Category Archives: Internet gambling
Kindred spirits: A brief look at responsible gambling
Anyone that has read my research on gambling will know that I am committed to player protection, harm-minimization, social responsibility, and responsible gambling. I was recently interviewed by Kindred Gaming for an article on their website. This blog contains the full unedited transcript of that interview.
Kindred: You have worked in the field for several years now, what are the biggest changes you have seen to the industry when it comes to responsible gambling and player protection?
MG: I’ve been working in the gambling studies field for 33 years and it was around 1996 that I first began to think about my research in terms of social responsibility issues. It was in the early 2000s that some of the more forward thinking gaming operators started to bring in socially responsible gambling features (particularly in countries such as Sweden, Norway, Canada and Australia although that might be more reflective of the clients who I had consultancy with at the time). It is over the past decade that responsible gambling has really come to the fore, and many gambling regulators around the world will not grant operating licences unless the gaming operators can demonstrate what they are doing in terms of player protection and harm-minimization. The biggest changes are arguably in the online medium because there are so many protective measures that can be initiated online such as various limit-setting features, temporary self-exclusions and cool-off periods, pop-up messaging, bespoke personalized feedback, mandatory play breaks, and the use of behavioural tracking tools.
Kindred: Focusing on your study “An Empirical Study of the Effect of Voluntary Limit-Setting on Gamblers’ Loyalty Using Behavioural Tracking Data” can you tell us a bit about the key findings, and how you view voluntary vs mandatory limits and other control tools?
MG: Kindred kindly gave us access to a dataset of 175,818 players who had placed at least one bet or gambled at least once during January 2016 to May 2017. In a nutshell we looked at active players over a one-year period and found that the percentage of active players in the first quarter of 2017 was significantly higher in the group of players who had set voluntary money limits in the first quarter of 2016 compared to players that did not. This suggests that players who set voluntary spending limits were more loyal to Kindred compared to those who do not. On the assumption that voluntary limit-setting should be part of a gaming operator’s corporate social responsibility strategy, our findings appear to underline the fact that CSR has a positive effect on business outcomes. With regards to the issue of voluntary vs. mandatory limit-setting, I’m personally in favour of it being mandatory for players to set their own time and money limits if they want to gamble. Many players don’t set their own limits but I think making it mandatory would help players in terms of managing their budgets. Some companies have default global monthly limits on how much money players can lose but that can become restrictive for those who can afford to gamble with larger amounts of money and can also be restrictive for some kinds of gambling (sports betting being the type of gambling most affected).
Kindred: How do you think operators and the academic world can work together for a safer and more sustainable gambling industry in the coming years?
MG: If both academics and the gambling industry have a shared goal of preventing and reducing problem gambling, I think there are good pragmatic reasons to work collaboratively. Personally, I think some of the best gambling research that I have done is working with gambling companies (and I would stress that I am working with gambling companies and not for them) simply because of the high quality data that gambling operators have. Obviously there are many academics who have criticized myself (and my colleagues) for such collaborations but I think the positives of working together outweighs the negatives. As long as we have complete independence to publish the results of what we find without interference from the operators, I do not have a problem in working together. My main area in this field is the evaluation of responsible gambling tools and whether the measures introduced by operators to help their players gamble more responsibly and/or can help prevent/reduce problem gambling. Over the past eight years, Dr. Michael Auer and myself have evaluated the efficacy of limit-setting, mandatory play breaks, pop-up messaging, personalized feedback, loss-limit reminders, and other gambling operator initiatives. Some of these appear to work and others less so. To move the field forward and to help maintain safe and sustainable gambling, collaborative research needs to continue. I have worked with and carried out consultancy with over 30 gambling companies around the world and am very proud of companies changing their practices and policies in relation to the findings of our research. If research findings cannot be applied to help the greater good, then what is the point of doing research if it has little practical benefit? For me, it’s a ‘win-win’ situation.
Kindred: Kindred has set an ambition to reach zero percent revenue from harmful gambling, what do you see as the key steps towards 100% enjoyable gambling?
MG: The aim is laudable but going to be difficult to achieve because harmful gambling (including problem gambling) can never be totally eliminated – although I do believe it can be kept to a minimum. I’ve always argued that problem gamblers have a relatively short customer life for gambling companies and that what sustainable companies need is long-term customer retention. Problem gamblers cannot give companies that and gambling operators need to think about lifetime customer value with decades of repeat business from those who gamble within their limits over a long period of time rather than relatively high spending from a minority of customers who may only gamble with the company for a few years. Customers will keep coming back to gambling operators if they have a product or products that customers feel is value for money and provides enjoyment – even if they lose money. There are a number of key steps that all gambling companies should take if they want sustainable and safe gambling including informed choice. These include (but are not limited to) (i) providing customers with all the information they need so that they can make an informed choice about whether they want to gamble, (ii) responsible marketing and advertising, (iii) robust age verification checks of customers, (iv) robust financial checks of customers, (v) mandatory limit-setting for customers, (v) using customer data to intervene and help high-risk gamblers via bespoke pop-up messaging and personalized messaging, (vi) partnering with gambling prevention and treatment agencies, and (vii) robust voluntary self-exclusion schemes.
Dr Mark Griffiths, Professor of Behavioural Addiction, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK
Further reading
Auer, M. & Griffiths, M.D. (2013). Voluntary limit setting and player choice in most intense online gamblers: An empirical study of gambling behaviour. Journal of Gambling Studies, 29, 647-660.
Auer, M. & Griffiths, M.D. (2014). An empirical investigation of theoretical loss and gambling intensity. Journal of Gambling Studies, 30, 879-887.
Auer, M. & Griffiths, M.D. (2015). Testing normative and self-appraisal feedback in an online slot-machine pop-up message in a real-world setting. Frontiers in Psychology, 6, 339.
Auer, M. & Griffiths, M.D. (2015). The use of personalized behavioral feedback for problematic online gamblers: An empirical study. Frontiers in Psychology, 6, 1406.
Auer, M. & Griffiths, M.D. (2016). Personalized behavioral feedback for online gamblers: A real world empirical study. Frontiers in Psychology, 7, 1875.
Auer, M. & Griffiths, M.D. (2020). The use of personalized messages on wagering behavior of Swedish online gamblers: An empirical study. Computers in Human Behavior, 110, 106402.
Auer, M. & Griffiths, M.D. (2020). Predicting limit-setting behavior of gamblers using machine learning algorithms: A real world study of Norwegian gamblers using account data. International Journal of Mental Health and Addictions. Advance online publication. https://doi.org/10.1007/s11469-019-00166-2
Auer, M., Hopfgartner, N. & Griffiths, M.D. (2018). The effect of loss-limit reminders on gambling behavior: A real world study of Norwegian gamblers. Journal of Behavioral Addictions,7(4), 1056-1067.
