NATIONAL GAMBLING EXPERIENCES
Gambling in Australia: experiences, problems, research and policy
Paul Delfabbro, School of Psychology, University of Adelaide, Adelaide, South Australia 5005, Australia. E-mail: email@example.com
Aims The aim of this paper is to provide a critical overview of the development and current status of gambling in Australia.
Methods The paper examines the history and current status of gambling in Australia with a particular focus on the prevalence of problem gambling in the community and developments in policy and treatment services.
Results The paper highlights the contradictory role of State governments as both providers of treatment services as well as agents for the liberalization for gambling. It also shows how the notion of ‘addiction’ is conceptualized in Australian research and treatment services, including the preference for harm-based and public health approaches. Such perspectives view problem gambling as having multiple pathways and determinants that extend beyond the pathology of individuals.
Conclusions Gambling in Australia provides a curious paradox. Highly liberalized State government policies that allow the proliferation of high intensity gambling coexist with extensive policy, regulation and research designed to address the negative impact of gambling on the Australian community.
Although there are likely to be many explanations for the recent world-wide growth in the gambling industry, it is generally accepted that governments have played a critical role [1–3]. From being an activity often viewed as a vice, a focus for criminal activity or a form of glamorous extravagance, commercial gambling is now a commodity which is sanctioned, taxed and regulated by many governments around the world. Gambling is attractive to governments because it provides a ready source of taxation revenue that might otherwise be difficult to collect through direct taxes [2,3], but it also gives rise to a number of tensions and paradoxes for those in authority. Not all people who gamble are necessarily able to gamble at a benign level. Gambling can cause significant and acute hardship for individuals and their families, and can often be disproportionately burdensome for less socially and economically segments of the community . Some gambling products or promotional strategies can also cause more harm than others. Thus, modern governments are faced with a dilemma of how to allow consumers their sovereignty to engage in the activities of their choosing while also fulfilling their obligation to govern in a way that protects people from potential harm [1–5].
The purpose of this paper is to provide a brief review of these tensions, which have been borne out in Australia over recent decades. It will be shown that the situation prevailing in Australia provides an interesting standpoint against which other nations might be compared. Although there are few countries in the world where high-intensity gambling is more readily accessible in the community, the Australian gambling industry has none the less been subject to extensive policy debates, research and legislative reform. In this paper, we provide a brief historical overview of the growth of the industry and its current state before reviewing the ways in which government regulation, reforms and funded interventions have been applied to reduce the harms associated with gambling.
GAMBLING IN THE PAST AND PRESENT
Gambling has been a feature of Australian life since settlement, and very probably before this. Historical evidence suggests that gambling was common in Aboriginal communities before British settlement. Although often taking the forms of traditional activities involving objects carved from plant or animal matter, there is also evidence that some communities were influenced by gambling activities practised by passing European traders . Among Europeans, gambling is known to have been common in the gold rushes of the 1850s (playing-cards) and the Melbourne Cup has been a national event ever since the 1860s. Lotteries were first introduced in the early 20th century, ostensibly as a way to raise public money, and illegal gambling (e.g. secret casinos, book-making), often associated with organized crime, was rife in most capital cities until the 1980s . Formal legalized gaming became more common over time. For example, electronic gaming machines (EGMs) were introduced into clubs in the State of New South Wales in 1956, and Australia's first casino (Wrest Point) opened in Hobart (Tasmania) in 1973. A dozen larger and small casinos followed in the 1980s and 1990s, but by far the largest change occurred in the early 1990s when all States and Territories (apart from Western Australia) legalized EGMs in community venues [3,4,7]. At this time, clubs and hotels existed in almost every metropolitan suburb and regional towns, so there was already an existing infrastructure in place for gaming machines to be made available in almost every part of the country [2,5].
