tag:theconversation.com,2011:/ca/topics/fixed-odds-betting-terminals-34984/articlesFixed odds betting terminals – The Conversation2018-11-14T16:08:25Ztag:theconversation.com,2011:article/1062662018-11-14T16:08:25Z2018-11-14T16:08:25ZFixed-odds betting machines are devastatingly addictive – why it’s right to cut maximum stakes<p>MPs rebelled, a minister resigned and the UK government was forced to change tack. No, this is not Brexit. It’s <a href="https://www.bbc.co.uk/news/business-46205812">fixed-odds betting terminals</a>(FOBTs), the incredibly addictive machines that are often found in betting shops. </p>
<p>The government had promised to reduce the maximum stake that people playing FOBTs would be limited to just £2 per play from April 2019. This is the figure <a href="https://www.gamblingcommission.gov.uk/news-action-and-statistics/news/2018/Gambling-Commission-publishes-advice-on-gaming-machines.aspx">recommended by the Gambling Commission</a> regulator – a dramatic reduction in price from the current £100 limit. But the chancellor announced in his budget that this reduction would be pushed back to October 2019. This would have allowed bookmakers to make an estimated <a href="https://www.theguardian.com/uk-news/2018/oct/25/uproar-over-delay-to-2-cap-for-bets-on-fixed-odds-betting-machines">£900m extra from FOBTs</a><strong>in the meantime</strong> and the government a lot more in tax revenues.</p>
<p>The move prompted sports minister Tracey Crouch <a href="https://www.theguardian.com/uk-news/2018/nov/02/fobts-row-minister-quit-over-claim-pro-gambling-mp-secured-delay">to resign</a> from the front bench of British politics and a growing number of MPs from across the political divide to call the government out for its decision to delay. It has bowed to the pressure and will once again reduce the maximum stake to £2 from April 2019.</p>
<p>The fact is, FOBTs are so addictive that they have been labelled the <a href="https://theconversation.com/gamblings-crack-cocaine-is-devastating-lives-and-not-doing-much-for-the-economy-either-77663">“crack cocaine”</a> of gambling methods, encouraging gamblers to play quickly and continuously.</p>
<p>Studies looking at a cross section of the UK population have long recognised FOBTs as contributors to harmful gambling. The <a href="https://www.gov.uk/government/publications/british-gambling-prevalence-survey-2010">2010 British Prevalence Study</a>, which was the government’s last big investigation into the UK’s gambling habits, found that certain types of gambling, including FOBTs, were strongly connected to harmful gambling. They offer a number of games, commonly roulette or sports race games, which enable easy and fast play.</p>
<p>My research into the effects of gambling in Ireland also reveals how highly addictive FOBTs are. Ireland, unlike the UK, has no legislation controlling or prohibiting FOBTs. I carried out Ireland’s first national study of the social impact of gambling, <a href="http://hdl.handle.net/10197/6796">Playing Social Roulette</a>. and in this it was clear that FOBTs were particularly bad for getting people hooked extremely quickly. </p>
<p>Not everyone who gambles has a problem, but harmful gambling happens when someone experiences difficulty with their impulse control and gambling becomes a compulsive activity for them. Gamblers Anonymous <a href="http://www.gamblersanonymous.org/ga/">defines</a> compulsive gambling as an illness. It is progressive in nature and can never be cured, but it can be stopped. As one young male participant in my study explained addiction through FOBTs:</p>
<blockquote>
<p>They are programmed to give you small wins and then you get into a false sense of contentment where you think, I have won this amount, so maybe I am going to win some more. But what it does is it just takes everything then. Once you decide to play on, it takes all your winnings until you are left with nothing.</p>
</blockquote>
<p>He went on:</p>
<blockquote>
<p>… you enter like a trance like state. It is almost like a euphoria, you become like a zombie, you are just watching this ball shoot out every 30 seconds and land in a space.</p>
</blockquote>
<p>The people in my study spoke of being exposed to gambling in their early years. Technology like FOBTs accelerated the amount they would play and would get them hooked. The gambler experiencing harm would spend continuously to feed their habit, motivated for example, by excitement, an escape from stress and negative emotions, and boredom.</p>
<p>The devastation caused by addiction through FOBTs was equally swift as addiction. For instance, one participant’s mother spoke of her grief to see her otherwise capable son afflicted and how the addiction crept up on them both. Participants in my survey who started playing FOBTs at a young age sought treatment for gambling addiction as soon as their early 20s. </p>
<h2>Beyond FOBTs</h2>
<p>FOBTs are but one of the many technologies that support gambling and increase people’s ability to play and to play more quickly. The rise of smartphones and online gambling websites, for example, make it quicker and easier for people to play. This also enables people to play secretively and hide their gambling from family and friends. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/245342/original/file-20181113-194485-4w88n3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/245342/original/file-20181113-194485-4w88n3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/245342/original/file-20181113-194485-4w88n3.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/245342/original/file-20181113-194485-4w88n3.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/245342/original/file-20181113-194485-4w88n3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/245342/original/file-20181113-194485-4w88n3.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/245342/original/file-20181113-194485-4w88n3.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">The ubiquity of smartphones makes betting easier – to do and to hide.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/businessman-using-smartphone-against-gambling-app-299106047?src=jK3KMb726LDOSi0_XG_T7Q-1-32">Shutterstock</a></span>
</figcaption>
</figure>
<p>This was clear in Playing Social Roulette. Wives of gamblers, for example, spoke of being aware that their husbands were suffering, but put it down to marital issues rather than the fallout from gambling addiction. </p>
<p>So regulations need to do more than limit FOBTs – they need to address multiple technologies and the addiction that they facilitate. It’s also important to recognise that this is a social issue, as much as a financial one. While gambling addiction may seem to be just about how much money people lose, the impact on people’s lives is also a significant part of the price people pay. Putting regulation into place that recognises this and protects the vulnerable should be a priority.</p><img src="https://counter.theconversation.com/content/106266/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Crystal Fulton received funding from the Irish Research Council, with support from the Department of Social Protection, and by the Department of Justice & Equality for the research mentioned in this article.
