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Background: Attempts to address gambling-related harms have evolved rubrics to foster responsible gambling and informed choice. Those efforts have largely focused on apportioning the relative responsibility placed on government, industry, and individuals for reducing excessive gambling that leads to adverse consequences. Empirical evaluations of responsible gambling measures, together with proposed frameworks that set out guidelines for accountability, have met with mixed results and criticism from divergent groups of stakeholders. Aim: While harm reduction remains a worthy goal, this position paper argues against maintaining a stringent focus on the government-industry-individual triumvirate in favor of adopting a syndemic approach to gambling-related harms. Approach: A syndemic perspective suggests that gambling disorder intersects, coexists, precedes or follows other comorbid conditions and interacts with social and environmental factors that promote and enhance the negative consequences of gambling problems. This paper discussions potential syndemic stakeholders and challenges in the implementation of this approach. Conclusions: Initiatives to reduce gambling-related harm should adopt a broader perspective, involving stakeholders from diverse syndemic problem areas in developing a network to identify and address gambling problems in early stages of development across multiple settings.
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Nower et al. (2018) studied this question.
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