The introduction of EGMs in the 1990s led to a profound transformation in the Australian gambling industry. In 1988–89, net gambling revenue in Australia was $7 billion and this increased to $17 billion by 2008–09; 60% of this came from EGMs . Many hotels and clubs increased their operations significantly using the additional EGM revenue. Australia now has almost 200 000 high-intensity gaming machines with 100 000 located in the State of NSW alone. Nation-wide, this represents approximately 11 machines per 1000 adults in the population [3,7]. In contrast to the lower-intensity machines often observed in the United Kingdom and Europe, most Australian machines allow up to 17–20 spins per minute (assuming no winning events), with bet amounts that can range from as little as a fraction of a cent to $10 .
State governments justified the introduction of machines based on anticipated taxation returns, fear of losing revenue to other States and in response to lobbying by the hospitality industry, who argued that gaming would contribute to employment and economic growth. Many State governments now derive a substantial proportion of their revenue from EGM taxes (some as high as 15%) [1–5]. This dependency arises because States are highly dependent on the central Commonwealth Government for their funding, which is not always sufficient to support State budgets .
On the whole, the public appeared to have found these new gambling opportunities highly attractive. Population surveys conducted since the early 1990s [3,4,7] indicate that approximately 70–80% of the population gambles for money at least once per year. Lottery gambling is most common (60%), followed by instant scratch tickets (35%). By contrast, only a minority of people (and more commonly younger males) gamble on activities such as sports, racing and casino table games . By far the most popular form of continuous gambling is EGM playing, although percentage participation rates have fallen from approximately 40% in the 1990s to approximately 30% in the late 2000s. EGMs are distinctive, in that they attract players from every demographic group, including women of every age, although participation rates tend to be highest in the 18–25-year-old age group.
PROBLEM GAMBLING IN AUSTRALIA
As in other countries, estimates of problem gambling have been derived from community telephone surveys. These began in the 1990s using samples of between 1000 and 2000 participants, but have now increased to samples of up to 30 000 [3,4]. In most of these studies, respondents who gamble regularly (weekly or fortnightly) are administered either the South Oaks Gambling Screen (SOGS)  (1990s) or the Problem Gambling Severity Index (PGSI) . Almost all these studies report a problem gambling prevalence rate of approximately 0.5–2% of the adult population, with another 2% being moderately at risk [3,4], which is generally consistent with figures reported for other westernized countries . Problems tend to be concentrated more highly in certain demographic groups: males (usually 60% at the population level), younger people (aged 18–35 years), Aboriginal people, people who are not in a stable relationship and among lower socio-economic groups [3,4,7]. Problem gamblers also tend to have a greater likelihood of having started gambling at a young age, to have experienced larger wins when they first started gambling and to have a history of problem gambling in their families . Similar findings have emerged from studies of adolescents [10–12], although in these studies problem gambling has tended to be differentiated more strongly by gender. Young males are more likely to gamble, to experience gambling-related problems and to have family members with gambling problems. In this age cohort, problem gambling is often associated with a higher probability of involvement in other high-risk behaviours .
In general, Australia's approach to the conceptualization and measurement of excessive gambling as a disorder shares many similarities with Canada and New Zealand). In all three countries, responsible gambling legislation has been enacted to guide government policies and industry operations and there are regulatory bodies that conduct research and reviews into the impact of gambling on the community [4,7]. Such policies generally impose greater constraints on the industry than similar policies in the United States, but generally grant greater autonomy to private gambling enterprises than would be observed in European countries (e.g. Holland or Norway). Another contrast with the United States is that Australia (such as New Zealand and Canada) tends to approach gambling from a similar conceptual or public policy framework. For example, less emphasis has been afforded to medical, genetic or traditional addiction frameworks. Although such conceptualizations are recognized and implicit in many of the common measures (e.g. SOGS and PGSI) used in Australian prevalence studies [3,4,7], psychological and sociological explanations are emphasized more strongly. For this reason, it has been customary to use the term ‘problem’ rather than ‘pathological’ gambler in research and policy discussions. Researchers who work in the field tend to emphasize the importance of psychological factors such as conditioned responses , schedules of reinforcement [14–16] and erroneous cognitions [17,18]. There is also acceptance that gambling, and particularly that undertaken on EGMs, often arises as a way to deal with other underlying psychological problems [19–22]. In this sense, problem gambling is often considered a psychological disorder rather than a form of physiological dependence, the model that is commonly adopted in discussions of substance-abuse disorders [23–28]. More broadly, there is recognition that multiple factors (biological, social, regulatory and geographical) probably influence whether people become involved in gambling to begin with, and that there are very likely multiple pathways into problem gambling. Blaszczynski & Nower's well-known pathways model , which draws upon clinical observations and builds upon earlier typologies [30,31], is indicative of the diversity of factors that are taken into account in understanding the development and maintenance of problem gambling.
