Livingstone & Adams  describe the consequences of the unprecedented experiment conducted by the governments of Australasia in the 1990s, when machine gaming was introduced on a large scale into local communities. The results of that expansion are now becoming increasingly clear, and should serve as a cautionary tale to government and regulatory authorities in this country as they come to terms with the new legislative regime of gambling.
That said, the structure, geography and political economy of Britain's 248 000 machines  differs from those in Australia and New Zealand. Machines exist in a variety of locations. Some are concentrated in casinos, bingo halls, adult gaming centres and family entertainment centres, others dispersed in betting shops, pubs and clubs. Sizes of stakes and prizes also vary, with stakes ranging from £100 to £0.10 and prizes from £4000 to £5 (this refers to cash stakes and prizes only, and is based only on machines currently licensed in Britain: Category As, with unlimited stakes and prizes, do not operate at present). Like Australasian ‘pokies’, some machines are truly random, while others use a form of compensatory mechanism, providing guaranteed payouts over shorter time-periods . Certain structural features of these products—including reinforcement schedules, spin speeds and credit values—are designed to attract and retain customers or, in industry terms, to maximize ‘time on device’, and have been shown to be associated with higher levels of harm than other forms of gambling [5,6].
British machines operate within a new legislative and regulatory regime [7,8]. The 2005 Gambling Act, implemented in 2007, swept away its predecessors' principle of ‘unstimulated demand’ and is based on the premise that ‘gambling is a massive global industry and is entitled to a regulatory framework that ensures continued growth’. While creating a regulator to oversee the industry and ensure player protection, its market philosophy of competition and consumer choice has also brought about an expansion of gambling opportunities, participation and expenditure . The legislation emphasizes the notion of ‘individual responsibility’ as a means of controlling behaviour: an emphasis which, it should be noted, is promoted increasingly by the new coalition government in the field of public health issues  and which, as Livingstone & Adams point out, is not conducive to upstream public health interventions.
While the legislation removed some machines from ‘ambient’ locations, it also allows the siting of up to four Category B2 machines in betting shops, with larger numbers permitted in casinos. B2s [previously Fixed Odds Betting Terminals (FOBTs)] are electronic devices that offer a variety of games, with stakes up to £100 and prizes up to £500. The gross profit from these high-stake/prize machines in betting shops in 2008/09 was £1138 million. As a point of comparison, the gross profit on all other forms of betting-shop activity was £1717 million in the same period . These machines are associated with higher levels of problems than other forms of gambling: the national problem gambling helpline reported that 31% of their calls in 2009/10 concerned FOBTs, while another 18% related to other types of machines  (figures for FOBTs include the category ‘roulette machine’, which describes the same type of machine). An emerging trend appears to point towards the clustering of betting shops containing FOBTs in urban areas, creating concerns about impacts in low-income communities [13,14].
While the Australasian case described by the authors should serve as a case study on the risks of EGM proliferation, it needs to be remembered that the harms of these global products are mediated by a range of local factors, including product variations, location and regulatory controls. At present not enough is known about the interaction of these variables in this country. Research is now required—and is beginning  (see the Gambling Commission's programme of research into gaming machines)—to investigate the potential harms of the structural and distributional features of British machines, as well as the types of regulatory controls and interventions that may be required to ameliorate them.