National Strategy to Reduce Gambling Harms 2019 to 2022

Prevention and education

Overview

The National Strategy to Reduce Gambling Harms was launched in April 2019 and ran until April 2022. The content and actions in these pages refer to programmes of activity to reduce gambling harms during that time.

An effective prevention plan must seek to identify the right mix of interventions to be applied at both the population and individual level.

It must also deliver a clearer understanding of activities which are less effective, or counterproductive, and should be stopped.

'Prevention' of gambling harms will include a broad spectrum of measures at population level, such as regulatory restrictions on product, place and provider. This priority also includes reference to public health messaging and education programmes, and to specific work with individuals who are at risk of harm.

A future prevention plan will need to consider the range of possible approaches, which includes the following.

Many prevention measures are already in place, whilst others are being developed. However, not enough is known collectively about which of these activities and programmes designed to prevent gambling harms should be extended or applied in order to achieve maximum impact.

Equally, there is evidence from other fields of addiction that prevention activities, if not done properly, can have little or no impact or carry the risk of unintended consequences.

At the universal level, gambling businesses are required to offer safer gambling information to customers and a range of preventative tools to limit time or money spent or to take time-outs from gambling.

Our understanding of how consumers use these tools and how to increase take-up is developing but still at an early stage.

For at-risk groups, campaigns and workforce education can be applied across a wide range of environments from healthcare and education professional settings to those in the third sector, such as debt advisers.

It is as yet unclear what the long-term effects on behaviour and attitudes of some education programmes such as those currently being delivered in schools will be, though care has been taken to align to the curriculum and set learning objectives.

Regulatory requirements apply to the identification of at-risk individuals by gambling businesses, but the Commission is driving further progress, and consideration is being given by financial, public health and third sectors on how to develop further means of identifying these individuals and applying measures to prevent harm.

Together, these and other activities designed to prevent gambling harms may have a positive impact, but there is further work to be achieved on co-ordination and evaluation.

At the moment, it is difficult to evidence how effective any or all of these are at reducing gambling harms. Therefore, in order to measure how effective these activities are, a key action will be to progress the framework for measuring harms under the Commission’s research programme.

We will also need to align this work to that being carried out by others.

This includes work:

• commenced by Public Health England and the National Institute of Health Research to conduct evidence reviews on gambling harms
• being undertaken in Wales, building on the Annual Report 2016 to 2017: Gambling with our health (opens in new tab) by the Chief Medical Officer for Wales
• progressed by the Scottish Public Health Network (ScotPHN) develop and implement a whole population approach to prevention and reduction of gambling harms, read more in the ScotPHN gambling update (PDF)

The framework for measuring gambling harms experienced by adults

Area	Impacts
Relationships	Partners, families and friends, community
Resources	Work and employment, money and debt, crime.
Health	Physical health, psychological distress, mental health.

Reducing gambling harms

We must improve our understanding of the impact of prevention activities on reducing gambling harms. Current screening tools that measure the prevalence of people identified as problem gamblers provide a useful insight, and will continue to do so, but they fail to capture the full scale of harms that are caused by gambling.

Progressing the frameworks for measuring gambling harms, is therefore an urgent priority for the strategy. In addition to the adult framework which was published last year, a specific framework for children and young people who are likely to experience harms from gambling in different ways, will be published shortly.

A better understanding of gambling harms for adults and children and young people will help to target prevention and education initiatives where they will have most impact. This work will span the life of the strategy and beyond, and at each stage new information about these harms will be used to further refine approaches to prevention and education activities.

Gambling-related harms may affect young people now, as well as their future potential.

They include the following factors:

• financial - living standards of family and attitudes to and concerns about money
• development - education and social and emotional functioning
• relationships - such as behaviour, family, friends and the community
• health - physical and mental health and family emotional wellbeing.

Realising the aim

All links to external organisations on this page open in a new tab.

A range of bodies across Great Britain, including Public Health England and Wales, NHS Health Scotland , Scottish Public Health Network, the Department for Education, and those gambling charities and experts by experience are actively working in the area of prevention and education and have a critical role to continue to support this work and help coordinate and target activity.

Work is already underway in England, Scotland and Wales. For example, the National Institute for Health Research (NIHR) assessment of gambling harms, the Public Health England evidence review of health aspects of gambling harms, and the NIHR call for proposals to measure the effect of prevention interventions.

Over the life of the strategy, research, expertise and action by all parties will need to be shared to inform the ongoing approach.

Treatment and support

Overview

The National Strategy to Reduce Gambling Harms was launched in April 2019 and ran until April 2022. The content and actions in these pages refer to programmes of activity to reduce gambling harms during that time.

Developing truly national treatment and support options includes availability of the right support, in the right place at the right time.

It means making treatment more accessible and relevant to those who need it, improving existing commissioning and oversight arrangements, improving care pathways via primary and social care, and support for those who have other mental health issues alongside experiencing gambling harms.

The aim is to make significant progress towards an effectively commissioned, comprehensive national treatment and support offer that meets the needs of current and future service users. There are a limited number of services available for people who are experiencing harm from gambling.

These are restricted in terms of funding, geographical coverage and reach, compared proportionately to that of other addictions, though waiting lists for access to these services are relatively short.

