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Measuring gambling-related harm: Validating a summary metric of potential adverse consequences

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 - Changes

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  1. Contents
  2. Method

Method

Measuring adverse consequences from gambling

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:

  1. reduce or cut back spending on everyday items such as food, bills, and clothing (potential adverse consequence to resources)
  2. use savings or increase use of credit, such as credit cards, overdrafts, and loans (potential adverse consequence to resources)
  3. experience conflict or arguments with friends, family, or work colleagues (potential adverse consequence to relationships)
  4. feel isolated from other people, left out, or feel completely alone (potential adverse consequence to relationships)
  5. lie to family, or others, to hide the extent of gambling (potential adverse consequence to relationships)
  6. be absent or perform poorly at work or study (potential adverse consequence to resources).

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:

Health and wellbeing

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.

Gambling behaviours

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.

Demographic characteristics

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.

References

1 Potential adverse consequences were also captured using 3 PGSI items:

  • borrowing money or selling items to gamble (potential adverse consequence to resources)
  • feeling that gambling has caused health problems including stress or anxiety (potential adverse consequence to health)
  • feeling guilty about gambling (potential adverse consequence to health).

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.

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