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Examining whether reporting one or more potential adverse consequences from gambling provides a valid population-level indicator of gambling-related harm.
Published: 16 July 2026
Last updated: 16 July 2026
This version was printed or saved on: 16 July 2026
Online version: https://www.gamblingcommission.gov.uk/report/measuring-gambling-related-harm-validating-a-summary-metric-of-potential-adverse-consequences
To build our understanding of the nature and prevalence of gambling-related harm within the population, we developed a set of survey questions that focus on some of the adverse consequences people might experience from gambling (Gambling Commission, 2024a). The survey questions distinguish between severe consequences, which are clearly and unequivocally harmful (for example, relationship breakdown or violence), and potential adverse consequences, which vary in severity and could have more cumulative effects on people's lives (for example, reducing spend on everyday items). The intention was to start to broaden our understanding rather than simply relying on the Problem Gambling Severity Index (PGSI, Ferris & Wynne, 2001 (opens in new tab)) as the only indicator.
In the 2025 Gambling Survey for Great Britain (GSGB), we report the percentage of people who endorse 'one or more' potential adverse consequences from gambling. This summary metric allows us to easily show trends in potential adverse consequences over time.
The primary aim for this report was to assess whether the prevalence of people reporting ‘one or more’ potential adverse consequences can be used as a meaningful topline indicator of gambling-related harm in the population.
To achieve this, we examined whether participants who report ‘one or more’ potential adverse consequences have poorer outcomes on other measures of health and wellbeing, compared with those who do not report adverse consequences from gambling. The purpose of this comparison was not to establish a causal link between potential adverse consequences and wellbeing, but to test whether the 2 are associated: If the summary metric captures meaningful experiences of harm, then people who report one or more potential adverse consequences would be expected to have poorer wellbeing than those who do not. We also explored the extent to which these groups differ on a range of demographic characteristics and gambling behaviours.
Compared with those who reported no adverse consequences from gambling, participants who reported ‘one or more’ potential adverse consequences:
The association between 'one or more' potential adverse consequences and poorer health and wellbeing remained significant after controlling for demographic differences.
These findings suggest that monitoring the prevalence of people experiencing ‘one or more’ potential adverse consequences will provide a useful further perspective and insight into the impact of gambling across the population. We therefore plan to report this metric in future GSGB publications, alongside other measures of harm and PGSI scores.
Protecting vulnerable people from being harmed or exploited by gambling is one of the Gambling Commission's core licensing objectives. Our Evidence Roadmaps identify the need to build our understanding of how gambling harms are experienced and who is most at risk (the Commission, 2025a).
To assess the prevalence of gambling-related harm within the population, we developed a set of survey questions that focus on some of the adverse consequences people might experience from gambling (the Commission, 2024a). This enabled us to broaden our understanding of gambling-related harm rather than simply relying on the Problem Gambling Severity Index (PGSI, Ferris & Wynne, 2001 (opens in new tab)) as the only indicator. The questions align with Wardle et al.'s (2018) Framework for Action (opens in new tab), which categorises gambling-related harm across 3 domains:
The survey questions distinguish between severe consequences, which are clearly and unequivocally harmful (for example, relationship breakdown or violence), and potential adverse consequences, which vary in severity and could have more cumulative effects on people's lives (for example, reducing spend on everyday items). We found that responses to these questions predicted variance in mental wellbeing beyond that explained by PGSI scores alone, suggesting that they provide a valid and conceptually distinct measure of gambling harm ((PGSI, Ferris & Wynne, 2001 (opens in new tab)), the Commission, 2024a).
In previous Gambling Survey for Great Britain (GSGB) publications, we reported the percentage of people who endorsed each ‘potential adverse consequence’ individually (that is, those responding 'occasionally', 'fairly often', or 'very often'). Going forward, we plan to report trends in potential adverse consequences over time, and this requires a summary metric that captures their overall prevalence across the population. One approach that we have used in this year’s GSGB publication is to report the percentage of people who endorse 'one or more' potential adverse consequences from gambling.
The primary aim of this report was to assess whether the prevalence of one or more potential adverse consequences provides a valid indicator of gambling-related harm. To test this, we examined whether participants who report one or more potential adverse consequences have poorer outcomes on measures of health and wellbeing, compared with those who do not report adverse consequences. The purpose of this comparison was not to establish a causal link between potential adverse consequences and wellbeing, but to test whether the 2 are associated: If the summary metric captures meaningful experiences of harm, then people who report one or more potential adverse consequences would be expected to have poorer wellbeing than those who do not. We also explored the extent to which these groups differ on a range of demographic characteristics and gambling behaviours. Results from this analysis will inform how we monitor and report adverse consequences in future GSGB publications, and provide insight into who is most at risk.
The 2025 Gambling Survey for Great Britain (GSGB) collected data from adults aged 18 years and older living in Great Britain (N=20,775). Fieldwork was carried out between January 2025 and January 2026. Further details, including the strengths and weaknesses of the methodology, can be found in the GSGB technical report (Gambling Commission, 2024b).
