Digital Health: Gambling

If you were recovering from drinking alcohol too much, it wouldn’t be a good idea to carry a bottle of booze around with you. These days, even carrying a mobile phone would be risky as in most cities you can order drink to be delivered 24/7 – for a lot of cash true, but when you’ve ‘got a habit’ any financial sense is the last thing that will protect you.

With gambling the problem is much worse. Unless you get rid of your phone and every other digital device you constantly have a casino in your pocket or near at hand on your other devices, 24/7 – in bed, at work, driving, on the bus or train, watching sports on television. And you’ll be assailed by precisely designed marketing to ‘enjoy’ playing ‘games’ precisely and scientifically designed to be potential instruments of addiction. Or instruments of torture.

You have choices with alcohol. Pour it down the sink. Avoid socialising with drinkers, at least early on in your recovery. Don’t carry it with you. Obviously.

But with gambling, unless you completely cut yourself off from the digital world, the supply is there by default. It follows you wherever you go. Younger people are ‘digital natives’. To them gambling is a completely normal and fun activity, especially associate with sport and sporting heroes. Loot boxes and other ‘games’ blur the boundary between childhood behaviour and adult ‘fun’. Every kid wants to grow up and act like the adults. Immersed in constant usage of digital devices – for good or ill – the ease of quick-thrill access to gambling, pornography and drugs (the latter just a text message away for quick delivery) puts many – not all – young people in harm’s way. What age checks may officially exist are easily circumnavigated. In the digital world you are not a thirteen-year-old you are a bundle of data. Very profitable data.

On our main site, The Machine Zone, we have begun to examine the huge area of what is known as Digital Health. This phrase is riding like a juggernaut through health services including the NHS and is already a multi-trillion dollar corporate industry. It is heavily promoted as A.Very.Good.Thing. In many ways it is and will be: there can be no doubt about that. But we’ll be looking at some more precautionary views. While data sharing can speed up and enhance healthcare, for instance, there are concerns about privacy. There’s also the question of whether a consultation with a human doctor may be more beneficial than diagnosis and treatment via remote apps and algorithms.

Well, it’s also the case that digital health should, in the interests of prevention, consider the digital causes of illness and ill-being. There are, in the case of gambling, many apps which prevent digital bank transactions – and credit card transactions are now illegal. One may ask, and be certain to be fiercely argued against, whether a truly effective preventive method may see the complete banning of all digital online gambling and hence marketing. Such a radical move, even the proposal, is enmeshed in the fundamental political questions around business and personal freedom, business and personal responsibility, loss in tax revenue, and – of course – the deprivation for millions who enjoy a little flutter responsibly and safely. Even tobacco regulation hasn’t gone nearly so far, and surely tobacco causes far more illness and death than gambling. All true.

It is hard to see where treatment for people with gambling-related distress may develop. ‘Addiction services’ in the UK have been decimated since the government transferred responsibility to local councils reeling under budget cuts. Stigmatising attitudes in all mental health care are institutionalised. Medical professionals, through no fault, do not have the knowledge and experience to help. Stigma prevents many people admitting to problems and seeking what help there may be. That help is there in some geographical regions (although in Scotland there are no dedicated gambling services). Anti-stigma projects around mental health are proving of some success: people generally are willing to identify their own issues, such as depression, and seek help. Perhaps one way forward to destigmatising gambling issues is to launch an ongoing social media campaign – the very social media that have proved their weight in gold to businesses of every shade. Funding for such a campaign is unlikely; less so a willingness to see the need for such a campaign.

The weight of prevention of gambling harms has been given over to schools and social enterprises funded ultimately by voluntary donations from the gambling industry. There is much good work being done – along with some not so good work. The big problem is that educational initiatives have behind them a paucity of evidence, research and effectiveness evaluation. Whether by design or not, the weight given to education repeats the dominant ideology of modern capitalism: individuals are responsible for their choices and behaviour; individuals identified as ‘pathological’ or ‘failing’ should be given support but ultimately everything is down to them. The responsibility of industry is thereby de-emphasised – in the case of gambling, the industry’s social responsibility to ensure harm minimisation by discontinuing harmful products, marketing and willingness to reduce profits in the name of rigorous procedures to monitor and prevent individual disasters. Not everybody will agree with this; some will vigorously disagree. That’s life, that’s politics, and no one anywhere can press a magic button to produce a win-win. The savage legal restrictions faced by the tobacco industry, the negative social perception of tobacco, emerged after more than 50 years of furious debate. While it’s true that the comparison between gambling and tobacco is often too heavily simplified and overstated, from a health perspective there remains a good deal to learn good lessons.

One of the dangers around ‘digital health’ is that it is embedded in wider ideological worship of data and algorithms. Buzz-words are efficiency, cost-saving, productivity. Unsurprisingly, the same words are almost holy icons in business. It can tend to work at a population level, seeking to insert a living human individual into a categorised ‘box’. It was the philosopher Kierkegaard who said, ‘To label me is to dehumanise me’. Sadly, in our ordinary lives we do tend to label people: ‘waster’, ‘junkies’, ‘alkies’. Big Data takes labelling into the realms of a high art, an ethereal cloud of digital bits totally disunited from the hearts and souls of a whole, living individual with all that means. The word ‘whole’ is where we get the word ‘health’ from. In seeking and recognising the unique wholeness of a person we have to go beyond statistics, data and ‘evidence’. That’s why it’s greatly to be welcomed that far below the data clouds the voices of individuals are being heard more and more. In health generally, perhaps most visibly, ‘Experts by Experience’ are coming to the fore. In what relatively little gambling research there is, there is a turn away from quantitative data-crunching towards qualitative research focused on individual human experiences, the voices of whole individuals. Such approaches may, of course, be appropriated by powerful stake-holders, including the researchers themselves, to ultimately hide those voices. Yet it cannot be denied that the gathered voices of ordinary people have been successful in so many ways in ‘bottom-up’ challenges to policy making so often driven drom the ‘top-down’.

We live in a digital world, breathe it, an air as invisible and taken-for-granted as the sea is by the fish that swim there. But we aren’t bits of cork bobbing about and carried this way and that by environments over which we have no control. We are not bits of data, we are human beings rich with the powers of solidarity and more power than we sometimes realise to make a better world just by being who we are.

