Gambling Harm Reduction Policy v. Tobacco and Other Harm Industries

Tobacco use is falling all the time in the UK. Some of this is the result of increased awareness of harms among on individuals. This results partly from public health campaigns and education in schools. But most of it is because of the factors indicated in the diagram above. Education is seen as less powerful than the impact of potent regulatory changes. The reduction – but not elimination – of disease, including fatal disease is an achievement reached after many decades of campaigning, in earlier days fought against by the tobacco industry and its various supporters.

Concerns about harms from gambling are more recent. Whereas tobacco users at any level are at very high risk of serious and fatal diseases, the vast majority of gambling consumers will suffer little or no harm. However, as with alcohol, all consumers are at some risk. Like alcohol, a significant number are suffering low to moderate levels of harm that impact negatively. Such a sector of the population moves towards higher risk, among them an unacceptable number of children and young people.

In any case, that between one and three percent of the population are suffering extreme harms, and between six to ten others will be seriiously affected by each gambler, and gambling is increasingly identified as a major cause of suicide, there is very clearly an urgent public health issue. There are certainly strong grounds for adopting the precautionary principle while current efforts to achieve evidence and prevalence of harmscontinue .

The ‘dominant narrative’ around harm prevention, favoured by the gambling industry and its supporters, is to educate people. Provision of ‘gambling education’ is now compulsory in English schools but not in Scotland. Everybody who works in education will probably agree that in general education about risks attendant upon gambling, alcohol and other hard drugs, unhealthy lifestyles, financial mismanagement, online behaviours and so on is patchy and varies widely between schools. Such ‘personal, social, health and economic’ education is often not given the priority it deserves. To this, there are increasing calls for ‘mental health education’. A further problem is that there is very little promotion of expertly designed curriculm design. Evaluation of delivery of these areas is generally difficult. Some individual schools can be held up as excellent exemplars but HM Inspectors usually report significant weaknesses. Pupils themselves, when asked, are not enthusiastic about such areas of the curriculum which may be delivered in fragmented chunks – three sessions about alcohol now and then. It’s not the schools’ or the teachers’ fault. They’re increasingly expected to be the sink in which some of society’s most intractable problems are supposed to be solved. Finally, to focus upon gambling, what if any evidence is there that a limited number of hours of discrete ‘gambling education’ has a measurable and significant effect on reducing gambling harms at population level.

The PSHE Assocation of teachers south of the Scottish border continue to work extremely hard to have the eduacational topics suggested above taken more seriously, given more resources, and seeing a senior school manager (for instance, a Deputy Head) have responsibility for organising a cross-discipline curriculum designed to progress from one year group to the next. Nationally, guidelines would be produced demonstrating age appropriate development from infant to school leavers. This would be buttressed by local authority specialist advisers and driven by  government policy, such delivery being resourced with specialist officers.

Asking questions about education’s role in preventing gambling harms must not imply it has no role to play.  The specialist gambling education in Scotland, Fast Forward, is more aware than most of us of the difficulties they face in providing high quality delivery to a fragmented education system in much need of radical reform. They are among the first to see the part they play in reducing gambling harms as running alongside many other stakeholders such as Public Health Scotland, the Scottish Alliance for Health and Social Care, the British Medical Association and others in influencing the powers of  regulators and government.

But at a societal level we live with an ideology that promotes personal responsibility at the heart of everything. If unemployment has devastated your area you should get on your bike and ride hundreds of miles get a job.  There is a danger that while we must continue pushing for a greatly improved education system and celebrate the value of education,  education can fall into the trap of supporting a dominant myth that if you become ill, depressed, addicted, suicidal – well, it’s all down to you. The problems aren’t with injustice, inequality, exploitation, trauma – the problem is you and only you can solve it.

The dominant narrative favoured by the gambling industry rests on personal responsibility (hence ‘responsible gambling’) and education as a cure-all protection against such industry practices as clustering bookmakers in deprived areas, saturation advertising, micromarketing and enticements via social media, and mass producing products designed to addict. If, this narrative goes, there are people devastated by gambling they are ‘problem gamblers’ Which is like saying that the 25% of Scots who leave school functionally illiterate must have been ‘problem pupils’.