http://www.phaa.net.au/policy/gambling.htm

<http://www.phaa.net.au/policy/gambling.htm>

GAMBLING AND HEALTH

The Public Health Association of Australia notes that:

1. Australia has a long history of gambling, and the highest per capita expenditure on gambling of all western nations.1

2. In recent years, there has been a rapid increase in the provision of commercial gambling venues throughout Australia, paralleled by an increasing reliance by state governments on revenue derived from gambling taxes. These increases have been particularly marked in where new facilities have been introduced. During the 1991/92 to 1995/96 fiscal years, Australian gambling expenditure (losses) have risen from $5.3 billion to $9.6 billion per fiscal year.2 A recent survey conducted by the Victorian Casino and Gaming Authority (VCGA) indicates that increasing numbers of residents are gambling, and that these gamblers are spending increasing proportions of their income on gambling.3

3. Australian gaming expenditure rose from 2.1% of household disposable income in 1991/92 to 3.1% in 1995/96.2 The proportion of Victorian gamblers who use money from their household budgets to finance their gambling has risen from 45% in 1995 to 53% in 1996 3 and a considerable proportion of gambling revenue currently derives from low income earners, such as “recipients of social benefits, public renters….. and the young”.4

4. Gambling is not necessarily unhealthy in that it may be undertaken responsibly and provides a leisure opportunity. For many people, it contributes to employment and government revenue.5

5. However, gambling can cause mental, social, legal, and physical health problems. About 1% of the adult Australian population experience a spectrum of mild to severe gambling problems, as defined by the South Oaks Gambling Screen,5 and these people contribute disproportionately to revenue accrued from gambling (about 25%, according to Dickerson et al’s Australian survey 6). Many gambling problems result from a desperate desire to recoup losses (“chasing losses”)1 and people with severe gambling problems suffer from a wide range of mental6 and physical health7 problems, including suicide attempts.1 Less is known about those who experience harms related to substantial intermittent gambling,8 because they are harder to trace, and generally do not seek counselling advice for problem gambling.

6. The effects of problem gambling are not confined to the individual. It has been estimated that one compulsive gambler affects on average 10-15 other people.9 The spouses and children of problem gamblers suffer emotional damage such as grief, stress, and the breakdown of family relationships, as well as financial damage such as loss of household income.1,10,11 The spouses of problem gamblers often report similar emotional and physical symptoms to those of the gambler.11 Problem gambling may also impact on the community, in terms of lost productivity, increased pressures on financial, legal, and social services, and criminal behaviour.1,5,8

7. The newer forms of gaming have added problems at a community economic level, diverting money from other commercial enterprises.12 For some defined and closed communities, commercial gaming has removed community monies which, traditionally, had been redistributed through other gambling activities.

8. A number of community leaders representing people of non-English speaking background have publicly expressed their concerns about the negative impacts of increased commercial gaming opportunities on individuals, families, and support organisations within their communities.13

9. Until recently, gambling has been a predominantly male-only activity in Australia. The Schilling Report (1994) on the introduction of electronic gaming machines in Victoria contained little discussion of gambling by women, or the likely social impacts of gambling, or problem gambling.4 Yet, these machines are attracting a new market of women problem gamblers, as evidenced by the high proportions of women (49%) who sought help from the Victorian Break Even Problem Gambling Counselling Services during 1995/96.14

10. There is increasing concern about underage gambling, as studies in the USA suggest that the prevalence of problem gambling among teenagers is over three times that of adults,15 and, in the UK, 50% of referrals to Gamblers Anonymous in the late 1980s were fruit machine gamblers, with about half of these being children and the other half young people in their late teens or early twenties.16 A recent survey of year 10 students in the north and western suburbs of Melbourne found that 2/3rds of those students had participated in gaming activities in Victoria, including using electronic gaming machines and going to the casino, while under the legal age for gaming.17

11. The State governments of Australia have contributed different levels of funding to service State-specific programs related to problem gambling. These have included one, more, or all of the following: counselling services, community education programs, and research programs investigating the social/economic impact of gambling.18 In general, there has been little community input on the decision-making processes for allocations from these funds. To date, there has been virtually no research conducted on the health effects of gambling on Australian communities, with the exception of two studies examining the associations between problem gambling, excessive alcohol consumption, and mental health.1,5