 

Digital Health: Dying?

Dying, facing our deaths and those near us, is something we all must do. Some of the greatest philosophers have concurred that to live is to prepare for death.

Yet we live in a death-phobic culture which – largely due to the digital environment – is incredibly fast, distracting, bright and shiny and ‘full of life’. In relatively recent history people accepted death as a normal part of life, inevitably to be faced with sadness and mourning but never as a sudden shock as if some malignant miracle had occurred.

With so many of us in the rich countries living longer than ever, longevitiy for the majority bringing with it pain and suffering, dementia and deadly diseases, how do we prepare for death? Do we expect the incredible medical advances and technology to keep us going for ever? Is that our goal – to squeeze as many years and days out of life as we can? Has technology in this as many other other cases further removed use from nature and being a human rather than a machine?

In any case, what, if anything, can ‘digital health do to address the truth of our mortality? Lots of big questions here but as you and I will die we need to think of our own deaths. As a society, the birth rate is falling quickly at the same time as the older population is greatly increasing. Who will look after the old, who will pay for that care?

Perhaps we need to understand that technology has little part in our dying, apart from its role as a tool to alleviate pain and enable diagnoses. Certainly, there is a small number of enthusiastic scientists who believe that in this century that not only all disease but death itself will be defeated. We’ll look at these claims in later posts but for us here and now, dying is the truth of our lives.

With luck, and perhaps some forethought, we will have a ‘good death’, one that is peaceful and pain -free. The stark evidence, however, suggests that the majority, especially the poor, may face death unprepared, bewildered, frightened. Some – about 5% of the population – will receive palliative care; most will die in busy hospital wards or nursing homes.

To end on a bright note, here is Dr Kathryn Mannix who has 40 years experience as a consultant palliative care physician. She’s written a lovely book called With the End in Mind. There has been a growth in recent times of interest in death: academically it’s called thanatology. In most UK cities there are ‘death cafes’ where ordinary folk meet to talk about dying – not only people with a terminal diagnosis but anybody who believes that one day they will die.

We will all die as unique individuals, in different circumstances. Some will die suddenly but most of us will die more slowly (in fact, from the age approximately of 21 we are all in the process of dying). Digital technology can provide huge swathes of data about populations but the individual alone is a unique human being, and part of that unique being is unique dying. As laypeople we may be able to ease and support someone’s dying: most of us can’t. We are frightened and adrift in the face of death. Some of us will demand of doctors futile medical treatment. Doctors and nurses themselves, in addition to their expertise, don’t always have the time and, especially, the understanding to help the dying. At this important point of a person’s life what is needed most of all is kindness. Kindness is also the most important part of living, something we forget in the full flood of youth and health.

In the area of digital health we should never forget that it is but a series of technical tools, perhaps as sharp as a scalpel, that in no way is as essential as the human touch. ‘Health’ comes from the word ‘whole’ and our whole being is our unique full personhood with all the fears and joys, memories and loves, body and soul. We should always put people before data, and before people we should put the unique individual human person.

Digital World

In the coming year The Machine Zone is broadening its scope to examine how digital technology is affecting our lives and wellbeing. We look ahead to possible futures in the next couple of years and beyond.

We continue our work around digital gambling at beatthefix.com . In many ways the subject of digital gambling is an encapsulation of the wider social and cultural impact of digital technology. Like so much in rapid technological development it has shown the inadequacy of old ways of thinking. Governments and regulators are ‘catching up’ with an unanticipated development (unseen, for instance, in the liberalising framework of the 2005 Gambling Act). More broadly, Professor Rebecca Cassidy argues in her 2020 book, Vicious Games: Capitalism and Gambling :

An experiment which began in the 1980s ((financial deregulation, neoliberalism)), to shift the burden of risk from the state to the citizen, has increased inequalities and changed the ways in which we imagine wealth is created and shared. Gambling has been at the heart of these shifts: in the City as it deregulated and embraced riskier, increasingly complex and opaque ways to make money, becoming less and less accountable as a result, and in government itself, which encouraged citizens to become self-sufficient individualists.

Vicious Games: Capitalism and Gambling

We now live in a world where we are strongly encouraged, ordered, commanded to see ourselves as self-sufficient individualists’. Thus, our ill or well being is seen as a matter solely of personal responsibility and choices. We are seen as isolated atoms, disconnected from not only each other but also disconnected from the power of business (for instance products, marketing and advertising), immune from vast social inequalities, disallowed from understanding that things like poverty or poor education may influence who we are. We must ‘stand on our own feet’.

Digital machinery turns us into data which is controlled and manipulated by powerful bodies. Increasingly, decisions of public welfare make appeal to population-level data and rarely to actual, living human beings. There are, fortunately, dissidents. (Staying with gambling, for instance, real individuals campaign about real human stories). ‘People not Data’ could be a battlecry. We see a healthy increase in citizens working together to bring the voices of real people to the fore.

Big Data follows us wherever we go. Algorithms keep us under constant surveillance. Facial and other biometric technology turns our bodies in real time into data. Data is bought and sold for enormous sums.

One huge expansion of digital technology is ‘digital health’. This is being promoted as ‘A Very Good Thing’ – not only by companies vying with each other for huge profits, but within the NHS, governments and Third Sector health organisations. We’ll look more closely in the coming months at what ‘digital health’ means. It ranges from record keeping to mental health apps, from thousands of ‘nano robots’ introduced into the body to fight disease to personal monitoring equipment. At its most spectacular it merges with the visions of such futurists as Ray Kurzweil who prophecy the end of illness and the defeat of death. (At one time in recent history ‘genomics’, the manipulation of genetic material, made similar wonderful claims that sadly failed to materialise).

We’ll examine digital health as part of the digital world, but we can only do this in a cursory way. There is an enormous number of academic research bases devoted to digital life and digital futures. Many universities have new departments devoted. Military and medical corporations are big players. Everything we touch these days is connected to digital machinery. Education, health, leisure, shopping, the ‘internet of things‘. Yesterday (28 August 2020) Elon Musk announced the successful implantation of a chip into a pig’s brain: the research is related to enabling control for people with a brain damaged, for instance, by stroke. (There’s a backround paper by Musk here). Others, with much broader enthusiasms, think on the possibility of ‘uploading’ a human mind into digital storage.

