INDUSTRY PLAYBOOK A 2021 Public Health England report found that people with gambling issues were‘ at least’ twice as likely to die as a result of suicide than the general population, although other studies have estimated the risk to be higher. As the University of Bristol study points out, however, that report’ s conclusions were then‘ strongly contested by the gambling industry, who argued, for example, that the report inappropriately inferred population-based harm from
Gambling is something that’ s become infinitely more accessible in recent years... Online gambling and smartphones have changed everything.
the most at-risk cohort’ – much the same playbook as that used by the alcohol industry. As Professor Heather Wardle of the University of Glasgow told DDN last year,‘ It’ s the common theme of corporate practice that runs throughout gambling, alcohol, tobacco – that there’ s this small percentage of people who are disordered or don’ t use the products properly, and if you just deal with them everybody else will be fine’( DDN, December 2024- January 2025, page 11).
But it’ s not just the industry that’ s hampering the ability to see the full picture. A disturbing study from earlier this year concluded that the families of people who’ d taken their own lives as a result of gamblingrelated harm were being‘ routinely denied’ inquests that properly took into account the role that gambling problems had played in the deaths( DDN, February, page 5). Even when the families had gone to‘ considerable lengths’ to submit detailed evidence of gambling harm to the coroner it was frequently ignored, the report said – meaning that opportunities to inform debate and prevent further tragedies were clearly being missed.
And gambling is something that’ s become infinitely more accessible in recent years. Whereas in the past much of it was centred around physical environments like betting shops – off limits to children and unwelcoming to women – online gambling and smartphones have changed everything, with a 2024 Lancet Public Health study concluding that governments and regulators were failing to appreciate the impact of this shift to digitalisation( DDN, November 2024, page 5). And although children are technically prohibited from accessing gambling sites, many people argue that the lines between gaming and gambling are becoming increasingly blurred – with features like‘ loot boxes’ helping to normalise gambling behaviours at a young age. Gambling marketing and sponsorship is also now ubiquitous online, with a recent GambleAware report finding that almost 90 per cent of 13-17-year-olds had been exposed to online gambling content – often via celebrities or social media influencers.
ONLINE PROLIFERATION As the people in the University of Bristol’ s study were growing up before this online proliferation of gambling sites, gambling ads and gambling sponsorship, are the issues highlighted likely to become even more of a problem in the coming years?‘ I think the increased accessibility of gambling – particularly via online sites – presents a very real future problem,’ says Bastiani.‘ Gambling is accessible at any moment via a phone, and unlike with other harmful products such as smoking, gambling advertising is still prolific. In terms of loot boxes, we’ re seeing a large number of games supplying gambling-like features which often have real monetary equivalents’ – these are especially
Oliver Bastiani is a PhD researcher at the University of Bristol’ s School of Psychological Science and lead author of The relationship between Problem Gambling Severity Index scores and suicidality.
‘ This study tracked people from birth, meaning we could look at the longterm impacts of problem gambling, and could rule out alternative explanations that hinder previous studies, such as that people might be drawn to problem gambling as a way of escaping pre-existing suicidal feelings...‘ I hope the starkness of this evidence contributes to a shift in the status quo, where we recognise gambling as the harmful activity it is – similar to discovering the link between smoking and cancer.’
The relationship between Problem Gambling Severity Index scores and suicidality: results of a 9-year cohort study of young United Kingdom adults, published in the journal Addiction at https:// onlinelibrary. wiley. com / doi / 10.1111 / add. 70156? af = R
worrying as they rarely have age restrictions, he adds.
The 2023 gambling white paper drew a lot of criticism for failing to do enough to tighten up restrictions around advertising and sponsorship – should the government be doing more?‘ More action could definitely be taken to limit engagement,’ he says.‘ While online slot spending limits have recently been reduced to £ 2 for adults aged 18-24 and £ 5 for people aged 25-plus, I think this fails to account for the real accessibility of these online sites.‘ Online slots allow quicker gambling than physical machines – even with these limits a person could lose hundreds of pounds very quickly, so I think limits for online slots should be much lower, and more action should be taken to reduce their appeal.’ When it comes to advertising, the white paper’ s aim to remove gambling ads on the front of football shirts‘ feels a bit token when these front-of-shirt advertisements only account for around 7 per cent of the gambling advertising in the Premier League’, he adds.
HARM REDUCTION As the industry tends to frame any harm reduction initiatives – such as maximum stakes – as‘ taking the“ fun” away from the many for the sake of a few“ problem” gamblers, I think it’ s really important to recognise that these harms are widespread throughout the gambling population’ he states –‘ as our, and many other studies, now show. So I think more advice and support will always benefit people, especially when it can be accessed by the entire population of people at risk of gambling harms – not just“ problem gamblers”.’
So with even the government’ s suicide prevention strategy explicitly mentioning gambling as a risk factor, how credible is the industry line that the problem only exists with a small proportion of people who misuse their products?‘ Everyone who gambles is at some risk of gambling-related harms,’ he says.‘ It’ s inherently addictive, and as our study shows, people may experience some very serious harms even if they don’ t reach this“ problem gambling” threshold. And behind the gamblers themselves there are families and friends, which extends the harmful effects. Ultimately, if gambling can lead to suicide, then any proportion of harms has a dire gravity – and more should be done save people’ s lives.’ DDN
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