Adolescents as customers of addiction: how do governments address young people’s gambling?

by Angelina Brotherhood and Harry Sumnall

Centre for Public Health at Liverpool John Moores University, UK

The recently published ALICE RAP policy paper on gambling highlights the gambling market as a very profitable sector of the European economy, with estimated annual revenues of around € 82 billion in 2011. This is contrasted with potential gambling-related harms. A systematic review of 39 studies in non-clinical national samples from different countries found overall prevalence rates of pathological gambling to be between 0.02% and 2.0% for the adult population [1]. Recent changes in the nature of gambling, such as the development of online gambling services, are thought to increase the likelihood of negative consequences for players [2]. Young people are identified as a special target group not only in the ALICE RAP policy paper but also in the European Commission’s recent Communication on online gambling [3]. Although international estimates of gambling behaviour in young people are not currently available [4], the surveys included in the review cited above reported prevalence estimates of pathological gambling in adolescents between 0.4% and 26.0% [5].

Within work package 16 of ALICE RAP’s Area 6, researchers from the Centre for Public Health at Liverpool John Moores University, UK, are specifically asking what activities EU Member State governments are undertaking in response to young people’s addictive behaviours (alcohol, tobacco, illegal drug use as well as gambling) and whether this corresponds to the scientific evidence of what works to reduce harmful outcomes. For this purpose, we conducted an online survey with policy experts in EU countries to identify and analyse relevant written policies, with an emphasis on young people.

We soon found out that it is difficult to identify experts for a policy area that is extremely under-developed. Our survey findings suggest that dedicated written policies appear to play a comparatively minor role in the gambling field. In fact, we were not able to identify any written national policies on gambling through the survey. Although this doesn’t mean that they do not exist, our study certainly indicates that they are currently underutilised as a tool for addressing gambling’s addictive potential. This is unlike the situation for illegal drugs, for example, where all reporting countries had a national strategy in place, and which often contained young people specific elements.

The absence of written gambling policies must be seen in the context of the governmental structures and processes which are in place to address gambling. The responses to our online survey indicate that in comparison with the substance use field, gambling is less formalised in terms of governance structures (e.g., government departments, policy making procedures) and research (e.g., relative lack of major prevalence studies). Moreover, while alcohol, tobacco and illegal drugs are mostly situated within Public Health and Justice structures, gambling is currently situated in a market/business context (both at EU level and nationally, where gambling is often regulated by the Ministry of Economics/Finance).

Supercasino challenge

The (withdrawn) plans of the UK‘s former Culture Secretary Tessa Jowell to introduce Las Vegas-style ‘super casinos‘ in England with a minimum customer area of 5,000 sq m and up to 1,250 unlimited-jackpot slot machines can serve as a historical example of how recent governments seem to have been encouraging gambling as an important revenue generator. Image source: Sunday Express (10.06.2007) "Ruling due on supercasino challenge”

The role of the state in this scenario is of particular interest, as gambling revenue (e.g. through state lotteries) can represent an important funding source for benevolent and public interest activities (including sports events in particular, as well as youth programmes and charity-related activities) [6]. Hence, the state can be in a position of ‘conflict of interest’, where expansion of the gambling market to increase tax revenue can be at odds with public health and social welfare priorities. If a business orientation leads to more liberal government approaches to licensing and other regulations, addictive behaviours in young people may be (inadvertently) promoted as the opportunities to engage in such behaviours will be increased.

At present, legislation appears to be the main driver for action on gambling. Consequently, young people targeted approaches appear mostly to consist of age restrictions (although due to our focus on written documents we cannot comment on the actual implementation of activities). The minimum age for gambling in the eight reporting countries was mostly 18 years, with some types of games allowed for younger age groups. Advertising regulations were reported to a limited extent in our survey but it was also noted that they were rarely adhered to in practice.

The potential challenge of relying exclusively on legislation is that legislation does not usually state what prevention, treatment or harm reduction should be offered (where required) and it does not specify strategic priorities and desired outcomes. What are the (public health) priorities of EU member states in relation to gambling, and specifically young people? We see the EC’s recent Communication “Towards a comprehensive European framework on online gambling” with its consideration of public health matters as a timely impetus for national governments to formalise and extend their efforts to address gambling-related harms.

As for the scientific evidence of what works in preventing problematic gambling in young people, this will be a topic for a future blog, but as a very recent public health issue, there is a real paucity of research in this area.





[1] Sassen M, Kraus L & G Bühringer (2011) Differences in pathological gambling prevalence estimates: Facts or artefacts? International Journal of Methods in Psychiatric Research, 20 (4), e83-e99, DOI: 10.1002/mpr.354.

[2] GREEN PAPER On on-line gambling in the Internal Market (COM/2011/0128 final), (last accessed 08.07.2013)

[3] European Commission (23 October 2012) Communication “Towards a comprehensive European framework on online gambling”, (last accessed 08.07.2013)

[4] The 2011 questionnaire of The European School Survey Project on Alcohol and Other Drugs (ESPAD) included two questions on gambling for 15/16 year olds in multiple European countries, but the corresponding data has not been included in the main report or the key results generator on the ESPAD web site.

[5] For a discussion of how such surveys define and measure pathological gambling (including cut-off scores), please see the review by Sassen and colleagues (2011).

[6] GREEN PAPER On on-line gambling in the Internal Market (COM/2011/0128 final), (last accessed 08.07.2013)