The digital world is invisible, like gravity. We only see its effects. At the level of a person, stripped of much personhood and what makes for a healthy and flourishing life, digital infrastructures become an extension of the nervous system. Even without wires and brain transplants, many are ‘hooked’ into digital social media, digital friends, digital games, digital scrolling, digital addiction, digital shopping, digital entertainment, digital distractions, a careless giving of information to digital surveillance. Digital gambling is but one manifestation and the purveyors are happy to take not only money but minds.

 

 

 

 

The Problem with “Problem Gamblers”

In the bad old days,  among the cruel behaviours of teachers was to make a child sit facing a corner and wear a hat with ‘Dunce’ written on it. If that didn’t make  them learn and behave properly, a child could expect a thrashing for their irresponsible waywardness.

More progressive education renamed ‘dunces’ as ‘problem children’.

Now, of course, in more enlightened times we speak of ‘problem schools’ as the main reason for between a quarter and a fifth of school leavers being functionally illiterate after eleven years of education. It has been a great leap forward for  society to recognise that the ‘problems’ may have something to do with the education system itself.

This month (July 2020) has seen the UK government launch a ‘war on obesity’. Proposals include advertising bans, stopping two for one incentives on junk foods, public health campaigns, taxes on industry, education, more help from primary health care and so on. There are critics of all this. They say that people should be able to eat whatever they want to, they are free to make their own choices and shouldn’t have that freedom removed by the nanny state. Parents, they say, have the right to feed their children whatever they like. The fact that unhealthy, fattening food is cheap should not stop poor responsible people making sensible meals with basic nutritious items such as turnips: if they can afford widescreen televisions and smartphones , they can afford to eat well. But such is the devastating impact on health and the economy, the state is now proposing to get tough, go beyond voluntary industry actions and the good sense of consumers.

After decades of denial the tobacco industry accepted that their product was both addictive and highly detrimental to health. Stringent government action has seen a huge fall in the number of people smoking.  A total ban on advertising and marketing, removal of branding on cigarette packs along with reference to tar and nicotine content which some took to allow for a choice of ‘safer smoking’, severe annual rises in duty, a ban on smoking in public places, and the hiding from sight of tobacco products in shops. Alongside this, smoking cessation programmes are free to everybody. Individuals remain free to use tobacco if they so wish.

These days, at the tobacco counter in a shop, the tobacco products are screened from sight. (It’s worth noting that alcohol is still freely on display, but that’s a different story for now). At the front of the counter, inches from the customer are advertisements for the National Lottery and a range of scratchcards priced from £1 to £5 each. Like sweets placed at a supermarket till they make impulse purchases more likely. They’re also an indicator of how normalised respectable gambling has become. A website called casinoplay.com warns the public that ‘it can actually be quite hard to win one of the top prizes.’ It advises that to increase your chances you should buy scratchcards in bulk.

The Myth of the ‘Responsible’ v ‘Problem Gambler’

Unlike smoking and obesity, the risks associated with gambling aren’t associated with physical health (except in the many tragic cases of suicide). Gambling risks include financial ruin, turning to crime, family and relationships breakdown, mental illness. Many sources of information refer to the incidence of gamblers running into such conditions is ‘only’ 0.5% of the adult population (the same way as ‘only’ 0.5% of the the population are schizophrenic). There are other figures for children and young people, and for adults ‘at risk’ of being in the 0.5%. Data is never simple. It isn’t always available. It’s a snapshot of a previous period in time. It requires interpretation – and these interpretations differ. But if the 0.5% figure is taken as it is, given the personal suffering indicated above, plus the damage to immediate others such as family, plus societal costs is not that alone reason to give gambling damage the same weighting as a serious mental disorder such as schizophrenia? And unlike schizophrenia which, although it can be managed and treated well, in many cases very difficult to treat and manage, are not problems associated with gambling more easily attenuated using the approaches we have seen with tobacco, and beginning with junk food?

Yet it’s sometimes implied that if there are only 300,000 or so people in deep trouble because of gambling, that’s all right. They didn’t stop when the fun stopped. No one made them spend much more than they could afford: they were irresponsible. It was down to their having that much-cherished freedom to chose, but making the wrong choices. Many millions more enjoy the fun of a flutter. The appeal to the ‘millions who safely (and responsibly) enjoy a flutter’ is something of an industry catchphrase, and it needs unpicking.

Having placed the ‘problem gamblers’ into a sort of pathological ghetto, the logic goes that everybody else is a ‘responsible gambler’, enjoying a harmless flutter. This isn’t so.

In all our lives fortune rises and falls, and this is more nearly literal in the case of the regular happy flutterer. A regular bettor or gambler will win some, lose some, and for the great majority, over time will lose more than they win. Winning £25 on a £5 scratchcard won’t compensate for the many weeks of getting into debt with rent or power or council tax after buying four such cards each week. The strain on marriages and families will increase as essential money leaks into slots or online gambling. The wage packet won’t be spent on days out with the kids or new school clothes. Things will be pawned, payday loans become essential as credit is refused elsewhere and credit cards are maxed out. Loans from friends and family go unpaid. There may be catastrophic times, perhaps a threat of eviction or repossession, survived only by a hair’s width and that survival with ongoing negative financial consequences. (Sometimes, such a catastrophe can be the impetus to stop gambling). Anxiety, depression, arguments may go with the territory. The danger of becoming one of the statistics in that ‘problem gambler’ ghetto may increase. As it is, there are many whose quality of life is negatively affected by gambling, and they don’t show up in the statistics.

Now obviously, this is painting a bleak picture. Not everybody who enjoys a doughnut or two will incur an obesity-related illness. Most people do spend money responsibly and can enjoy a harmless flutter. There is, of course, even for them a risk of going beyond the harmless flutter. Even somebody new to betting and gambling can (not will) spiral down to dangerous levels.

What’s needed is research into the ‘twilight zone’ of gambling-induced harms. This is an area which has to involve personal testimonies of experience over time. It’s especially important in relation to young people who have been nurtured in a normalised gambling environment. It may lead to a more nuanced understanding of the scale and nature of gambling harms than that offered by dominant narratives of ‘problem gamblers’ versus the rest of us.