12. In December 1995, the Licensed Clubs Association of South Australia and the Australian Hotels Association (SA) released a “Guidelines for Responsible Service” aimed at educating licensees and gaming staff on their legal and ethical responsibilities under the Gaming Machines (SA) 1994 Act. In February 1997, the Victorian Gaming Industry introduced a formal, more extensive “Code of Conduct for the Responsible Service of Gaming”, pertaining to the use of gaming machines at hotels, clubs and the Crown Casino – to be reviewed after six months.

This has been viewed as a constructive step, although it has attracted a number of comments: 19  · Imprecise advertising codes of practice.  · Inadequate guidelines for age monitoring.  · Lack of an independent evaluation process.  · Is not a national code.  · Delay in release.  · Self-monitoring – no provisions for enforcement.  · Voluntary – some gaming venues may refuse to adopt the code.

The Public Health Association of Australia recognises that:

13. There are controversies over the definitions of “compulsive” or “pathological gambling” and “problem gambling”,9 which have implications for prevention. A broader definition would shift the focus away from the individual to a wider social context.

14. There are political, economic, and cultural obstacles to promoting responsible gambling, in that increased gambling facilities create more opportunities for problem gambling to occur. All state governments in Australia derive 10% or more of their taxation revenue from legalised gambling.1

The Public Health Association of Australia recommends that: 15. The PHA and other professional bodies adopt a public health model for problem gambling, which emphasises the general protection and promotion of well-being in the community, and includes the central premise of harm reduction. This model would take into account the interaction of the individual, gaming opportunity, gaming environment and the community. Harm reduction allows for a range of interventions to be developed along a continuum of gambling activity and behaviours.20

16 The government plays a lead role in ensuring that responsible gaming practices are adopted by gaming venues, and that the effectiveness of these practices are monitored by independent bodies.

17. The PHA and other professional bodies develop a common definition of “problem gambling” such as ” ‘Problem gambling’ refers to the situation when a person’s gambling activity gives rise to harm to the individual player, and/or his or her family, and may extend into the community” 21 which takes into account communities, gender-specific issues, and a culturally diverse perspective on gambling.

18. The Australian Institute for Gambling Research, in conjunction with the Australian Institute for Health and Welfare, develops a comprehensive set of psychosocial, health and economic indicators, so that the real effects of gambling on individuals and communities may be monitored continuously. 19. Programs designed to minimise the harms associated with gambling are planned within an evaluation framework so that the appropriate data to measure the intended objectives can be collected from the beginning.

20. Given that the impacts of problem gambling are not static, and vary according to the susceptibility of the community to gambling, the availability of various forms of gambling, and the introduction of members of the community to these forms of gambling, regular surveys should be conducted under the advice and supervision of independent bodies such as the Australian Institute for Gambling Research to determine the incidence of problem gambling in the community. Special reference should be made to newly vulnerable groups, such as women, young people, non-english speaking people, Aboriginal people, and the intellectually and psychiatrically disabled. These studies should take into account the different patterns of gambling (intermittent, regular and habitual).

Research be initiated immediately through the auspices of the ARC and the NHMRC to explore the impact of increased gaming opportunities on the overall health of families and communities.

22. The various community support funds derived from gaming revenue:  · Commit 20% per annum of their funds to address the outcomes of problem gambling.  · Provide support to welfare and church organizations to meet demands placed on their services due to problem gambling.  · Have their funds disbursed by a Board of Management which includes community representatives.  · Continue to fund health and social research independent of government and gaming interest groups, and regularly communicate the results of this research to the public.

23. Collaborate with other professional bodies in promoting the principles of harm minimization to reduce the social and economic costs associated with commercial gaming. 24. Lobby for funding to be allocated specifically for the purposes of health research related to the impact of gaming. 25. Lobby Government and gaming interests to develop a mutually agreed code of conduct for all gaming venues in Australia. 26. Oppose further increases in gaming outlets or the installation of further electronic gaming machines until the extent of the harms generated from current gaming practices has been established.