We welcome the commitment in the NHS England Long Term Plan (opens in a new tab), and the progress being made to develop in partnership with the Northern Gambling Clinic and Leeds Support Hub (the second NHS-hosted clinic commissioned and funded by GambleAware).

There is a discrepancy between the numbers of people experiencing harm and might be assumed to be receptive to treatment, and the numbers of people we know are currently accessing some form of formal treatment or support.

There are around 2 million adults who may be experiencing some level of harm from their gambling, including 340,000 people who are classified as problem gamblers in Great Britain, as found in the Gambling behaviour in great Britain report (PDF). A significant number who may benefit from treatment or support may either not be aware of the options, or are not accessing those options.

The majority of specialist services for those affected by gambling harms in Great Britain is currently commissioned and funded via GambleAware. GambleAware seeks to commission treatment for problem gambling across England, Scotland and Wales, free at the point of delivery.

This charity receives the bulk of its funds from industry donations which are made as a licence condition to provide funding to support research, prevention and treatment. The amounts and the recipients of these voluntary contributions are not specified, and therefore uncertain. This arrangement is often referred to as ‘the voluntary arrangements’.

Based on the data available, in 2017 and 2018 around 8,800 people received treatment through GambleAware-funded services, and the national helpline received 30,000 calls. It is unknown how many people receive support through networks such as Gamblers Anonymous, or through smaller charitable or community support groups.

This figure is about 2% of those who are classified as problem gamblers. Treatment may not be needed by all of these individuals, but in contrast early brief treatment or support is often needed by a much wider range of people, such as those at risk of or experiencing moderate harm, or affected others.

Primary care and other NHS services are currently diagnosing and treating people for co-occurring challenges or conditions such as alcohol dependency or mental ill health, for whom gambling may be a related factor.

Limited data on this method of diagnosis and potential treatment is available but is not routinely collected, so it is uncertain how many people have accessed some form of treatment or support in this way, and the extent of the role NHS treatment services already play is hidden.

While some people will recover without help, this discrepancy between the numbers of people in treatment compared to the potential need raises concerns about underdeveloped referral routes into treatment and support, a potential lack of awareness of the services available, for example by GPs and social workers, and a lack of national availability.

There is also a knowledge gap in terms of where the unmet need is, what types of treatment and support are most effective, for whom and in what circumstances.

Treatment services across England, Scotland and Wales should provide the right mix of a broad range of options that address the identified needs.

This should include:

• access to a national helpline
• individual treatment
• group treatment and support
• online treatment and support
• residential treatment
• peer support
• support for affected others.

Collectively, we need to understand further the effectiveness of the various treatment methods for those with gambling addiction and those experiencing gambling harms, in order to identify which treatment methodologies and support options best suit different groups.

We also need to understand much more about those who do not access treatment or support in order to identify the barriers to access, such as the stigma that can be associated with gambling addiction, and ways to overcome those barriers. This will inform and support future work led by others to increase the reach of treatment and for long-term sustainability.

Through our research programme, the Gambling Commission is committed to driving and supporting progress to ensure that current GambleAware commissioned treatment options are evaluated and that treatment needs are assessed across England, Scotland and Wales to address current geographical barriers to access, increase the numbers receiving treatment and target treatment options to where there is greatest need.

This assessment will also consider those who are not seeking treatment, to understand how their needs could be addressed.

Realising the aim

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We support the positive moves by government departments and public health bodies across Great Britain to understand the nature of gambling alongside other forms of addiction, and also the nature and impact of gambling harms.

We welcome the commitment by NHS England to extend the reach of treatment. The wider work to reduce health inequalities will also need to continue in order to achieve NHS mental health and wellbeing outcomes, to develop new and strengthen existing partnerships, and to create and maintain effective transitions between mental health services and gambling treatment or care.

These strategic partnerships should seek to embed treatment evaluation, oversight and inspection in ways similar to that which applies in other areas of health and social care. There are important lessons from other sectors, especially on how to involve experts by experience in the design and delivery of services.

The UK government’s referral to the National Institute for Health and Care Excellence (NICE) to consider treatment guidelines for England and Wales will be critical to inform future treatment and support, and partnership working will be key to embedding the guidelines as they progress.

Over time, clinical guidelines can work in tandem with effective standards to enable inspection of treatment services. An appropriate route for such inspection would need to be identified, along the lines of that provided by Care Quality Commission (CQC) in England, Healthcare Improvement Scotland and Healthcare Inspectorate Wales for other treatment services.

Primary care practitioners may be largely unaware of the impact of gambling harms on mental health, so education and training for the healthcare workforce will play a key role in raising awareness of gambling harms when assessing those presenting with stress or other mental health or addiction related disorders.

Health Education England, NHS Education for Scotland and Health Education and Improvement Wales have a role to play in highlighting workforce needs for this population.

Professional bodies are well placed to shape the public health response by raising awareness of gambling harms and educating the workforce.

These include the following:

• Faculty of Public Health
• Royal Society for Public Health
• Royal College of General Practitioners
• Royal College of Psychiatrists
• Royal College of Nursing.

Regulation and oversight

Purpose

The National Strategy to Reduce Gambling Harms was launched in April 2019 and ran until April 2022. The content and actions in these pages refer to programmes of activity to reduce gambling harms during that time.