Auer, M., Hopfgartner, N. & Griffiths, M.D. (2018). The effect of loss-limit reminders on gambling behavior: A real world study of Norwegian gamblers. Journal of Behavioral Addictions,7(4), 1056-1067.
Auer, M., Hopfgartner, N. & Griffiths, M.D. (2020). The effects of voluntary deposit limit-setting on long-term online gambling behavior. Cyberpsychology, Behavior and Social Networking, 23, 113-118.
Auer, M., Hopfgartner, N. & Griffiths, M.D. (2020). An empirical study of the effect of voluntary limit setting on gamblers’ loyalty using behavioral tracking data. International Journal of Mental Health and Addiction. Advance online publication. https://doi.org/10.1007/s11469-019-00084-3.
Auer, M., Malischnig, D. & Griffiths, M.D. (2014). Is ‘pop-up’ messaging in online slot machine gambling effective? An empirical research note. Journal of Gambling Issues, 29, 1-10.
Ukhov, I., Bjurgert, J., Auer, M. & Griffiths, M.D. (2020). Online problem gambling: A comparison of casino players and sports bettors via predictive modeling using behavioral tracking data. Journal of Gambling Studies. Advance online publication. https://doi.org/10.1007/s10899-020-09964-z
(Loot) boxing clever? Has child and adolescent problem gambling really risen in the UK?
A couple of months ago, teenage gambling was grabbing the media headlines. The UK Gambling Commission published its annual statistics showing that based on a self-report survey of 2865 children and adolescents aged 11-16 year-olds, that the prevalence of problem gambling had risen to 1.7% (2% for boys and 1.3% for girls) compared to 0.4% in 2016 and 0.9% in 2017. This lead to predictable headlines such as “Number of child gamblers quadruples in just two years”.
I’ve been researching adolescent gambling for over three decades and was the topic for my first two books in 1995 and 2002. While the figures were concerning, the good news is that the prevalence of adolescent problem gambling has been on the decline in the UK over the past 20 years. For instance, the prevalence of adolescent problem gambling back in 2000 was approximately 5% but by 2016 was less than one-tenth of that. The rise over the past two years is a potential worry although the Gambling Commission’s ‘technical annex’ report about the methodology used to collect the data for the latest survey did suggest that one of the main reasons for the significant increase in problem gambling was likely due to a change in the way data were collected.
In short, the filtering questions in the latest study were changed (so that they more matched the adult gambling prevalence surveys that are carried out) which lead to a doubling of teenagers completing the problem gambling screen that was used to assess problem gambling (18% completing the problem gambling screen in 2017 compared to 34% in 2018). However, it is still worth noting that using the same methodology, there was more than a doubling of adolescent problem gambling from 2016 to 2017 (0.4% to 0.9%).
If there has been a genuine increase in adolescent problem gambling over the past couple of years, I think one of the main factors in this is the playing of simulated gambling games (or gambling-like activities such as the buying of loot boxes) in video games. The Gambling Commission’s report noted that 13% had played gambling-style games online, and that 31% had accessed loot boxes in a videogame or app, to try to acquire in-game items.
The buying of loot boxes takes place within online videogames and are (in essence) virtual games of chance. Players use real money to buy virtual in-game items and can redeem such items by buying keys to open the boxes where they receive a chance selection of further virtual items. Other types of equivalent in-game virtual assets that can be bought include crates, cases, chests, bundles, and card packs. The virtual items that can be ‘won’ can comprise basic customization (i.e., cosmetic) options for a player’s in-game character (avatar) to in-game assets that can help players progress more effectively in the game (e.g., gameplay improvement items such as weapons, armour). All players hope that they can win ‘rare’ items and are often encouraged to spend more money to do so because the chances of winning such items are minimal. Many popular videogames now feature loot boxes and these require the paying of real money in exchange for a completely random in-game item.
At present, the UK Gambling Commission does not consider loot boxes as a form of gambling because (they claim) the in-game items have no real-life value outside of the game. However, this is not the case because there are many websites that allow players to trade in-game items and/or virtual currency for real money. The Gambling Commission appears to acknowledge this point and claim that the buying of in-game loot boxes (and their equivalents) are not gambling but, if third party sites become involved (by allowing the buying and selling of in-game items), the activity does become a form of gambling. Personally, I view the buying of loot boxes as a form of gambling, particularly because the ‘prizes’ won are (in financial terms) often a lot less than that of the price paid.
A study published in the journal PLoS ONE claimed they had evidence for a link between the amount that videogame players spent on loot boxes and problem gambling severity in a large survey of 7422 gamers. The paper concluded that:
“This link was stronger than a link between problem gambling and buying other in-game items with real-world money…suggesting that the gambling-like features of loot boxes are specifically responsible for the observed relationship between problem gambling and spending on loot boxes”
However, this evidence is correlational not causal. I’ve also cited empirical research in my academic papers that engaging in simulated gambling within videogames is a risk factor for both gambling with real money and problem gambling. In November 2018, the Mail on Sunday (MoS) published some of my concerns after they interviewed me about the issue of simulated gambling in online videogames. Although no real money is staked, I have argued that such activities normalize gambling for children and that such activities behaviourally condition children towards gambling.
The MoS claimed that I said that children should be banned from playing online games such as Candy Crush. What I actually said was that children should be prohibited from engaging in gambling simulations within videogames. Candy Crush now features a gambling-type element in the form of a ‘wheel of fortune’ type game (which has also been used in other videogames like Runescape and which I have also argued are gambling when players have to pay to spin the wheel) and that children should be prohibited from accessing such gambling-like features. There is no evidence that the playing of Candy Crush causes problematic behaviour but the playing of simulated gambling-type games has been shown to be a risk factor for problem gambling among adolescents.
The question as to whether there has been a genuine increase in problem gambling among children and adolescents cannot be answered from the Gambling Commission’s latest report but based on other pieces of research there does appear to have been a slight rise over the past couple of years.
(Please note that a different version of this article was first published in The Conversation).
Dr. Mark Griffiths, Distinguished Professor of Behavioural Addiction, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK
Further reading
Calado, F., Alexandre, J. & Griffiths, M.D. (2017). Prevalence of adolescent problem gambling: A systematic review of recent research. Journal of Gambling Studies, 33, 397-424.
Calado, F. & Griffiths, M.D. (2016). Problem gambling worldwide: An update of empirical research (2000-2015). Journal of Behavioral Addictions, 5, 592–613.
Griffiths, M.D. (2002). Gambling and Gaming Addictions in Adolescence. Leicester: British Psychological Society/Blackwells.
