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Analysis

Statutory levy on gambling may do more harm than good

BMJ 2023; 381 doi: https://doi.org/10.1136/bmj-2023-075035 (Published 06 April 2023) Cite this as: BMJ 2023;381:e075035

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An industry built on harm
  1. May C I van Schalkwyk, NIHR doctoral fellow1,
  2. Samantha Thomas, professor of public health2 4,
  3. Martin McKee, professor of European public health1,
  4. Greg Fell, vice president3,
  5. Mike Daube, emeritus professor4
  1. 1London School of Hygiene and Tropical Medicine, London, UK
  2. 2Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Australia
  3. 3Association of Directors of Public Health, London, UK
  4. 4Faculty of Health Sciences, Curtin University, Perth, Australia
  1. Correspondence to: M C I van Schalkwyk may.vanschalkwyk{at}lshtm.ac.uk

Although a levy would raise funds, May van Schalkwyk and colleagues argue there are many reasons why it may be ineffective at preventing gambling harms

The gambling industry is dominated by highly profitable multinational corporations that have invested heavily in sophisticated addictive products. The use of innovative technologies, coupled with a lack of robust regulatory structures, has allowed the industry to recruit new generations of gamblers, transcending geographical boundaries to develop and expand markets across the world.12 As money spent on gambling, often by people of modest means, is no longer available for essentials of healthy living, the scale of its operations makes this industry a serious threat to the health of individuals, families, and communities worldwide.23456

Gambling harm is a public health problem

The UK has one of the largest gambling markets in the world.7 UK Gambling Commission statistics report 2419 gambling operators in the market in 2022,8 with earnings of £14.1bn (€16bn; $17bn) in the year to March 2022.8 An estimated 60% of online gambling industry profits come from roughly 5% of gamblers who are classified as experiencing “problem gambling” or as “at risk.”9 An evidence review published by Public Health England (now the Office for Health Improvement and Disparities) documented the broad range of health and social harms associated with gambling, including homelessness, crime, relationship conflict and breakdown, mental health issues, and suicide.7 It estimates that the annual socioeconomic costs associated with gambling are around £1.05bn-£1.77bn,10 although the review acknowledges that these figures are likely to underestimate the true scale of harm experienced by those who gamble or who are harmed by another person’s gambling.7 The actions of the gambling industry are recognised to increase the risk of gambling harms,11 which in turn widen inequalities, disproportionately affecting individuals and …

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