The following questions were used to assess potential adverse consequences from gambling (that is, consequences which vary in severity and can have cumulative effects on people’s lives)1:
How often, in the last 12 months, has gambling led you to:
Response options were 'Never', 'Occasionally', 'Fairly often', and 'Very often'.
Item endorsement was defined as responding 'Occasionally', 'Fairly often', or 'Very often'. A binary indicator was then derived to identify participants who reported one or more potential adverse consequences, based on endorsement of at least one item.
We compared participants who reported one or more potential adverse consequences, with those who reported no adverse consequences, on the following measures2:
Short Warwick–Edinburgh Mental Wellbeing Scale (SWEMWBS). The SWEMWBS captures positive experiences such as feeling optimistic, useful, and able to think clearly. Higher scores indicate better mental wellbeing.
Self-rated general health. Participants were asked to rate their general health using a five-point scale ranging from 'Very bad' to 'Very good'.
Suicidal thoughts or attempts. Participants were asked whether they had thought about or attempted suicide in the past 12 months.
Problem Gambling Severity Index (PGSI). The PGSI was used to assess gambling behaviours associated with increased risk. The scale consists of 9 questions relating to 'at-risk' patterns of gambling, such as chasing losses and spending beyond one's means. PGSI scores range from 0 to 27 and are categorised as follows: 0 'non-problem gambling', 1 to 2 'low risk gambling', 3 to 7 'moderate risk gambling', and 8 or more 'problem gambling'.
Types of gambling activity. We compared which gambling activities participants had played in the past 4 weeks (for example, lottery draws, scratchcards, sports betting, casino games, slots, and bingo), and whether they had gambled online, in person, or both.
Number of different gambling activities. We also compared the number of different types of gambling activities participants had played in the past 4 weeks.
We compared participants' age, sex, ethnicity (White or ethnic minority background), equivalised household income quintile, and educational attainment (whether they held an educational qualification).
Follow-up regression analyses were conducted to test whether reporting one or more potential adverse consequences from gambling was independently associated with poorer health and wellbeing after controlling for demographic characteristics.
1 Potential adverse consequences were also captured using 3 PGSI items:
To avoid confounding the outcome and predictor variables in subsequent analyses, responses to these items were used only in the calculation of PGSI scores and were not included as indicators of adverse consequences.
2 Chi-squared tests were used to compare categorical variables, and Mann–Whitney U tests for continuous variables. Post-hoc pairwise comparisons used Bonferroni corrections for multiple comparisons.
The sample consisted of 12,194 participants who had gambled in the past 12 months. Of these, 11.7 percent reported ‘one or more’ potential adverse consequences.
Two-fifths (41 percent) of participants who reported ‘one or more’ potential adverse consequences, reported only one (Table 1). The most frequently reported consequences were ‘reducing or cutting back spending on everyday items’ (55 percent), ‘lying to family or others’ (50 percent), and using savings or increased use of credit (50 percent).
| Number of potential adverse consequences | Percent of participants with 'one or more' potential adverse consequences |
|---|---|
| 1 | 41 |
| 2 | 17 |
| 3 | 8 |
| 4 | 7 |
| 5 | 11 |
| 6 | 17 |
Unweighted base: Participants reporting ‘one or more’ adverse consequences from gambling (N=1,119). Note: Base excludes participants who did not give valid responses to all 6 questions about potential adverse consequences.
Participants who reported ‘one or more’ potential adverse consequences from gambling had significantly poorer mental wellbeing (as indicated by lower Short Warwick–Edinburgh Mental Wellbeing Scale (SWEMWBS) scores) than those who reported no adverse consequences (Table 2). They were also twice as likely to say they had thought about, or attempted, suicide in the past year (20.9 percent compared with 10.4 percent), and were more likely to rate their general health as ‘bad’ or ‘very bad’, compared with those who did not report adverse consequences from gambling (9.1 percent compared with 5.1 percent).
| Variable | No adverse consequences | One or more adverse consequences | Significance test |
|---|---|---|---|
| Mean SWEMWBS score (Standard Deviation) | 25.3 (4.7) | 22.6 (5.4) | Significantly different |
| Suicidal ideation (percentage) | 10.4% | 20.9% | Significantly different |
| Self-rated general health: Bad and/or Very bad (percentage) |
5.1% | 9.1% | Significantly different |
| Base size (unweighted)† | 10,976 | 1,126 | N/A |
Participants who reported ‘one or more’ potential adverse consequences from gambling were significantly younger than those who did not report adverse consequences (mean age 41 years, compared with 50 years) (Supplementary Table S1). The prevalence of ‘one or more’ potential adverse consequences was highest among males (14 percent compared with 9 percent of females), people from ethnic minority backgrounds (28 percent compared with 9 percent of White participants), those living in lower-income households (15 percent compared with 8 percent of people in higher-income households), and those who do not hold an educational qualification (16 percent, compared with 10 percent of those with an educational qualification).