Griffiths, M.D. (2003). Adolescent gambling: Risk factors and implications for prevention, intervention, and treatment. In D. Romer (Ed.), Reducing Adolescent Risk: Toward An Integrated Approach (pp. 223-238). London: Sage.
Griffiths, M.D. (2008). Adolescent gambling in Great Britain. Education Today: Quarterly Journal of the College of Teachers. 58(1), 7-11.
Griffiths, M.D. (2011). Adolescent gambling. In B. Bradford Brown & Mitch Prinstein (Eds.), Encyclopedia of Adolescence (Volume 3) (pp.11-20). San Diego: Academic Press.
Griffiths, M.D. (2013). Adolescent gambling via social networking sites: A brief overview. Education and Health, 31, 84-87.
Griffiths, M.D. (2018). Is the buying of loot boxes in videogames a form of gambling or gaming? Gaming Law Review, 22(1), 52-54.
Griffiths, M.D. & King, R. (2015). Are mini-games within RuneScape gambling or gaming? Gaming Law Review and Economics, 19, 64-643.
Griffiths, M.D. & Parke, J. (2010). Adolescent gambling on the Internet: A review. International Journal of Adolescent Medicine and Health, 22, 59-75.
Remote control: ‘Cashing out’ in sports betting
“Cash Out lets you take profit early if your bet is coming in, or get some of your stake back if your bet is going against you – all before the event you’re betting on is over. Cash Out offers are made in real time on your current bets, based on live market prices. Whenever you are ready to Cash Out, simply hit the yellow button. Cash out is available on singles and multiples, on a wide range of sports, including football, tennis, horse racing, and many more! You can Cash Out of bets pre-play, in-play, and between legs” (Definition of ‘cash out’ betting on Betfair website, 2017).
Most European sports betting operators now feature ‘cash out’ functionalities in their online platforms. This means that bettors can withdraw their bets before the event bet upon has concluded, obtaining a smaller but guaranteed return if the outcome of the bet is going their way, or, conversely, cutting down the monetary impact of a foreseeable loss. The ‘cash out’ functionality has rapidly become popular among sports bettors that bet in-play (i.e., during the game on things such as soccer matches and horse races) as a way of maximising value on the bets they have made.
Industry voices such as David O’Reilly, from Colossus Bets, have identified four major benefits of cash out features for bookmakers: (i) reducing the volatility of the operator’s revenue; (ii) increasing the recycling of player returns, with more players banking smaller amounts; (iii) enabling players to avoid their ‘near miss’ frustration; and (iv) improving the player engagement with the platform by introducing a mechanism that promotes constant checking. However, for sports bettors, cashing out strategies might typically involve cutting down the profit while being ahead but rarely reducing the loss when going behind. In this regard, cashing out does not appear to differ greatly from other new internet-based betting forms (e.g. so-called ‘exotic’ or multiple bets), which have been found to possess, in general, higher expected losses for gamblers and greater profit margins for operators.
However, beyond the feature’s financial rationale, cash out affects the nature of sports betting in more meaningful ways. It is, arguably, a game-changer, that leads (along with other features such as ‘edit my acca’ features in which specific bets can be removed from ‘accumulator’ bets) to the transformation of sports betting from a discontinuous to a continuous form of gambling. Here, our contention is that cash out is a key component of the contemporary bettor-bookmaker interaction, and that the widespread adoption by devoted sports bettors merits a closer look into the implications of such an interaction from a problem gambling perspective. Such an examination also suggests that regulators and policymakers need to think about how to protect gambling consumers from the potential harm caused by this new type of betting.
Structural characteristics have been proposed as a determining factor that can influence problem gambling behaviour. Structural characteristics are those associated with the design of a gambling product that shape the way gamblers interact with it. Typical structural characteristics include, but are not limited to, bet frequency, bet duration, event frequency, near misses, stake size, jackpot size, probability of winning, and interface design (e.g., the use of music and colour stimuli in the design of slot machines).
The internet has altered significantly the structural characteristics of gambling and sports betting more specifically. For example, in a number of European countries, the football (soccer) pools used to comprise bets placed during a weekday on the outcome of a game played typically on a Saturday or Sunday (i.e., a once a week wager). This reward delay was a major protective factor against excessive gambling, which on a psychobiological level has been theorised as an imbalance in an individual’s dopamine receptors, and therefore, highly sensitive to shorter bet reward periods. Betting via the internet has reduced such delays in receiving rewards from gambling, thus modifying a major structural characteristic of betting from once a week to (in some instances) every few minutes.
In parallel to the increased uptake of Internet betting in many jurisdictions, a second dynamic, namely globalisation, has further widened the possibilities of betting across countries, sports, and time zones, ultimately transforming sports betting into a 24/7 activity where the bookmaker never closes the shop any day during the year. For the first time, if a gambler has a craving to bet, the market is able to respond to that demand anytime and anywhere via a range of Wi-Fi enabled portable devices (e.g., smartphone, tablets, laptops, etc.). Virtual sports have expanded the availability of betting options even more, eliminating the need to bet on real world sport events.
Although the time between bets (i.e., bet frequency) was effectively reduced to near zero, the time within bets (i.e., bet duration) changed little until cash out functionality was first introduced by the gaming operator William Hill in December 2012. With cash out features, sports betting has become a potentially continuous gambling activity, one that resembles the playing mechanics the stock market. As with investing in stocks, bet values in in-play sports betting are re-calculated seamlessly. The outcome of a sport event might not be as relevant for many bettors as the value their bet will acquire in the next few seconds, even if that bet turns out to be erroneous at the end of the game. As in stock market investing, betting becomes continuous because non-actions also qualify as actions in themselves. Every single second that a bettor decides not to cash out, a new bet takes place. Eventually, cash out features introduce the notion that it is the bet itself the commodity that is being traded in the sports betting market. This new continuous type of sports betting raises questions concerning the gambling-related harm that could be associated with it. It also suggests that the kinds of regulation found widely in the stock market investment sector might have some utility if applied to this new form of gambling.
From a marketing perspective, cash out functionality is often advertised as a control-enhancing mechanism for bettors. Given that cashing out is typically presented in television advertisements as a risk-free operation, the product is likely to be perceived as reimbursable if the client is not happy with it, arguably promoting less planned gambling behaviours. Some gaming operators use the alternative name of “edit my bet” to refer to cash out, focusing on the capacity of bettors to correct later possible errors of judgement. The problem is that (and as happens in stock market investing), cashing out is only possible at the current value of the stock (which may be inferior to the purchasing price). Additionally, and contrary to what happens in stock market investing, betting operators automatically devalue the bet price immediately after the purchase. For example, a bookmaker will typically offer to cash out for $0.95 or similar a $1 bet placed one second ago, a price devaluation unmotivated by any new information or event actually affecting the predicted value of such a bet.