 

Where does GAMBLING EDUCATION fit in?

Article by Adrian Bailey, Director, The Machine Zone

This is a long post, sorry! Skip the preamble/disclaimer by all means.

PREAMBLE/Disclaimer

This post is a ‘light touch’ consideration of some of the questions arising around the idea of gambling education. The introduction below gives some background and points to some of the major questions.

It’s good to start, though, by stating firmly what this article isn’t. It doesn’t and couldn’t offer criticism of the many gambling education initiatives currently running. It doesn’t claim to be other than very tentative. It claims no expertise.

It does try to highlight questions underlying all approaches to gambling education. This highlighting is drawn from existing practitioners and theorists for whom such questions have always been basic.

I taught in secondary schools and then further education back in the 70s and 80s. During this time I was also engaged in educational research. I’ve never been a gambler but I have had a serious addiction and severe and enduring mental health problem. After teaching I worked in the mental health field, and in the last seven years of paid employment I worked with people recovering from various compulsive behaviours. Only in the past three years have I become familiar with the area of gambling.

Through work and personal experience I have ‘researched’ (as an ‘educated layperson’) mental health, and ‘addiction’. Like many of you I don’t like that word, ‘addiction’ but for convenience will use it here. Regard it as no more than a signpost to what we may prefer to call by less stigmatised words, and even these are only signposts to the area of personal experiences.

These experiences are painful to individuals and their immediate networks. They relate to great social costs – economic costs, of course, but also serious negative repercussions upon the health and wellbeing of society. As such, they are public health issues in the widest sense. Because of this they are political issues too. Governments allocate funding for treatment, research and more; governments also, by attending – or not attending – to the issues raised suggest the priority – or lack of priority – of the issues raised and the allocation of resources.

Since it is a political issue, it is of concern to all citizens. In a democracy, a childless citizen has the right to be engaged with education. Someone who is young and healthy will engage with the health and social care policies of government, and provision for aging people. We may be materially well-off but have the right to challenge the existence in our own country of poverty and inequality. Concern for military horrors witnessed across the world gives every citizen the right to ask of the government’s foreign policy questions about arms sales it allows. So, you don’t have to be an ‘addict’, or mentally distressed or otherwise in pain to be involved, any more than you need to be a child in poverty to care about child poverty.

So, while having a specific interest in mental health and what is called addiction, by engagement with gambling education is as a concerned citizen. I can’t see any way of framing this as other than political.

Like most important issues, complexity encourages a wide variety of approaches and attitudes. As an interested citizen layperson I follow expert understandings of due humility.

As the philosopher William Irwin has written:

We ought to regularly and open-mindedly reconsider (alternative opinions and approaches) if only to remind ourselves why we believe what we believe.

 

INTRODUCTION

Gambling and gaming have been around since history began. Today we see a very wide spectrum. Truly, many millions do enjoy a ‘harmless flutter’ on a lottery or bet. Some buy scratch cards at £2 or £10 a time. It’s fun! Even without money we enjoy games of chance, the throw of a dice. Kids like me bet by throwing coins against a wall, then got into cards along with the cigarettes behind the bike shed. I’m sure kids still do. It’s something we learned in school but not from teachers. From our mates and the culture of kids passed on from one generation to the next.

If you’re on unemployment benefit or a low income, ten pounds can take a chunk out of basic living costs. Power, rent, food, council tax, presents for the kids. Even what looks like a small amount can have serious consequences. When people become hooked on gambling, often people in well-paid jobs or with good incomes, they can lose many thousands, even millions of pounds. Some – tragically – are driven to suicide. Others steal from their employers and end up in jail.

In the last ten years we’ve all become aware of the damage gambling can do. In response, a 2019 survey of the general public done by the Gambling Commission found that 27% of people think it would be best if ALL gambling were banned, while 82% agree that there are too many gambling opportunities today. The media regularly report on the often tragic impact of gambling on some individuals. For instance, in July 2020 The Guardian headlined a story: ‘How the Gambling Industry Got its Claws into Kids’. Former gamblers have initiated many organisations which document individuals’ stories; these are pressure groups, campaigners aiming to bring about fundamental changes in regulation, advertising and marketing, and the ‘addictive’ nature of some gambling products. Their work is mirrored in that of many academic researchers. Politicians from all parties have been and remain intent upon bringing about reform.

The industry, whose biggest members are represented by the Gaming and Betting Council, and its supporters point out that millions of people enjoy having ‘a harmless flutter’. It distinguishes between what it claims is a ‘small number’ of ‘problem gamblers’ from the vast majority of ‘responsible gamblers’. The industry also directly funds harm-prevention organisations such as Gamble Aware and thereby directs some of its 1% voluntary levy towards education and treatment. Against this, campaigners have claimed that concentrating upon education and treatment, while important areas (in particular, treatment which is greatly under-resourced or provided), can lead to neglect or disguising of vital systemic issues such as product design, marketing and advertising, regulatory issues and conscious exploitation of vulnerable psychological attributes of the human being. Such a claim is also made at various levels by academic researchers. Rather than develop this tension here, I’ve appended some web addresses at the end to give you an idea of such research.

Education about health, finance, citizenship, alcohol and other drugs, mental health and all the other things that relate to our wellbeing is not only confined to schools and other formal education settings. Nor is it limited to youth. Public Health campaigns mount many informal educational projects. The mental health sector provides very many sources of guidance, information and learning. And, of course, kids learn from their parents, their peer group and the culture they live in  – probably in some important ways far more than they learn in school. We also learn from social media. We learn from the mass media: in particular, popular music is a potent source of learning; so is television. Taking the latter, a ‘soap opera’ with a storyline about gambling or other mental health problems can provide more powerful learning than in formal settings. We also learn from advertisements and marketing. We learn, for instance, that Product X is fun, or will make us happy. Not all learning benefits us. Some addiction experts believe that an addiction is learned behaviour (as opposed to some sort of disease).