</span></em></p>Studies looking at a cross section of the UK population have long recognised FOBTs as contributors to harmful gambling.Crystal Fulton, Associate Professor of Information and Communication Studies, University College DublinLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/968282018-05-18T12:40:25Z2018-05-18T12:40:25ZFixed-odds betting terminal cap must be just the start of gambling regulation<figure><img src="https://images.theconversation.com/files/219554/original/file-20180518-42230-19efjl2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Fixed-odds betting terminals have been called the 'crack cocaine' of gambling.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/download/confirm/287164913">massimofusar/Shutterstock</a></span></figcaption></figure><p>The maximum stakes permitted on fixed-odds betting terminals in the UK is to be cut <a href="https://www.theguardian.com/uk-news/2018/may/17/maximum-stake-for-fixed-odds-betting-terminals-cut-to-2">from £100 to £2</a>, following years of campaigning for the change in the face of gambling industry lobbying. Those who campaigned hardest for greater protection for users of the machines such as the <a href="http://fairergambling.org/">Campaign For Fairer Gambling</a> will be pleased by the UK government’s decision, but the loudest cheers will come from people like <a href="https://twitter.com/gamblinghurts?lang=en">Tony Franklin</a> who have suffered terribly because of decisions taken by British governments – of all stripes and over many years – that allowed high-stakes electronic gambling to enter the previously low-stakes world of high street betting shops.</p>
<p>I’ve been among those arguing for the maximum stakes to be reduced, in <a href="https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/707763/drive-download-20180514T173730Z-001.zip">many government consultations on the issue</a>, and I’m glad that common sense has prevailed at last. But the decision to cut maximum stakes leaves other problems still to be tackled – and these go to the heart of gambling policy. The government’s announcement shows they have yet to come to grips with a powerful industry which lobbies hard for self-regulation.</p>
<p>Fixed-odds betting terminals (FOBTs) were introduced around 2000, and it soon became apparent that they were used differently from the fruit machines that they replaced. A tax change in 2001 had enabled bookies to create digitised, virtual games of roulette and allow punters to bet on the outcome of each spin, as they would on the outcome of a horserace. The vital difference is that while a horserace takes place a few times each hour at a track – or every few minutes, if you beam action from around the world into the betting shop – each spin of a digital roulette real on an FOBTs takes 20 seconds, quicker even than the real thing.</p>
<p>Not every bookmaker expected FOBTs to be popular – some were taken by surprise when their profits outstripped over-the-counter betting. This was less <a href="https://www.amazon.co.uk/Addiction-Design-Machine-Gambling-Vegas/dp/0691160880">“Addiction by Design”</a> and more a flotation device for betting shops, which had been struggling to find new customers as the older generation of punters betting on horses and dogs were not replaced. Some bookies did not expect the machines to survive as long as they have in their current, high-stakes, high-frequency form. One said to me recently that the only real surprise is that it took the government so long to act.</p>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/219556/original/file-20180518-42210-t2343y.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/219556/original/file-20180518-42210-t2343y.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/219556/original/file-20180518-42210-t2343y.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=840&fit=crop&dpr=1 600w, https://images.theconversation.com/files/219556/original/file-20180518-42210-t2343y.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=840&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/219556/original/file-20180518-42210-t2343y.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=840&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/219556/original/file-20180518-42210-t2343y.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1056&fit=crop&dpr=1 754w, https://images.theconversation.com/files/219556/original/file-20180518-42210-t2343y.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1056&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/219556/original/file-20180518-42210-t2343y.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1056&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Digital betting terminals can serve up bets quicker than the real thing.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/london-uk-mar-5-2018-mature-1039609732">Alexandre Rotenberg/Shutterstock</a></span>
</figcaption>
</figure>
<p>But is it really a surprise?</p>
<h2>Industry influence</h2>
<p>As I’ve <a href="https://www.gold.ac.uk/media/documents-by-section/departments/anthropology/Fair-Game-Web-Final.pdf">written elsewhere</a>, much of the evidence on which policy decisions in the UK are nominally based is acknowledged to be limited – compromised by the involvement of industry that not only funds research but also can control access to data.</p>
<p>If we want policy makers to make timely, well-informed decisions about gambling we need better data, and more of it. That can only come from a strong research culture, supported by a data sharing agreement and an independent commissioner.</p>
