Gambling and the Definition of Harm

Gambling is the wagering of something of value on an event with a random outcome, and an intention to win something of value (money or other goods). This includes betting on games of chance such as slot machines, roulette, poker, and blackjack, as well as sports events and horse races. It can also include games with a skill element, such as marbles, pogs, or Magic: The Gathering, where the player wagers collectable game pieces instead of money.

Problem gambling is defined as a persistent preoccupation with, or escalation of, risky gambling behaviour, resulting in a negative impact on the gambler’s life. It can be a significant cause of detriment to the health and wellbeing of individuals, families, communities, and even entire populations. Problem gambling can also result in serious legal consequences and is associated with a number of other mental health problems, including unmanaged depression, anxiety, and stress.

A common feature of gambling is that the player’s illusory perception of control is reinforced through a series of algorithms that optimise the payout frequency to maximise reward for the minimum input, and to distract from the probability of winning or losing. This is known as the ‘Gambler’s fallacy’.

There is a long history of people making a living, both dishonestly and honestly, from gambling. Some societies have banned it, either out of morality or to prevent gambling from interfering with public order. The concept of harm minimisation is becoming increasingly accepted as a key objective in both the development and delivery of gambling policy. However, the definition of harm remains a key issue and there are many different opinions on what it should mean.

The aim of the current article is to provide a clearer and more consistent interpretation of the term, which will be useful for treatment providers, researchers, and policy makers. It builds on the work of other groups, including those that have developed a framework and taxonomy for understanding harm. It moves away from pathogenic approaches that view harm as a result of participation in gambling and allows for the influence of comorbidities to be considered.

The framework and taxonomy we propose will also help to create a shared language around gambling related harm. This will allow for better communication across the sector and more consistent measurement of harm. It will also allow for consideration of a broad range of harms that are presently overlooked, such as harms to family members, friends and other supporters, who may not have direct involvement in the gambling behaviour. It will also allow for the inclusion of legacy harms, which are those that persist even when a person’s engagement with gambling has ended. It is important to recognise that these harms are not caused by the gambling activity itself but by a variety of interacting social and environmental factors. This approach is consistent with other public health approaches to the prevention and management of a wide range of behavioural risky behaviours.