But here we’ll focus on school education, and in particular education about gambling. This is normally provided by what’s known in England and Wales as Personal, Social, Health and Economic education. This is a developing area. There is a very active PSHE association which, as well as providing resources and curriculum discussion, lobbies for greater weight and training to be given to the area. They have some excellent guidance for teaching about gambling,  The extract below demonstrates just one aspect of the theory and practice of gambling education and its complexity if it’s to be considered thoroughly. The extract also demonstrates some aspects of gambling education lacking in certain other current approaches:

 

Understanding of gambling industry strategies to draw people in and keep them gambling, including those that exploit natural human biases and errors

Dark nudges — a term used by researcher Philip Newall— describe the techniques gambling organisationsuse to encourage participation in gambling. Researchers suggest the gambling industry utilises arange of techniques including:

      • Normalisation of gambling behaviours, particularly bycreating a perception that it is a key part of enjoyingsport entertainment

      • Legitimisation through partnering with trusted organisations(to convey the impression that gamblingis accepted by those known to be ethical)

      • Extensive advertising with particular focus on vulnerablegroups

      • ‘Free bet’ promotions and ‘welcome back’ bonuses

      • Encroachment into gaming including throughnon-monetary forms, e.g. ‘loot boxes’

      • Over-emphasising a distinction between problem and responsible gambling — encouraging people to think of themselves as responsible gamblers

      • Adverts and encouragement to bet on highly specificevents where participants are less likely to win (e.g.first goal scorer or specific scoreline)

      • Additional techniques are used in online gambling:

      • Use of ‘near miss’ outcomes exploit the human bias to try again if someone has a near miss

      • Losses disguised as partial wins (with audio and visual prompts to support this)

      • Meaningless ‘bells, whistles and associations’ makeuse of the human tendency to search for meaning in patterns

It is plausible that helping young people to become   aware of these techniques can help them to be moreresilient to them.

Understanding of gambling risks and harms

Most gambling education programmes aimed at adolescents include a component on gambling’s risks and harms. This would seem an inherent part of enabling young people’s informed decision-making. Two caveats however merit highlighting: first, the recent review of school-based gambling education programmes concluded that ‘promoting a negative viewpoint of gambling and its associated consequences are not sufficient to prevent gambling problems’— therefore this should only be a component rather than the entirety of gambling education.

Second, some young people may find risks enticing rather than aversive, linked to developmental differences in perceptions and responses to risk42, so how risks are presented and discussed is important.

from How to address gambling through PSHE education

It’s important to note that the PSHE work with Gamble Aware (funded by the industry). Some have felt that any funding from industry is not permissible but the PSHE – and Gamble Aware itself – have shown repeatedly that this is not necessarily the case.

In the extract above, young people are introduced to the role of industry in gambling harms. It’s noticeable too that the sort of education mooted here is not restricted to standalone sessions. As per government advice on all PSHE it can be integrated into the whole school curriculum. English/media education (analysing advertisements), mathematics (odds and risks) for instance. The PSHE experts are fully aware of age and development needs. One also has to consider learning disabled pupils. There is an emphasis (as there should be in all teaching) on teacher delivery. Research has shown what doesn’t work and may have effects opposite to what is intended. This includes being very careful about inviting former gamblers to speak: a totally unintentional outcome may be to make gambling risks attractive. The idea that most people can gamble without problems and only a few run into trouble is dangerous too. Scaring young people is very dangerous: many young people have ‘heard it all before’ about the terrible harms of alcohol, cannabis junk food: such scare stories conflict with their deeper learning from ‘real life’. Gambling educated should not be parachuted in to occupy a few sessions like a magic pill or injection: it should be part of a carefully integrated whole school developmental curriculum. Lessons should be participatory and interactive: few teachers these days (hopefully) talk at their students or expect them to magically absorb wisdom from texts.

The purpose of the foregoing has been to suggest that providing education about gambling is complex and requires expertise. Education cannot be some simple panacea that can be ‘injected’ into a young person’s mind. In a school it also requires commitment from senior management to PSHE generally to design a developmental curriculum. It seems unlikely at present that delivery is optimal in all schools. Elsewhere, after training about gambling education (often a one day or less session) teachers have felt unprepared – or faced with an only choice of delivering a handful of discrete session to students.

Implementing gambling education requires theory partly based on what has been learned about teaching about other risky behaviours. Such research has looked at other countries. In the UK, the Alcohol Education Trust which works with the PSHE Association, founded in 2010, provides a promising future for what gambling education may achieve. The AET has had the time needed to evaluate programmes – and give statistically significant indicators of positive impact on students’ drinking behaviours. The gambling education field is new. It is, therefore, difficult for evaluation of particular programmes (the AET does compare its own work with others’). Nevertheless, by virtue of existing at all, the importance of very enthusiastic and well-managed projects contributes to establishing gambling education ‘on the agenda’. Good work is being done in this area by DEMOS, EPIC and YGAM as well as the PSHE itself as ‘insiders’ with the power to link to other organisations and provide specific expertise. In Scotland, FastForward with its emphasis on peer group participatory workshops, theatre and a harm minimisation approach has a gambling hub to complement its work in health, risk and wellbeing. Many other projects continue to occur regionally, initiated by a range of organisations.

There are many obstacles to overcome and many contradictory approaches that need evaluating but education about gambling is growing and driven by enthusiasm and a wide, varied skills base.

HOWEVER!

There’s always a ‘but’! Here are some questions I think are important though I make no attempt to answer them.

    1. Within the context of all factors contributing to gambling harms is ‘gambling education’ emphasised too much and thus working to divert attention from other important factors?
    2. Given the current state of gambling education which offers promise but has many basic difficulties associated with it (as suggested above) is it likely to be a significant player in reducing gambling harm?
    3. How, when and by whom will gambling education programmes be evaluated and compared?
    4. How, when and by whom will gambling education within school curricula be evaluated?
    5. Which approaches to risky behaviours that have been evaluated in PSHE could potentially inform gambling education?
    6. Should gambling education be positioned and weighted within an integrated national policy for reducing harms?
    7. Given that a fifth of school leavers are ‘functionally illiterate’ is there scope for informal youth education to reach young people? (Functional illiteracy refers to minimal literacy, insufficient for full functioning in life such as ability to comprehend more than very basic texts).
    8. Given that 49% of the working age population have numeracy levels less that those expected of a primary school child (National Numeracy) is it realistic to assume that all pupils will be able to engage with such things as odds, percentages etc. in delivery of gambling education?
    9. Gambling problems can affect anybody but since there will be a demographic sector correlating with (7) and (8), hence less reachable by education and less capable of understanding fully the architecture of gambling, does such a group represent a vulnerable sector at risk of exploitation?