<p>Who might take on this key role? The Gambling Commission, which <a href="https://www.theguardian.com/uk-news/2018/mar/19/gambling-regulator-urges-government-to-cut-fobt-stakes-to-30">did not recommend a reduction to £2</a>, has both a duty to permit gambling and also a duty to consider the impact of its activities on economic growth. It is telling that gambling policy in the UK is determined by the Department for Digital, Culture, Media and Sport. In New Zealand, by contrast, gambling policy is a matter for the Department of Health.</p>
<p>While the cap on stakes has been broadly welcomed, the government’s announcement of “a major multi-million pound advertising campaign promoting responsible gambling”, supported by industry and GambleAware, has raised eyebrows. What made the government decide that this was the best way to educate people about the harm caused by gambling? Or even a good idea?</p>
<h2>Legislators must arm themselves with evidence</h2>
<p>Unsurprisingly, the international evidence does not support the idea that industries producing harmful products are best placed to <a href="https://epublications.marquette.edu/comm_fac/337/">communicate their risks</a>. On the contrary, we know that these campaigns are often tactics for <a href="http://jech.bmj.com/content/early/2017/09/29/jech-2017-209710">delaying the imposition of meaningful regulation</a>.</p>
<p>The government also announced that the Industry Group for Responsible Gambling has amended its <a href="http://igrg.org.uk/wp/industry-advertising-code/">code</a> to ensure that a responsible gambling message will appear for the duration of all TV adverts.</p>
<p>In Australia, gambling advertising during broadcasts of live sports has been banned before the watershed precisely due to concerns that children will <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/1753-6405.12564">associate betting with sport</a>. Yet in the UK, the government has chosen to accept industry promises to add warnings to adverts, even though evidence from alcohol advertising suggests that responsible drinking messages may in certain contexts actually <a href="https://www.ncbi.nlm.nih.gov/pubmed/25577316">increase alcohol consumption</a>.</p>
<p>All this points to UK gambling policy continuing along a path of compromise. As other nations move to a public health approach that recognises that the harm caused by gambling is <a href="https://responsiblegambling.vic.gov.au/about-us/news-and-media/assessing-gambling-related-harm-victoria-public-health-perspective/">not restricted to the gambler alone, or to their mental health</a>, the British government remains rooted to the model of “promoting responsible gambling” – part of what DCMS minister Tracey Crouch has called “<a href="https://www.gov.uk/government/news/government-to-cut-fixed-odds-betting-terminals-maximum-stake-from-100-to-2">a healthy gambling industry that contributes to the economy</a>”.</p>
<p>Until we have more independent research about the effects of gambling, any attempt to change the rules in order to protect people from harm will take years. We need a compulsory levy and no more horse-trading with industry. GambleAware, the charity responsible for funding research into gambling, must be reformed – and at the very least not have <a href="https://about.gambleaware.org/about/trustees-and-management/">industry representatives on its board</a>.</p>
<p>The delay to the cap in betting stakes – arriving five years late due to the lack of evidence that FOBTs “cause” problem gambling (itself a gigantic <a href="https://gamblingacrossborders.wordpress.com/2015/01/16/the-ghost-in-the-machine/">red herring</a>) – has cost people not just their money, but their homes, their relationships, their jobs and <a href="https://www.theguardian.com/commentisfree/2018/mar/19/gambling-life-fixed-odds-betting-terminals-maximum-stake-addicts">even their lives</a>. If it is evidence-based policy that governments claim to aim for, then they must ask where that research will come from in future – and if it is worth the paper it is written on.</p><img src="https://counter.theconversation.com/content/96828/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Rebecca Cassidy was funded by the European Research Council, grant number 263433, between 2010 and 2015. Between 2006 and 2009 she received £90,697.22 from ‘Research into Problem Gambling’, a collaborative research initiative between the Economic and Social Research Council (ESRC) (lead organisation) and the Responsibility in Gambling Trust (RiGT), (now GambleAware). All aspects of the grant were administered by the ESRC. Between 2007 and 2009 she received ad hoc support from the National Lottery Commission for the Gambling Research Network, a group of early career and PhD researchers coming together in London two or three times a year. Money covered refreshments and no explicit restrictions or inducements were placed on the group by the NLC. Since 2015, she has had her travel expenses to speak at an international conference paid for by the Alberta Gambling Research Institute, an organisation that is funded by the provincial government of Alberta, and by the New Zealand Problem Gambling Foundation and The Gambling and Addictions Research Centre at AUT University. She has also received support from the British Academy and Edinburgh University. She has paid to attend industry-sponsored events and attended free, industry-supported events in order to conduct anthropological fieldwork. </span></em></p>That the government has finally moved to limit the damage is welcome, but there is much still to do.Rebecca Cassidy, Professor of Anthropology, Goldsmiths, University of LondonLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/862562017-11-01T10:25:47Z2017-11-01T10:25:47ZMore than just financial loss, the social impact of gambling cannot be underestimated<p>The UK government is <a href="https://www.theguardian.com/uk-news/2017/oct/31/uk-government-cracks-down-fixed-odds-betting-terminals-fobt">mulling a review of the regulations on fixed odds betting terminals</a> commonly found in pubs and betting shops, in order to reduce the risk of problem gambling developing. </p>
