Industry interests in gambling research: Lessons learned from other forms of hazardous consumption

Involving lived experience in regional efforts to address gambling-related harms: going beyond 'window dressing' and 'tick box exercises'

BACKGROUND

Lived Experience (LE) involvement has been shown to improve interventions across diverse sectors. Yet LE contributions to public health approaches to address gambling-related harms remain underexplored, despite notable detrimental health and social outcomes linked to gambling. This paper analyses the potential of LE involvement in public health strategy to address gambling-related harms. It focuses on the example of a UK city-region gambling harms reduction intervention that presented multiple opportunities for LE input.

METHODS

Three focus groups and 33 semi-structured interviews were conducted to hear from people with and without LE who were involved in the gambling harms reduction intervention, or who had previous experience of LE-informed efforts for addressing gambling-related harms. People without LE provided reflections on the value and contributions of others' LE to their work. Data analysis combined the Framework Method with themes developed inductively (from people's accounts) and deductively (from the literature, including grey literature).

RESULTS

Four themes were identified: (1) personal journeys to LE involvement; (2) the value added by LE to interventions for addressing gambling-related harms; (3) emotional impacts on people with LE; and (4) collective LE and diverse lived experiences. Two figures outlining LE involvement specific to gambling harms reduction in the UK, where public health efforts aimed at addressing gambling-related harms coexist with industry-funded programmes, are proposed.

CONCLUSIONS

Integrating a range of LE perspectives in a public health approach to gambling harms reduction requires local access to involvement for people with LE via diverse routes that are free from stigma and present people with LE with options in how they can engage and be heard in decision-making, and how they operate in relation to industry influence. Involving LE in gambling harms reduction requires enabling people to develop the affective and critical skills necessary to navigate complex emotional journeys and a challenging commercial and policy environment.

Young people's views about the use of celebrities and social media influencers in gambling marketing

Young people's exposure to gambling marketing has had a clear impact on their gambling attitudes, risk perceptions and consumption intentions. Celebrities and social media influencers (SMIs) are increasingly used by the gambling industry in a wide range of promotions. While there is evidence that these types of promotions are influential in shaping young people's attitudes towards other harmful products, there is limited evidence in relation to gambling. Qualitative focus groups (n = 22) with n = 64, 12-17 year olds were conducted in Australia. These investigated young people's exposure to celebrity and SMI marketing for gambling and the influence they perceived this marketing had on young people's gambling attitudes. Reflexive thematic analysis was used to construct four themes from the data. First, young people perceived that celebrities and SMIs created additional appeal and recall of gambling advertisements because they were attention grabbing and familiar. Second, young people thought that celebrities and SMIs increased the trust, legitimacy and social acceptance of gambling. Third, the use of celebrities and SMIs lowered the perceptions of risk associated with gambling. Lastly, there were suggestions to reduce the impact of celebrity and SMI gambling promotions on young people, such as bans and restrictions. This study highlights the importance of a comprehensive approach to preventing young people's exposure to gambling marketing, that not only considers imposing stronger regulations to restrict the way the gambling industry is allowed to promote its products, but also aims to counter the novel ways the gambling industry attempts to appeal to children and young people.

The politics and fantasy of the gambling education discourse: An analysis of gambling industry-funded youth education programmes in the United Kingdom

Background

The provision of commercialised gambling products and services has changed radically in recent decades. Gambling is now provided in many places by multi-national corporations, with important implications for public health and policymaking. The United Kingdom is one of the most liberalised gambling markets globally, however there are few empirical analyses of gambling policy from a public health perspective. This study aims to provide a critical analysis of a core element of UK gambling policy, the provision of industry-funded youth gambling education programmes.

Methods

Adopting a commercial determinants of health lens, a discourse theoretical analysis was conducted using the logics of critical explanation. The data comprised resources provided by three gambling industry-funded charities (GambleAware, GamCare and the Young Gamers and Gamblers Education Trust) and their partners.

Results

The resources present a gambling education discourse that serves to reproduce the 'responsible gambling' agenda, while problematising children and young people. While the resources appear to offer educational content and opportunities for debate, the dominant focus is on teaching about personal responsibility and on the normalisation of gambling and gaming and their industries, while constraining the concept of agency. The resources encourage young people to act as individuals to control their impulses, and to correct what are portrayed as faulty cognitions with the aim of becoming responsible consumers. Our findings demonstrate how the gambling education discourse aligns with wider industry interests, serving to deflect from the harmful nature of the products and services they market while shifting responsibility for harm onto children, youth and their families.

Conclusions

Despite being delivered in the name of public health, the resources construct a discourse favourable to corporate interests. Educators, parents, policymakers, and others need to be empowered to address the conflicts of interest that exist in the delivery of gambling industry-funded resources. The promotion of such industry-favoured interventions should not be allowed to undermine efforts to implement regulations to prevent gambling harms.