Regulators and other accountable bodies, such as those who provide oversight or inspection of treatment services, have a key role to play to deliver progress across the strategy.

Regulation and oversight reinforces the public health approach, by making the most of increasing evidence through research and evaluation, facilitating the sharing of good practice, and enabling widespread adoption using existing regulatory frameworks.

The Gambling Commission has a statutory licensing objective to protect children and vulnerable people and has committed to work to prevent harm to consumers and the public from gambling.

We apply a range of regulatory tools and levers to make gambling safer, which include both requirements for and restrictions on product, place and provider, from the start of the customer journey.

The Commission as the national regulator plays a key role to make gambling safer and reduce gambling harms, as outlined in the Commission’s corporate strategy: Making gambling fairer and safer. However, the regulation and oversight of activity to reduce gambling harms also goes beyond the Gambling Commission’s remit.

It ranges from the shared regulation of gambling premises with Licensing Authorities, to work with other national regulators in areas such as advertising and other industries that facilitate gambling, such as financial services.

Working in partnership

Regulators have a range of tools available to facilitate the adoption of best practice, including stopping provision or practices based on evidence of harm. Other bodies also have an interest in reducing gambling harms, and effective partnerships with regulators and other public bodies are essential to harness the potential of regulatory frameworks and standards to reduce gambling harms.

Regulators and other public bodies have a role to assess, understand and evaluate existing practices to find evidence of what does and doesn’t work, and take action to prevent harmful practices where evidence exists.

Partnership actions

To work with and support regulators and other bodies

Regulators such as the Advertising Standards Authority (opens in new tab) or the Competition and Markets Authority (opens in new tab) have a continued role to prevent unfair practices and inappropriate advertising which present an increased risk of harm to vulnerable consumers.

As the system for treatment services develops and expands, the role of oversight/ inspection will become increasingly important.

The Commission will continue to work with these regulators and will further develop working relationships with a range of other bodies.

To support effective local regulation

Licensing authorities have a co-regulatory role. The Commission will continue to support the important work of licensing authorities to implement an effective regime of premises inspection and enforcement to ensure operators are protecting young and vulnerable persons.

This work includes developing and actively applying statements of licensing policy on how they exercise their functions. These statements allow licensing authorities to reflect locally specific gambling concerns and set out clear expectations for local gambling operators to protect consumers and the wider public.

Gambling Commission actions

This strategy forms the basis of the Gambling Commission’s safer gambling priorities. We will expect gambling operators to demonstrate how they are supporting and delivering the strategy through raised standards in compliance, including evidence of ongoing trials and evaluation of safer gambling activities, evidenced through the assurance statement process and our ongoing compliance activity.

As set out in the Commission’s strategy for 2018–21, we will continue to require operators to assess and improve protections designed to prevent gambling harm and support consumers who need help to manage or control their gambling.

Whilst we expect that over time, the developing framework for measuring gambling-related harms will inform where preventative measures should be targeted, we are committed to other actions to make progress as this work continues.

This includes driving live environment trials of preventative interventions as part of the research programme as well as industry-based interventions, such as proactive safer gambling messages to consumers, the design of products and games, and the availability and promotion of safer gambling tools.

Where there is clear evidence of what works to reduce the risk of gambling harms, the Commission will expect widespread adoption by operators, and we will use the full range of our regulatory tools to deliver appropriate consumer protections.

Where we have concerns about practices which might cause harm, we may adopt a precautionary approach to restrict these practices. Where there is conclusive evidence of practices known to cause harm, which are not being mitigated, we will take action to restrict or prevent these in order to reduce harm.

We will continue to assess the effectiveness of controls and tools to support customers to manage or to cease gambling. This will involve continued work with gambling operators to identify and implement improved information and signposting to help and support.

We will continue to hold to account licensees who do not take sufficient action to mitigate against the harms caused by gambling, or take account of lessons learned, using the full range of our enforcement powers, as evidenced by the increasing levels of financial penalties for regulatory failure.

Collaboration

Purpose

The National Strategy to Reduce Gambling Harms was launched in April 2019 and ran until April 2022. The content and actions in these pages refer to programmes of activity to reduce gambling harms during that time.

Businesses and other key organisations with a role in reducing gambling harms need to work, with their regulators, to continue to develop and improve existing practice, and to identify new ways to reduce gambling harms.

Working collaboratively in a coordinated manner to focus efforts and share more widely what does and does not work, will achieve greater impact than more isolated efforts.

The gambling industry is increasingly collaborating on activities to promote safer gambling, and even more can be achieved through active targeting, direction and support for this collaboration by the Gambling Commission as the industry regulator.

Working towards the outcomes in this strategy is by no means restricted to the gambling industry and will require collaboration by all businesses and partners involved in reducing gambling harms.

These include national and local health and social care bodies, commissioning bodies, service providers for prevention and treatment programmes and third sector organisations in order to make real progress.

Groups involved in collaboration:

• Government departments responsible for gambling, health and education
• public health bodies
• research community including individual academics, research centres and charities
• businesses such as gambling, financial, advertising and technology
• health and social care services including funding, commissioning, treatment provision, oversight, professional bodies and charities
• regulators national, local, international (applying advice from the Advisory Board for Safer Gambling)
• consumers service users, and those with lived experience
• third sector education and support charities, including GambleAware, Citizens Advice and other advisory services.