Participants who reported ‘one or more’ potential adverse consequences scored higher on the Problem Gambling Severity Index (PGSI) compared with those who did not report adverse consequences from gambling. They also engaged in a greater number of gambling activities in the past 4 weeks (Table 3), and were more likely to have taken part in all gambling activities except for lottery draws (Supplementary Table S2). The largest differences were observed for participation in casino games (23 percent compared with 3 percent), fruit and slot games (27 percent compared with 6 percent), and event betting (16 percent compared with 1 percent). Both online and in-person gambling participation rates were higher among those who reported ‘one or more’ potential adverse consequences (Supplementary Table S2).
| Variable | No adverse consequences | One or more adverse consequences | Significance test (p<0.05) |
|---|---|---|---|
| Median PGSI score (inter-quartile range) | 0 (0 to 0) | 4 (1 to 9) | Significantly different |
| Median number of gambling activities played (inter-quartile range) | 1 (1 to 2) | 2 (1 to 4) | Significantly different |
| Base size (unweighted)† | 10,976 | 1,126 | N/A |
Follow-up regression analyses showed that associations between ‘one or more’ potential adverse consequences and poorer health remained significant after controlling for age, sex, ethnicity, education, and household income. Regression outputs are provided in supplementary material (Tables S3 to S5).
† Base excludes participants who did not respond to one or more of the questions.
The aim of this report was to test whether the prevalence of ‘one or more’ potential adverse consequences provides a valid top-level indicator of gambling-related harm. We examined whether participants who report one or more potential adverse consequences have poorer outcomes on measures of health and wellbeing, compared with those who do not report adverse consequences. We also compared these groups on a range of demographic characteristics and gambling behaviours.
Participants who reported one or more potential adverse consequences from gambling had poorer mental wellbeing and self-rated health, and were nearly twice as likely to report suicidal ideation or attempts. They were also more likely to be younger, male, from ethnic minority backgrounds, living in lower-income households, and without an educational qualification. Importantly, associations between one or more potential adverse consequences and poorer health and wellbeing remained significant after controlling for demographic characteristics. These findings suggest that monitoring the prevalence of people reporting ‘one or more’ potential adverse consequences offers a useful population-level indicator of gambling-related harm.
Our findings showed that participants who reported one or more potential adverse consequences played a wider range of gambling activities compared with those who did not report adverse consequences. They also scored higher on the Problem Gambling Severity Index (PGSI), and were more likely to have played each type of gambling activity over the past 4 weeks, except for lottery draws. The largest differences were observed for casino games, fruit and slots, and event betting. This is consistent with our previous research, which showed that participation in these activities was most strongly associated with increased gambling risk (assessed using the PGSI) and both potential and severe adverse consequences (Gambling Commission, 2025b; the Commission, 2026).
The link between potential adverse consequences from gambling and suicidal ideation reflects findings across the wider evidence base. For example, a recent meta-analysis found that people with gambling disorder had more than double the odds of suicidal ideation and nearly triple the odds of suicide attempts, compared with those without gambling disorder (Kristensen and others, 2024 (opens in new tab)). However, evidence on gambling-related suicide in Great Britain remains limited. Strengthening this evidence base is therefore a key priority for the Commission, and our evidence roadmaps emphasise the need for more robust data on deaths by suicide related to gambling (the Commission, 2025a). Improving the quality and availability of this evidence will be important for informing effective regulatory approaches.
It is important to note that the prevalence of people with one or more potential adverse consequences provides a summary of the overall prevalence of adverse consequences and does not capture their frequency or severity. While our findings indicate that the metric adequately reflects experiences of harm, we will continue to report endorsement of individual items alongside this summary metric. It should also be noted that, because the Gambling Survey for Great Britain (GSGB) is a cross-sectional survey, these findings cannot establish causality; poorer health and wellbeing may result from adverse consequences of gambling, contribute to them, or reflect shared underlying factors.
This report contributes to Theme 3 of our evidence priority roadmaps, which focuses on understanding gambling-related harms and identifying who is most at risk (Gambling Commission, 2025a). Our findings show that people who report one or more potential adverse consequences from gambling have poorer mental wellbeing and self-rated health, and a higher likelihood of suicidal ideation compared with those who do not report adverse consequences. These associations remained significant after controlling for demographic characteristics, indicating that this metric captures meaningful differences in health and wellbeing.
Taken together, these findings support the use of one or more potential adverse consequences as a population-level indicator of gambling-related harm. We therefore plan to report this metric in future Gambling Survey for Great Britain (GSGB) publications, enabling us to monitor trends in adverse consequences over time. This analysis also provides insight into who is most likely to experience adverse consequences from gambling, which will help inform efforts to protect those most vulnerable to harm. Going forward, we will continue to develop a wider range of indicators that, taken together, will provide a more rounded understanding of gambling-related harm across the population.