Report
Understanding the adverse consequences of gambling
This report presents secondary analysis of Year 2 (2024) GSGB data
Introduction
Understanding gambling-related harm is one of our key evidence gaps and priorities. In particular, we aim to gather insight into how gambling harms are experienced, and who may be most at risk. The PGSI was designed to measure gambling behaviours in the general population. The Gambling Commission uses the PGSI to estimate the prevalence of ‘at risk’ patterns of gambling and inform regulatory decisions. While the PGSI is often used as a proxy measure of harm, it was not specifically developed for this purpose. As a result, the PGSI does not fully capture the range of adverse consequences that people can experience from gambling. Furthermore, GambleAware (2023) suggest that the PGSI does not align with established frameworks of gambling harm and that it overlooks the broader impacts on friends, family and the wider community. The PGSI also conflates gambling behaviours (for example, uncontrolled gambling) with potential consequences2. These limitations highlight the need to develop new methods of assessing gambling-related harm that are rooted in established theoretical frameworks.
Given the limitations of the PGSI, we recently developed a new set of survey questions that aim to provide a comprehensive understanding of the potential negative impacts of gambling. This involved a multi-stage process involving stakeholder consultation, piloting, and cognitive testing. Items were selected from a broader 72-item harms checklist3, and aligned with the Framework for Action by Wardle and others, which categorises harms across 3 domains:
- Resources (for example, financial strain).
- Relationships (for example, conflict or isolation).
- Health (for example, psychological distress).
The final set of questions differentiate between severe consequences, which are clearly and unequivocally harmful (for example, relationship breakdown, experiences of violence, losing significant financial assets, and crime), and potential adverse consequences, which can vary in severity and often have more cumulative effects (for example, reduced spending on everyday items). Severe consequences are assessed using binary (Yes or No) questions, while potential adverse consequences are measured on a 4-point frequency scale, ranging from 'Never' to 'Very often'.
Initial analysis found that the new survey questions demonstrated good internal reliability and construct validity. Notably, participants’ responses to the questions predicted additional variance in mental wellbeing scores (assessed using the Short Warwick-Edinburgh Mental Wellbeing Scale, SWEMWBS), above and beyond the variance predicted by PGSI scores alone. This finding highlights the added value of the new items in capturing the negative impacts of gambling that may be missed by the PGSI. The finalised survey questions are now included in the Gambling Survey for Great Britain (GSGB) and reported on an annual basis.
In collaboration with NatCen, we recently conducted qualitative research to gain a deeper understanding of individuals’ negative experiences with gambling. The project involved follow-up interviews with participants who had completed the GSGB and reported experiencing adverse or severe consequences from their own gambling. Our findings showed that different types of consequences, such as those affecting one’s finances, relationships, and health, are often experienced simultaneously or in reinforcing cycles. For example, participants talked about how financial strain from gambling could lead them to spend less on essential items, trigger arguments with family members, and contribute to heightened levels of stress or anxiety. In some cases, relatively infrequent harms were described as having substantial and lasting effects.
The aim of this report was to provide further insight into who is most at risk of experiencing adverse consequences from gambling, and the extent to which different types of consequences overlap. Specifically, we conducted secondary analysis of Year 2 (2024) GSGB data to address the following research questions:
- To what extent are demographic characteristics (age, sex, ethnicity, and household income) associated with experiencing potential adverse consequences (affecting resources, health, and relationships) and severe consequences (that is relationship breakdown, violence, significant financial loss, and crime)?
- Among those who reported negative impacts from gambling, what proportion had experienced these impacts across multiple areas of their life (that is, affecting financial resources, relationships, and health)?
To examine associations between demographics and consequences, we controlled for the number of gambling activities participants engaged with. However, our analysis does not account for differences in the types of activities played. This is an important caveat given that certain activities (for example, betting on non-sport events, online slots, and casino games) tend to be associated with higher PGSI scores4. We therefore plan to conduct a follow-up analysis to explore the extent to which associations between demographic profiles and adverse consequences can be explained by differences in gambling activity.
References
2 National Centre for Social Research, University of Plymouth. Frameworks and Measurement of Gambling Related Harm: A Scoping Study (2023).
3 Li, E., Browne, M., Rawat, V., Langham, E., & Rockloff, M. (2017). Breaking Bad: Comparing Gambling Harms Among Gamblers and Affected Others. Journal of gambling studies, 33(1), 223–248.
4 Wardle H and Tipping S. (2025) Exploring the relationship between gambling activities and Problem Gambling Severity Index (PGSI) scores. Gambling Commission: Birmingham.
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Understanding the adverse consequences of gambling - Methods
Last updated: 2 October 2025
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