References:

1. Dickerson M, Baxter P, Boreham P, Harley W, Williams J. Report of the First Year of the Study into the Social Impact of the Introduction of Gaming Machines to Queensland Clubs and Hotels, The State of Queensland (Department of Families, Youth and Community Care), 1995. 2. Australian Gambling Statistics 1972-73 to 1995-96, Tasmanian Gaming Commission 1997. 3. Maddern C & Golledge S (for Market Solutions P/L) Fourth Survey of Community Gambling Patterns, Victorian Casino and Gaming Authority, January 1997. 4. Review of Electronic Gaming Machines in Victoria: Schilling Report, vol 1 & 2, 1994. 5. Dickerson M, Alcock C, Blaszczynski A, Nicholls B, Williams J, Maddern R Study 2. An Examination of the Socio-economic Effects of Gambling on Individuals, Families and the Community, including Research into the Costs of Problem Gambling in New South Wales. Australian Institute of Gambling Research, University of Western Sydney, Macarthur, 1996. 6. Dickerson M, Baron E, Hong S-M, Cottrell D. Estimating the Extent and Degree of Gambling Related Problems in the Australian Population: a National Survey”. University of Western Sydney, 1994. 7. Ladouceur R, Boisvert J-M, Pepin M, Loranger M, and Sylvain C. Social costs of pathological gambling. Journal of Gambling Studies 10 (4) 1994. 8. Walker M and Dickerson M. The prevalence of problem and pathological gambling: a critical analysis. Journal of Gambling Studies 12 (2) 1996. 9. Dickerson M. Compulsive Gamblers. Longman, 1984, p.3. 10. Jacobs DF. Illegal and undocumented: A review of teenage gambling and the plight of children of problem gamblers in America. Compulsive Gambling – Theory Research and Practice, Ed. Shaffer HJ, Stein SA, Gambino B, Cummings TN, Lexington Books, 1989. 11. Lorenz V, Yaffee R. Pathological gambling: psychosomatic, emotional and marital difficulties as reported by the gambler. Journal of Gambling Behaviour 2(1) 1986. 12. Ewing T. Life’s a gamble in a town like Moe. Place Your Bets: Gambling in Victoria, Ed. Cathcart M and Darien-Smith K, The Australian Centre, University of Melbourne. 13. Nguyen P. The psychological impacts of gambling and the Casino on the Vietnamese community and families in Melbourne. Chong R. Lose our shirt and our cultural values. PHA Seminar: Gambling With Our Health? University of Melbourne, 22nd February, 1997. 14. Jackson AC, Thomason N, Ryan V. Client & Service Analysis Report No. 1. Analysis of Clients Presenting to Problem Gambling Services from July 1, 1995 to June 30, 1996. Office of the Family, Department of Human Services, Victoria, March 1997. 15. Haubrich-Casperson J, Van Nispen D. Coping with Teen Gambling, Rosen, 1993, p33. 16. Griffiths M. Factors in problem adolescent fruit machine gambling: results of a small postal survey. Journal of Gambling Studies 9: 101-120, 1993. 17. Hebron, H. Adolescent Gambling: A Justification of the Gambling Education Programs Targeting Minors. Thesis, Faculty of Education, University of Melbourne. 18. Volberg RA, Dickerson MG, Ladoucer R, Abbott MW. Prevalence studies and the development of services for problem gamblers and their families. Journal of Gambling Studies 12 (2) 1996. 19. Wootton R. The Gaming Machine Industry’s Code of Practice for the responsible service of gaming. PHA Seminar: Gambling With Our Health? University of Melbourne, 22nd February, 1997. 20. Mellor N, Wootton R. Gaming industry reforms: Harm minimization and problem gambling. Annual Conference: National Association for Gambling Studies, Fremantle, 1995. 21. Dickerson M, McMillen J, Hallebone E, Volberg R, Woolley R. Definition and Incidence of Problem Gambling, Including the Socio-Economic Distribution of Problem gamblers. Victorian Casino and Gaming Authority, Victoria. August 1997.

Adopted at the 1997 Annual General Meeting of the Public Health Association of Australia