On the Limits and Challenges of Public Health Approaches in Addressing Gambling-Related Problems

Many governments around the world have adopted a public health (PH) approach as a framework to minimise, reduce or prevent gambling-related harm. In principle, this appears very sensible given the success of PH approaches in other areas of society: in disease control, nutrition, physical exercise and reductions in smoking. In this paper, we examine the challenges that are faced in applying PH principles to gambling. We argue that gambling is a difficult activity to address because of the highly skewed distribution of severity that makes PH interventions seem less relevant for the majority and difficult to apply to the complex minority. In our view, gambling harm can really only be reduced by changing the behaviour of individuals, and this objective is very much informed by the principles and practices of ‘individual-focused disciplines’ including psychology, social work and the medical sciences. Greater evidence and evaluation are needed to demonstrate how the ‘whole of population’ approaches advocated by PH are superior than ecological, individual-focused or responsible gambling approaches to reduce gambling-related harm.