During my first visit to England 20 years ago much was familiar and as expected. But there were surprises. In Brighton I walked past large numbers of adults sitting at the seaside in overcoats amidst rain and wind. Taking shelter I was even more perplexed to be surrounded by children of varying ages engrossed in gaming machine play. Returning to London I noticed that the hotel where I had resided for the past week was adjacent to a casino. However had I ventured in, I discovered later, I would have been ejected. Back home in New Zealand we didn’t have casinos, gaming machines were not legal and we went to the seaside when it was warm and sunny. Since then things have changed a lot on the gambling front—in Britain, New Zealand and many other parts of the world. Shortly, perhaps particularly in Britain, they will change a great deal more. Relative to other jurisdictions, throughout much of the twentieth century Britain has been liberal. However, liberalism (as indicated by Dixon (1991) and quoted by Orford 2005) was balanced by ‘unstimulated demand’. While many ‘hard’ forms of gambling were allowed, they were not actively promoted. During the past 15 years gambling has been a major growth industry globally. This has been particularly so with electronic gaming machines and casinos, following an earlier phase of lottery expansion. Britain and most other parts of Europe have been somewhat left behind and are viewed as under-exploited markets. It has been argued that the evolution of commercial gambling is driven by a variety of deep-seated, interrelated factors, played out on the world stage (Abbott & Volberg 1999). While consumer choice is frequently cited as a reason for further liberalisation, Eadington (2004) maintains that gambling is usually not legalised for the benefit of consumers ‘but for the economic rents that can be captured by specific interests, especially governments’. Rapid gambling expansion has been accompanied by rising concern about problem gambling, as well as by research on this topic and specialist service provision for problem gamblers. In some jurisdictions this in turn has led to significant tightening of regulations, reductions in the number of gaming machines and the mandating of comprehensive prevention and treatment services. Recent examples include New Zealand, Nova Scotia and some Australian states. I have followed the British gambling review with interest. At the outset of the Gambling Review Body's deliberations the Chairman, Sir Alan Budd, circulated a note to members headed ‘The Chairman's dream.’ It read: I hope we shall be able to establish principles . . . acceptable to all sensible people and shall make proposals consistent with those principles. The (unanimous) Report will then be published (to schedule) to widespread acclaim and all its recommendations will be accepted. (Gambling Review Body 2001, Chairman's Introduction) Wither Sir Alan's modest dream? The report was unanimous and published to schedule. It established principles and made proposals. Whether they are ‘acceptable to all sensible people’ depends on the definition of ‘sensible’. Professor Orford, for one, does not agree with them, particularly the view that benefits outweigh the costs of significantly increasing gambling availability. He is not alone. Public and political debate around the report and ensuing legislation has been volatile. While public opinion was divided, the government did accept most of the recommendations. With a notable exception concerning the introduction of new casinos, they have now passed into law A major thrust of Orford's article, echoing Room (2004) on alcohol, is that the government is unduly influenced by industry and is disingenuous in introducing legislation that will increase gambling problems while claiming to provide protection for children and vulnerable people. Among other things he also asserts that the Abbott et al. ‘government commissioned’ (2004a, 2004b) report recommends future research projects that are predominantly predicated on the assumption that problem gamblers are to blame for their problems. There is at least a hint that the list is industry tainted. I do not believe these views are grounded in fact. Almost all of the 37 recommended projects have now been approved. Given the diminutive British academic gambling community mentioned by Orford, it would be unfortunate if this deterred its members from participating. Apart from the foregoing objection, I broadly agree with much of what Orford has to say. One could quibble over detail or point to scanty supportive documentation in places and black and white portrayals when reality is in many shades of grey. However, the article serves its purpose as a catalyst for debate. Further comment is confined to the question of whether or not increased gambling liberalisation in the UK will result in an increase in the prevalence of problem gambling and some of Orford's comments about the Abbott et al. (2004a, 2004b) report. While the UK adult prevalence estimate of 0.7% is marginally higher than Sweden's (Volberg et al. 2001) and not insignificant, it is substantially lower than rates from many North American and Australian jurisdictions. Based on current international research it is likely that the UK prevalence of problem gambling will increase in the short to medium term, possibly 3- to 4-fold. This would have substantial flow-on costs to families, communities and wider society. It is also probable that current gender, age, socio-economic and ethnic differences will diminish as gambling and problem gambling spread throughout the population (Abbott et al. 2004b, 2004c). Most things that go up usually come down. This is also true in epidemiology. Abbott et al. (2004b) cite research strongly suggesting that problem gambling prevalence will eventually level out and decline, even if accessibility continues to increase. Greater public awareness, expanding services for problem gamblers and regulatory, industry and public health measures are among the likely contributors. What is not known is how quickly these and other factors can have a significant impact and whether or not they could prevent problem escalation if introduced in the UK concurrently with increased access to ‘hard’ gambling. Gambling and gambling research are politically charged. Research findings sometimes challenge strong vested interests. Researchers are often accused of being either pro- or anti-gambling and biased, irrespective of the reality of the situation. Some of us have been subject to vitriolic attack from both the gambling industry and problem gambling service providers. While acknowledging human proclivity for self-deception, I believe I do my best to say it as I see it and to hell with the consequences. The following is from Abbott et al. (2004b; p. 53) ‘Historically, gambling industry reactions to problem gambling prevalence research appear to have been typically dismissive. Efforts have been made to publicly discredit studies and argue that methodological deficiencies artificially inflate prevalence estimates. The usual stance is that pathological gambling is a rare mental disorder that is predominantly physically and/or psychologically determined. Whilst acknowledging that gambling plays some part, it is maintained that if those people did not become pathological gamblers they would manifest some other, possibly more disabling, mental disorder. Emphasis has been placed on research that investigates risk factors in the host rather than in the agent or environment.’ There is more in the full 299 page report (Abbott et al. 2004b) along these lines and major sections review literature on the role of gambling in the development of gambling problems and other adverse outcomes. It does not focus on or blame individuals. The report and its recommendations are organised within an explicit public health framework. While placing strong emphasis on the agent, gambling, it also examines the role of the wider environment in which gambling occurs and the ‘host’. As with other public health issues, comprehensive understanding requires full consideration of agent, environment and host, and interactions between them. Rather than reinforcing individual pathology, we expected that examining problem gambling this way would help position it as a public health issue in the UK. The most expensive recommendation is for the implementation and evaluation of a public awareness campaign. There is provision for sociological studies and researcher-initiated applications. The importance of independent peer-review is also stressed. Perhaps someone will incorporate a trip to Brighton or its present-day equivalent? Hopefully on a fine day. Funding was obtained from the Responsibility in Gambling Trust to prepare Abbott et al. (2004a)A review of Research of Aspects of Problem Gambling.
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Max Abbott (2005) studied this question.
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