A losing bet? Alcohol and gambling - investigating parallels and shared solutions

Note: This report was jointly published by our predecessor organisation Alcohol Concern Cymru and the Royal College of Psychiatrists in Wales.

The majority of people drink alcohol or gamble at some point in their lives, and report doing so in the previous year. Problematic gambling and misuse of alcohol can both be regarded as significant health problems, and with adverse consequences to society.

There are various shared features of alcohol use and gambling. In particular, the Licensing Act 2003 and the Gambling Act 2005 facilitated a relaxation in the rules governing alcohol and gambling. The former abolished set licensing hours in England and Wales and removed authorities’ previous discretion to assess licensing applications based around the issue of ‘need’; the latter similarly stipulated that unmet demand would no longer be a criterion for licensing authorities, and permitted casinos, bookmakers and online betting sites to advertise their services on TV and radio in the UK for the first time.

In recent years, the stigma attached to women’s drinking has faded, driven by and resulting in an abundance of marketing specifically targeting women and the emergence of a ‘ladette’ drinking culture in the 1990s. Gambling, which has traditionally been a male domain, may be undergoing a similar change, with latest figures showing over half of women admitting they had gambled at least once (excluding the National Lottery) in the past year, coupled with a noticeable rise in female-targeted gambling marketing.

There is increasingly strong evidence of an association between problematic gambling and heavy drinking. Whilst further research is needed in this area, prevalence of gambling and problem gambling has been shown to be higher amongst clients of substance misuse services. Recent research highlights similarities between pathological gambling and addiction. The latest US psychiatric classification system (DSM-V) is being worked upon, with consideration being made to classifying pathological gambling as ‘Addiction’ rather than under the previous heading of ‘Impulse Control Disorders’.

As the alcohol and gambling industries expand, investing in increasingly sophisticated marketing and technology, the ‘normalisation’ of alcohol consumption and gambling participation is likely to continue at a steady pace and, without the necessary restrictions, there is a real danger that this will be matched in future with more people suffering alcohol and gambling addictions. Much academic work has been undertaken relating to alcohol misuse, in terms of the most effective approaches to lowering overall alcohol consumption and reducing alcohol-related harm. Many of these approaches may have applicability to the gambling field, including restricting the availability of gambling opportunities, curtailing marketing, protecting children and young people from harm, and ensuring help and treatment is accessible to everyone who needs it.

This joint report makes the following recommendations:

Further research is needed into the effects of curtailing gambling opportunities. Evidence from the alcohol field shows how reducing availability can regulate consumption and reduce alcohol-related harm. The same is likely to be true of gambling. Particular attention must be paid to technological advancements, namely the emergence of gambling via the internet, interactive television and mobile phone.

Greater protection must be afforded to children and young people, who are at particular risk of harm from potentially addictive products. Recommendations from the alcohol field, such as the implementation of more effective marketing restrictions, should be adopted. The Gambling Commission should continue to monitor the ability of children to access gambling premises through regular testpurchasing.

Everyone for whom alcohol has become a problem should have suitable access to treatment and support. Whilst it is true that fewer people participate in, and suffer from, gambling than compared to alcohol, for those that do suffer with gambling problems, it is essential that access to appropriate advice and treatment is available and well-funded.

Screening for gambling problems, amongst people attending substance misuse treatment services, should be routine. More research is needed to assess the impacts of integrating treatment of gambling problems alongside treatment of alcohol problems.

More awareness-raising about problematic gambling is needed amongst public health practitioners, and the general public, in the wider context of addiction and its dangers.

A national database is needed to capture the scope of problems associated with gambling and which should feed into national strategies for managing addictions (with recognition of behavioural addictions in addition to chemical addictions). This will help in raising awareness of the issue, and ensure that it is addressed in local service planning and that resources are made available to tackle this growing problem.

There is a need for more research in England and Wales into how best to identify problematic gambling and new treatments that can be used for tackling this issue.

Government policy for gambling in England and Wales currently rests with the Department for Culture, Media and Sport. Given the serious implications of problem gambling to public health, consideration should be given to a greater role for the Department of Health in gambling policy.