Gambling Disorders
Gambling involves the risking of something of value (money or goods) on an event that is characterized by some degree of uncertainty. It includes activities that involve a game of chance, such as lotteries and betting on sports events, as well as those activities in which skills can improve the chances of winning, such as playing card games or betting on horse races. Gambling can be a social activity and is widely practiced around the world. It is estimated that the total amount of money legally wagered annually worldwide is about $10 trillion.
People generally participate in gambling as a form of entertainment, often for the thrill of trying to beat the house or winning a prize. While many gamble without a problem, some individuals develop serious gambling disorder that has negative personal, family, and social consequences. In some cases, the disorder can lead to suicide. In addition, problem gambling has been linked to increased alcohol and drug abuse.
The etiology of gambling disorders is complex and varies by individual. However, research has shown that some people are genetically predisposed to developing a gambling disorder. Other factors include environmental influences such as peer and familial pressure to gamble, and the availability of legal and illegal opportunities to do so. Gambling is also associated with certain psychosocial characteristics such as sensation-seeking and novelty-seeking, which are related to a desire to experience complex or varied sensations. Zuckerman’s theory of sensation-seeking as applied to gambling suggests that individuals entertain the risk of a financial loss in order to experience positive reinforcement and states of high arousal, while Cloninger’s theory of addiction links the motivation to seek sensation with the pleasure derived from drinking.
Vulnerability to developing a gambling disorder is also influenced by socioeconomic status and cultural factors. For example, gambling is more common among people with lower incomes, and young people are particularly susceptible to developing a gambling disorder. Also, gambling products are often located disproportionately in areas of greater disadvantage, and aggressive marketing and sponsorship of gambling by the gaming industry drives normalization and increases gambling activity.
In addition, the prevalence of gambling disorders has been fueled by an increasing emphasis on profit in business and society. The globalization of the economy has brought with it the expansion of the gaming industry and the growth of Internet communications, which have transformed the way that gambling is marketed and consumed.
The impact of gambling on health is significant, and the WHO recognizes that multisectoral action is required to reduce harms, including financial stress, relationship breakdown, family violence, and mental illness. Population-wide interventions can include ending advertising and promotion, centralized account registration to allow individuals to set binding loss limits, and restrictions relating to access and availability (opening hours, density). In addition, education and awareness is essential. The WHO recognizes the need to support the development of a culture of responsible gambling and encourages national governments to implement such measures. This includes education and training of healthcare professionals, as well as a focus on upstream efforts to prevent and manage gambling harms.