Gambling is the wagering of something of value, such as money, property or services, on an event with an uncertain outcome. People engage in gambling activities for a variety of reasons, including recreation, social interaction and entertainment. In addition, some individuals gamble to meet financial obligations or as a way to alleviate stress. However, gambling can also lead to serious harms that impact mental health and quality of life. These include financial problems, family and relationship breakdown, substance abuse and even suicide. The legacy of harm from gambling can last a lifetime.
Over time, the understanding of pathological gambling has undergone a significant shift. Traditionally, it has been viewed as a disorder characterized by impulsiveness and a disregard for social mores and customs. It has been classified as an impulse control disorder in the Diagnostic and Statistical Manual of Mental Disorders, which is published by the American Psychiatric Association. However, the validity of this disorder has been challenged.
The majority of research on gambling is based on the measurement of pathological gambling. Several instruments have been developed, ranging from a lifetime measure (the SOGS) to questionnaires with single-item measures. These have been used to investigate prevalence, incidence and characteristics of gambling disorders. The accuracy of these instruments is dependent on many factors, such as the underlying theory and conventional wisdom on the nature of pathological gambling. This means that as theories and beliefs change, so too do the instruments that are based on them.
An estimated 1.2% of the world’s adults are pathological gamblers, and the risk of becoming a problem gambler is high for those who have experienced trauma or loss in their lives (including separation, unemployment, injury or the death of a loved one). Harms from gambling also occur at levels well below the clinical threshold. They can include loss of job or income, poverty as a result of the diversion of household spending on gambling and reduced access to healthcare and education.
Despite the fact that gambling is legal in most countries, there are still concerns about how it is promoted. Heavy promotion of gambling products on TV, in sports and online increases the likelihood that people will gamble, and can encourage problem gambling by normalizing the behavior. In addition, VIP schemes – loyalty programs that reward gamblers by giving them extra money or free spins – are an important source of promotional activity. It is essential that these are not used to lure vulnerable people into gambling. The uptake of treatment for gambling disorder is low and stigma prevents people from seeking help. A more effective approach would be to develop a public awareness campaign to promote responsible gambling, and to provide education and support for people who have gambling problems. This would be in line with other public health campaigns such as smoking or drinking alcohol responsibly. This would also help to reduce the incidence of gambling harm, which currently costs the global economy US$ 700 billion a year.