<p>Based on a <a href="https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/655969/Consultation_on_proposals_for_changes_to_Gaming_Machines_and_Social_Responsibility_Measures.pdf">report</a> from the UK Department for Digital, Culture, Media and Sport, this would see the maximum stake gamblers can bet on the machines reduced from £300 a minute to between £2 and £50. </p>
<p>Given that the Gambling Commission, the industry regulator, found 43% of people who use the machines are either problem or at-risk gamblers, some such as opposition Labour MP Tom Watson, have described this as “<a href="https://www.theguardian.com/uk-news/2017/oct/31/uk-government-cracks-down-fixed-odds-betting-terminals-fobt">a squandered opportunity</a>”. Critics believe the proposals don’t go far enough to protect people from fixed odds betting terminals, sometimes described as “the crack cocaine of gambling” due to their addictive nature.</p>
<p>Harmful gambling can have crippling financial and social effects on the gambler, their friends and family. In the first <a href="http://hdl.handle.net/10197/6796">national study of the social impact of harmful gambling in Ireland</a>, we examined how it affected recovering gamblers, their families and friends. We also heard stories from counsellors and those who provide services to help gamblers. Talking to people from all walks of life, from different age groups and different economic backgrounds, we found that a common theme was the devastating social effects gambling had on people’s lives.</p>
<p>In particular, we learned that gamblers were often exposed to gambling at an early age, for example by collecting betting proceeds for a family member, or watching adults place bets. This then led them to participate in gambling before the legal age of 18. </p>
<p>Gamblers reported gambling in secret, isolating themselves from family and friends to feed their addiction. As relationships deteriorated, the gambler’s behaviour would only be discovered when they were no longer able to maintain a double life, such as failing to intercept unpaid bills that had been part of trying to maintain a facade of normality. The availability of technologies, such as smartphones, means that it’s possible to conceal a secret gambling habit for years, before financial and emotional crises reach breaking point.</p>
<p>For young people, such technology exacerbates the potential harm of gambling. The participants in our studies frequently spoke of their concern for young people and their risk of addiction due to the availability of gambling apps and websites easily accessible from their smartphones. And while there is supposedly agreement <a href="https://www.irishtimes.com/news/gambling-committee-chief-opposes-betting-machines-1.898604">not to offer fixed odds betting terminals in Ireland</a>, some gamblers reported that they had got themselves into trouble using them.</p>
<h2>Gambling as a public health issue</h2>
<p>The social harms that stem from addictive gambling are not only for the gambler. For example, the wives of gamblers in our study reported how they could sense there was a problem, but believed they were struggling with marital issues, rather than the fallout from gambling addiction. Parents and children of gamblers reported that they could no longer trust the gambler, that they could no longer leave money unattended, and that the gambler had become someone they did not recognise or understand.</p>
<p>In Ireland, the legislation around regulating gambling is outdated. The regulations that might mitigate harms for the individual and for society have not been introduced, and – with support from the <a href="http://research.ie/">Irish Research Council</a> and Ireland’s <a href="https://www.welfare.ie/en/Pages/home.aspx">Department of Social Protection</a> and <a href="http://www.justice.ie/">Department of Justice and Equality</a> – our research sought to provide the evidence base to help draw up the necessary social policies. </p>
<p>The government indicated its intention to move forward with legislation in early 2017, and my <a href="http://hdl.handle.net/10197/6796">research</a> and its <a href="http://hdl.handle.net/10197/8612">follow-up study</a> should inform politicians how to address the social harms of gambling – the costs of which the <a href="https://www.publichealth.ie/files/file/Developing%20a%20population%20approach%20to%20gambling.pdf">Institute of Public Health in Ireland</a> has estimated to be greater than government revenue from gambling taxes. </p>
<h2>Listen to what gamblers say they need</h2>
<p>The participants interviewed said there is a need for open discussion about gambling and the risk it can pose to individuals and their families. Gambling addiction carries with it significant social stigma, shame and isolation – talking openly about its effects can change how we approach this issue.</p>
<p>Interviewees suggested a variety of measures government could take, including regulations that would protect the most vulnerable to gambling addiction, and particularly in regulating how technology now enables secretive gambling. They also identified the need for support that would help prevent and address the harmful effects of gambling addiction. </p>