Working in partnership

Businesses who actively innovate and collaborate to reduce gambling harms should be recognised and should share good practice for wider adoption.

Partnership actions

In financial services, businesses should continue to work together to develop and offer tools and controls to help customers manage the amount they spend on gambling, and work to understand and support vulnerable consumers who are at an increased risk of harm.

The Gambling Commission and licensing authorities work in partnership through shared regulation of gambling premises and will use the findings and evidence generated through the developing public health model to build on existing toolkits for gambling, using an evidence-based approach. We will also support the evaluation of the impact of public health plans.

There is a need for businesses, service providers, charities, and local health partnerships to collaborate to provide better signposting and pathways to the range of treatment and support options. This includes workforce education and development to equip practitioners to identify the signs of harm and collaborate to identify the right pathways to support and treatment to meet an individual’s needs.

Gambling Commission actions

Collaboration for and by gambling businesses on prevention and education and treatment and support starts with responsible product and game design, and creating and providing clear information for customers about the risks of gambling and how products behave.

It means improving up front consumer protections to encourage safer gambling, promoting the use of tools to manage gambling as a measure to prevent harm and developing support mechanisms such as exclusion options and referral processes to ensure people who need to cease gambling have the right tools and support to help them do so.

In our annual business plans and through engagement with operators and trade associations, the Commission will set clear priority areas for operators to focus on in order to raise standards.

We will continue to facilitate collaboration to identify what does and doesn’t work and will look at new and innovative ways to share lessons learned, and to recognise and share best practice to accelerate progress.

We expect collaboration to lead to clear outcomes, and for efforts to understand and develop interventions and practices to reduce gambling harms to have a clear purpose, include testing and evaluation, and for findings and outcomes to be shared more widely to help inform safer gambling practices.

Evaluation

Purpose

The National Strategy to Reduce Gambling Harms was launched in April 2019 and ran until April 2022. The content and actions in these pages refer to programmes of activity to reduce gambling harms during that time.

Well-designed and well-delivered evaluation will be a core part of the evidence base for widespread adoption of measures proven to reduce gambling harms.

Good evaluation looks not only at the process, but also the impact on people and behaviour. In order to achieve the overall aim of the strategy, a greater understanding is needed of the impact that interventions and activities have on how people gamble, how they experience harm, and how they respond to prevention and support activities and interventions. This means that evaluation needs to be built in from the beginning of an intervention or project.

The key principles of good evaluation, as set out in the existing protocol are:

Robustness and credibility:

Appropriate evaluation generates robust evidence. This includes drawing on quantitative and qualitative data and incorporating the consumer and, or as well as, user voice.

Proportionality:

Evaluation should be proportionate to the risk and scale of the intervention, so scale should be considered and documented at the outset.

Independence:

Independent evaluation is perceived as more objective, robust and credible, but may not be proportionate for all interventions.

Transparency:

Evaluations should be as open as possible about the rationale and details of the intervention, the evaluation process, results generated, and conclusions. Transparency increases confidence and credibility and allows stakeholders to think about how lessons learned can be transferred.

Working in partnership

Evaluation has started to take place under the Commission’s independent research programme, to help understand the effectiveness of activities designed to reduce the risk of gambling harms, and working with partners to do so.

Examples include evaluating the impact of reducing friction for customers to encourage setting limits in online gambling, trialling safer gambling messaging on gaming machines in bingo premises, and the work to evaluate the effectiveness of multi-operator self-exclusion schemes.

Partnership actions

To support evaluation across all partners

Evaluation is not confined to what the gambling industry does. It is important to find out what works in wider prevention programmes, and in treatment and support options.

The success of the strategy will be reliant on how all parties involved approach and use evaluation to help determine the right mix of interventions and options to prioritise activity and reduce gambling harms.

Good evaluation will enable and empower commissioning bodies to base funding and prioritisation decisions on evidence of what does and doesn’t work.

Longer term evaluation needs

Over the longer term, those involved in delivering the strategy may benefit from a more coordinated approach to evaluation. Options to prioritise and coordinate evaluation, including ownership and implementation, will be explored during the life of the strategy.

Gambling Commission actions

We will work with evaluation experts, and a range of stakeholders delivering interventions to reduce harm, including gambling businesses, to review and revise the 2016 RGSB evaluation protocol (PDF)

It may be appropriate to further supplement the protocol and existing guidance with additional or updated practical tools and advice, in order to raise standards in evaluation at the individual operator level and to begin to embed proportionate evaluation into both current practices, and at the beginning of new practices.

Crucially, we want to understand what does not work as much as what does, so that we can match our expectations to the most effective methods of reducing harms.

It is important that new measures or programmes are properly evaluated. For the Gambling Commission, this includes monitoring progress of significant new policy initiatives or regulatory changes and measuring progress against the strategy from the start. We will support and encourage other bodies to do the same.

Research to inform action

Purpose

The National Strategy to Reduce Gambling Harms was launched in April 2019 and ran until April 2022. The content and actions in these pages refer to programmes of activity to reduce gambling harms during that time.

Reducing gambling harms demands a much stronger link between research and policy, supported by a research programme that both informs and is informed by action, involves a wide range of agencies and researchers, and has the right research infrastructure to deliver it.