Beyond its most apparent attributes, we have demonstrated that cash out within in-play gambling is a pivotal feature that has been introduced by the sports betting industry to transform sports betting from what was traditionally a discontinuous form of gambling into a continuous one. It is contended that, although cashing out presupposes more engaged gamblers that feel more in control of their bets, the emotionally charged context in which it is often used and the structural attributes of the product itself might actually make some bettors lose control over their gambling wagers. Consequently, gambling policymakers and regulators should be cognizant of the challenges of this transformation of sports betting and consider the implications for the protection of gambling consumers.
[Note: This article was co-written with Dr. Hibai Lopez-Gonzalez]
Dr. Mark Griffiths, Professor of Behavioural Addiction, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK
Further reading
Betfair (2017). Sportsbook: What is cash out and how does it work? Retrieved March 1, 2017, from: https://en-betfair.custhelp.com/app/answers/detail/a_id/4/~/sportsbook%3A-what-is-cash-out-and-how-does-it-work%3F
Gainsbury, S. M. (2015). Online gambling addiction: The relationship between internet gambling and disordered gambling. Current Addiction Reports, 2(2), 185-193.
Griffiths, M.D. (1993). Fruit machine gambling: The importance of structural characteristics. Journal of Gambling Studies, 9, 101-120.
Griffiths, M. D. (2005). A biopsychosocial approach to addiction. Psyke & Logos, 26(1), 9–26.
Griffiths, M.D. & Auer, M. (2013). The irrelevancy of game-type in the acquisition, development and maintenance of problem gambling. Frontiers in Psychology, 3, 621. doi: 10.3389/fpsyg.2012.00621.
Lopez-Gonzalez, H., & Griffiths, M. D. (2016). Understanding the convergence of online sports betting markets. International Review for the Sociology of Sport. http://doi.org/doi:10.1177/1012690216680602
Lopez-Gonzalez, H. & Griffiths, M.D. (2017). ‘Cashing out’ in sports betting: Implications for problem gambling and regulation. Gaming Law Review: Economics, Regulation, Compliance and Policy, 21(4), 323-326.
McCormack, A., & Griffiths, M. D. (2013). A scoping study of the structural and situational characteristics of internet gambling. International Journal of Cyber Behavior, Psychology and Learning, 3(1), 29–49.
Newall, P. W. S. (2015). How bookies make your money. Judgment and Decision Making, 10(3), 225–231.
Newall, P. W. S. (2017). Behavioral complexity of British gambling advertising. Addiction Research & Theory. http://doi.org/10.1080/16066359.2017.1287901
Parke, J., & Griffiths, M. D. (2007). The role of structural characteristics in gambling. In G. Smith, D. Hodgins, & R. Williams (Eds.), Research and Measurement Issues in Gambling Studies (pp. 211–243). New York: Elsevier.
Sports Trading Life. (2015). Is “cash out” actually BAD for betting punters? Retrieved March 1, 2017, from http://sportstradinglife.com/2015/03/is-cash-out-actually-bad-for-punters/
Gripped by ‘crypt’: A brief look at ‘crypto-trading addiction’
Last week I was approached by Rupert Wolfe-Murray, a PR representative of a well-known addiction treatment clinic (Castle Craig) asking what my views were on Bitcoin and cryptocurrency trading (colloquially known as ‘crypto trading’) and whether the activity could be addictive. More specifically he wrote:
“I write to you about the research we’re doing into addiction to Bitcoin and cryptocurrency trading. We’ve had an enquiry about this at Castle Craig and they would treat it as a gambling addiction. We think it’s a new type of behavioural addiction and we plan to publish a web page (and FAQ) with the intention of alerting people that the online trading of cryptocurrencies may be addictive. It would be very helpful if we could get a quote from you, putting it into perspective. Do you think it’s a growing problem? There’s very little information about this issue online but there is an active forum of ‘crypto addicts’ on Reddit, where I got some friendly feedback…The therapist I often turn to when writing about gambling and the behavioural addictions told me that it sounds like addiction to day trading. Would you agree?”
In short, I couldn’t agree more although my own view is that this is not a ‘new’ addiction but a sub-type of online day-trading addiction (on which I first published an article about back in 2000 for GamCare, the gambling charity I co-founded with Paul Bellringer in 1997) and/or stock market trading addiction (which I’ve written a couple of previous blogs about, here and here, and an article in iGaming Business Affiliate magazine). However, I decided to do a bit of research into the issue.
A recent January 2018 article in the Jakarta Post by Ario Tamat examined this issue which was a personal account of his own experiences (‘Bitcoin trading: Addictive ‘hobby’ that could break my bank’). He wrote:
“I was always interested in Bitcoin, not that I really understand the technology, but first impressions were appealing: a decentralized currency, mined by solving mathematical equations and potentially accessible to anyone…Fast forward to 2017. Discussions on cryptocurrencies had entered the public consciousness, Bitcoin prices were sky high… A few friends introduced me to a local site on cryptocurrency trading – the most suitable term for the entire affair, actually – bitcoin.co.id. Taking the leap, I took some money out of my measly savings and bought myself some Bitcoin…In three days, I had made 6 percent. I was hooked… I’ve noticed that the whole cryptocurrency trading trend is like placing bets on a never-ending horse race, where new horses are introduced to the race almost daily”.
Another article by Douglas Lampi on the Steemit website noted that “the elements of addiction and gambling are a consistent risk that traders must always be on the guard against” and provided some signs to readers that they may be trading impulsively. These included (i) feeling muscle tension, (ii) feeling background anxiety, (iii) checking the price of Bitcoin and alt coins several times through the day, and (iv) thinking about trading while engaged in other activities. While these ‘symptoms’ and behaviours might be found among those addicted to crypto day trading, on their own they are arguably little more than mildly problematic. These signs applied to gambling or social media use would be unlikely to raise many worries among addiction treatment practitioners.
I also visited the online Bitcoin Forum where one of the topics was ‘Is crypto trading an addiction’ prompted by a Russian who allegedly committed suicide after losing all his money crypto trading. Most of the people on the forum didn’t think it was an addiction and claimed the suicide was reminiscent of the suicides that occurred at the time of the 2009 stock market crash (although a couple of individuals believed that crypto trading was a potentially ‘addicting’ activity). One participant in the discussion noted:
“Yes [crypto trading is] highly addictive, specially formulated if you start to notice that need, urge in side you, to check the price even in the middle of the night. Find yourself skipping your daily routines it is and can be addictive if you don’t know how to control you and your emotions. I have found somewhere that some say that it is like being in casino, betting, playing rules etc. because like every coin was made mostly for pure profit and it’s all speculation rather than to have their own sole purpose which when I think of it can make sense to even why it can be addictive”.