Some Links

Education Organisations

https://www.pshe-association.org.uk/content/gambling

www.YGAM.org

https://demos.co.uk/project/reducing-the-odds/

https://www.epicriskmanagement.com/

https://gamblingeducationhub.fastforward.org.uk/

https://alcoholeducationtrust.org/

Parliament

http://www.grh-appg.com/

https://www.parliament.uk/business/committees/committees-a-z/lords-select/gambling-committee/news-parliament-2019/lords-gambling-report-published/

 

Gambling Commission (3 year strategy for reducing harms)

https://www.reducinggamblingharms.org/asset-library/national-strategy-to-reduce-gambling-harms.pdf

 

Public Health

https://www.frontiersin.org/articles/10.3389/fpubh.2020.00320/full

https://www.bmj.com/content/365/bmj.l1807

https://www.gov.uk/government/publications/gambling-related-harms-evidence-review/gambling-related-harms-evidence-review-scope

Some Academics

https://www.gold.ac.uk/media/documents-by-section/departments/anthropology/Fair-Game-Web-Final.pdf

https://www.youtube.com/watch?v=TazssD6L7wc

http://eprints.gla.ac.uk/179965/

http://eprints.whiterose.ac.uk/148267/1/CHB_Loot_Box_Features_Accepted.pdf

Media

https://www.theguardian.com/lifeandstyle/2020/jul/11/my-son-would-be-shaking-trying-not-to-go-online-how-the-gambling-industry-got-its-claws-into-kids

https://www.reform-magazine.co.uk/2014/08/a-change-for-the-better/

https://www.theguardian.com/society/2020/jun/24/uk-betting-firms-move-to-redirect-problem-gambling-funds-raises-concerns

https://www.cypnow.co.uk/news/article/primary-schools-teach-pupils-about-gambling-risks

 

‘Personal Responsibility’ and Addiction

One of the hottest topics relating to addiction is the concept of personal responsibility. Do addicts bring it on themselves? Are addicts morally weak? Do addicts repeatedly fail in recovery because they refuse to take on responsibility?

On the other hand, it can be rightly claimed that all this emphasis on the individual is distorting an understanding of addiction. If, as some claim, addiction is a ‘disease’ how can people be responsible for it? Why is there virtually no alcohol addiction in Saudi Arabia (where alcohol is prohibited by law)? What social factors play a part in addiction? Do some commercial products – tobacco is an example – ‘hook’ some people in the right circumstances?

There is no such thing as an addict; there are only individuals suffering with addiction. Everybody is different, but some groups seem more prone to addiction to others. In the professions journalists, the police, doctors, entertainers, sportspeople and politicians have high rates of addiction. So too do people with multiple and complex disadvantages such as homelessness, poverty, lack of educational and cultural capital, mental illness, criminal background, adverse childhood experiences, trauma – or just one of these.

And people from different social backgrounds seem to be treated very differently when their addictions come to light. Newspaper readers will weep over the death of a pop idol through drugs; a politician will be praised for his ‘brave struggle’ against alcohol. In popular culture – films, books and television – we have come to expect our flawed heroes often to have an addiction problem as one of their flaws, a lonewolf cop bucking the rules and knocking back malt whisky while meditating on a case, a singer in rehab, a public figure making public penance.

Less favourably are seen the ‘scagheads’, the ‘junkies’,  the street addicts, the working class addicts. Although victims all their lives of unequal and unjust social conditions, turning to drugs or drink or gambling to escape if only for a moment, it is they who are most harshly blamed and despised for their lack of responsibility – while those with a lifetime of advantages are treated with adulation and sympathy.

In his remarkable book, Good Cop Bad War, former undercover cop Neil Woods charts his journey of increasing knowledge through the ‘low life’ of desperate addicts (in contrast to the venomous gangster business cartels that bring drugs to market). He grow increasingly sympathetic to the friends he makes while pretending to be himself an addict. Apart from their addiction, most are essentially decent, often intelligent, kind and caring. One such friend , Cammy, tells him his heart-felt news that he has heard a good friend has died. Neil asks whether he will go to the funeral to say goodbye and Cammy replies, ‘I’m not going to the funeral. I wouldn’t do that to the family. The last thing they want is some dirty junkie turning up and ruining everything.’ As Woods observes, ‘No matter how society may condemn and look down on the addict, it is never, ever as low a view as he has of himself.’

That internalisation of social attitudes and stigma is something all addicts have to deal with. Part of them remains ‘clean’ and is a constant accusing voice; the addict hates themself. Guilt and shame alone can maintain an addiction – that belief of such utter worthlessness that there is no point in trying to stop, instead seeking that absurd temporary negation of inner torment with a fix.

Of course, those with a lot going for them tend to do better. Not everybody, of course: the nature of every individual addiction, while having common attributes, is unique in the complexities of an individual. It’s probably easier on the whole if you’re, say, a teacher to have three months leave on full pay to attend rehab, or just to get your life together, than if you are without any money, any support, any care, any love, surviving in brutal conditions. Though yes, many who seem to have well insulated lives with all the support in place do succumb, grow sick and die. And yes, too, some at the very bottom recover and flourish.

There are as many as 40% of addicts who recover spontaneously, relatively painlessly, without any intervention by ‘experts’ or support organisations. A well known example of this is ‘maturing out’ whereby young people who have addictive or risky tendencies literally grow out of them when they settle into employment, get married, start a family. Another famous example is how 80% of American soldiers deemed heroin addicted in Vietnam lost their addiction when they returned to the States and their families. Against this, many others in recovery are certain that addiction is a disease for life and that the only way to manage it is by faithfully following a programme such as a 12-steps one.

