NATIONAL GAMBLING EXPERIENCES
Gambling in Taiwan: problems, research and policy
Cheng-Fang Yen, Department of Psychiatry, Kaohsiung Medical University, No. 100, Tzyou 1st Road, Kaohsiung 807, Taiwan. E-mail: email@example.com
Aims This study provides a systematic review of existing research that has evaluated unique gambling experiences in Taiwan.
Methods A comprehensive review of electronic databases, including Scopus, PubMed, Chinese Electronic Periodical Services and the Index to Taiwan Periodical Literature System, was conducted to identify evaluations of gambling experiences in Taiwan. Studies that met inclusion criteria were synthesized and assessed.
Results Various types of gambling are prevalent in Taiwan, even though the laws of Taiwan forbid illegal gambling. Both traditional and novel types of gambling have brought adverse impacts to Taiwanese people in multiple aspects of everyday life. The strategies and attitudes of the government towards gambling have been forced to change as gambling has flourished.
Conclusions Various types of gambling have developed in Taiwan in response to social, economic and cultural changes over time. The psychological aspects of gambling, however, need further study to provide fundamental information for developing intervention models for pathological gambling.
Gambling is a traditional recreational behaviour among Chinese societies, and has adverse moral implications. Problem gambling among the Chinese population has attracted attention in the recent medical literature. In the past decade many studies of pathological gambling as a type of addiction have been conducted by western and Chinese research teams. Apart from echoing the interest of academia in associated issues, these studies have also pointed out the shortcomings of current research regarding theoretical frameworks, methods of enquiry and socio-economic–cultural–historical variables that have been largely ignored due to the limitations of research design.
This study conducted a comprehensive review of electronic databases, including Scopus, PubMed, Chinese Electronic Periodical Services, and the Index to the Taiwan Periodical Literature System, to identify evaluations of gambling experiences in Taiwan. Studies that met inclusion criteria were synthesized and assessed in an attempt to envisage possible incision points regarding the comprehension of gambling in Chinese societies, as well as factors that could possibly shape pathological behaviour in a geographically defined area.
GAMBLING AND CHINESE SOCIETY
Scholars of Chinese studies have revealed the significance of gambling in Chinese culture, which has also influenced gambling in Taiwan. For example, from the perspective of material culture, gambling has been considered a mutually dependent activity with opium use since the late Imperial period . Another analysis indicates that traditional Chinese concepts of fate, destiny and luck could possibly influence the formation of gambling activities . A review of gambling behaviours among the Chinese population reiterates the general assumption that social gambling is widespread, shows that pathological gambling is increasing and points out the need for culturally specific, theory-based interventions tailored specifically for Chinese problem gamblers .
A review from a socio-historical–cultural perspective found elevated levels of gambling addiction among Chinese populations compared to their western counterparts . The main reason given by the author is the rapid expansion of gambling venues within the Pan-Pacific region . A research team concluded that Chinese gambling is a trait, not a status, problem . A cross-cultural study compared the gambling behaviours and motivations of Chinese and Caucasian people in a geographically defined area and found that different ethnic groups are prone to different types of gambling and motivated by different types of rewards . Western gamblers prefer one-off games such as animal races, while Chinese cling to long-term chasing behaviours although a historical study shows a short-term enthusiasm with greyhound racing in Shanghai in the 1930s, during the years of rapid westernization . There are also studies into the comorbidity between problem gambling and other pathological behaviours or diseases among Chinese, including problem drinking among youth and patients with Parkinson's disease who take dopamine agonists [8,9].
Most of these studies offer few factors that validate their hypotheses, and most comparison studies cannot show systematically the distinct causes in Chinese society regarding the development of problem gambling. To demonstrate the aspects that facilitate gambling behaviours as a whole in a society, interdisciplinary and in-depth enquiries into economic history, material culture, legal system, policy and mental health are necessary. To narrow the scope of the obtainable data, Taiwan, which shares to a considerable degree the characteristics of Chinese society, and which has unique and relatively homogeneous socio-economic and demographic factors, serves as a touchstone to conduct such a review.