Historically, barriers to research have included practical considerations around accessing sufficient consistent and useful data on customers’ gambling activities, and ethical concerns about the source of funding for research.

The strategy is therefore prioritising steps towards the creation of a central data repository that would enable access to anonymous datasets for research.

Over the long-term, this repository would:

• streamline the process for accessing data for research purposes
• accelerate the pace of research
• open up access to a broader range of researchers.

The Gambling Commission’s governance and commissioning arrangements for its independent research programme have already broken the link between funding and commissioning research, and consideration will be given to the long-term research structures that are necessary, including the potential role of one or more research centres.

There is however a need to facilitate better application of the body of evidence to policy decisions. The Commission will be supported and challenged to do so by its independent advisors, the Advisory Board for Safer Gambling.

An independent research hub would enable an ever-increasing evidence base for policy, and therefore drive more effective action. It would also help map the needs for future research.

Interim steps by the Commission to share the evidence under its independent research programme will be critical, alongside working with partners to develop the longer-term approaches to a hub.

Working in partnership

Partnership actions

To explore a research hub to disseminate policy implications of research

Over time, the body of research to inform – and be informed by – the strategy will grow and create a more comprehensive evidence base to influence policy. An independent research hub to collate and disseminate research, and assess the impact of research on policy, would strengthen this link between research and action.

This could include all relevant research related to reducing gambling harms: as part of the Commission’s independent research programme, public health research, international research, and research undertaken by charities, treatment providers, experts by experience, the gambling industry and others.

Longer term, it will be important to assess the viability of a hub which is independently coordinated by experts.

Consider the use of one or more national research centres

As the strategy progresses, a clearer picture of how to create a research infrastructure in order to underpin and facilitate high quality research should emerge, and the role of national research centres as part of that infrastructure will be considered.

Gambling Commission actions

The Gambling Commission’s independent research programme separates the setting of priorities for research, from the funding for research, and is designed to support delivery of the strategy.

As we learn more, the research programme will adapt and respond to continue to provide the evidence we need to find out what works to reduce gambling harms.

We will work with partners to establish a central repository of anonymised data to inform research.

To support the foundations for the data repository, the patterns of play research project will pilot the process of researchers identifying what data from online gambling should be collected to allow maximum benefit to inform action, and the Commission will drive progress with the industry to deliver that data.

This early step towards a data repository will also be set alongside the results of a scoping exercise currently underway about how further phases could be implemented, and what governance arrangements should be put in place to do so.

As a first step towards a research hub, the strategy microsite will host key research, and for projects delivered under the Gambling Commission’s research programme, be the home of research briefs, published reports and an assessment of key policy implications that arise.

In the first year of the strategy, the Commission will lead work to further embed the measuring gambling related harms framework (PDF), published in July 2018, through the research programme. This framework will help to develop a clear understanding of the hidden harms – and costs – of gambling, on resources, health and relationships.

Whilst we place a particular emphasis on the harms work to inform where preventative measures should be targeted, we are committed to other actions to make progress. These include driving live environment trials of preventative interventions as part of the research programme.

Where these are industry-based, such as more proactive safer gambling messages to consumers, the design of products and games, and the availability and promotion of safer gambling tools, the Commission is well-placed to apply our regulatory powers to make progress and to work with those with lived experience on how best to achieve these goals.

Research programme

The Gambling Commission's 2018 to 2022 research programme (PDF) is required to progress the delivery of the National Strategy to Reduce Gambling Harms. It is based on six core research themes.

These themes have been set on the advice of the Advisory Board for Safer Gambling (ABSG) (opens in new tab).

Theme 1: Gambling related harms

"We need to develop a way to comprehensively understand and measure the harms caused by gambling."

Theme 2: Patterns of play

"We need to understand how gambling behaviour varies across different products and environments, and which characteristics are most strong associated with harm."

Theme 3: Changes in gambling behaviour over time

"We need to understand how gambling behaviour changes over time and why people move in and out of harmful play."

Theme 4: What works in harm-minimisation?

"We need to use evaluations to assess the effectiveness of interventions, and identify best practice in industry-based harm minimisation."

Theme 5: Education and prevention

"We need to understand what works in preventative education through insights provided by research and evaluation."

Theme 6: Treatment

"We need to understand what works in gambling treatment and build the evidence base to help formulate an effective and inclusive approach to treating gambling related harms."

These themes will enable us to be ambitious in our research objectives and deliver large scale projects which will provide robust evidence to feed into a complex, evolving policy environment and support the Evaluation enabler of the National Strategy to Reduce Gambling Harms.

It will allow the research to be commissioned through consortium teams which encourage the involvement of experts and specialists new to the field of gambling.

Research governance

The Gambling Commission own the research programme and set the research questions on the advice of ABSG. Currently, the Commission and GambleAware both take responsibility for the commissioning of the research necessary to underpin the strategy.

The majority of funding for commissioned research is either supplied voluntarily by the industry or becomes available through regulatory settlements.

Defining, measuring and monitoring gambling-related harms

The overall aim of this theme is to help us better understand the nature of gambling-related harms and how they can be reduced which will help us move away from simply identifying the number of problem gamblers within a population.

Improving our understanding of gambling-related harms is the underpinning principle of the Prevention and Education theme of the National Strategy to Reduce Gambling Harms.