A word is needed here too about dependence versus addiction. Through force of habit, culture, lifestyle, many drinkers, for instance consume not only health-damaging amounts but quantities which make them physically dependent. The withdrawal from physical dependency can be life- threatening and ideally requires medical supervision. Yet many heavy drinkers then go onto just stop or greatly limit consumption: they were heavy drinkers, not alcohol addicts. There is an additional dependence which is separate from addiction – psychological dependence. Partly this is just the force of habit, neural correlates in the brain ‘speaking’ loudly to perform an action when certain triggers arise. Usually one can become psychologically dependent on a substance or activity to avoid stress, negative feelings or often an undiagnosed mental disorder such as anxiety and depression. Dependence can, and often does, lead to addiction but it’s still possible to recognise a dependence and take responsibility for halting it with acceptance of necessary effort and suffering which will vary greatly in terms of time and intensity according to unique individuals in unique circumstances.

Addiction by its very nature, the heart of addiction, disowns the individual’s core self. It disowns the possibility of being responsible for one’s destiny, for making deep choices. No addict will be able to understand what is going on. They are fully aware of the misery they leave in their wake, of their loss of pride, reputation, money, health, relationships, status, children. They desperately want to stop. But they can’t. In the old days people spoke of a demon inside that controlled them. The demon took them over. This degree of inner torment varies from individual to individual. It’s certainly true that there are many ‘highly functioning addicts’ in all walks of life, folk nobody begins to suspect as being an addict, and, of, course, another core attribute of addiction is the addict’s propensity to deny their addiction. It’s for this reason that common wisdom has it that people must ‘hit rock bottom’ before they can start to recover. This is, fortunately, a myth. It may be true that a secret gambler’s addiction only comes to light when the bailiffs arrive to take the family home and he or she spirals into heavy debt, bankruptcy, prison or failed suicide attempts. But in many cases – often in consort with worried others – many are lucky enough to address their addiction before absolute calamity.

The foregoing suggests just a few of the strands in the complexity of an individual’s addiction. If there is a common attribute of addiction it is that to take responsibility for recovery one must already have made a vital move. This vital move, this perception that one is not only the addicted self, is the precursor of recovery. For some, this vital move is totally unconscious and involves little pain and effort, for others it is a lifelong process.

To conclude, to return to the topic of addiction and responsibility. All of us are a product of our environments, probably more so than products of our genes. Children have been sold drugs from icecream vans (dealers do not ask for age verification or advise responsible use of their products) so 12= year-olds have become heroin addicts. The vans are part of the environment, behind the vans are networks of the drugs business, also part of the environment. People continue to smoke cigarettes but on the packets is written ‘smoking kills’, and tobacco is more and more restricted by government policies: it’s recognised that tobacco addiction is not the result of weak responsibility in individuals. Campaigns to restrict and limit junk food (itself addictive), sugar, salt, fat are not controversial. People argue about minimum pricing for alcohol, but the argument is not seen as being around any bizarre claims. In short, government and industry are seen as having a major role in addressing the damage that harmful products may do to individuals and society, including addictive products.

Current debate about addiction is skewed towards a focus on individual responsibility. Just as a parent is deemed responsisible for feeding their children high doses of sugar and fat (These being by far the cheapest foods to buy for those in poverty), so the addict is held reponsible for choosing their addiction (even if this was motivated by a need to escape misery and despair into 20 minutes of arificial paradise). There are no jackpots, magic fixes that will ever beat the scourge of addiction but government and industry have to stop denying their role in attenuating it.

 

Social Media Addiction = Gambling Addiction

The Guardian published an extract from Richard Seymour’s book, The Twittering Machine. It’s well worth a read.

It makes the claim that no only are social media addictive, but why they are. The machines most of us use every day – phones, tablets, laptops – hook us with bait, Seymour writes, in just the same way that gambling online does.

Here’s the start:

We are swimming in writing. Our lives have become, in the words of the author and academic Shoshana Zuboff, an “electronic text”. Social media platforms have created a machine for us to write to. The bait is that we are interacting with other people: our friends, colleagues, celebrities, politicians, royals, terrorists, porn actors – anyone we like. We are not interacting with them, however, but with the machine. We write to it, and it passes on the message for us after keeping a record of the data.

The machine benefits from the “network effect”: the more people write to it, the more benefits it can offer, until it becomes a disadvantage not to be part of it. Part of what? The world’s first ever public, live, collective, open-ended writing project. A virtual laboratory. An addiction machine, which deploys crude techniques of manipulation redolent of the Skinner Box created by behaviourist BF Skinner to control the behaviour of pigeons and rats with rewards and punishments. We are users, much as cocaine addicts are users.

What is the incentive to engage in writing like this for hours each day? In a form of mass casualisation, writers no longer expect to be paid or given employment contracts. What do the platforms offer us, in lieu of a wage? What gets us hooked?

Read the rest of the article to see what gets us hooked.

Grand National Pandemic

The Grand National this year will be ‘virtual’ but promises to give all the excitement of the real thing. The development of this impressive digital machine has seen trials during the previous three years and shown a fairly accurate correspondence with the actual race results.

Essentially, it is driven by random number generators which ‘weight’ different outcomes via complex algorithms taking in form, probable weather conditions and so on. Perhaps less exciting is that the virtual race has already been run and recorded for television as ‘live’, the results guarded, it is said, by only 20 people sworn to secrecy.

For bettors who frequent betting shops, virtual racing is nothing new. It’s been up on the wall for many years now, quite a change from the old days when bookies were not allowed even to have television screens. For most viewers it will be a novelty with all the family fun of the real thing. Excited kids, snacks, often more than a little booze. What a good way to fill the time in these days of isolation.

We All Love Our NHS and Carers

We’ve recently enjoyed an outpouring of appreciation for NHS staff, carers and all the lowly paid workers at the front line of maintaining essential services. Very sincere, heart-warming, freely given and costing nothing. Like the Grand National, a celebration of what it is to be British.

Of course, there will always be those cynics who claim that among the people being applauded were many facing deportation post-Brexit. There will always be that miserable minority of lefties and liberals who’ve been going on for years about how the NHS and other public services are grossly underfunded, or how badly some are paid while others grow rich.

How wonderful, therefore. it is to see the whole nation pulling together despite such gloomy naysayers.

The Benevolence of the Gambling Industry

All betting profits from the virtual Grand National will be given to NHS Charities Together  (which collectively provides £1 million a day to help the nation’s health and ameliorate underfunding of the NHS). The British Betting and Gaming council, a recent amalgamation of the Association of British Bookmakers and the Remote Gambling Association is focused upon lobbying politicians and recovering from the industry’s negative image of recent years. It is promoting the industry as contributing to the nation’s needs in the time of coronavirus.