GAMBLING IN TAIWAN
Early Taiwanese people favoured the same forms of gambling that prevailed in the southeast coasts of mainland China, such as Mah-Jong, Pai-Gow, dicing and lotteries, and were brought into Taiwan by immigrants during the 17th century. These traditional gambling games remain popular today, and are connected with cultural customs. For example, many people in Taiwan play Mah-Jong with family and friends for entertainment during the Chinese lunar year vacation. An anthropological study points out that high-stakes Mah-Jong in Taiwan is fraught with political significance and is related strongly to luck, martial imagery that reproduces idealized masculine values and patterns of citizenship . In addition, Taiwanese people have a long history of enthusiasm for lotteries. At the end of the Ching Dynasty (1912), lottery tickets found their way to Taiwan from China and the Philippines. The Japanese colonial government in Taiwan (a.d. 1895–1945) also published lottery tickets in 1906 to collect funds for construction projects, although only five issues were sold. To collect funds to solve financial difficulties, the Kuomintang (KMT) government published its ‘Patriotic Lottery Ticket’ (aiguo jiangquan, PLT), starting in 1950 .
It has been argued that gambling in postwar Taiwan comprises several phases in its contemporary history, each representing an economic aspect . From 1951 to 1986, the government published PLT to resolve the financial difficulties of national economic construction . In poorer times in Taiwan's history, people were eager to win a lottery jackpot and become rich: PLT provided this hope. However, over time Taiwanese society became more wealthy, and Taiwan was full of economic prosperity in the 1980s. The Everybody Happy Lottery (da-jia-le, EHL), the most popular illegal lottery, flourished. The winning numbers of EHL were determined according to the results of the PLT, but EHL prizes were much bigger and many people were so enthusiastic about EHL that superstitious gamblers gathered not only at illegal betting shops but also in the cemeteries at night, and prayed to ghosts for the winning numbers. Some temples famous for their efficaciousness were full of superstitious gamblers eager for the winning numbers. According to anthropologist Hu Taili , individuals who participated in EHL pursued simplistic symbols in an authoritarian state, and the opportunities to accumulate wealth in a rapidly changing society. She assumes that through superstitions related to EHL, modern citizens sought ways to relive the interpersonal intimacy of agricultural society while acquiring the capital needed to survive in industrialized society . The Taiwanese government stopped selling PLT in 1987 in an attempt to put an end to the EHL. However, the organizers of the EHL began to determine its winning numbers according to the results of Mark Six (liu-he-cai), the legal lottery published in Hong Kong. The great mass fervour did not subside as the Taiwanese government had hoped, but has instead lasted to the present day.
In 2002, the Taiwanese government approved the Public Welfare Lottery Issue Act, and the ‘Public Welfare Lottery’ (gonyi caiquan, PWL) commenced operation. As the first legal gambling game in Taiwan, the PWL has many different types of lottery tickets and prizes. In a study that concerns the social impact of the state-approved PWL, evidence suggests that Taiwanese people believe that the issue of PWL would help government finance; however, the majority of Taiwanese people (59%) agree that PWL impacts society negatively .
During the pinnacle of EHL, other forms of illegal gambling began to mushroom, such as electronic mechanical games, pigeon-racing and baseball gambling. Electronic mechanical games (e.g. slot machines, horse-racing machines and video poker) were illegal in Taiwan until 1990. Since then the Taiwanese government has set up laws to control the operation of electronic mechanical games and pachinko (a kind of pinball slot-machine game from Japan) and allows players to exchange tickets or small balls won from machines for non-monetary gifts or commodities. However, because of the profitability of electronic mechanical games, some businessmen have applied creative strategies to avoid the attention of the police, such as paying cash for the non-monetary gifts that players win or bribing the police to overlook scrutiny. These bribes have, at times, become major news events in Taiwan.
Pigeon-racing is a unique form of animal racing in Taiwan. Enthusiasts rear, cultivate and train racing pigeons to make them swift and strong enough to overcome difficult climatic and geographic conditions and fly safely over long distances. Nowadays, there are many pigeon-racing organizations in Taiwan and many races and prizes. The Taiwanese enthusiasm for pigeon-racing is supported by its profitability. Bankers organize illegal events where gamblers bet on which pigeon will win. Unofficial statistics report that the money involved in pigeon-racing may be $NT70 billion . Both kidnapping of racing-pigeons and bankruptcy caused by betting on pigeon-racing occur frequently. However, gambling in pigeon-racing is so deep-rooted that it seems currently beyond the government's ability to control.
