Changes in gambling harms show need to consider the relationship between harms and availability

The Lancet Regional Health Europe 2022;12: 100288 Published online xxx https://doi.org/10.1016/j. lanepe.2021.100288 Recent figures from the British Gambling Commission (GC), published on Oct 26 2021, suggest that rates of gambling harms in Britain have significantly fallen for the first time since their measurement began in 1999, with (conservative) rates of problem gambling falling from c.0.5-0.6% in the preceding four years to 0.3% in 2021. The Betting and Gaming Council, the leading lobbyist for the gambling industry, have been quick to attribute this change to their actions in promoting responsible and safer gambling (See https://bettin gandgamingcouncil.com/news/betting-and-gamingcouncil-pledges-to-keep-up-the-momentum-as-newreport-suggests-problem-and-at-risk-gambling-rates-arefalling). Yet, the Gambling Commission report also shows that participation in gambling in the past four weeks has also declined in 2021, from a high of 47% in 2019 to 42% in 2021. This is no surprise, the COVID19 pandemic saw nearly all retail forms of gambling close during various national lockdowns. In 2021, all retail gambling (apart from lottery tickets and scratchcards sold in shops) closed on January 6 2021. Bookmakers did not reopen until April 12 2021 and bingo halls and casinos, not until May 17 2021. Such restrictions on the supply of gambling activities are likely to affect who gambles, how often and their resultant experiences of harms. These findings are consistent with our expectations of applying the total consumption model to gambling, whereby Rose and Day originally proposed that “the population mean predicts the number of deviant individuals “(their language). This suggests that when mean consumption changes, as it did during COVID-19 pandemic, it is expected that the proportion of people experiencing problem gambling will change accordingly. This initial data from the Gambling Commission appears consistent with this hypothesis. Further support is provided by studies examining what happened during the initial COVID-19 lockdown in March-June 2020, where around of one third of regular sports bettors simply stopped gambling altogether when neither sports nor their preferred form of betting were available. Understanding the patterns that underlie these trends is important. Retail-based gambling is a multi-