We know that gambling-related harms take many forms, with negative impacts possible on peoples’ resources, relationships and health and include those experienced by other people, not just the gambler – including families, children of gamblers, employers, communities and society more generally.

Harms can be temporary, episodic or longer term in nature, and can occur at all levels of gambling participation.

We know that harms from gambling can extend beyond the gambler to their friends, family, community and society.

We need to develop a way to comprehensively measure the harms caused by gambling and their cost to society.

This will allow us to understand the scale of the issue and whether we've successfully reduced harms, and more effectively target interventions.

Research projects

Measuring gambling-related harm

Measuring gambling-related harms: a framework for action (PDF) is a report published by the Gambling Commission, ABSG, and GambleAware. This report agreed a preliminary working definition of gambling-related harms and adapted models of how harms sit within broader eco-social and prevention models.

Measuring gambling-related harms: methodologies and data scoping study (PDF). This study considered different methodologies for estimating social costs of gambling-related harms and makes recommendations as to which methods are most feasible. Understanding and measuring gambling-related harms is one of the Gambling Commission’s top priorities. More information is available in the methodologies and data scoping study project brief (PDF).

The work was completed by the Care Policy and Evaluation Centre at the London School of Economics. It has also produced an accompanying costing guide: Methods for assessing costs of gambling related harms and cost-effectiveness of interventions (PDF) outlining economic approaches to measuring gambling-related harms and cost-effectiveness of interventions.

The report was considered whilst forming the next steps on measuring gambling harms, impact and success (PDF) published in July 2020.

Gambling-related suicide

Suicide is one of the most serious of the possible harms associated with gambling and one of the priority themes identified in the framework. Using existing data sets, this project focuses on providing insights into rates of suicides, suicide attempts, suicide ideation and self-harm which are associated with problem gambling. This will compare prevalence between those reporting different risk factors.

Work on this project has been conducted by Dr Heather Wardle and Swansea University. Read the gambling-related suicide project brief (PDF) for more information.

Outputs

There are three outputs from this research.

These reports are:

1. Problem gambling and suicidal thoughts, suicide attempts and non-suicidal self-harm in England (PDF) evidence from the Adult Psychiatric Morbidity Survey 2007.

2. Exploring problem gambling, loneliness and lifetime suicidal behaviours (PDF) a cross-sectional study using the Adult Psychiatric Morbidity Survey 2007.

3. Scoping current evidence and evidence-Gaps in research on gambling-related suicide (PDF)

Children and young people

Measuring gambling-related harms among children and young people: a framework for action (PDF) is a report published by Ipsos MORI and follows a similar approach to that set out in the framework for action, to develop a dedicated framework to measure harms experienced by children and young people.

This includes developing and piloting a set of survey questions to improve our understanding of the dimensions of harm experienced by children as a result of their own or someone else’s gambling’. You can read more about the questions in the analysis report of the Young People's Omnibus pilot findings (PDF).

You can also find out more about problem gambling screens (opens in new tab) and the difference between problem gambling and gambling related harm (opens in new tab).

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Following an audit the 'problem gambling and gambling related harm' link has been updated.

Patterns of play

We need to understand how patterns of play vary across different environments, products and characteristics. The research required in this area, as outlined in the ‘Research to inform action’ section of the National Strategy to Reduce Gambling Harms, will help us better understand if, how and why some gambling products are more harmful than others.

Answering these questions will involve analysis of real play data provided by the gambling industry, and linking it to data on the socio-economic, demographic and low-risk/moderate-risk/problem gambling status of gamblers using different products.

To achieve this, all sectors of the gambling industry will need to regularly share data and make it available for research.

We also aim to establish an open repository for industry data, which would allow data to be collected and retained on an ongoing basis for harm-minimisation and research purposes.

This is a complex task, but will contribute efficiencies and benefits to researchers, industry, policy-makers and other key stakeholders. It will enable multiple research projects to be conducted from the same datasets and minimise the burden placed on both the industry and research participants.

We have a reasonable understanding of patterns of play on certain types of gaming machine, but this has been limited to play with sessions.

We need to analyse industry data to explore how patterns of play vary across other products and environments, and which characteristics are most strongly associated with harm.

This will help us to encourage safer play and target interventions and regulatory change where they will be most effective.

Research projects

Using industry data to understand patterns of play

This study will form phase 1 of our work to understand patterns of play, focussing on online gambling. It will involve an extensive analysis of real play data provided by online gambling companies, and surveys to link this data to socio-demographic data and problem gambling status.

This work is being delivered by NatCen and the University of Liverpool. Read more in the understanding patterns of play project brief (PDF) and risky gambling environments project invitation to tender (PDF).

Analysing bank transactional data

In addition to analysing industry data to explore patterns of play, we are also keen to learn more from bank transaction data. GambleAware commissioned the Behavioural Insights Team (BIT) to conduct research, with two reports published in 2021: Monzo data analysis (opens in a new tab) and HSBC data analysis (opens in a new tab) .

Amongst the findings, BIT identified that Monzo’s gambling block was used by both gamblers and non-gamblers, but gamblers were more likely to use the tool after increased gambling activity and were more likely to subsequently lift the blocks. They also found that more engaged gamblers spent more on unarranged overdraft fees (HSBC) and transferred less money into savings pots (Monzo).