<p>While there are addiction treatment centres around the country which include services to address harmful gambling, there is little help for those affected by a partner’s or family member’s gambling. The <a href="http://www.therisefoundation.ie/">RISE Foundation</a> is a notable exception, providing treatment for the families of those affected by a variety of addictions. But it is based in Dublin only, and family members may no longer have the financial resources to access treatment and support there.</p>
<p>There is an urgent need for a unified, transparent approach to tackling gambling’s harms in Ireland – a national strategy that encompasses public and private sector organisations, similar to those that target alcohol and drug addiction. The UK has the <a href="http://www.gamblingcommission.gov.uk/home.aspx">Gambling Commission</a> and NHS <a href="https://www.nhs.uk/Livewell/addiction/Pages/gamblingaddiction.aspx">support and advice</a>; Ireland has nothing comparable.</p>
<p>Despite the lack of progress from government on the issue there have been benefits to this research: uncovering the extent of gambling’s social harms has helped to get people talking about gambling. For example, in September 2017 the <a href="http://www.guengl.eu/">European United Left/Nordic Green Left</a> European Parliamentary Group sponsored a one day conference in Dublin to direct the spotlight on the subject and emphasise the need for updated legislation. </p>
<p>Within the Republic, <a href="http://www.problemgambling.ie/">Problem Gambling Ireland</a> recently opened its doors to lobby against the spread of harmful gambling and to provide referral services to those affected by gambling. These may seem like small steps, but it is small steps that lead the charge for change.</p><img src="https://counter.theconversation.com/content/86256/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Crystal Fulton receives funding from the Department of Justice & Equality and from the Irish Research Council, with support from the Department of Social Protection.
</span></em></p>Ireland is the ‘wild west’ of gambling, with little regulation to protect people from the potential social harm. This needs to change.Crystal Fulton, Associate Professor of Information & Communication Studies, University College DublinLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/753172017-06-13T12:33:12Z2017-06-13T12:33:12ZWhy healthcare services have a problem with gambling<blockquote>
<p>I have a problem with gambling. There’s not enough of it.</p>
</blockquote>
<p>That was the admission from billionaire Steve Wynn, a major figure in the casino industry, <a href="http://news3lv.com/news/local/steve-wynn-addresses-international-gaming-conference-in-return-to-mirage">speaking</a> at a recent gambling research conference in (where else?) Las Vegas. And sure, it made for a good quote. But it’s also a rather glib dismissal of a serious issue that affects many thousands of people across the world. </p>
<p>The UK certainly has a problem with gambling. At least it has since 2007, when <a href="http://www.legislation.gov.uk/ukpga/2005/19/pdfs/ukpga_20050019_en.pdf">laws were changed</a> to allow for huge growth in gambling opportunities and exposure. It has been hard to ignore the subsequent explosion in industry advertising, which <a href="https://www.ofcom.org.uk/__data/assets/pdf_file/0026/53387/trends_in_ad_activity_gambling.pdf?lang=en">increased by around 500% between 2007 and 2013</a>. By contrast, you may have missed the increased numbers of high intensity electronic gambling machines, called Fixed-Odds Betting Terminals (FOBTs), which now occupy the high street (within betting shops) and allow punters to wager up to £100 every 20 seconds. </p>
<p>Yet Britain doesn’t have much insight into its problem with gambling. Compared to most other addictive behaviours, involving drugs or alcohol for example, gambling is largely ignored by health services and public health agencies. This is partly because gambling is a hidden concern. It does not manifest with physical warning signs. Indicators are usually visible in extreme cases only, and generally following major life crises such as extreme debt or relationship breakdown. </p>
<p>On top of this, the gambling industry has a surprisingly direct <a href="https://about.gambleaware.org/fundraising/">role in funding</a> a great deal of the research into gambling, directly and indirectly through a third party organisation called GambleAware. It therefore <a href="https://about.gambleaware.org/media/1211/statement-of-intent-document-final-with-logo-v2.pdf">plays a significant part</a> in determining what we know about the nature of problems and possible solutions.</p>
<p>But people with gambling problems account for large amounts of industry revenue (<a href="http://www.tandfonline.com/doi/abs/10.1080/14459795.2012.689001">up to 60%</a> in dog racing). And this creates a clear conflict of interest for the gambling industry. Any success in reducing gambling problems is likely to reduce profits too. </p>
<p>So what of general practice, which is usually the first point of a contact with the healthcare system? Does it have a problem with gambling? <a href="https://www.ncbi.nlm.nih.gov/pubmed/28289016">Our recent research</a> suggests it does. In a study of more than 1,000 patients in waiting rooms of general practices in the south-west of England, around one in 20 patients reported at least some degree of gambling problem. These levels were higher among young males and patients showing signs of depression or risky drinking. Around 7% of respondents reported problems among family members and were also likely to experience harms from gambling. </p>
