Following the submission of The Royal College of Psychiatrists in December and my attendance, as the Royal College representative, at the Committee Hearing on 8 January, this further submission is presented, as agreed at the Hearing.

  As a Consultant Psychiatrist, I have been involved for many years in helping people in difficulty as a result of pathological gambling. I was involved in setting up Gamblers Anonymous in the UK and was its first honorary psychiatrist. Also, I was the first chairman of the Society for the Study of Gambling. I have done extensive research on this topic, which has been published in the academic literature.

  Arising out of the discussion at the Hearing, the Committee's attention is drawn to the following matters:

DEFINITION OF PATHOLOGICAL GAMBLING

  The World Health Organisation defines financial, social and/or psychological disorder resulting from gambling as pathological gambling. Whatever other term is applied to this state (ie problem, compulsive, disordered or excessive gambling), it is important to recognise that it is a heterogeneous behaviour disorder, akin to alcohol misuse. This definition and formulation is based on my contributions to the literature.

ASPECTS OF COMMERCIAL GAMBLING THAT LEAD TO PATHOLOGICAL GAMBLING

1.   Organisation of gambling industry

  1.1  Commercial gambling is organised on the basis of unequal conditions, as far as the outcome of the transaction between the industry and the gambler is concerned. The commercial interests in gambling make their profit by arranging the odds in their favour. The long-term facts of gambling are that, while the occasional gambler wins, the majority loses, the stake being a payment for taking part in the activity. This way of organising gambling is clearly very profitable to the industry.

  1.2  In view of the likelihood of deregulation, the gambling industry has been attempting to present a socially aware image. In this context, the notion of "responsible gambling" has been promoted. An example of this is the Victoria Gaming Machine Industry's Code of Practice, which has been more generally adopted in gambling. In this, it is stated that,

"Responsible gaming is each person exercising a rational and sensible choice based on his or her individual circumstance" and "The industry's role is to offer products and services in a way that facilitates customers' ability to engage in responsible gaming".


  1.3  The implication of this is that, if those who participate are given information and educated about gambling, then they will be able to exercise an informed, free choice. However, the facts are otherwise.

2.   Psychological effects of gambling

  2.1  Operant Conditioning, which is learning by providing rewards, is most effective in habit-formation on the basis of intermittent variable ratio reinforcement. In this, the reward is presented intermittently and, although the rate of reward overall is fixed, its actual presentation varies unpredictably at any given time. This schedule underlies all gambling activity. Since this unpredictable contingency of reinforcement produces a stable and persistent response, the long-term net gain or loss to those who gamble is almost irrelevant to the continuation of the activity.

  2.2  Rapid gambling turnover, as is usually found in casinos, restricts the gambler's ability to apply any considered judgment. Inevitably, gambling becomes more impulsive, easily leading to excessive participation.

  2.3  Gambler's assessment of probability of winning (psychological probability) differs from the mathematical probability. At low probabilities it is higher than the mathematical probability and at moderate and high probabilities, it is lower. This occurs however well informed the person taking part in gambling.

  2.4  Negative Recency Effect is the irrational belief, in a gambling situation involving only random processes, that a string of losses makes a win more likely. It is observed even in mathematicians who are aware of the independence of the outcome of successive events in this situation. It forms the basis of many spurious gambling systems, especially in roulette—hence the term "Monte Carlo Fallacy", by which it is often known.

  2.5  Large prizes, even at very low probabilities, entice the gambler because of the possibility of winning. The stimulant effect of rollovers in the National Lottery illustrates this.

  2.6  Skill is usually overrated and often implies an unrealistic ability to control the uncertain event that is the subject of the gamble.

  2.7  Credit reduces the likelihood that those gambling will set a limit on the amount of money staked.

3.   Physiological effects of gambling

  3.1  Brain activity. A gambling loss in normal subjects has been found immediately to result in particular localised activity in the medial frontal cortex of the brain. This is then associated with subsequent more risky gambling choices. This would account for the well-recognised phenomenon in gambling referred to as the Negative Recency Effect (see paragraph 2.4).

  3.2  In normal subjects, a great range and strength of emotions is experienced during gambling decisions. These are associated with cortical responses in the brain to the expectation of winning money. In addition, the subjects are found to lose track of time during a gambling session.

  3.3  Effect of alcohol. It has also been found that normal, social levels of drinking alcohol alter self-control over decision-making. This results in regular gamblers finding it more difficult to decide at what point to stop, when losing.

4.   Developments in commercial gambling

  4.1  Remote gambling. Unlike gambling in the social environment of licensed premises, that on the Internet is typically done in an isolated setting. There is therefore the added danger for the gambler of acting on impulse, because the checks and constraints that can be exercised by the presence of others are lacking. This applies also to gambling via interactive television.

  4.2  Loyalty cards. In a CNN report on 3 July 2001, the CIO at MGM Mirage in Las Vegas, Nevada, when referring to loyalty cards, said,

"Our target is mass-producing a high-roller experience for the common person. We want to provide you with the best experience imaginable, so that you'll want to come back."

  4.3  Yet, at the Joint Committee Hearing on 16 December 2003, the Minister said that, loyalty cards

". . . could be helpful in the control of problem gambling; it could be helpful in identifying the effects of gambling on individuals and communities". (Q42)

5.   Conclusion

  5.1  It is evident that the psychological and physiological effects on the gambler of commercial gambling inherently encourage the chasing of losses. This is exacerbated by the way commercial gambling is organized and by developments in the way in which commercial interests, as well the Government, are promoting it. (Detailed references in the literature regarding the matters raised in section 2 and 3 above can be supplied, on request).

  5.2  Within such a situation, the manner in which the notion of "responsible gambling" is being used by the gambling industry is completely disingenuous. It is increasingly agreed that, in commercial transactions, decisions should be made in a calm and secure place and manner and that there should be a cooling off period available to ensure that a change in choice is possible.

  5.3  This is not the situation in commercial gambling. While claiming to be behaving responsibly by giving information and advice, the gambling industry actively stimulates further participation. Consequently, the incentives offered to continue gambling appear to be far greater than the warning given. The whole exercise, which chooses to ignore the facts about gambling, is a cynical device for transferring the whole of the responsibility to the gambler.

  5.4  In such a situation, the suggestion by the Minister that loyalty cards are a way of controlling pathological gambling indicates that he is remarkably ill informed. One wonders who is advising him.

  5.5  As far as treatment is concerned, in a paper published in 2003 on Interventions for pathological gambling in the prestigious Cochrane Library, there was a review of 1,264 citations in the literature. The conclusion was that,

"This systematic review revealed a lack of evidence for effective treatment of pathological gambling".

  5.6  The experience of alcohol misuse should alert one to the vital importance of preventative measures, in terms of availability, rather than treatments that are of limited value.

  5.7  The Report of the Gaming Board for Great Britain, 1995-96 stated that,

"To a large degree, the extent, and potential adverse consequences, of problem gambling have been controlled in this country by the restrictive regime applied to gambling generally and to gaming in particular. Of especial relevance to this have been the principle that facilities should be no more than adequate to meet the unstimulated demand for them and the controls on advertising and promotion, on access to gambling facilities and on gambling on credit." (paragraph 1.19)

  5.8  It is now probably not possible to return to a situation where gambling in the UK is provided on the basis of unstimulated demand. However, in view of the nature of gambling, if a serious increase in pathological gambling is to be avoided, there should be far tighter controls on the amount of stimulation, means of access and the protection of children than the present Draft Gambling Bill provides.

January 2004