Governments as Promoters of Dangerous Consumptions

Adams, Raeburn de Silva [1] describe the way in which the independence of governments can be threatened as a result of their support for gambling operators and the benefits they accrue from gambling as a result of taxation. In his book Gambling, Freedom and Democracy, Adams [2] has extended that argument by describing the conflicts of interest faced by universities, researchers, charitable organizations and others who become dependent on funds from gambling companies or who otherwise get close to them. The way in which national, state or local governments can become ‘addicted’ to gambling in that manner has been described before [3,4], but the Auckland group has taken a lead in addressing this issue, and New Zealand appears to be well ahead in developing a public health approach that involves raising awareness about the powerful processes at work and the ways in which those who should be protecting citizens from harm can become complicit in the production of that harm and shackled when it comes to acting effectively to prevent it. Readers of Addiction will be familiar with the same argument in the context of government and the alcoholic drinks industry (e.g. [5]). It can be argued, however, that the problem of collusion with the purveyors of dangerous consumptions, and the conflicts of interest and restraints on action that result, are rather worse in the case of gambling. There are at least the following two reasons for thinking that might be so. The first is the phenomenal growth of gambling in New Zealand, the United Kingdom and many other countries that has taken place in the last two decades, accompanied by new legislation removing many of the controls on gambling that existed previously. The passing into history of a view of gambling as inherently immoral or undermining of national morale, along with the embracing by governments of an international free market philosophy, plus the inventiveness and assertive lobbying by gambling promoters, has produced a revolution in gambling availability which had little to do with consumer demand [6]. Something similar has occurred in the case of alcoholic drinks, but the change has not been so dramatic. The second factor that characterizes gambling particularly is the ambivalence and confusion that may still prevail, probably among health professionals as much as among members of the lay public, about the dangerousness of gambling and the need to support services for the treatment of problem gambling and campaigns for its prevention. This is not likely to be due to public innocence about the potential dangers of gambling for gamblers and their families. The addiction potential of gambling has been well known since at least the early 18th century [7]. In the second British Gambling Prevalence Survey, 65% agreed with the statement ‘Gambling is like a drug’, with only 10% disagreeing [8]. The problem, rather, is that harms associated with gambling, other than perhaps insider crimes such as fraud, match-fixing and money laundering, have for the past two or three generations been only at the margins of public consciousness and not something for which any statutory bodies or services have taken much responsibility. Symptomatic in Britain has been uncertainty about where in government the responsibility lies. The Home Office, with its interest in the prevention of crime, had been the lead department throughout most of the 20th century and had overseen the evolution of policy from one characterized mainly by prohibition to one of tight regulation [6]. In the run-up to the liberalizing 2005 Gambling Act the lead was passed, with little public debate, to the Department for Culture, Media and Sport (DCMS). That department's predecessor was the Department for National Heritage created, among other things, to promote the National Lottery and dubbed by its first Secretary of State as the ‘Ministry of Fun’[5]. Meanwhile, the Department of Health has taken no interest in the subject whatsoever. Meanwhile, the Treasury is reaping substantial rewards from gambling. The conflict of interest is compounded by the fact that, like many other national governments, the British Government has set itself up as a direct promoter of gambling in the form of the National Lottery. That has compromised the government's position by making it the more difficult to resist the demands of other sectors of the gambling industry for lifting of former restraints. Governments that promote gambling themselves inevitably find it more difficult, in an age of global markets, to argue for maintaining national barriers against cross-border gambling trade—a particular issue in a free market trading area such as the European Union, the rules of which make it illegal to prevent such trade except under special circumstances [9]. In general, governments find themselves in an awkward position regarding the promotion of gambling, wishing to promote it while reducing the problems associated with it. They want to have their cake and eat it. Indeed, the Gambling Commission, now the British regulator of all gambling except the National Lottery and spread betting, is charged explicitly with facilitating the promotion of gambling while regulating it to keep crime out, to ensure that gambling is conducted fairly and openly, and to protect children and other vulnerable people from being harmed or exploited. That flies in the face of a public health model which suggests that increased engagement in a dangerous activity will lead to a higher prevalence of harm. It can only be squared with a view that supposes that gambling is essentially harmless, the only exceptions being the irresponsible gambling patterns of a tiny minority characterized by special personal vulnerability. It also sits most easily with an approach to prevention which privileges education—a weak form of prevention—rather than a legislative or fiscal approach which makes the activity less available or affordable [10]. Part of Adams et al.'s paper that I found of particular interest was the section on mobilizing communities to be vigilant about gambling in their areas. Most of the research to date on the concentration of gambling outlets in different localities has come from Australia (e.g. [11]), and it seems that New Zealand is well ahead in thinking of gambling as something that is of concern, not only to individuals, their families and any treatment providers who may be called upon to respond to their problems, but also to the communities in which people live. This is a refreshing approach and not one, sadly, with which we have much familiarity in Britain. The community perspective has, in fact, been led by gambling promoters and local politicians who argue that gambling facilities are good for regeneration, and local residents have, on the whole, been silent. I have seen draft regulations produced by the DCMS and the Gambling Commission, following the 2005 Gambling Act in Britain, and a general criticism of mine is that they lean in the direction of facilitating the setting-up of a gambling outlet and making it difficult for local communities to object—for example, by allowing relatively little time for objections to be made so that potential operators will not be inconvenienced. None.