A Systematic Review of Internet Delivered Interventions for Gambling: Prevention, Harm Reduction and Early Intervention

Internet delivered interventions are accessible and easy to access and can be used to deliver brief interventions. These interventions can be tailored according to individual need for the prevention and minimisation of gambling harm or early intervention for those that are displaying some signs of problems. The objective of this review was to summarise the existing literature on the effectiveness of prevention, harm reduction and early intervention programs when delivered online. A systematic review was conducted for peer-reviewed studies that evaluated internet delivered interventions for the prevention, harm reduction or early intervention for gambling problems. Four electronic databases were consulted in the past 20 years (2000-2020) resulting in a total of 15 included studies. Across identified studies just one study provided prevention with 7 harm reduction and 7 early interventions. The quality of the literature was variable with just 8 randomised controlled trials with the remainder matched controls or longitudinal cohort studies. The target group was predominantly gamblers accessing betting and casino websites (n = 8). Studies administered four types of interventions which included personalised and normative feedback, limit setting, self-directed cognitive and behavioural therapy and self-exclusion. These were delivered via customer gaming accounts, email, and self-learning packages. The available literature shows promise in the effectiveness of internet delivered interventions. However, the limited number of studies included in this review highlight significant lost opportunities to leverage technology in the prevention and reduction of gambling harm.

Expanding on the multidisciplinary stakeholder framework to minimize harms for problematic risk-taking involving emerging technologies. •

As new types of problematic behaviors and new forms of online risk-taking emerge, forming collaborative relationships while understanding complexities of motivations may help to promote harm reduction and intervention. While it may be too early to form a stakeholder framework without first conceptually understanding the problematic behaviors involved, we attempt to build upon a proposed multidisciplinary stakeholder framework to minimize harms for problematic risk-taking involving emerging technologies. We propose an expansion of roles for individual stakeholders and an expansion of proposed roles for family stakeholders to include partner/spouses, others living in the household, and/or those with close relationships with individuals who are experiencing problems. Empowering individuals who use emerging technologies through participatory action research and knowledge translation/dissemination may lead to improvements in the quality of research and a greater impact on policy and practice. Also, we discuss benefits of industry self-regulation and collaboration on data-sharing practices. We recommend approaches to promote global collaboration with a larger group of relevant stakeholders (including but not limited to individual consumers of technology, families, communities, treatment and welfare providers, researchers, industries, and governments) to address protection of vulnerable populations and reduce harms for users of rapidly advancing technologies.

Editor and peer reviewer financial conflict of interest policies in public health journals

The influence of harmful commodity industries on health research has heightened concerns around author financial conflicts of interest (FCOIs) in public health journals (PHJs), with little discussion of potential editorial, i.e., editor and reviewer, FCOIs. In this analysis of 20 prominent PHJs, detailed disclosure requirements, the inclusion of timeframes, and policy accessibility were found lacking in editorial, compared with author, FCOI policies. Disclosure forms were employed in 32% of PHJs for authors but not for editors or reviewers. Recusal policies were similar for reviewers (68%) and editors (60%). Strengthening editorial FCOI policies will increase the integrity of PHJs' editorial processes.

'It's a tradition to go down to the pokies on your 18th birthday' - the normalisation of gambling for young women in Australia

OBJECTIVE

To understand the range of factors that may influence the normalisation of gambling for young women in Victoria, Australia.

METHODS

In-depth qualitative telephone interviews with 45 women aged 18-34 years.

RESULTS

Young women were exposed to gambling environments and some were gambling from an early age. Family members were the key facilitators of these activities. Once reaching the legal age of gambling, peers and boyfriends were instrumental in young women's gambling practices. Women attributed the normalisation of gambling to excessive marketing, feminised gambling environments, and the widespread availability of gambling in the community.

CONCLUSIONS

This study found several factors that influenced and encouraged young women to gamble, such as the feminisation of gambling products and environments, and determined that gambling is becoming a socio-culturally accepted activity for young women. Implications for public health: Researchers and policymakers should be increasingly focused on how different forms of gambling may be normalised for young women. Attention should be given to how young women may become a target market for the gambling industry, and how to implement strategies aimed at preventing any future potential harm posed by these industries and their marketing tactics and products.

A public health advocacy approach for preventing and reducing gambling related harm

OBJECTIVE

To develop a framework to guide the application of public health advocacy strategies aimed at preventing and reducing gambling-related harm.

METHODS

A narrative review of theories of change and public health advocacy literature.

RESULTS

An eight-step public health advocacy framework was created, which outlines the critical steps and considerations when developing and implementing successful change efforts. Implications for public health: To date, a clear public health advocacy approach to gambling harm prevention and reduction has not been well established. This study proposes a gambling-specific framework to guide future public health advocacy efforts to prevent and reduce gambling harm.