• Australian Greens

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23 December 2011This document outlines the debate around gambling reform in Australia and looks at some proposed reforms through the lens of health policy. This paper aims to present some concrete options for gambling reform as well as avenues for further investigation, In order to frame the discussion and solicit feedback on possibilities for government action. Further reforms, with a focus on public health, should complement but not supplant existing plans to further regulate poker machines and other forms of gambling.

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Australians are the world’s most prolific gamblers. We spend an impressive $1200 per capita every year on wagers. Of the $19 billion gambled by Australians every year, 60% or $12 billion goes into electronic gaming machines (EGMs) most commonly known as ‘pokies’. About 4% of the adult population (600,000 people) play these pokies at least weekly. There are over 200,000 poker machines in Australia, of which approximately 50% are in NSW alone. Despite Australia’s small population, we have the 7th highest number of these machines in the world.

Problem gambling is most commonly defined as “difficulties in limiting time and/or money spent on gambling which leads to adverse consequences for the gambler, others or for the community.” According to the Productivity Commission, there are up to 160,000 Australians, or 15% of the people who gamble weekly, who are problem gamblers (with a further 230,000 to 350,000 at moderate risk). These problem gamblers spend an estimated $5 billion a year on poker machines alone. Finding this money takes a toll on the social fabric of the nation. Gambling problems are major causes of theft and bankruptcy, and for each problem gambler at least five other people are affected. Problem gamblers sacrifice the well‐being of themselves and their families as they plunge into poverty and crime. The harm this causes the community is enormous. As money is taken out of family budgets the social costs add up, and are estimated at $4.7b per year.

It’s no coincidence that poker machines are so addictive. Hundreds of millions of dollars has been spent on poker machine design, with the express goal of making them as addictive as possible.

The issue of problem gambling can be approached from several directions. In many ways it is both a medical problem and public health problem. In 2011 a letter signed by leading experts from the public health community to the Prime Minister urged her to take action on poker machine reform as a health priority, likening it to “serious and immediate” public health threats such as tobacco, firearms and the road toll. Any serious attempt to treat gambling addiction holistically must recognise the individual medical and public health aspects of gambling policy.

From a medical point of view, problem gambling can be treated as an addiction in the literal and clinical sense. Treatments for other forms of addiction such as drug and alcohol dependence can, in some circumstances, be applied by medical practitioners to combat problem gambling. Furthermore, there is significant comorbidity with other medical conditions, especially with regards to mental health. Research shows that major depression, substance abuse, anxiety disorders and mood and personality disorders are highly correlated with gambling addiction.

There is broad agreement that gambling policy is best treated as a public health issue. From a public health perspective, prevention, treatment and harm minimisation are the tools to be applied at a population level. To this end, continued education is crucial. A coordinated national approach to safe gambling messages, based on the latest research and combined with data collection on outcomes, could increase the effectiveness of the campaign over the current, fragmented, state‐based approach.

Public health demands policy built on a strong evidence base. However, in order to have good evidence‐based policy the evidence must first be gathered and research conducted. Despite the size of the industry, there are still significant gaps in the data on the prevalence of problem gambling and the most effective treatment options.