Another individual on the Bitcoin Pub website wrote:
“I think I might actually have an unhealthy addiction to [crypto trading]. I’d say 3/4 times when I unlock my phone I’m checking Blockfolio, when I’m at work, at home, with my girlfriend, or even between sets at the gym. I’m starting to think I need to discipline myself to NOT check it or limit it to maybe 1-2 times a day as its noticeably impacting my passions and in turn my mental state. I’m not a day trader, I hold all my coins in cold storage. So there’s really no reason for me to be checking that frequently, or watching crypto analysis YouTube videos, or reading articles about it several times a day”.
The issue was also discussed in a recent February 2018 article in the Irish Times by Fiona Reddan (‘It’s addictive’: Why investors are still flocking to bitcoin and crypto’). Interviewing Nicholas Charalambous (Managing Director of Alpha Wealth) was quoted as saying: “Previously, I would have described cryptos as ‘shares on steroids’; now I would say they’re shares with jetpacks and boosters and then some”. While Bitcoin shares have fallen, there are plenty of new cryptocurrencies that individuals can dabble buying shares in (ethereum, litecoin, ripple, putincoin and dogecoin) and all can be akin to gambling. Reddan also interviewed Jonathan Sheehan (Managing Director, Compass Private Wealth) who said:
“It has the exact same risk and return characteristics as a naive gambler, who has opened their first online betting account. There is absolutely no valuation metric for these currencies and allocating capital to them is an extreme and unnecessary risk”.
One country that has taken crypto trading addiction seriously is South Korea. Their government’s Office for Government Policy Coordination has introduced new rules to inhibit the speculation on cryptocurrencies. According to a Market Watch article:
“The proposed measures…range from levying capital-gain taxes on trading cryptocurrencies, to restricting financial firms from holding, acquiring and investing in them…The new regulations come amid mounting concern within South Korea about the potential for people to become addicted to bitcoin trading”.
The country’s prime minister Lee Nak-yon went as far as to say that the increasing interest in cryptocurrencies could “lead to some serious distorted or pathological phenomenon”.
I did quickly check what had been written about academically. I came across a couple of papers on Google Scholar that mentioned possible addiction to crypto trading. Justine Brecese (in a 2013 ‘research note’ on the socioeconomic implications of cyber‐currencies for ASA Risk Consultants) asserted that “risks with virtual currency include the potential for addiction and resultant over-spending” (but providing little in the way of empirical evidence for the claim). In a paper by Haraši Namztohoto on ‘cryptocoin avarice’, he noted:
“Reason often discretely quits the cognitive battlefield whenever hoarding tendencies of human beings are coupled with addictive behaviour which financial derivate trading surely is, thus leaving humans prone to caprices of mass psychology”.
Given that addictions rely on constant rewards and reinforcement, there is no theoretical reason why crypto trading cannot be addictive. However, there is only anecdotal evidence of addicted individuals and if they are addicted a case could be made that this is a type of gambling addiction.
Dr Mark Griffiths, Professor of Behavioural Addiction, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK
Further reading
Brecese, J. (2013). Research note – Money from nothing: The socioeconomic implications of “cyber-currencies”. Seattle, WA: ASA Institute for Risk & Innovation
Griffiths, M.D. (2000). Day trading: Another possible gambling addiction? GamCare News, 8, 13-14.
Griffiths, M.D. (2009). Internet gambling in the workplace. Journal of Workplace Learning, 21, 658-670.
Griffiths, M.D. (2013). Financial trading as a form of gambling. i-Gaming Business Affiliate, April/May, 40.
Namztohoto, H. (2013). Myth, machinery and cryptocoin avarice. Wizzion.com. Located at: http://wizzion.com/papers/2013/cryptocoin-avarice.pdf
Jeong, E-Y. & Russolillo, S. (2017). South Korea mulls taxing cryptocurrency trade as fears mount about bitcoin addiction, speculation. Market Watch, December 13. Located at: https://www.marketwatch.com/story/south-korea-mulls-taxing-cryptocurrency-trade-as-fears-mount-about-bitcoin-addiction-speculation-2017-12-13
Lampi, D. (2018). Two sure signs YOU are a crypto trading addict. Steemit.com. February. Located: https://steemit.com/cryptocurrency/@ipmal/two-sure-signs-you-are-a-crypto-trading-addict
Reddan, F. (2018). ‘It’s addictive’: Why investors are still flocking to bitcoin and crypto. Irish Times, February 13. Located at: https://www.irishtimes.com/business/financial-services/it-s-addictive-why-investors-are-still-flocking-to-bitcoin-and-crypto-1.3388392
Tamat, A. (2018). Bitcoin trading: Addictive ‘hobby’ that could break my bank. The Jakarta Post, January 8. Located at: http://www.thejakartapost.com/life/2018/01/08/bitcoin-trading-addictive-hobby-that-could-break-my-bank.html
Eyes on the prize: Is the buying of loot boxes in videogames a form of gambling?
The buying of loot boxes takes place within online videogames and are (in essence) virtual games of chance. Players use real money to buy virtual in-game items and can redeem such items by buying keys to open the boxes where they receive a chance selection of further virtual items. Other types of equivalent in-game virtual assets that can be bought include crates, cases, chests, bundles, and card packs. The virtual items that can be ‘won’ can comprise basic customization (i.e., cosmetic) options for a player’s in-game character (avatar) to in-game assets that can help players progress more effectively in the game (e.g., gameplay improvement items such as weapons, armor). All players hope that they can win ‘rare’ items and are often encouraged to spend more money to do so because the chances of winning such items are minimal. Many popular videogames now feature loot boxes (or equivalents) including Overwatch, Middle-earth: Shadow of War, Star Wars Battlefront 2, FIFA Ultimate Team, Mass Effect: Andromeda, Fortress 2, Injustice 2, Lawbreakers, Forza Motorsport 7, and For Honor. In short, all of these require the paying of real money in exchange for a completely random in-game item. In an interview with Eurogamer, psychologist Jamie Madigan said:
“Whenever you open [a loot box], you may get something awesome (or you may get trash). This randomness taps into some of the very fundamental ways our brains work when trying to predict whether or not a good thing will happen. We are particularly excited by unexpected pleasures like a patch of wild berries or an epic skin for our character. This is because our brains are trying to pay attention to and trying to figure out such awesome rewards. But unlike in the real world, these rewards can be completely random (or close enough not to matter) and we can’t predict randomness. But the reward system in your brain doesn’t know that. Buying [loot boxes] puts them into the same category of packs of Pokémon cards or baseball cards. Unlike gambling in a casino, you’re going to get something out of that pack. Maybe just not the thing you wanted”.
