anonymous editorial in The Lancet called “Gambling: a harmful commodity“. Gambling is not really a goods. The inspiration for this title was almost certainly the contemporary temperance textbook “Alcohol: No Common Goods.” Alcohol is also not a commodity.
Gambling is often thought of as a bit of innocuous fun: a carefree flutter at a sporting event or a quick try at a scratch card. But gambling harms physical and mental health and can cause wider societal harm. One study suggests that last year’s problem affects gambling 0.1–5.8% of adults worldwide.
Lancet Readers will be relieved to learn that the prevalence of problem gambling in the UK is at the very low end of this range. The latest figures show that it is “statistically stable at 0.3 percent.” alas, Lancet readers may never know because the editorial doesn’t mention it.
… efforts to address problem gambling have tended to focus on individual responsibility and ignore broader systemic policy changes. Why? In large part, this is because the gambling industry has adopted tactics used by other harmful industries, such as tobacco and alcohol, to avoid meaningful regulation.
What are these “tactics”? What is “meaningful regulation”? The editorial does not describe the problem, let alone acknowledge the trade-offs. He merely provides a series of clichés about the “gambling industry” and offers no solutions other than a salad of words like “broader systemic policy changes”. It does not include any solid policy proposals. The best he can do is demand “regulation” and “taxation” and rant about the “affordability, availability and geolocation of gambling products”.
What about casinos, for example, which are currently under-regulated? What about bingo? Dog racing? Fruit machines? Do you Lancet have a view on the government’s plan to introduce affordability checks? If taxation is the answer, what exactly is being taxed and how would it help? Do not expect any responses from the author Lancet Editorial because even though gambling is being rebranded as a “public health” issue, nobody in “public health” seems to know much about it, other than that it’s bad.
For decades, industry-funded research has hindered the production of independent and robust evidence on the harms of gambling.
This claim is central to the “public health” lobby’s zero-year approach to gambling. I have written earlier about how they are erasing the entire academic literature on pathological gambling so they can replace it with junk social science that supports prohibitionist policies. Put simply, the existing literature correctly sees problem gambling as a complex mental disorder (“gambling disorder”) best addressed by clinicians and reinforced by harm reduction policies. In contrast, the “public health” approach is to stigmatize gambling, demonize the gambling industry, and use tobacco-style regulations to discourage as many people as possible from gambling. The difference between the two approaches is that the former is evidence-based and works, while the latter is based on willful ignorance, creates negative unintended consequences, and fails.
Industry funding of charities dedicated to gambling education and treatment, such as GambleAvare, allows the gambling industry to control the narrative and portray the industry as a benefit to society.
For years we’ve been told that Britain is suffering from a growing epidemic of gambling addiction caused by a predatory industry that bombards us with advertising. Add in some dubious suicide statistics and the occasional mention of money laundering and that’s a “narrative.” The idea that the industry controlled that narrative is eccentric. The idea of doing it through a charity like GambleAware is messed up. GambleAvare runs a National Gambling Helpline that helps thousands of people every year. If the industry didn’t fund it, Lancet he would write furious editorials asking why not. She lobbied for stricter restrictions on advertising and a mandatory tax for gambling companies, which the industry does not want. The only way you could consider it a sinister front group pushing an industry-friendly agenda would be if you knew nothing about it and thought anything short of a ban was industry-friendly.
Although some groups are at greater risk of gambling disorders, such as young men from low-income and marginalized groups, the epidemiological landscape of gambling is changing, with more women and adolescents engaged in harmful gambling.
The rate of problem gambling among women did not change. Was 0.2 percent in 2010 and it was peaceful 0.2 percent in 2021. Among 11-16 year olds, the article it links to Lancet notes that there was a fourfold increase in problem gambling between 2016 and 2019. Such an incredibly large change often points to a methodological problem. Of course, the diagnostic test moved online in 2019. The rate was unchanged before and has been the same ever since. It is a statistical artifact rather than evidence of a real increase in prevalence (see page 14).
Additionally, the harmless gambling versus gambling disorder dichotomy propagated by the industry is overly simplistic, with research showing that so-called low- and moderate-risk gamblers may account for the majority of gambling-related harm.
This is another cut and paste from the temperance lobby who claim that there is more harm from alcohol among the large number of moderate drinkers than among the small number of heavy drinkers. Known as the “prevention paradox,” this theory appeals to the puritanical “public health” lobby because it gives them cover for drinking in all its forms rather than trying to deal with heavy drinking. It’s questionable whether the theory holds up when it comes to alcohol, but unless you’re using a ridiculously broad measure of “harm”, it certainly he can’t stand gambling.
The involvement of the gambling industry in co-creating and implementing solutions to the problems it has created is morally dubious and doomed to failure. Widespread advertising and marketing of gambling, especially in relation to sports, has replaced tobacco and alcohol advertising, which is more strictly regulated.
Gambling advertising has not replaced alcohol advertising and gambling advertising is more heavily regulated than alcohol advertising. For example, gambling advertising can only be broadcast after 21:00 except during sports. Alcohol advertising can be broadcast at any time. In any case, the rate of problem gambling has not increased since gambling advertising was legalized in 2007. On the contrary, it has decreased.
Health damage from gambling is not a matter of individual will and control, but the result of ruthless profit-driven tactics. This requires strong, broad-based regulation and legislation in response, based on approaches used to control tobacco and alcohol. An understanding of the commercial determinants of health provides frame for do so. Gambling must be treated as a harmful industry.
You have noticed that gambling has now ceased to be a commodity and has become an industry. In fact, it is an activity and it’s an activity that thrives regardless of whether there’s a legal industry to facilitate it, as any number of Chinese and American players could tell you. There may be policies that the government could usefully introduce to help the 0.3 percent of the population who have a gambling problem, but don’t expect to find them on the pages of The Lancet where juvenile howls of anti-capitalist rage take precedence over reasoned debate.
The “public health” lobby has had years to prepare for gambling to be squeezed uncomfortably under its purview. His supposed experts will soon be fed up a slush fund worth millions of pounds for “research” and yet remain woefully ignorant of the most basic facts. The best they can manage is to demand that the “approaches used to control tobacco and alcohol” somehow creep into this very different market (or rather markets, since gambling covers a wide range of activities). There is little recognition that the “health harms” of gambling are psychological rather than physical, and there is no understanding that the anti-tobacco policies they want to recreate, such as plain packaging, smoking bans and tax enforcement, simply do not transfer to gambling. Instead, they have an unwavering faith in their simplistic dogma and binary worldview — and that’s very much in clown country in Britain these days.
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