<p>The findings suggest an issue for primary care that is hidden from healthcare providers. Gambling problems are strongly linked with <a href="https://www.karger.com/Article/Abstract/437260">poor mental health, suicidal tendencies</a> and serious consequences for families through <a href="http://onlinelibrary.wiley.com/doi/10.1111/add.13402/full">relationship problems</a> and <a href="http://onlinelibrary.wiley.com/doi/10.1111/add.13522/abstract">domestic violence</a>. Gambling problems also create difficulties for the broader community through <a href="https://www.karger.com/Article/Abstract/437260">overuse of healthcare services</a>. Primary care has important roles in responding to many such health concerns, including other addictive behaviours such as smoking and alcohol misuse and complex psycho-social issues such as domestic violence – it could have similar involvement in improving help-seeking and intervention for people with gambling problems. </p>
<h2>Responding to a hidden addiction</h2>
<p>There’s much more we need to know before we can determine the best ways in which general practice can help respond to gambling problems. There are different ways of identifying people who would benefit from help or intervention, such as universal screening or “case-finding” by questioning of patients demonstrating visible risk. Clinical responses can also vary and range from brief advice to onward referral. These may lead to very different equations in terms of the costs of interventions, including burdens on practitioners, and the balance of these compared to potential benefits. </p>
<p>In the absence of much attention to the health risks of gambling – and a lack of independent funding for research and interventions – it seems unlikely that there will be rapid progress in responding to gambling problems in general practice. But there is a need now for practitioners to be vigilant and inquire about potential problems. This is particularly important among young males or patients showing signs of depression, risky drinking or drug use, and financial difficulties. </p>
<p>As we’ve seen, the problem with gambling is that these issues are hidden from view. They have not been a priority when compared to health concerns that are more visibly obvious, such as obesity and alcohol misuse. GPs and practice nurses have an important part to play in putting these problems on the healthcare agenda.</p><img src="https://counter.theconversation.com/content/75317/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Sean Cowlishaw has received funding from multiple sources in the UK, including the Avon Primary Care Research Collaborative (APCRC), the National Institute for Health Research (NIHR), and the Economic and Social Research Council (ESRC). Further sources include agencies that are funded primarily by government departments to commission gambling-related research, including the Victorian Responsible Gambling Foundation (Australia) and the Gambling Research Exchange Ontario (Canada). Sean has not knowingly received funding from the gambling industry or any industry sponsored organisation. He has participated in scholarly and policy-related conferences which were sponsored by industry, but received no payment for involvement or expenses. He is a voluntary member of the steering committee for a pilot gambling help service that is provided by the 'Living Room Cardiff' charity and recovery centre. Sean has no other conflicts of interest (whether real or perceived) to declare.</span></em></p>The signs of a gambling problem can be hidden from view.Sean Cowlishaw, Research Fellow in Primary Health Care, University of BristolLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/708302017-01-17T15:28:11Z2017-01-17T15:28:11ZWhy football bets are far more profitable to bookmakers than gambling machines<figure><img src="https://images.theconversation.com/files/153063/original/image-20170117-23058-111395b.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Theatre of dreams. </span> <span class="attribution"><span class="source">Phil Shirley</span>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span></figcaption></figure><p>When the government completes its <a href="http://totallygaming.com/news/street/uk-government-announces-machine-review">review</a> of the gambling sector in the coming weeks, a clampdown on fixed odds betting terminals (FOBTs) looks to be on the cards. <a href="http://www.mirror.co.uk/news/uk-news/clampdown-looms-crack-cocaine-gambling-9116392">Dubbed</a> the “crack cocaine of gambling” for allowing punters to bet stakes of up to £100 in games like roulette and poker, even former UK culture secretary Tessa Jowell <a href="http://www.dailymail.co.uk/news/article-4114164/Now-Tessa-Jowell-architect-crack-cocaine-gambling-demands-new-clampdown-addictive-game-machines.html">has joined</a> the chorus demanding curbs – despite overseeing their expansion in the 2000s.</p>