Although there are many definitions in many disciplines defining gambling, there are a number of common elements that occur in the majority of gambling instances that distinguish ‘true’ gambling from mere risk-taking. These include: (i) the exchange is determined by a future event, which at the time of staking money (or something of financial value) the outcome is unknown, (ii) the result is determined (at least partly or wholly) by chance, (iii) the re-allocation of wealth (i.e., the exchange of money [or something of financial value] usually without the introduction of productive work on either side, and (iv) losses incurred can be avoided by simply not taking part in the activity in the first place. Added to this it could be argued that the money or prize to be won should be of greater financial value than the money staked in the first place. Based on these elements, the buying of loot boxes (or equivalents) would be classed as a form of gambling, as would other activities such as the Treasure Hunter and Squeal of Fortune games within the Runescape videogame and online penny auctions (which I have argued in previous papers – see ‘Further reading’).
In the UK Gambling Commission’s most recent (March 2017) position paper on virtual currencies and social casino gambling noted:
“One commonly used method for players to acquire in-game items is through the purchase of keys from the games publisher to unlock ‘crates’, ‘cases’ or ‘bundles’ which contain an unknown quantity and value of in-game items as a prize. The payment of a stake (key) for the opportunity to win a prize (in-game items) determined (or presented as determined) at random bears a close resemblance, for instance, to the playing of a gaming machine. Where there are readily accessible opportunities to cash in or exchange those awarded in-game items for money or money’s worth those elements of the game are likely to be considered licensable gambling activities [Section 3.17]…Additional consumer protection in the form of gambling regulation, is required in circumstances where players are being incentivised to participate in gambling style activities through the provision of prizes of money or money’s worth. Where prizes are successfully restricted for use solely within the game, such in-game features would not be licensable gambling, notwithstanding the elements of expenditure and chance [Section 3.18]”.
Consequently, the UK Gambling Commission does not consider loot boxes as a form of gambling because (they claim) the in-game items have no real-life value outside of the game. However, this is not the case because there are many websites that allow players to trade in-game items and/or virtual currency for real money. The Gambling Commission appear to acknowledge this point and claim that the buying of in-game loot boxes (and their equivalents) are not gambling but if third party sites become involved (by allowing the buying and selling of in-game items), the activity does become a form of gambling. As Vic Hood (in a 2017 article in Eurogamer) rightly notes, this appears to be a case of the law struggling to keep pace with technology. There are also issues surrounding age limits and whether games that offer loot boxes (or equivalents) should be restricted to those over the age of 18 years.
Predictably, those in the videogame industry do not view the buying of loot boxes as gambling either. For instance, Dirk Bosmans (from PEGI [Pan European Game Information], the European-based videogame rating organization) stated in a recent interview with Eurogamer that:
“Loot crates are currently not considered gambling: you always get something when you purchase them, even if it’s not what you hoped for. For that reason, a loot crate system does not trigger the gambling content descriptor. If something is considered gambling, it needs to follow a very specific set of legislation, which has all kinds of practical consequences for the company that runs it. Therefore, the games that get a PEGI gambling content descriptor either contain content that simulates what is considered gambling or they contain actual gambling with cash payouts. If PEGI would label something as gambling while it is not considered as such from a legal point of view, it would mostly create confusion. We are always monitoring such developments and mapping consumer complaints. We see a growing need for information about specific features in games and apps (social interaction, data sharing, digital purchases), but the challenge is that such features are rapidly becoming ubiquitous in the market, yet they still come in very different shapes and sizes.”
This appears somewhat hardline given that PEGI’s descriptor of gambling content is used whenever any videogame “teaches or encourages” gambling. Such a descriptor would arguably cover gambling-like games or activities and the buying of loot boxes is ‘gambling-like’ at the very least. The same stance has been taken by the Entertainment Software Rating Board (ESRB) which rates videogames in Canada and the USA. A spokesman for the ESRB told Eurogamer that:
“ESRB does not consider [the buying of loot boxes] to be gambling because the player uses real money to pay for and obtain in-game content. The player is always guaranteed to receive something – even if the player doesn’t want what is received. Think of it like opening a pack of collectible cards: sometimes you’ll get a brand new, rare card, but other times you’ll get a pack full of cards you already have. That said, ESRB does disclose gambling content should it be present in a game via one of two content descriptors: Simulated Gambling (player can gamble without betting or wagering real cash or currency) and Real Gambling (player can gamble, including betting or wagering real cash or currency). Neither of these apply to loot boxes and similar mechanics.”
At present, there are a number of countries (mainly in South East Asia such as China and Japan) who do view the buying of loot boxes as a form of gambling and have incorporated such activities into their gambling regulation. However, most countries have either not considered regulating the buying of loot boxes at all, or (like the UK) have ruled out that buying loot boxes does not currently meet their regulatory definition of gambling. Although there has been little published in academic journals on loot boxes, a number of articles in the trade press have claimed that the buying of loot boxes can be problematic and/or addictive because they are designed using highly similar reward schedules to those used in the design of slot machines. This is something that have also pointed out in relation to similar activities to the buying of loot boxes where individuals play for points rather than money. Personally, I view the buying of loot boxes as a form of gambling particularly because the ‘prizes’ won are (in financial terms) often a lot less than that of the price paid. Obviously I am out of step in relation to the regulators in my own country, but if third party websites continue to host services where in-game virtual items can be bought and sold, the activity definitely constitutes a form of gambling by almost any definition of gambling currently used in the field of social sciences.
(N.B. This article uses material from a paper I recently published in Gaming Law Review)
Dr. Mark Griffiths, Professor of Behavioural Addiction, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK
Further reading
Alexandra, H. (2017). Loot boxes are designed to exploit us. Kotaku, October 13. https://kotaku.com/loot-boxes-are-designed-to-exploit-us-1819457592
Avard, A (2017). Video games have a loot box fetish, and it’s starting to harm the way we play. Games Radar, October 10. Located at: http://www.gamesradar.com/loot-boxes-shadow-of-war/
Gambling Commission (2017). Virtual currencies, esports and social casino gaming – position paper. Birmingham: Gambling Commission.
Griffiths, M.D. (2015). Adolescent gambling and gambling-type games on social networking sites: Issues, concerns, and recommendations. Aloma: Revista de Psicologia, Ciències de l’Educació i de l’Esport, 33(2), 31-37.
Griffiths, M.D. (2017). Is the buying of loot boxes in videogames a form of gambling or gaming? Gaming Law Review, 22(1), 52-54.
Griffiths, M.D. & Carran, M. (2015). Are online penny auctions a form of gambling? Gaming Law Review and Economics, 19, 190-196.
Griffiths, M.D. & King, R. (2015). Are mini-games within RuneScape gambling or gaming? Gaming Law Review and Economics, 19, 64-643.
