An effective prevention plan must seek to identify the right mix of interventions to be applied at both the population and individual level.
It must also deliver a clearer understanding of activities which are less effective, or counterproductive, and should be stopped.
'Prevention' of gambling harms will include a broad spectrum of measures at population level, such as regulatory restrictions on product, place and provider. This priority also includes reference to public health messaging and education programmes, and to specific work with individuals who are at risk of harm.
A future prevention plan will need to consider the range of possible approaches, including:
Many prevention measures are already in place, whilst others are being developed. However, not enough is known collectively about which of these activities and programmes designed to prevent gambling harms should be extended or applied in order to achieve maximum impact. Equally, there is evidence from other fields of addiction that prevention activities, if not done properly, can have little or no impact or carry the risk of unintended consequences.
- At the universal level, gambling businesses are required to offer safer gambling information to customers and a range of preventative tools to limit time or money spent or to take time-outs from gambling. Our understanding of how consumers use these tools and how to increase take-up is developing but still at an early stage.
- For at-risk groups, campaigns and workforce education can be applied across a wide range of environments from healthcare and education professional settings to those in the third sector, such as debt advisers. It is as yet unclear what the long-term effects on behaviour and attitudes of some education programmes such as those currently being delivered in schools will be, though care has been taken to align to the curriculum and set learning objectives.
- Regulatory requirements apply to the identification of at-risk individuals by gambling businesses, but the Commission is driving further progress, and consideration is being given by financial, public health and third sectors on how to develop further means of identifying these individuals and applying measures to prevent harm.
Together, these and other activities designed to prevent gambling harms may have a positive impact, but there is further work to be achieved on co-ordination and evaluation.
At the moment, it is difficult to evidence how effective any or all of these are at reducing gambling harms. Therefore, in order to measure how effective these activities are, a key action will be to progress the framework for measuring harms under the Commission’s research programme. We will also need to align this work to that being carried out by others. This includes: the work which has been commenced by Public Health England and the National Institute of Health Research to conduct evidence reviews on gambling harms; the work being undertaken in Wales, building on the Annual Report 2016/17 by the Chief Medical Officer for Wales, Gambling with our health, and the work in Scotland to scope, develop and implement a whole population approach to prevention and reduction of gambling harms being progressed by the Scottish Public Health Network.
We must improve our understanding of the impact of prevention activities on reducing gambling harms. Current screening tools that measure the prevalence of people identified as problem gamblers provide a useful insight, and will continue to do so, but they fail to capture the full scale of harms that are caused by gambling.
Progressing the frameworks for measuring gambling harms, is therefore an urgent priority for the strategy. In addition to the adult framework which was published last year, a specific framework for children and young people who are likely to experience harms from gambling in different ways, will be published shortly. A better understanding of gambling harms for adults and children and young people will help to target prevention and education initiatives where they will have most impact. This work will span the life of the strategy and beyond, and at each stage new information about these harms will be used to further refine approaches to prevention and education activities.
A range of bodies across Great Britain, including Public Health England and Wales, NHS Health Scotland, the Scottish Public Health Network, the Department for Education, and those gambling charities and experts by experience are actively working in the area of prevention and education and have a critical role to continue to support this work and help coordinate and target activity.
Work is already underway in England, Scotland and Wales. For example, the National Institute for Health Research (NIHR) assessment of gambling harms, the Public Health England (PHE) evidence review of health aspects of gambling harms, and the NIHR call for proposals to measure the effect of prevention interventions.
Over the life of the strategy, research, expertise and action by all parties will need to be shared to inform the ongoing approach.
This increasing body of evidence will inform a collective prevention plan, which will consider appropriate options for delivering a range of interventions, and how they can be delivered most effectively.