Betting on sports has undergone a long struggle of legitimization in Taiwan and is associated with the fever surrounding baseball games. Since the end of the 1960s, Taiwanese student baseball teams have won numerous international competitions; in poorer times, watching baseball games became a key source of entertainment for Taiwanese people. Professional baseball leagues have been organized since 1990. However, the scourge of illegal gambling soon came to professional baseball. Gamblers bet illegally on baseball game scores organized by illegal bankers. In order to ensure specific baseball victories or defeats and earn large gambling stakes, gangsters used bribery, seduction and threats to compel baseball players to cheat . The hidden machinations of baseball gambling were first exposed in 1995, and many gangsters, coaches and players involved in cheating and baseball gambling have since emerged. In 2008, the owners of a professional baseball team were found to be operating an illegal baseball gambling operation and that teams cheated in most of their games. The repeated cheating scandals harmed baseball's popularity with Taiwanese people, and interest in baseball games has declined over time. To address illegal sports betting, the Taiwanese government issued the Taiwan Sports Lottery in 2008. People can bet on the results of baseball, basketball and football played in the United States, Europe, Japan, America, Oceania and Africa—but not in Taiwan. However, illegal gambling on the results of Taiwanese professional baseball games continues to this day.
From the late 1980s to the present, economics in Taiwan have become concentrated on capital, and the routes to formal investigation such as stocks, futures and funds have became common. In an unpublished thesis, it has been argued that during this period, Taiwanese became opportunistic money chasers despite the dwindling chances of accumulating rapid wealth . Systems of betting are now so comprehensive in Taiwan that gamblers can bet over the telephone or the internet on a wide range of events, including the closing price of the stock market, election results and the scores of foreign sports games. With the introduction of the internet, online gambling, which covers all forms of the betting behaviours mentioned above, began to emerge. Online games such as Mah-Jong and poker are legitimate if the points that the players win are not exchanged for money. However, high-stakes illegal online gambling is commonplace, and overseas online gambling can also be played. Controlling online gambling has become an increasingly difficult challenge for the Taiwanese government.
THE TAIWANESE GOVERNMENT'S CHANGING CONCEPTS AND PRACTICES TOWARDS GAMBLING
Current Taiwan laws forbid gambling in public places, and those who violate these laws can be fined. Taiwanese laws also forbid people from operating any casino or illicit lottery for the purpose of earning money. In Taiwan, no casino is legally certified. Taiwanese gambling is ruled by Chapter 21 of the Penal Code, next to the laws ruling indecent exposure (Chapter 16), hindrance of marriage and family (Chapter 17), damage of corpses and graves (Chapter 18), hindrance of farming, working and business (Chapter 19) and opioid use (Chapter 20). All these chapters affect behaviours that interfere with ‘good morals’. If society tolerates gambling, people delay their obligations and the risk of major crimes increases . The National Police Agency of the Ministry of the Interior is responsible for gambling matters, and police officers in every administrative division monitor gambling and enforce restrictions. However, traditional approaches towards controlling gambling in Taiwan have been challenged repeatedly in recent years, with a growing number of calls for the decriminalization of gambling. The establishment of legal lottery tickets indicates an important change in the attitude of the Taiwanese government towards gambling. In order to develop tourism and reduce population outflows on its outer islands, in 2008 the Taiwanese government passed the ‘Offshore Islands Development Act’, legalizing casinos on Taiwan's outer islands if a majority of island residents vote in favour of doing so. The first referendum to establish legalized casinos on Penghu, the largest outer island of Taiwan, was held in 2009, but the referendum was not passed. Although the involvement of the global gambling industry in Taiwan is limited due to the restrictions of Taiwanese law, the possible influence of the global gambling industry on legislation needs further investigation. International casino business groups have set up casinos successfully in East Asian countries (e.g. Macao and Singapore). If casinos are established in the outer islands, the impacts on those societies and public security need to be studied. The possible change in Taiwan may provide valuable information for other countries concerning the legalization of casinos; it can be expected that the debate regarding the decriminalization of gambling in Taiwan will continue.