Hood, V. (2017). Are loot boxes gambling? Eurogamer, October 12. Located at: Located at: http://www.eurogamer.net/articles/2017-10-11-are-loot-boxes-gambling
Lawrence, N, (2017). The troubling psychology of pay-to-loot systems. IGN, April 23. Located at: http://uk.ign.com/articles/2017/04/24/the-troubling-psychology-of-pay-to-loot-systems
Perks, M. (2016). Limited edition loot boxes: Problematic gambling and monetization. Cube, October 11. Located at: https://medium.com/the-cube/limited-edition-loot-boxes-problematic-gambling-and-monetization-756819f2c54f
Wikipedia (2017). Loot box (2017). Located at: https://en.wikipedia.org/wiki/Loot_box
Wiltshire, W. (2017). Behind the addictive psychology and seductive art of loot boxes. PC Gamer, September 29. Located at: http://www.pcgamer.com/behind-the-addictive-psychology-and-seductive-art-of-loot-boxes/
Learning, yearning, but not earning: A brief look at student gambling
Last week, the UK Gambling Commission put out a press release relating to student gambling. Having been in the university sector for as long as I have been researching gambling (i.e., 30 years), student gambling is an area that has always been close to my professional heart. I have published dozens of papers on youth gambling and student gambling over the last three decades (see ‘Further reading’ below for a few examples).
With my daughter leaving home to go to university this week there are lots I could potentially worry about and gambling isn’t necessarily my main concern where my daughter is concerned, but gambling is still of concern to me especially because a study I published back in 2012 with Luke Benson and Dr. Christine Norman (in the International Journal of Mental Health and Addiction) found that first year university students gambled more than final year students and were more susceptible to problem gambling compared to final year students.
The Gambling Commission have just published their own research into the topic. They hired Youth Sight who conducted 1,000 online interviews with undergraduate students in August 2017 (the students were part of an online panel recruited from applicants through Universities and Colleges Admission Service). The quotas chosen reflected the UK student population in terms of gender, course year and university group. Here are some of their key findings:
- Two-thirds of students had gambled in the previous month
- Over half of student gamblers (54%) engaged in gambling to make money
- Two-fifths of students said they felt guilty after they had gambled
- One in eight student gamblers had missed lectures due to gambling
- One in four student gamblers (25%) had spent more money gambling than they could afford
- One in 25 student gamblers (4%) were in debt because of their gambling
- One in four students that had a gambling debt, had a debt of over £10,000
The Gambling Commission noted there were are number of limitations with the study. They specifically noted that gambling participation rates may have been higher than if the data had been collected using other methodologies (telephone, face-to-face interviews) due to the self-selecting nature of online surveys. However, online surveys were chosen due to students’ access to technology and the availability of a representative panel via this method.
On the back of their survey, the Gambling Commission also provided their top ten tips to help students avoid getting into trouble with gambling. I have reproduced them here verbatim.
- Ask yourself why you are gambling: Are you gambling to escape debt or as a way to make quick money? Think carefully about your motivations to gamble. Gambling shouldn’t be seen as the answer to improving your personal finances. If you have concerns about money, speak to a financial adviser or student support services.
- Monitor how often you’re gambling online: Websites must give you access to historic account activity. This means you can see exactly when, how much and what you’ve been gambling on over time and make well-informed choices about what to do next.
- Keep track of how much time you’ve spent gambling: With a reality check, you can set alerts to pop up on screen, which help you to monitor the time spent gambling either online or on gaming machines in a betting shop.
- Limit how much you can spend: If you’re concerned about how much money you’re gambling, you can set a limit on how much you spend across individual gambling products online. You can also set a limit on how much you spend on gaming machines in a betting shop.
- Give yourself a timeout: During a timeout, you can block yourself from gambling online for a set amount of time, of up to 6 weeks, and even bar yourself from gambling during a specific time of day.
- Need a longer break? Self-exclude from gambling firms for a minimum of 6 months: If you think you are spending too much time or money gambling – whether online or in gambling premises – you can ask to be self-excluded. This is when you ask the company to stop you from gambling with them for a period of time. The exclusion will last for a minimum of least six months. Self-exclusion can be used if you think you have a problem with gambling and want help to stop. [The Gambling Commission] are also working with industry representatives to develop a national online self-exclusion scheme.
- Read the terms and conditions: Did you know almost 80% of gamblers haven’t read the terms and conditions on the websites they are gambling on? By taking the time to read the T&Cs, you can ensure you understand exactly what you are gambling on, and what restrictions are attached to promotions and bonus offers (such as a minimum spend level before the bonus is paid) – this will help you make an informed decision.
- Make sure the website you’re gambling with is licensed: Make sure you’re gambling with a Gambling Commission licensed business. This means you’ll be protected by gambling and consumer protection rules in Great Britain. Licensed gambling businesses must display that they are licensed and provide a link to our licence register where you can see what type of activities they are allowed to offer and also if we have taken any regulatory action against them.
- Check how your money is protected: Any gambling business that holds customer funds must explain in their T&Cs how customer funds are protected if the business goes bust – this should help you decide who you want to gamble with.
- Feel it’s getting too much? Talk to someone: There are a number of gambling support groups available if you feel your gambling is getting out of control or too much. More information about the signs of problem gambling can be found on the Gambleaware and Gamcare websites [You can call the National Gambling Helpline on Freephone 0808 8020 133]. They also provide general information about gambling, including how to gamble safely and where to get help if you or someone you know has problems with their gambling.
Dr. Mark Griffiths, Professor of Behavioural Addiction, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK
Further reading
Benson, L., Norman, C. & Griffiths, M.D. (2012). The role of impulsivity, sensation seeking, coping, and year of study in student gambling: A pilot study. International Journal of Mental Health and Addiction, 10, 461-473.
Canale, N., Griffiths, M.D., Vieno, A., Siciliano, V. & Molinaro, S. (2016). Impact of internet gambling on problem gambling among adolescents in Italy: Findings from a large-scale nationally representative survey. Computers in Human Behavior, 57, 99-106.
Canale, N., Vieno, A., Lenzi, M., Griffiths, M.D., Borraccino, A., Lazzeri, G., Lemma, P., Scacchi, L., Santinello, M. (2017). Income inequality and adolescent gambling severity: Findings from a large-scale Italian representative survey. Frontiers in Psychology, 8, 1318. doi: 10.3389/fpsyg.2017.01318
Gambling Commision (2017). Commission raises awareness of potential risks for students who gamble. September 12. Located at: http://www.gamblingcommission.gov.uk/news-action-and-statistics/news/2017/Commission-raises-awareness-of-potential-risks-for-students-who-gamble.aspx
Griffiths, M.D. (1995). Adolescent Gambling. London: Routledge.
Griffiths, M.D. (2002). Adolescent gambling: What should teachers and parents know? Education and Health, 20, 31-35.