Another development in Australia has been the increasing application of public health principles to the study and regulation of gambling [4,7]. This perspective is implicit in the current national definition of problem gambling, which states that the disorder arises as a result of ‘difficulties in limiting money and/or time spent gambling which leads to adverse consequences for the gambler, others, or for the community’. Central to this definition is the assumption that excessive gambling can give rise to various forms of harm. Thus, a focus of government policy has been on the identification of risk and vulnerability factors that may contribute to the development and escalation of problems over time. It is assumed that greater liberalization and accessibility contributes to greater interest and involvement in gambling, and that the more intensive the gambling, the greater the risk of harm (dose–response relationship) . Policy is therefore seen as having a primary function (to reduce harms before they develop), a secondary function to prevent the progression of regular to problematic gambling and a tertiary role to provide services to people already affected by gambling-related problems .
THE NATURE AND CHALLENGE OF REGULATION
In Australia, both legislative and non-legislative provisions exist to protect consumers from the potential harms arising from gambling. Industry groups operate under consumer and trade practices legislation and also duty-of-care provisions specific to their sector of the industry. All gaming machines are approved, tested and regulated according to State gambling laws and national gaming machine standards [33,34]. Most States and Territories have also passed legislation concerning the appropriate provision of gambling services. This usually takes the form of mandatory codes of practice that require venues to advertise and provide gambling products in appropriate ways and for staff to undertake approved responsible gambling training. In some States (e.g. NSW) codes of practice are still voluntary, so that not all industry operators are subject to legislated audits and sanctions, although the State government is still active in the promotion of responsible gambling policies and information . In other States (e.g. Queensland), a co-regulatory arrangement exists in which industry, the non-government sector and government collaborate to design, facilitate and monitor the implementation of various provisions and policies [36,37]. Typical examples of these provisions include: appropriate signage and information concerning support services; the availability of automated cash terminals in the venues; rules concerning the access of minors or the provision of alcohol on the gaming floor; avoidance of promotions that mislead the public about player opportunities to win money; and appropriate training for staff relating to the codes of practice, how to approach and identify patrons with potential gambling problems and the operation of venue exclusion schemes [35–37].
Evaluations of these regulatory provisions generally show that they are applied inconsistently and fragmented in their approach [2,34,38–40]. Not all areas of the industry equally embrace regulatory reforms or codes of practice. Smaller venues often have fewer resources to implement changes to the same extent as larger venues. Moreover, there are also structural challenges associated with applying so-called ‘responsible gambling’ legislation, in that each State and Territory has its own gambling laws as well as regulatory and enforcement bodies. Thus, it does not necessarily follow that innovations in one jurisdiction can be applied or replicated elsewhere. Another difficulty, identified in several sociological critiques [1–3], is that responsible gambling provisions often place greater emphasis on the modification of the behaviour of individuals rather than the industry itself. Instead of implementing laws that reduce the riskiness of various forms of gambling, legislation tends to provide only broad ad-hoc recommendations concerning industry practices which are often not translated into specific and enforceable reforms . As Livingstone has pointed out, policy reforms are constrained by what he terms a ‘business as usual’ discourse which involves a resistance to reform predicated on the view that problem gambling represents only a small minority of total gamblers, is attributable largely to individual behaviour and is unlikely to be influenced by the nature of the products themselves. These views have persisted despite the fact that approximately 20–5% of regular (or weekly) EGM gamblers have been found to be problem gamblers and that 60% of revenue is likely to derived from problem and moderate risk gamblers, as indicated by surveys based on PGSI classifications .
