Self-exclusion from gambling: A toothless tiger?

While there is evidence for self-exclusion (SE) as an individual-level harm reduction intervention, its effects on reducing harm from gambling at the population level remain unclear. Based on a review of national legal frameworks and SE programs, including their utilization and enforcement in selected high-income societies, the present analysis aims to explore the reach and strengths of SE in the protection of gamblers in these jurisdictions. It places particular emphasis on SE programs' potential to prevent and minimize gambling harm at the population level. The overview examined SE in Finland, Germany, Italy, Massachusetts (USA), Norway, Sweden, and Victoria (Australia). These jurisdictions differ considerably in how gambling is regulated as well as in how SE is implemented and enforced. The reach and extent of enforcement of SE apparently vary with the polity's general policy balance between reducing gambling problems and increasing gambling revenue. But in any case, though SE may benefit individual gamblers and those around them, it does not appear to be capable of significantly reducing gambling harm at the population level. To render SE programs an effective measure that prevents gamblers and those linked to them from financial, social, and psychological harm, utilization needs to be substantially increased by reforming legal regulations and exclusion conditions.

Sense or sensibility-Ideological dilemmas in gamblers' notions of responsibilities for gambling problems.

The gambling market is a complex field of conflicting stakeholders and interests involving dimensions, such as economy, health, social inequality and morals. The division of responsibility between gamblers, the gambling industry and the regulating state for limiting the harmful effects of this activity, however, are unclear. The aim of this study was to explore how gamblers in the Swedish market attribute responsibility to various actors within the gambling field. Qualitative interviews were conducted with 37 gamblers experiencing extensive gambling problems. Based on a discourse analytical approach, five ideological dilemmas were identified, highlighting the tension between the, often contradictory, values that the participants need to relate to. On the individual level, the gamblers emphasize their own responsibility for their problem, thereby showing accountability in relation to themselves, their significant others and their peers as agents in recovery. On the corporate- and state levels however, the participants argue for a stronger public health approach, where the gambling companies should take further responsibility by living up to the legal regulations and where the state should ensure compliance and safeguard funding for treatment and research. The essential paradox between the individual responsibility discourse of self-regulation and the prevailing medical discourse of the gambler's incapacity for self-control signifies an impossible equation that imposes feelings of guilt and shame upon an individual who is concurrently considered as both responsible and incapable. In order to reduce harm, the gambling industry must be more proactive with coercive external control measures to fulfill the duty of care they claim to adhere to, and the regulating state must ensure its compliance.

Setting Limits: Gambling, Science and Public Policy-summary of results.

The gambling industry has grown into a global business in the 21st century. This has created the need for a new emphasis on problem prevention. This article highlights the core themes of the book Setting Limits: Gambling, Science and Public Policy, taking a broad view of the consequences of gambling for society as a burden on health, well-being and equality. The book covers the extent of gambling and gambling-related problems in different societies and presents a critical review of research on industry practices, policy objectives and preventive approaches, including services to people suffering from gambling and its consequences. It discusses the developments in game characteristics and gambling environments and provides evidence on how regulation can affect those. Effective measures to minimize gambling harm exist and many are well supported by scientific evidence. They include restrictions on general availability as well as selective measures to prevent gamblers from overspending. The revenue generated from gambling for the industry, governments, and providers of public services funded from gambling returns presents an obstacle to developing policies to implement harm-reduction measures. A public interest approach must weigh these interests against the suffering and losses of the victims of gambling.

Government monopoly as an instrument for public health and welfare: Lessons for cannabis from experience with alcohol monopolies.

BACKGROUND: Government monopolies of markets in hazardous but attractive substances and activities have a long history, though prior to the late 19th century often motivated more by revenue needs than by public health and welfare. METHODS: A narrative review considering lessons from alcohol for monopolization of all or part of legal markets in cannabis as a strategy for public health and welfare. RESULTS: A monopoly can constrain levels of use and harm from use through such mechanisms as price, limits on times and places of availability, and effective implementation of restrictions on who can purchase, and less directly by replacing private interests who would promote sales and press for greater availability, and as a potential test-bed for new policies. But such monopolies can also push in the opposite direction, particularly if revenue becomes the prime consideration. Drawing on the alcohol experience in recent decades, the paper discusses issues relevant to cannabis legalization in monopolization of different market levels and segments - production, wholesale, import, retail for off-site and for on-site use - and choices about the structuring and governance of monopolies and their organizational location in government, from the perspective of maximizing public health and welfare interests. CONCLUSION: While the historical record is mixed for government monopolies of attractive but hazardous commodities, experience with alcohol in recent decades shows that for public health and welfare public monopolization is generally a preferable option.

Responsible gambling in practice: A case study of views and practices of Swedish oriented gambling companies.

The Swedish gambling market faces a major change in legislation that will allow foreign-based companies to apply for a gambling licence in Sweden. A key element in the new legislation are consumer protection measures. The Swedish gambling market is currently divided between licensed companies and non-Swedish-based companies providing online gambling services without a licence in Sweden. How these companies view their responsibility for preventing gambling-related harm and how prepared they are for the new regulations are important questions regarding the new Swedish gambling market. AIMS: To compare and analyse the views and practices on problem gambling and responsible gambling (RG) measures among licensed and unlicensed gambling companies on the Swedish market. DESIGN/METHODS/DATA: Eleven semi-structured interviews were carried out with responsible gambling managers who are members of either of the two Swedish industry associations. Content analysis was used to analyse the interviews. RESULTS: Non-licensed companies have implemented behaviour tracking and monitoring of gamblers in a more extensive way than licensed companies. Both the licensed and the unlicensed companies conceptualise problem gambling in a similar manner and rely on informed choice in preventing gamblers from developing problems, seemingly arguing that offering responsible gambling measures on their website is enough. CONCLUSIONS: There are several similarities in how the two types of companies define problem gambling and responsible gambling. Both groups lack a critical perspective when discussing RG. There is a need for companies not only to provide RG measures, but to take an active role in preventing harm among gamblers. Future research should focus on exploring how companies work with RG after the legislative change.

Contextual determinants of alcohol consumption changes and preventive alcohol policies: a 12-country European study in progress.

Beginning with France in the 1950s, alcohol consumption has decreased in Southern European countries with few or no preventive alcohol policy measures being implemented, while alcohol consumption has been increasing in Northern European countries where historically more restrictive alcohol control policies were in place, even though more recently they were loosened. At the same time, Central and Eastern Europe have shown an intermediate behavior. We propose that country-specific changes in alcohol consumption between 1960 and 2008 are explained by a combination of a number of factors: (1) preventive alcohol policies and (2) social, cultural, economic, and demographic determinants. This article describes the methodology of a research study designed to understand the complex interactions that have occurred throughout Europe over the past five decades. These include changes in alcohol consumption, drinking patterns and alcohol-related harm, and the actual determinants of such changes.