Griffiths, M.D. (2002). Gambling and Gaming Addictions in Adolescence. Leicester: British Psychological Society/Blackwells.
Griffiths, M.D. (2008). Adolescent gambling in Great Britain. Education Today: Quarterly Journal of the College of Teachers. 58(1), 7-11.
Griffiths, M.D. (2013). Adolescent gambling via social networking sites: A brief overview. Education and Health, 31, 84-87.
Griffiths, M.D. (2015). Adolescent gambling and gambling-type games on social networking sites: Issues, concerns, and recommendations. Aloma: Revista de Psicologia, Ciències de l’Educació i de l’Esport, 33(2), 31-37.
Griffiths, M.D. & Calado, F. (2017). Adolescent gambling. Reference Module in Neuroscience and Biobehavioral Psychology (pp. 1-12). Oxford: Elsevier.
Griffiths, M.D. & Linsey, A. (2006). Adolescent gambling: Still a cause for concern? Education and Health, 24, 9-11.
Griffiths, M.D. & Parke, J. (2010). Adolescent gambling on the Internet: A review. International Journal of Adolescent Medicine and Health, 22, 59-75.
Doctor, doctor: What can British GPs do about problem gambling?
A study published in the British Journal of General Practice in March 2017 reported that of 1,058 individuals surveyed in GP waiting rooms in Bristol (UK), 0.9% were problem gamblers and that a further 4.3% reported gambling problems that “were low to medium severity”. This is in line with other British studies carried out over the last decade which have reported problem gambling prevalence rates of between 0.5% and 0.9%.
I have long argued that problem gambling is a health issue and that GPs should routinely screen for gambling problems. Back in 2004, I published an article in the British Medical Journal about why problem gambling is a health issue. I argued that the social and health costs of problem gambling were (and still are) large at both individual and societal levels.
Personal costs can include irritability, extreme moodiness, problems with personal relationships (including divorce), absenteeism from work, neglect of family, and bankruptcy. Adverse health consequences for problem gamblers and their partners include depression, insomnia, intestinal disorders, migraine, and other stress related disorders. In my BMJ article I also noted that analysis of calls to the GamCare national gambling helpline indicated that a small minority of callers reported health-related consequences as a result of their problematic gambling. These included depression, anxiety, stomach problems, and suicidal ideation. Obviously many of these medical problems arise through the stress of financial problems but that doesn’t make it any less of a health issue for those suffering from severe gambling problems.
Research published in the American Journal of Addictions has also shown that health-related problems can occur as a result of withdrawal effects. For instance, one study by Dr. Richard Rosenthal and Dr. Henry Lesieur found that at least 65% of pathological gamblers reported at least one physical side effect during withdrawal, including insomnia, headaches, loss of appetite, physical weakness, heart racing, muscle aches, breathing difficulty, and chills.
Based on these findings, problem gambling is very much a health issue that needs to be taken seriously by all in the medical profession. GPs routinely ask patients about smoking cigarettes and drinking, but gambling is something that is not generally discussed. Problem gambling may be perceived as a grey area in the field of health, and it is therefore very easy for those in the medical profession not to have the issue on their wellbeing radar. If the main aim of GPs is to ensure the health of their patients, then an awareness of gambling and the issues surrounding it should be an important part of basic knowledge and should be taught in the curriculum while prospective doctors are at medical school. One of the reasons that GPs don’t routinely screen for problem gambling is because they are not taught about it during their medical training and therefore do not even think about screening for it in the first place. As I recommended in a report commissioned by the British Medical Association, the need for education and training in the diagnosis, appropriate referral and effective treatment of gambling problems must be addressed within GP training. More specifically, GPs should be aware of the types of gambling and problem gambling, demographic and cultural differences, and the problems and common co-morbidities associated with problem gambling. GPs should also understand the importance of screening patients perceived to be at increased risk of gambling addiction, and should be aware of the referral and support services available locally.
I also recommended that treatment for problem gambling should be provided under the NHS (either as standalone services or alongside drug and alcohol addiction services) and funded by gambling-derived profit revenue.
Back in 2011, Dr. Jane Rigbye and myself published a study using Freedom of Information requests to ask NHS trusts if they had ever treated pathological gamblers. Only 3% of the trusts had ever treated a problem gambler and only one trust said they offered dedicated help and support. I’m sure if we repeated the study today, little will have changed.
It is evident that problem gambling is not, as yet, on the public health agenda in the UK. NHS services – including GP surgeries – need to be encouraged to see gambling problems as a primary reason for referral and a valid treatment option. Information about gambling addiction services, in particular services in the local area, should be readily available to gamblers and GP surgeries are a good outlet to advertise such services. Although some gambling services (such as GamCare, the gambling charity I co-founded) provide information to problem gamblers about local services, such information is provided to problem gamblers who have already been proactive in seeking gambling help and/or information. Given that very few GPs could probably treat a problem gambler, what they must have is the knowledge of who they can refer their patients to.
Dr. Mark Griffiths, Professor of Behavioural Addiction, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK
Further reading
Calado, F. & Griffiths, M.D. (2016). Problem gambling worldwide: An update of empirical research (2000-2015). Journal of Behavioral Addictions, 5, 592–613.
Cowlishaw, S., Gale, L., Gregory, A., McCambridge, J., & Kessler, D. (2017). Gambling problems among patients in primary care: a cross-sectional study of general practices. British Journal of General Practice, doi: bjgp17X689905
Griffiths, M.D. (2001). Gambling – An emerging area of concern for health psychologists. Journal of Health Psychology, 6, 477-479.
Griffiths, M.D. (2004). Betting your life on it: Problem gambling has clear health related consequences. British Medical Journal, 329, 1055-1056.
Griffiths, M.D. (2007). Gambling Addiction and its Treatment Within the NHS. London: British Medical Association (ISBN 1-905545-11-8).
Griffiths, M.D. & Smeaton, M. (2002). Withdrawal in pathological gamblers: A small qualitative study. Social Psychology Review, 4, 4-13.
Rigbye, J. & Griffiths, M.D. (2011). Problem gambling treatment within the British National Health Service. International Journal of Mental Health and Addiction, 9, 276-281.
Rosenthal, R., & Lesieur, H. (1992). Self-reported withdrawal symptoms and pathological gambling. American Journal of the Addictions, 1, 150–154.
Wardle, H., Moody. A., Spence, S., Orford, J., Volberg, R., Jotangia, D., Griffiths, M.D., Hussey, D. & Dobbie, F. (2011). British Gambling Prevalence Survey 2010. London: The Stationery Office.
Wardle, H., Sproston, K., Orford, J., Erens, B., Griffiths, M.D., Constantine, R. & Pigott, S. (2007). The British Gambling Prevalence Survey. London: The Stationery Office.