Putting Problem Gambling in Perspective
by Andrew Klebanow

The nascent success of casinos in Singapore and their effect on stimulating tourism coupled with the need for governments to find new sources of taxation in the face of a persistent global recession, has caused policy makers in other countries to consider the introduction of casinos in their jurisdictions.

As governments explore gaming development, there is a tendency to approach it solely as a tool for tourism development. Public policy makers often restrict local residents from enjoying gaming entertainment. This paternalistic approach fails to appreciate that most adults enjoy gaming entertainment and the vast majority do so responsibly. Regardless, there is a fear among policy makers that allowing its citizens to enter casinos would cause an increase in problem gambling.

Any public debate on the pros and cons of casino development inevitably brings up the topic of problem gambling and its economic and social costs on society. Often these debates take place without a reasonable understanding of what problem gambling is, how prevalent it is and how significant the problem is when compared to other pathologies. These debates are frequently led by those who are morally opposed to casino gambling and it is that moral opposition that often clouds reasonable discussion on the pros and cons of gambling. The purpose of this article is to clarify what problem gambling is, explore its prevalence in society, and compare its social and economic costs to other forms of aberrant behavior. This article relies on what has been learned in the United States over the past two decades.

Definition of a Problem Gambler
So what is problem gambling and how prevalent is it? Clinically, the American Psychiatric Association in its Diagnostic and Statistical Manual of Mental Disorders classifies pathological gambling as an impulse control disorder and describes ten criteria to guide diagnoses, ranging from “repeated unsuccessful efforts to control, cut back or stop gambling” to “committing illegal acts such as forgery, fraud, theft or embezzlement to finance gambling.” The diagnostic criteria and their associated behavior patterns are listed in the following table.

The American Psychiatric Association uses the following formula to classify gaming behaviors based on these ten criteria.

In 1999, the United States National Gambling Impact Study Commission (“NGISC”) submitted its Report to the US Congress and the President. The NGISC Study reported on three studies completed in 1997 and 1998 that estimated the percentage of US adults classified as pathological gamblers ranged from 1.2 to 1.6%. The rate of problem gambling has remained fairly constant since the NGISC report was released despite the growth of gaming development in the United States over the past ten years. In other words, even with greater access to gaming entertainment, the percent of adults in the US who can be considered pathological gamblers has remained constant at about 1.4%.

The NGISC reported that pathological gambling often occurs in conjunction with other behavioral problems including substance abuse and personality disorders. The NGISC further noted that mood disorders such as depression, suicidal thoughts, and anti-social hyperactivity often co-exist with pathological gambling. These joint occurrences are referred to as “co-morbidity.”

Co-morbidity presents a wealth of challenges to the medical researcher and government policy maker. How does one isolate the effects of pathological gambling on say, marital stability, from the effects of co-existing conditions like substance abuse? Is pathological gambling a bi-product of say, substance abuse? Is substance abuse a bi-product of problem gambling or is the combination of disorders caused by a more fundamental personality disorder? Is the severity of one disorder related to the other?

These issues are presented to the reader to illustrate the challenges that medical, social and economic researchers and government policymakers face when attempting to identify the social and economic costs of gaming and the effects that pathological gamblers have on society. It is simply not an easy task to quantify their effects.

Recognizing the possible social costs associated with problem gambling, the US casino industry, comprised of publicly owned companies, Native American gaming enterprises and state-run lotteries, and led by the American Gaming Association (“AGA”), instituted a number of policies and programs designed to educate the casino employee population in identifying problem gaming behavior; inform the gaming public as to the signs of problem gambling and where to get help; and support treatment initiatives for problem gamblers. These initiatives came at a significant cost. Casinos contribute significant portions of their gaming revenues to fund these programs and they have demonstrated an ongoing commitment to support these initiatives at their properties. One cannot walk through a casino anywhere in the United States without seeing brochures that spell out the signs of problem gambling or posters that advise where to call if one needs help. Casinos have also employed self-exclusion programs that allow patrons to ban themselves from casinos if they so desire.

In sum, it is generally agreed that about 1.4% of the adult population in United States qualifies as problem gamblers and that a subset of that population incurs a cost that society must pay for. It is for these reasons that the US gaming industry has and continues to support initiatives that educate and treat problem gambling. However, other industries have been far slower to embrace the costs that their products and services impose upon society yet communities rarely raise a sign of protest against them.

Putting the Numbers in Perspective
In August of 2010 the US Center of Disease Control issued a report stating that 27% of the US population (72.5 million Americans) are now classified as obese. Unlike problem gambling, where the costs on society are hard to measure, obesity has some very real and significant costs. On average, an obese person incurs $1,400 more a year in medical costs than a person of normal weight. The US Centers for Disease Control report estimates the costs to US society at $147 billion a year. And unlike problem gambling, whose physical effects are for the most part, unknown, obesity is known to lead to heart disease, stroke, diabetes, cancer and premature death. Obesity in the United States has, over the last decade, become an epidemic.

US government policy and the food industry’s response to this epidemic stand in stark contrast to the efforts of the gaming industry to police itself and government’s role in public policy towards casino gambling. US agricultural policy subsidizes the production of corn, soybean and other commodities that are the raw ingredients of many foods linked to obesity. Cattle and hogs are fed feed made from corn. High-fructose corn syrup is the primary sweetener in soft drinks and a myriad of other products are produced from raw agricultural ingredients whose production is subsidized by taxpayers. Agricultural subsidies have the net effect of reducing the costs of food production and allow food manufacturers, restaurant companies and fast food chains to increase portion size while reducing food costs. Any attempt to reduce these subsidies to US farmers is summarily blocked by politicians from agriculture states, lobbyists who represent agricultural interests and food companies with a vested interest in maintaining current policies.

Recognizing the obesity epidemic, both the US federal government and state governments have explored a number of initiatives to limit consumption including instituting a tax on sugary soft drinks. Rather than address its role in combating the obesity epidem

Date Posted: 11-Nov-2010

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