<p>With proposals to reduce maximum stakes to £2 and restrict the number of terminals, the industry is on <a href="http://www.racingpost.com/news/horse-racing/fred-done-done-draconian-limit-on-machines-would-be-damaging/2225983/#newsArchiveTabs=last7DaysNews">tenterhooks</a>. One of its <a href="http://docplayer.net/9262805-Fixed-odds-betting-terminals-and-the-code-of-practice-a-report-for-the-association-of-british-bookmakers-limited-summary-only.html">defences</a> is that FOBTs have a gross margin of between 2% and 3%, meaning between 97% and 98% of stakes end up being returned to punters in winnings. Which sounds reasonable until you reflect that the high maximum stakes and the speed at which people can bet means they can still run up large debts in a short space of time.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/153036/original/image-20170117-23071-u0cqm6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/153036/original/image-20170117-23071-u0cqm6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/153036/original/image-20170117-23071-u0cqm6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=450&fit=crop&dpr=1 600w, https://images.theconversation.com/files/153036/original/image-20170117-23071-u0cqm6.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=450&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/153036/original/image-20170117-23071-u0cqm6.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=450&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/153036/original/image-20170117-23071-u0cqm6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=566&fit=crop&dpr=1 754w, https://images.theconversation.com/files/153036/original/image-20170117-23071-u0cqm6.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=566&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/153036/original/image-20170117-23071-u0cqm6.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=566&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Fixed-odds machines.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/gamingfloor/8732529863/in/photolist-4eriD-f5A8mP-nx9SKQ-n1nFRD-eiEuTH-DPBjp-DPvSA-DPvSk-DPvSx-DPvS7-DPBju-DPBj7-DPvSM-DPBjf-DPBj1-DPvSH-kCFAbK-mz3rTg-mz3hYn-kr1CJ2-j62NZF-kqZYsV-kqZXcZ-edbyUD-j64eut-cX94dC-cX94bs-RfcANK-zXv7yK-cDoMJy-cSuNeu-q7kS2g-j654E7-cDoMMo-atpst-daTYuS-ciznU1-pr2ADQ-e9i4Dr-daU7UB-daU9FQ-wrFKCo-zEZGdt-QfpwSE-NDigfr-z1tw9d">Ian Sutton</a>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span>
</figcaption>
</figure>
<p>Nonetheless, FOBTs are serving as something of a lightning rod for other types of gambling that are also unfair to punters but poorly understood. I’m referring to bets where people bet not just on the outcome but on other aspects such as the scoreline, who scores first and combinations of outcomes. Supposing it were an Arsenal vs Burnley game, the bookmaker might be offering say 50-1 on Arsenal’s Alexis Sánchez to score first, any Burnley player to score second and Arsenal to win 4-1. </p>
<p>All these betting offers <a href="https://theconversation.com/how-bookies-play-with-your-emotions-to-make-you-place-unlikely-bets-42863">have exploded</a> in recent years. You’ll see them all over the windows of high street bookmakers. It may not be quite as easy as with FOBTs to place lots of bets quickly, but online betting certainly makes it quick and there’s no maximum stake. There’s also no defence of a low gross margin. Do the maths and you find it can be as much as ten times higher. </p>
<h2>How it works</h2>
<p>Suppose in an upcoming international football match between England and Germany, a bookmaker offered odds of 3-1 on Germany to win. That bookmaker is implying that if the game were played four times, Germany would win once. The probability of Germany winning is 1/(3+1), or 0.25, or 25%. In theory the bookmaker is also implying a 0.75 (or 75%) chance of Germany either drawing or losing, since the probabilities of the various possible outcomes has to add up to 1. </p>
<p>I say “in theory” because the above imagines a situation where a benevolent bookmaker told you what they really thought was probable. In reality, bookmakers build in a profit margin by quoting odds that imply a sum of probabilities greater than 1. In other words, they say every outcome will happen slightly more than is possible – hence offering lower potential wins than they “should”. This <a href="http://www.investopedia.com/terms/d/dutchbooktheorem.asp">allows them</a> to make a risk-free profit from their customers’ wagers that is the same no matter which event actually happens. The higher the sum of probabilities, the higher a bookmaker’s profit margin.</p>
<p>For example one bookmaker offered odds on the Germany vs Argentina <a href="http://www.fifa.com/worldcup/archive/brazil2014/">2014 World Cup final</a> that gave Germany a 0.44 probability of winning in 90 minutes, Argentina an 0.29 probability of winning and a 0.31 probability of a draw. These add up to 1.04, implying a gross profit margin of 0.04/(1+0.04) = 3.8% (see <a href="http://www.investopedia.com/articles/dictionary/042215/understand-math-behind-betting-odds-gambling.asp">here</a> for an explanation of how this maths works). </p>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/153035/original/image-20170117-23040-1aaxbdj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/153035/original/image-20170117-23040-1aaxbdj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/153035/original/image-20170117-23040-1aaxbdj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=671&fit=crop&dpr=1 600w, https://images.theconversation.com/files/153035/original/image-20170117-23040-1aaxbdj.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=671&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/153035/original/image-20170117-23040-1aaxbdj.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=671&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/153035/original/image-20170117-23040-1aaxbdj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=843&fit=crop&dpr=1 754w, https://images.theconversation.com/files/153035/original/image-20170117-23040-1aaxbdj.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=843&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/153035/original/image-20170117-23040-1aaxbdj.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=843&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">2014 and a’ that.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/damien_thorne/14190520427/in/photolist-nBY8ki-nWqw2f-nQ2z3L-q9z5XB-ncLK7V-o5fNfu-nWaCEX-mzz7kA-nE3N2P-mzxF5B-o9HzbE-nT7u1k-nEq8MX-jGkcoT-mzxLxa-nWAuA8-ofq6Yw-nA1vNx-nHmZkq-paZSrR-oiH6pP-nZdEV5-qqW1Cw-nWxtGe-nWxtme-nWXXrK-nU9LQV-nU94XJ-o1hbkg-oboGqv-k6uTHr-nVeicS-obCBRg-pH3sc3-o7y1m1-oSEhZR-5Qxwpa-nU9kRA-nUgafS-nQhDjH-nYnCXJ-nYeD5s-q3t2W2-nU9rWc-p112YV-nZYZG2-nZZ2di-o1agh1-o1brYG-oEsqTd">Damien Thorne</a>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span>
