Title: Examining Gambling Issues From a Public Health Perspective
Author: David A. Korn
Abstract: Public health has a tradition of addressing emerging and complex health matters that affect the whole population as well as specific groups. AIDS, environmental tobacco smoke and violence are examples of contemporary health concerns that have benefited from public health analysis and involvement. This article encourages the adoption of a public health perspective on gambling issues. Gambling has been studied from a number of perspectives, including economic, moral, addiction and mental health. The value of a public health viewpoint is that it examines the broad impact of gambling rather than focusing solely on problem and pathological gambling behavior in individuals. It takes into consideration the wider health, social and economic costs and benefits; it gives priority to the needs of vulnerable and disadvantaged people; and it emphasizes prevention and harm reduction. This paper looks at the public health foundations of epidemiology, disease control and healthy public policy, and applies them to gambling. Major public health issues are analyzed within a North American context, including problem gambling trends amongst the general adult population and youth, and their impact on other specific populations. There is significant opportunity for public health to contribute its skills, methodologies and experience to the range of gambling issues. By understanding gambling and its potential impacts on the public’s health, policy makers, health practitioners and community leaders can minimize gambling’s negative impacts and optimize its benefits.
Title: “Everything’s Bubbling, But We Don’t Know What the Ingredients Are” – Casino Politics and Policy in the Periphery
Author: Julie E. Scott
Abstract: With the global spread of commercial gambling, the casino industry is fast establishing itself in many of the world’s peripheries – economically and politically marginal locations, simultaneously remote from, but dependent on metropolitan centres of finance and decision-making. Using the case of northern Cyprus, this paper examines the political and economic context of decisions by such peripheries to embark on casino tourism as a development strategy and explores some of the problems faced in attempting to regulate and control the sector. The paper suggests that it is the condition of dependency, rather than simple resource constraints, which is the major obstacle to establishing an adequate policy and regulatory framework.
Title: Casino Gambling in Switzerland -The Legal Situation, Politics and Prospects for Prevention and Harm Reduction
Authors: Daniela Dombrowski, Ambros Uchtenhagen, & Jürgen Rehm
Abstract: In April 2000, a new law came into effect in Switzerland that permits casino gambling with unlimited stakes for the first time since 1921. Casinos can now be run only with a concession granted by a newly established federal agency. In addition to economic and administrative information, each casino applying for a concession has to submit a fully developed “social concept” that includes detailed prevention measures for dealing with people with gambling problems, staff training and evaluation research, which an independent advisory board will control. In the fall of 2001, the first casino concessions will be granted based on the quality of each applicant’s overall proposal. The new legislation is creating a unique situation in Switzerland. To reduce the potential harm for gamblers that is associated with new forms of gambling, the legislation should be standardized and continuously optimized. These new measures require evaluation and government control.
Title: Gambling-Induced Analgesia: A Single Case Report
Authors: Alexander Blaszczynski & Fiona Maccallum
Abstract: This paper describes a single case study of analgesia induced by gambling. The subject is a 48-year-old male diagnosed with pathological gambling problems, suffering chronic back pain resulting from a road trauma. The reported intensity of arousal associated with slot machines and roulette produced a state of dissociation or distraction that temporarily reduced levels of pain. Consistent with an operant conditioning model, this reduction in pain was a negative reinforcer that acted to elicit further gambling whenever the pain reached a certain level of discomfort. In the absence of any effective analgesic medication, he used gambling as his predominant strategy to manage pain. He began to enjoy gambling, and within a relatively short period, lost more than he intended and commenced chasing losses. Pain levels decreased following chiropractic interventions, but his gambling continued. The additional, positive reinforcing effects of the excitement generated by the slot machines and roulette gaming became sufficient to maintain persistence in gambling independent of pain experienced. This case highlights the possibility that psychological factors involved in establishing a gambling habit may differ from those involved in maintaining persistence.