Problem gambling from here?

Source: PHA NEWS - NOVEMBER 2007

Original document: http://www.pha.org.nz/onlinenews/newsnov2007.pdf

What is the way forward for problem gambling prevention and harm minimisation? DrKawshi De Silva, Director Public Health of the Problem Gambling Foundation, argues the public health paradigm used to tackle health risks such as smoking, alcohol and obesity can also be used for problem gambling.

The argument has been that if products are neutral, or beneficial in their effect, there is no problem. But if, as with tobacco, the product is lethal in itself, or is engineered to cause addiction as with gambling, we have to act. Food and alcohol are other examples of what in moderation may have a beneficial effect but excessive use of which can cause harm.

The fundamental question is how social and health policies should be formulated when it comes to unhealthy products. Products such as alcohol, tobacco, and pokie machines have economic and social gain to a country but there is political bias towards their control. However, we are aware that sustained legislative and regulatory presence is important for meaningful policy change for tobacco, alcohol and gambling. Change in environmental social factors that support unhealthy and unsafe practices are also an important milestone toward prevention and harm minimisation.

Tobacco, alcohol and gambling are legal within the free market economy. Their industries stand for profit supply, marketing to increase demand, minimal regulation to curtail use, purchase or use age restrictions in some cases and location restrictions being implemented to demonstrate social responsibility.

George Thomson states an ‘industry focus’ approach helps move responsibility from smokers to the tobacco industry. Industry ‘denormalisation’ has been the theme used within comprehensive tobacco control strategies and has needed continued political commitment for its effectiveness. In considering the industry focus a number of principles have been recommended to keep in mind. These are: to include a comprehensive approach for tobacco control; the need for political defences; and the need for periodic new approaches to the use of the focus.1

The tobacco industry uses a range of strategies to survive and prosper. They include the denial of or deception about health and addiction risks, deception about the true nature of the product, damaging the credibility of industry opponents, and delaying and defeating attempts to regulate the industry.2

It has been shown that the reduction of the prevalence of obesity is more likely to come from policy-related changes to the environment than from medical interventions targeted at individuals. The perceptions and beliefs in society about obesity can profoundly influence behaviour change and resistance to it. Industry marketing has a huge influence on individuals’ perceptions and behaviour. The social determinants of obesity and cultural aspects are important factors contributing to the situation.

Recognising the role of food supply, its influence in the food chain and the food choices for individual and communities is important before intervening. The rights of the consumer to know what they are eating and its effects on them have been stated strongly within this debate. This means clear, informative, accurate and scientifically proven labelling of food and its benefits or the potential harmful effects of the food being disclosed. The personal choice has to be made in an environment where consumers are fully informed.

The harm minimisation approach has been adopted toward tobacco, gambling and alcohol. One of its key strategies is to decrease demand and increase control of supply. Availability and accessibility directly influence the control of supply. The liberalisation and deregulation of outlet density has been shown to increase alcohol-related disturbances to public order, the costs of which have to be borne by the taxpayer. Increased access to alcohol within or in close proximity to universities has been associated with an increased number of binge drinkers.3

The public health approach to drug control can help develop policies to reduce harmful use of substances, minimise negative health effects on the individual and limit secondary drug-related harms to society. It has been observed that the goal of the public health approach, which is to minimise harm, often puts public health in conflict with different interest groups whose main activity is increasing supply and demand through marketing and PR strategies.4

The public health approach to issues such as tobacco, alcohol and gambling focuses on health promotion, prevention and minimisation of harm. It incorporates individual and societal health protection measures through protecting and promoting physical environments and social policy frameworks that maximise health and minimise individual and community harm. The guiding principle should be "First do no harm".

This principle should be applied to all services (health, social, enforcement etc), as well as to new and existing policies so as not to exacerbate problems introduced by industry products.5

In summary, industries producing harmful products will portray their social responsibility, downplay addiction, play tricks with language, try their best to form formal relationships with politicians, build networks of relationships with individuals and groups within society, demonstrate good intentions to the economies of both the country and local communities, and attempt to offload responsibility.

We should rise above all such strategies and advocate for society’s right to be free of dangerous addictions such as gambling. The ethical argument and human rights used in many social movements globally can be used effectively for products such as alcohol and gambling that generate social and health inequities.

The success of strategies in areas like tobacco control gives confidence that similar strategies using models which target industry, environment and population policies can generate social change.

This principle should be applied to all services (health, social, enforcement etc), as well as to new and existing policies so as not to exacerbate problems introduced by industry products.5

The success of strategies in areas like tobacco control gives confidence that similar strategies using models which target industry, environment and population policies can generate social change.

1.Thomson G (2003). Focusing on the Tobacco Industry: A report to New Zealand NGOs. Department of Public Health, Wellington School of Medicine.

2. Thomson G (2005). Trust Us We’re Socially Responsible: The truth behind British American Tobacco NZ’s Corporate Social Responsibility reports. Department of Public Health, Wellington School of Medicine and Health Sciences, University of Otago.

3. Chaloupka JF, Wfchsler H (1995). The impact of price, availability, and alcohol control policies on binge drinking in college. National Bureau of Economic Research, Cambridge.

4, 5. Health Officers Council of British Council of British Columbia (2005). A Public Health Approach to Drug Control in Canada: A discussion paper. Health Officers Council, British Columbia.