BGC Chief Executive Michael Dugher has said: “With the UK understandably and rightly in lockdown, unfortunately the Grand National can’t take place; however the virtual Grand National will be the closest we can get to creating one of those moments when we can all come together in celebration, not just for the world’s greatest sporting event, but for the NHS heroes working on the front line to keep us all safe.”

As part of the ‘deal’, all bets are limited to £10 or £10 each-way. Betting companies will not advertise their services for this event except to existing customers. There will be no competition between different companies but all will offer the same odds. There will be no special offers, free bets or similar enticements associated with this event.

Virtual Images and Reality

Corporate philanthropy has always been an essential contribution to brand value. Some companies do sincerely and practically operate with a core value of social responsibility. At the other extreme, charitable donations, grants and social partnerships are seen as marketing tools. A company’s image can severely impact on profits. Negative image can bring about  political pressures such as through tighter regulation and taxation. Advertising and marketing are essentially about image – how important players, including consumers feel attracted or repelled. Image manipulation is a vital function in company development.

It is for the reader to consider what the present case of the betting industries’ generosity amounts to. Though we should add, of course, that with an already negative corporate reputation which holds in some quarters, clearly for betting to continue as normal at a time when national crises are bringing out sacrifice, fortitude and risks in so many would be a public relations disaster.

The idea of watching a cartoon race that has already been run as if it were a real horse race in live time, neatly reflects the differences between corporate image and corporate reality.

New to Gambling?

People who’ve always enjoyed their once-yearly bet on the National will, if they have access, go online and register with a company. For some this will be a gateway to a new experience. Soon after the National people may return to gambling sites, perhaps enticed by the advertisements which will inevitably come their way. Then the offers will entice further – the free spins, the free bets, the multitude of new games to spend money upon.

Children watching cartoon racing for the first time will undoubtedly love it, becoming one of the adults’ pleasure and excitement. A virtual horse race is so similar to a computer game, great fun. Like loot boxes. Products aimed at children which are not classified as gambling have been repeatedly shown by research to often lead to gambling behaviour and addiction.

Locked in and bored, with a few weeks yet to go before a ban on using credit cards for gambling, there is a likelihood that a number of people will run into great financial trouble.

A letter today – to Nigel Huddleston, the UK minister responsible for gambling, and to the BGC – signed by 22 MPs, two Lords and one of the UK’s foremost gambling addiction experts said, “People are at home and are severely restricted, with access to mini-casinos on their laptops or mobile phones.” They called for urgent tight restrictions upon advertising, reduction of stakes on ‘highly dangerous’ slot-like games, ending the VIP scheme which rewards heavy losers with enticements, a mandatory maximum for deposits. They also ‘called on companies to release internal data to independent researchers to help them assess the scale of harm caused by gambling during the coronavirus outbreak compared with normal circumstances.’

 

That’s in stark contrast to what some would see as the British Betting and Gambling Association’s self-promoting generosity on behalf of the heroic NHS workers.

 

 

 

We All Live in an Influence Machine

George Orwell’s Nineteen Eighty-Four presents a nightmare dystopia of humanity curtailed by constant misinformation and devastating surveillance. As such it is a non-fiction allegory of the present. It is congruent with life in Nazi Germany, other totalitarian states and perhaps even more alarming the world as it is today. Digital technology follows us everywhere. We walk into it without seeing, willingly allowing our lives  to be monitored and data about us stored.

In a long article today in the Guardian about life after the many crises Coronavirus has brought, it’s pointed out that:

Not all surveillance is inherently malign, and new tech tools very well might end up playing a role in fighting the virus, but Zuboff worries that these emergency measures will become permanent, so enmeshed in daily life that we forget their original purpose. Lockdowns have made many of us, sitting at home glued to our computers and phones, more dependent than ever on big tech companies. Many of these same companies are actively pitching themselves to government as a vital part of the solution. It is worth asking what they stand to gain. “People have a hard time remembering privacy rights when they’re trying to deal with something like a pandemic,” says Vasuki Shastry, a Chatham House fellow who studies the interplay of technology and democracy. “Once a system gets scaled up, it can be very difficult to scale it back down. And then maybe it takes on other uses.”

Very few of us even in ‘the best of times’ care much about anything beyond immediate personal concerns. Things like climate change don’t (yet) impact on our lives so it’s easy, all too human, to dismiss them. Orwell was intensely concerned about the political dimensions of life, the uses and abuses of power, the potential enslavement of minds. But how often have people said, ‘Politics? Pah. Not interested. All a load of nonsense.’ Or something similar – thereby dismissing in a throwaway remark Aristotle’s basic claim that to be human is to be a ‘political animal’.

Yet some parts of the population see digital surveillance as a sinister intrusion into their lives. We are all bits or bytes transformed by analogues into potential purchasers of products. Digital technology is a marketing dream come true – the ability to micro-process advertising and deliver it with increasing accuracy to the individual rather than the mass.

Let’s take the case of gambling. At a time when awareness is growing about gambling addiction, particularly to digital forms, people in recovery continue to be bombarded with advertisements. Young people who were tracked through their interest in loot boxes become potential fodder for gambling industries: see the Ipsos Mori report, The effect of gambling marketing and advertising on children,young people and vulnerable adults People who may have bet on the Grand National or enjoyed a little online bingo are enticed by ‘free bets’ and introduced to games like roulette. Research shows that electronic roulette in particular can be highly addictive.

Another example would be that if you go to a reputable site looking for, say, vitamins, algorithms may eventually bring you to ‘bottom feeders’ selling expensive, untested and possibly dangerous supplements.

With internet shopping addiction being researched and identified as a genuine addiction, one may ask overall as in the Wired article, Why Don’t We Just Ban Targeted Advertising?

Of course, such a question is political. For who ‘we’ are is a world of differing and frequently stark interests.

Nevertheless, although some of us will be aware of some impacts of some micro-advertising, perhaps the most insidious dangers are those most difficult to see. There is, apart from content, the increasing surveillance of our lives and invasion of privacy by many centres of power. Combined with this, content and information may erode democratic values and voices, may instil the sort of ideologies Orwell warned against.