Gambling and Public Health


Gambling involves risking something of value on an event that is determined at least in part by chance, with the intention of winning something else of value. It is most commonly seen in the form of placing a bet, with an object having monetary value such as money, a car, or a holiday as the prize. However, gambling can also be conducted with non-monetary objects such as marbles or collectable items like Pogs and Magic: The Gathering cards. Alternatively, gambling may occur through activities such as buying lottery tickets or office pool betting.

While most people have gambled at some point in their lives, for some, this can result in significant harms to their physical and mental health, relationships, work or study performance, and personal and family finances. This can lead to homelessness, serious debt and even suicide. It can also have a negative impact on the wellbeing of their children, friends and community. For many, gambling is a way to escape the day to day and enter a ‘zone’ where they can disconnect from their worries. This is often the case when people engage in activities such as playing slot machines and scratchcards.

There is an international recognition that the current landscape around gambling does not adequately address its harmful consequences. Rather than focusing on problem gambling disorder, which only includes those with a diagnosis of a specific problem, a wider and more inclusive framework is needed to better understand the impacts of gambling. This is particularly important when considering that the harms of gambling extend beyond those who gamble to affect their families, communities and society as a whole.

Harmful gambling is widely recognised as a public health issue and requires a multidisciplinary approach encompassing research, policy and practice. A key first step is developing a functional definition of gambling related harm, which can be operationalised to support measurement consistent with standard epidemiological protocols used in public health. This paper proposes such a definition and links it to an existing theory to create a conceptual framework that defines harm as a consequence or outcome, separate from gambling behaviour or clinical diagnosis and aligned with social models of health.

The framework identifies six different thematic classifications of harm that can occur in parallel or sequentially and are experienced by a person who gambles, their affected others and their communities. A seventh category of legacy harm was added to recognise that some harms endure after engagement in gambling has ceased or is reduced. This is a more inclusive framework than those currently in use, and one that can be applied to a range of contexts, including those involving culturally significant practices of indigenous and CALD groups. It is also relevant to other risky activities that are gaining in popularity, such as tobacco smoking, illegal drugs and excessive alcohol consumption. This is a valuable addition to the evidence base and can help guide future research into the harms of gambling.