RESEARCH AND TREATMENT
Research into, and treatment of, gambling problems in Australia shares many similarities with other countries (e.g. Canada). Most States conduct regular community prevalence studies (usually household telephone surveys every 2–5 years), and there are dedicated research centres and individual researchers working in various areas of the field. In 1999 and 2010, the Federal Productivity Commission produced extensive reviews of most aspects of the industry based on a combination of primary and secondary data sources . The Commission's work reveals that much of the Australian gambling research agenda is fragmented and does not always use a consistent methodology, particularly in the area of prevalence research. Most experienced researchers are in the field of psychology, although an increasing number of public health, economic and marketing researchers are also becoming involved. Developments in gambling are reported annually in the national conference of the National Association for Gambling Studies, a peak not-for-profit body founded by academics, but which encourages discussion of issues relevant to policy makers, regulators, service providers and the industry.
Much of the research in Australia is funded incrementally on a tender-based approach by State governments (e.g. [36–38,41–44]), but there is also a national body, Gambling Research Australia, that funds policy-relevant research with a national focus. Although not underfunded, a common criticism of much of this research is that the agenda is established largely by government which, in turn, maintains a power of veto over any reports produced. Researchers wishing to pursue topics of their own choice also have opportunities to apply for funding through nationally competitive grant schemes (e.g. Australian Research Council), but this has often proved difficult because of the nature of the selection criteria. No journals in the gambling field are considered ‘high-impact’, which undermines track record ratings, and the projects themselves are often under-funded or of an insufficient duration to allow large, progressive studies to be conducted.
Treatment services are available in every State or Territory and are generally funded by government through levies imposed on the gambling industry. Although some dedicated clinical treatment centres exist in several of the major cities, most services are eclectic and not always theoretically driven or evidence-based. Various forms of therapeutic counselling coexist with the provision of financial and relationships advice and empirically informed therapies such as cognitive–behavioural therapy (CBT), behavioural therapy and motivational interviewing. Most Australian States also have local chapters of the US-derived Gamblers Anonymous, but such groups usually attract only a small number of problem gamblers because of their small scale and exclusive focus on abstinence. Many services are incorporated into large religious organizations that provide a range of services and State government funding is often apportioned on a percentage basis to the range of services provided (e.g. what percentage has to be financial counselling). With a few exceptions [41,45–48], much of this work has not been evaluated extensively and relatively few large-scale clinical outcome studies have been conducted. As in other countries, the most empirically rigorous work typically involves CBT-style interventions, where imaginal desensitization, cue exposure or cognitive restructuring and debiasing techniques are used in combination by trained clinicians .
In summary, gambling in Australia is shrouded by many contradictions. Although the operation of the gambling industry is governed by specific gaming legislation, various codes of practice and is extensively monitored and studied by policy-makers and researchers, scepticism remains concerning the rigour of these provisions. State governments are both the funders of policy, research and treatment services, but also the major beneficiaries of taxation revenue derived from gambling. A direct conflict of interest therefore exists in those departments of government concerned with the social impact of gambling and those (e.g. Treasury departments) concerned with the maintenance of revenue. The possibility for consistent gambling policy is also hindered by the nature of Australia itself as a federalized country with different jurisdictions, each with their own particular legislation, industry composition and budgetary considerations.
The principal characteristic that sets Australia apart from much of the world is the impact of EGM gambling. Gaming machines are available wherever there are clubs or hotels, so that even a small State such as South Australia (population 1.5 million) has almost 600 venues with EGMs. EGMs are thought to be the cause of 80% of gambling problems, but the source of 60% of national gambling revenue. They are played regularly by less than 5% of the adult population, criticized incessantly in the media, social welfare groups and by many politicians, but attempts to impose significant restrictions on EGMs are challenged vigorously by both the industry and many in public life. It is this form of gambling that, therefore, highlights so strongly the inherent contradictions and conflicts of interest relating to gambling in Australia.
Declarations of interest