Despite the hot weather of late, I seem to spend an awful lot of time watching television. Perhaps, extended walks in the sunshine are tiring me into such a vegetable state that the only energy I can muster up is changing channels. Anyway, I was watching 'Neighbours' sponsored by Ladbrookes when it struck me that there has been a huge surge in advertising for gambling. Every ad break is filled with rejected housewives resorting to online bingo, winning and celebrating with tonnes of imaginary friends. Late at night, channels convert to poker games and even lunchtimes are filled with images of cyber card games where you can be whoever you want to be. Sure there is a tiny warning of www.gambleaware.co.uk in the corner but there is a certain uneasiness about this sudden rise in a time of recession. Not least because it is tinged with deja vu. Twenty years ago, the television was filled with persuasive marketing of junk food. We now have a massive obesity problem in the UK. Is gambling the next great health issue?
For many, the odd flutter at the slot machines is not considered to be of any harm. However, a casual gambler can soon become an obsessive one. Gambling is an addiction. And like alcohol dependency and drug misuse, gambling causes health and social problems. Gamblers drink more, smoke more heavily, eat unhealthily and exercise infrequently. Gambling leads to a neglect of family duties, domestic violence, marital breakup, absenteeism from work, bankruptcy and crime. Gamblers are prone to depression, anxiety, insomnia and suffer stress related disorders like migraines. Suicide rates are also on the increase amongst those who gamble regularly.
As of now, there is a lack of information on the prevalence of problem gambling in the UK. However, there have been reports of increased betting activities amongst the poor and the unemployed since the recession started in late 2008. There is evidence to show that gambling is more likely to occur amongst those who can least afford it. The low socio-economic groups spend a higher percentage of their disposable income on gambling than do the middle or high income earners. As George Bernard Shaw said, "Gambling promises the poor what property performs for the rich - something for nothing." Studies have also found that elderly people who are socially isolated are more prone to becoming problem gamblers and that the teenagers are particularly vulnerable. Their vulnerability is related to risk-taking behaviour that is the norm for this age group. In fact, the earlier the age of initiation into gambling, the higher the risk of pathological gambling.
So what can public health do? Already some public health folk have been tackling the issue of gambling. I know of a public health team who were able to stop the erection of a casino in the north of England. The team gathered the scientific evidence and population based observations and weighed up the costs and benefits of a casino. The casino had been paraded by property developers as a way to introduce jobs into the area. Public health and their partners successfully showed how the casino would actually have a negative effect on the local community, causing local businesses to close and the enticement of people to gamble in the casino would also result in the reduction of these people's work productivity and subsequent job loss. Elsewhere in the world, gambling has become 'medicalised', deemed a chronic condition. In Singapore, GPs are encouraged to ask about gambling behaviours with the view that early intervention can be beneficial. Across the ocean, Australian patients presenting at A&E with drug or alcohol dependency are screened by addiction nurses for gambling behaviours. It is early days for gambling and public health. We need more data, more statistics. We need research on what works in reducing problem gambling in a population. It is an important health issue and one that warrants immediate attention.