The research highlights the potential of financial industry data to predict, identify and mitigate gambling harms in both the short and long term, as well as highlighting the potential for more nuanced interactions and tools that might benefit gamblers.

Gambling Data Centre

As part of this programme of work we need to identify an approach to establishing a Gambling Data Centre to store data and make it available for further use and secondary research.

The University of Leeds produced a scoping study for how this independent repository of gambling industry data (PDF) could be structured. The recommendations are being explored further with relevant stakeholders.

Changes in gambling behaviour over time

Existing population surveys such as the Health Surveys and Welsh Problem Gambling Survey are effective at monitoring rates of gambling participation and the prevalence of problem gambling. They are limited, however, in exploring how gamblers’ behaviour changes over time.

It is increasingly recognised that gambling behaviour can be fluid and variable, where changes in intensity of engagement over time are the norm and patterns of problematic gambling unstable. For this reason, longitudinal research is necessary to explore gambling trajectories, including movement in and out of problem gambling status.

We envisage the findings of this longitudinal research will ultimately be used to inform the development of safer gambling policy and enable us to better understand where policy changes should be targeted.

It will also inform the development of effective prevention and treatment approaches. However, we also recognise that we will need help understanding how the findings will inform policy.

We know that harmful gambling can be episodic and is often non-linear as people move in and out of harmful play.

We need to understand how gambling behaviour changes over time, and why some people move in and out of harmful play whilst others do not.

This will allow us to make gambling safer by learning from gamblers who continue to play safely, and exploring the triggers that can lead to harm.

Research projects

In order to develop a longitudinal study of this kind, we commissioned a Longitudinal Study of Gambling (PDF) to conduct a rapid consultation and explore the methodological options for conducting longitudinal research and make recommendations on which approach or approaches will most effectively answer the research questions.

The consultation and review have been completed by NatCen and Dr Heather Wardle. More information is available in the longitudinal scoping invitation to tender (PDF).

The final report will be published as part of the brief for the delivery phase of the longitudinal research.

What works in industry-based harm-minimisation

Through the National Strategy to Reduce Gambling Harms, the Commission sets an expectation that the gambling industry should evaluate the impact of the interventions and harm-minimisation tools they develop.

With Collaboration as a key strategy enabler, we encourage the use of collaborative pilots (established with industry input) to test interventions, evaluate their effectiveness, and identify good practice. This will enable us to collectively improve our understanding of which interventions work, for whom, and in what circumstances.

There are some areas where evaluations are being led by the Commission, working in conjunction with ABSG and GambleAware. We intend to use evaluations from across the industry to generate good practice principles and consolidate the key lessons learnt to enable ongoing improvement of both interventions and evaluations.

There has been some piloting by operators of new interventions and approaches to harm-minimisation.

We now need to make better use of evaluations to understand the effectiveness of interventions, and identify best practice in harm minimisation.

This will help to identify which interventions work, for whom, and under what circumstances.

Research projects

Evaluation of the impact of Multi-Operator Self-Exclusion Schemes and awareness and barriers to self-exclusion

This is an evaluation of all of the multi-operator self-exclusion schemes. This work will also provide insight into self-exclusion from individual operators.

The evaluation has been split into two phases:

Phase 1

Phase 1 has focused on effectiveness of the process of planning and implementation of the Multi Operator Self-Exclusion Schemes, including enablers and barriers to each scheme running efficiently and has provided baseline evidence of the impact of the schemes, including awareness and perceptions of them amongst gamblers.

Phase 2

Phase 2 will evaluate how effective multi-operator self-exclusion schemes are in modifying harmful gambling behaviours and identify improvements that can be made to the schemes to improve their effectiveness in the short and medium term, by engaging with a larger sample of scheme users.

More information about the project is available in the Multi-operator self-exclusion schemes invitation to tender (PDF)

The Process and Impact Evaluation of the Multi-Operator Self-exclusion Schemes (PDF) is the phase 1 report completed by Ipsos Mori.

Applying Behavioural Insights to Reduce Problem Gambling

This research, conducted by the Behavioural Insights Team (BIT) for GambleAware, involves exploring the ways that behavioural science can be used to reduce harmful play online.

The first phase, completed in 2018, explored methods of reducing risky play in online environments and tested behavioural science informed messages with two operators, with the aim of increasing uptake of Safer Gambling tools. BIT found that making the tools more accessible (reducing friction) increased uptake, but that normative messaging did not. The report is available here.

The second phase of this work, completed in 2021, involved piloting and evaluating the effectiveness of two interventions to reduce risky play across the industry: Anchoring and Commitment Devices.

The Anchoring research investigated the influence of pre-defined financial dropdown options on the decision of an individual when setting a deposit limit. The trial included the finding that the removal or reduction of the pre-defined options resulted in a significant decrease in the deposit limit set by the individual. The report PDF (opens in a new tab) is available on the GambleAware website.

The Commitment Devices trial investigated the impact of asking an individual to provide a reason (‘commitment’) for setting their deposit limit at their chosen threshold. BIT found that presenting customers with the option of providing a reason decreased take-up of the deposit limit tool. Those that did set a limit in the trial groups selected lower deposit limits after a period of increased activity, but subsequent gambling activity did not vary. The report is available here (opens in a new tab).