</figcaption>
</figure>
<p>When I <a href="http://journal.sjdm.org/14/141026a/jdm141026a.pdf">studied bookmakers’ odds</a> across that tournament, I found the profit margins on different bets varied remarkably. The size of the profit margin was related to the number of possible outcomes in a given bet. Bets on which a team would win a match had the lowest profit margins – 4.5% on average. (Note this means even these plain vanilla bets have a higher profit margin than FOBTs.)</p>
<p>When it comes to betting on the scoreline of a game, Netherlands to win 2-0, say, there are many more possibilities than for the match outcome. The average gross margin on these bets was 21.9%. As for bets on which player would score the first goal, these have even more permutations – there are 20 outfield players, after all, or no one might score. The average margin on these bets was 32.3%. Meanwhile, aggregated bets that combine different outcomes like first scorer and who wins <a href="http://www.soccerwidow.com/football-gambling/betting-knowledge/systems/case-studies/impact-overround-accumulators-multiple-bets/">can also</a> have much higher profit margins than bets on a single match’s outcome. </p>
<p>No surprise that when I looked at the bookmakers’ advertising, both on TV and in their shop windows, I found it almost entirely dominated by scoreline, first goalscorer and aggregated bets. These trends have continued; in work I will be publishing soon, I find that Premier League TV gambling advertising in January and February of last year was similarly geared toward bets with high bookmaker profit margins. </p>
<h2>When Saturday comes RIP</h2>
<p>There are also endless opportunities to get in on this action. Football betting was a low frequency affair when the majority of matches were on Saturday afternoons. Now high-profile matches take place almost every night of the week. To make it easier still, <a href="https://www.betfair.com/exchange/inplay">“in play” betting</a> lets punters place bets during a match, with the option to “cash out” for a sure money amount before the result. Combine this with the high profit margins and modern football betting has become a high-risk gamble for the average customer. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/153048/original/image-20170117-23071-2xd3xf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/153048/original/image-20170117-23071-2xd3xf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/153048/original/image-20170117-23071-2xd3xf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=398&fit=crop&dpr=1 600w, https://images.theconversation.com/files/153048/original/image-20170117-23071-2xd3xf.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=398&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/153048/original/image-20170117-23071-2xd3xf.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=398&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/153048/original/image-20170117-23071-2xd3xf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=500&fit=crop&dpr=1 754w, https://images.theconversation.com/files/153048/original/image-20170117-23071-2xd3xf.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=500&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/153048/original/image-20170117-23071-2xd3xf.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=500&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">OK Coral?</span>
<span class="attribution"><span class="source">Philip Newall</span></span>
</figcaption>
</figure>
<p>There is therefore a strong argument that the UK government should do something about these bets as part of its reforms of betting. Gambling losses <a href="http://www.thetimes.co.uk/article/gambling-losses-rise-sharply-to-300-per-person-cnx0phq5n">are running</a> at record highs – £286 per adult per year in the UK and up by a third between 2010 and 2015. Your chance of beating the bookies really depends on whether you can restrict yourself to bets with a low average profit margin.</p>
<p>Capping the maximum margin is one option for the government – though FOBTs are proof you need to do more than that. The govermnment could also aim to educate and disclose, similar to what is done with alcohol. Or it could restrict or ban this type of advertising or even these types of bets altogether. At any rate, it is time for a debate. “The house always wins” is an old saying in gambling. These days, bookmakers are increasingly taking it to extremes.</p><img src="https://counter.theconversation.com/content/70830/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Philip Newall does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Fixed odds betting terminals attract all the attention, but something alarming is being overlooked.Philip Newall, PhD Graduate, University of StirlingLicensed as Creative Commons – attribution, no derivatives.