TO FORMULATE GAMBLING POLICIES ON THE PREMISE THAT PROBLEM GAMBLING IS AN ADDICTION MAY BE PREMATURE
In his article, Orford (2005) is critical of the new United Kingdom Gambling Bill, arguing that the government, heavily influenced by industry pressure, has adopted legislative policies that will lead to the liberalization and expansion of gambling. He expresses concerns that this trend will have a negative impact on the incidence of problem gambling within the community, particularly in affecting the gambling behaviour of children and adolescents. However, availability is one factor interacting among a myriad of others to explain the development and maintenance of problem gambling. Despite Orford's dismissal of the findings of the DCMS' commissioned review of young people and gambling as erroneous, disputes over the accuracy of index measures and reported rates of adolescent problem gambling continue unabated in the literature (Derevensky, Gupta & Winters 2003; Jacques & Ladouceur 2003). There is accumulating empirical evidence that the high rates of problem gambling are inflated. More research needs to be conducted in order to confirm that problem gambling is more prevalent among young adults. In addition, it raises the need to further clarify the fundamental construct of problem gambling and the validity of its conceptualisation as either an addictive or impulse control disorder. Orford's relevant discourse, I believe, raises two substantive and related questions that are of philosophical and theoretical significance: 1) what are the relative responsibilities of individuals versus industry in preventing problem gambling and 2) is gambling a product that contains properties which in and off themselves, inherently cause addiction? Orford is of the view that gambling is no ordinary commodity but one that is inherently 'dangerous' in its capacity to form addictions and create harm, and therefore, there is paternalistic imperative to protect the community from the insidious collusion of governments and industry in expanding gambling. He raises the public health versus personal responsibility debate, one that has parallels and precedence in other areas of health and lifestyle choice as noted by Leichter (2003). Public health and consumer policies are increasingly based on the assumption that people have the capacity and freedom to make sensible choices resulting in legislation that requires relevant consumer information to be clearly displayed or provided to individuals. In support of this position, Blaszczynski, Ladouceur & Shaffer (2004) argue that in the absence of any comorbid psychiatric disorder such as manic depression or schizophrenia that causes affective disturbance and/or impairs cognitive processes, gambling represents an informed choice with the responsibility for making that choice remaining the individual's. However, to make a reasonable informed decision, the gambler requires the industry to provide full, timely and accurate information about the characteristics of the game, probabilities of winning, possible risks of harm arising from participating, and available options for assistance. Responsible gambling is the joint responsibility between informed choices made by individuals, and the provision of sufficient and necessary information by industry in the context of ethical business/commercial practices. Orford's perspective is also founded in part on the assumption that there is some inherent property of gambling that causes addiction and that with technological innovations, this addictive property is magnified. Accordingly, the implication is that any expansion of gambling carries with it serious risk of personal and social harm. However, should gambling be considered a unique product or should it be seen as similar to other products and activities such as alcohol, shopping or internet use? There are similarities but also essential differences between different appetitive activities. Should all such activities be construed as falling within the domain of an addiction? Alcohol and other substances involve the direct action of an external reinforcing agent on neurobiological and cognitive processes leading to neuroadaptive changes and psychological dependence. There is no similar action associated with gambling although there is some tentative data suggesting the involvement of dopaminergic neurotransmitters and genetic vulnerabilities although the cause effect relationship requires further clarification. Gambling has more in common with other impulse control disorders such as compulsive shopping or kleptomania rather than substance dependence disorders (Blaszczynski & Nower 2002). It must be remembered that the criteria for problem gambling was modelled on that of substance abuse with minimal recourse to supportive empirical evidence. Debate continues to linger as to whether gambling is an addictive, impulse control or obsessive-compulsive spectrum disorder. Therefore, discussion of inherent addictive qualities of gambling as a product is somewhat premature. As a product, gambling is not unique and should not be differentiated from any other human recreational activity. If we start to stigmatize gambling, we are at risk of stigmatizing any appetitive activity that causes harm to a minority. Gambling is construed as a neutral activity in which the majority (97%) of the adult population responsibly participate. The excitement produced by gambling is linked to anticipated wins and not the consequence of the direct act of gambling. Take away the prospect of winning, for example playing a simulated PC gambling game with no money, and the activity becomes boring. Erroneous and irrational beliefs and misunderstandings of probability theory and concepts of mutual independence of chance events maintain persistence in gambling in the face of adverse consequences. Therefore, a cognitive rather than addictive model describing the phenomenon of dependence observed in gambling appears a more parsimonious explanation of problem gambling. Gambling does not cause addiction any more than open department store displays and marketing strategies can be said to cause kleptomania or compulsive shopping. A powerful car does not make the driver speed. As in a range of other areas of excessive appetitive behaviours, community education programs in conjunction with initiatives to change attitudes toward participation in gambling is a far more effective approach to reduce the incidence of problem gambling than restrictive legislative policies. After all, the moral imperative of the prohibition era did little to eliminate alcoholism or problem gambling. This is why we strongly believe that informed choice is the pivotal element in reducing harm that is potentially associated with gambling activities. I would like to thank Professor Robert Ladouceur for his comments on this commentary. The author has received funding support for research into gambling from the NSW Government funded Casino Community Benefit Fund, the National Health and Medical Research Council, the Gambling Industry Operators Group and the Australian Gaming Council. He was on the Responsible Gaming Expert Advisory Committee for Crown Casino and is a member of the Victorian Gambling Research Strategy Independent Peer Review Panel. He is a founding member of the NSW Council for Problem Gambling and the National Association for Gambling Studies.
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