RESEARCH ON THE ASSOCIATION BETWEEN GAMBLING AND PSYCHOLOGICAL WELLBEING
It has been argued that, from economic perspectives, gambling is highly addictive in Taiwan . However, most of the previous studies on gambling in Taiwan have emphasized legal issues and, surprisingly, few have examined the psychological aspects of gambling. The lack of research may be due to the traditional concept in Taiwan that gamblers are morally decayed and deserve the consequences of their gambling. Traditionally, gambling in Taiwan has not been considered to be a psychological problem.
Lu and colleagues provided the first academic case report of pathological gambling in Taiwan, studying a 40-year-old male who lost control over playing gambling video games despite serious financial and family consequences . His compulsive gambling behaviour subsided after treatment with fluoxetine and sulpiride . Lin and colleagues reported that, compared with their female counterparts, methamphetamine-abusing males were more likely to engage in pathological gambling . However, details of their gambling were not reported in their study. Wan and colleagues reported five cases of patients with epilepsy in which seizures were triggered by playing or watching Mah-Jong .
From 2004–06 there were two different versions of the PWL in Taiwan, including a lower-prize, lower-cost ‘small lottery’ and a larger-prize, higher-cost ‘big lottery’. Chen and colleagues investigated the association between weekly numbers of suicides and contemporaneous sales figures from both lotteries and found that, after adjusting for the effects of seasonal fluctuation, temperature and monthly unemployment, suicides were correlated negatively with sales of tickets for the small lottery but correlated positively with recent sales of big-lottery tickets . They concluded that a low-prize, low-publicity system appeared to be more benign than a high-prize, high-publicity one .
Ko and colleagues have been researching internet behaviours and found that online gambling is associated positively with aggressive behaviours in Taiwanese adolescents . A recent study regarding the epidemiological and psychiatric features of gender dysphoria in non-clinical young adults indicated that males who suffer from gender dysphoria are more likely to develop a range of co-occurring psychiatric symptoms, including pathological gambling . In addition, while the issuing of the Taiwan Sports Lottery was under discussion, concerns have been expressed about gambling behaviours and addiction among sportsmen and audiences . The decriminalization of gambling and legalization of tourism casinos on the outlying islands of Taiwan have also attracted serious concerns from public health scholars about the possible increase of problem behaviours . However, due to the lack of valid diagnostic instruments and useful research designs, neither convincing statistics nor compelling clinical case reports have been made.
Various types of gambling prevalent in Taiwan share their ancestry with traditional Chinese culture, but have also developed distinct features because of unique socio-economic processes. In the past, gambling in Taiwan did not attract a great deal of scholarly attention because it was not considered a pathological problem in Taiwanese society. Nevertheless, as gambling has flourished, the strategies and attitudes of the government towards gambling have been forced to change. Traditional concepts towards gambling and its association with moral decay are outdated. It is time for the Taiwanese government and population to examine the meaning of gambling in modern Taiwanese society; further discussion concerning the legalization of gambling would be the first step towards developing practical strategies regarding gambling control. A full-scale ban against gambling might now be impossible in Taiwan. Deciding how to choose some forms of gambling with a lesser tendency to addiction, and lifting the ban if they are set up in controlled areas, needs further study.
Furthermore, the psychological aspects of gambling need further study to provide fundamental information for the development of intervention models for pathological gambling: first, prevalence and risk factors need investigation into the variety of gambling types. Secondly, study is needed to determine how best to introduce Taiwanese people to the idea that pathological gambling is not necessarily due to moral decay, but may instead signal psychiatric disturbance; thirdly, the psychological mechanisms of and disturbance related to pathological gambling need further study; and fourthly, treatment models must be proposed for pathological gambling in Taiwan. Socio-cultural particularities must be taken into consideration when developing these treatment models.
Touching upon these four aspects, gambling-associated behaviours must be considered carefully, and psychological impacts can be measured with appropriate assessment instruments, which are already under development [29–31]. As well as developing tailored screening packages for Taiwanese society, one must be aware of whether there exist disproportionate problem behaviours among different cultures. Furthermore, from Taiwan's experience, factors that could confound the simple hypothesis of cultural gaps need to be considered, such as problems encountered during the modernization of Taiwanese society, e.g. gender issues, immigration and uneven social capital that motivate gambling behaviours.
Declarations of interest