Developing gambling industry best-practice for harm-minimisation: Safer gambling messaging

Revealing Reality are building on their previous research into collaborative innovation to identify good practice and inspire change with a new phase of work focused on safer gambling messaging. Read the Responsible Gambling: Collaborative innovation identifying good practice and inspiring change report (PDF).

Working with operators from a variety of sectors, safer gambling messages will be developed, tested and refined to produce recommendations and good practice guidance for industry. Depending on findings, there will then be the potential for a large-scale pilot, which would be evaluated by the Behavioural Insights Team.

Prevention and education

In principle, prevention of harm is better than cure. The role of education therefore, as a key form of prevention, needs to be better understood.

This will provide the evidence to inform the development of a collective and clear prevention plan, as set out in the new National Strategy to Reduce Gambling Harms, which identifies the right mix of interventions to be applied at both the population and individual level.

This will need to consider approaches suitable for mainstream audiences, groups which are particularly vulnerable to harm, and children and young people.

We know that education is relatively effective at improving knowledge and changing attitudes, but evidence of behaviour change is inconclusive.

We need to understand what works in preventative education through insights provided by research and evaluation.

This will help us to develop a national strategic plan to make that preventative education is delivered in the most effective way.

Research projects

Understanding the impact of advertising on children, young people and vulnerable people

This project explored the content and tone of gambling marketing and advertising and its effect on behaviour and perceptions of children, young people, and vulnerable people.

It assesses whether there are specific characteristics of advertising that are particularly harmful to these groups. Improving our understanding in this area will help us explore whether changes to the way gambling products are advertised could prevent harm.

This has been completed by a consortium led by Ipsos Mori and the Institute for Social Marketing at the University of Stirling. The Interim Synthesis Report (PDF) was published in July 2019 which explored the exposure, tone and format of gambling related marketing and advertising.

The Final Synthesis Report (PDF) was published in March 2020 which adds further findings on the impact of gambling marketing and advertising on children, young people and vulnerable adults, and extends a set of recommendations for the gambling and advertising industries, regulators and further research.

Treatment

Treatment and Support remains at the heart of the National Strategy to Reduce Gambling Harms as one of the two strategic priorities. As part of the research programme, we need to make sure that the treatment available to those who need it is effective and accessible.

This applies to treatment provided by GambleAware-funded services, whilst also recognising that people may need support with issues related to gambling in other settings – including mainstream healthcare or wider addiction services. For example, alcohol, substance abuse and misuse, or debt advice.

More research is needed on what works in treatment. A programme of research is already underway and it will be important that we apply the findings to future commissioning decisions, and find more ways to combine research with treatment to understand what works, and for who.

GambleAware has developed improved systems to gather data to inform the commissioning of treatment.

We need to understand what works in gambling treatment and build the evidence base to inform an effective and inclusive approach to treating gambling-related harms.

This will inform a national strategic plan to provide the right kind of treatment where it is most needed, in the most effective way.

The Rapid Evidence Review: Effective Treatment and Support for Problem Gambling (PDF) is a report completed by Gambling Research Exchange (GREO).

This is an up to date review of the international evidence on treatment and support for gambling problems, ranging from primary care to specialist services and brief to intensive interventions, in order to identify the efficacy of these interventions.

This research has helped us understand what interventions work best, for who and why. It will ultimately inform the range of treatment services currently offered by GambleAware.

More information is available in the GREO project brief (PDF).

Treatment delivery gap analysis

This project involved a mixed methods approach of the current provision to determine where needs are, and are not, being met in terms of geography, demographics and severity of harm.

This research also explored the profile of ‘affected others’ who are those that have experienced harm as a result of someone else’s gambling; and provided new insights into the characteristics of this group. The findings will be used by policy makers to inform future commissioning and fundraising decisions.

Work on this project has been conducted by NatCen, ACT Recovery and YouGov.

More information is available in the gap analysis project brief (PDF) and gap analysis project invitation to tender (PDF).

Outputs from this research

The seven outputs are:

1. Treatment Needs and Gap Analysis in Great Britain – A Synthesis of Findings (PDF) (May 2020) - NatCen Social Research.

2. Gambling Treatment and Support (PDF) (March 2020) YouGov.

3. An assessment of the accuracy of survey estimates of the prevalence of problem gambling in the UK (PDF) (March 2020) Professor Patrick Sturgis, London School of Economics.

4. Gambling Treatment Services Needs Assessment Report (PDF) ACT Recovery.

5. A Rapid Evidence Assessment of Gambling Treatment Services (PDF) July 2019, NatCen Social Research.

6. Secondary Data Analysis of the Data Reporting Framework and the Health Survey for England (PDF) October 2019, NatCen Social Research.

7. A Needs Assessment for Treatment and Support (PDF) October 2019, NatCen Social Research.

Evaluation of GambleAware funded treatment system

An independent evaluation of the current treatment and support system for those affected by difficulties with gambling, funded by GambleAware.

The scope of this project is to evaluate the three main providers and their partners of GambleAware funded treatment and support, to:

• demonstrate service quality and effectiveness in terms of treatment outcomes and cost-effectiveness
• understand how services function together in a coherent national system
• assess GambleAware commissioning.

It will involve developing a set of clear, practical and evidence-based recommendations for improvement.

More information is available in the treatment evaluation project brief (PDF) and invitation to tender (PDF).