Gambling involves an activity whereby two or more people bet money on an event or outcome that is uncertain in terms of probability. It can be as simple as a bet on a sporting or racing event or as complex as a game of poker or roulette.
Gambling is often regarded as a recreational behaviour that can be enjoyed by most people. However, for those who become addicted to gambling this can be a serious problem that interferes with their work and social lives.
There are many forms of gambling including casinos, horse racing, lotteries, and online gaming. There are also a range of different types of problems related to gambling.
Harm minimisation is the concept that there should be as little harm to people from participating in gambling as possible. It is a concept that has been used in public health approaches to prevention and treatment of problem gambling, but is somewhat ambiguous due to the lack of a consistent definition, conceptualisation of the breadth and experience of harms, and an appropriate means of measuring harm.
Identifying gambling related harm is the key for effective prevention and treatment of gambling problems. Developing a better understanding of the impact of gambling on individuals and their families is essential to improving services, supporting policy makers, and helping researchers.
The first level of harm that was identified from the data was the impact of gambling on the individual who gambled. This was characterised by distorted cognitions, erroneous beliefs and feelings of powerlessness. It also impacted on their ability to manage their gambling and the negative impacts from it, such as financial losses.
This was experienced at any level of involvement in gambling, but particularly at the most problematic levels and was associated with experiences of shame and stigma. It could also include feeling a loss of identity and a reduced connection to the cultural community.
Another harm was the resulting decrements to the health of the person who gambles and their family, friends or community. These were a direct consequence of gambling engagement and reflected an increase in the burden of disease in the community. This included increased risk of mental illness and suicide, although it was not clear how the onset of these comorbidities were affected by the engagement in gambling.
These were identified at any level of gambling and reflected the link between the social and cultural values surrounding gambling. They were primarily experienced by those who were experiencing problem gambling and were strongly linked to suicidal ideation and attempts.
In contrast, other harms at the broader community level were less apparent and included emotional or psychological distress and decrements to health affecting those who were not directly involved with gambling, such as their employers or communities. These were not able to be quantified as easily as the financial harms but they were a key threshold in seeking assistance or treatment.
The most pervasive type of harm was the experience of a loss of self worth as a result of engaging with gambling. This was a direct consequence of the behaviour and it was associated with extreme levels of emotional or psychological distress, loss of identity, social isolation, feelings of depression or low self esteem, and a sense of failure. It was also linked to the impact of other legacy harms such as financial harm and relationship breakdown.