Don’t go for broke : Addressing gambling-related harms

The Bottom Line

  • Though most people gamble safely for entertainment, there is an emerging concern about gambling-related harms among some individuals and communities.
  • More research evidence is needed to determine best practices for screening for problem gambling, however, the recent expansion of online gaming may challenge existing screening methods.
  • There are a range of approaches which may help to reduce gambling-related harms, including: mandatory limit setting accompanied by reminders; low bet limits (for example, $1); mandatory shut-downs and reduced operating hours; and on-screen clocks displaying cash used and remaining, rather than credits. 
  • If you recognize the signs of problem gambling, seek help. 

Government-operated gambling has grown over the past two decades,(1) with revenues reaching $6.6 billion in 2014-2015 in Ontario alone.(2) While these revenues support a range of health, education and other social services, it has also come at the price of emerging concerns about gambling-related harms.

While many individuals gamble without causing harm to themselves or others, about 2.5% of individuals exhibit evidence of problem gambling, with similar proportions among youth but a slightly higher proportion among older adults.(3) However, the proportion of those who seek treatment is small, with estimates suggesting that only 10% of problem gamblers seek support. There may be many other individuals who do not seek support who continue to experience social distress, debt or other symptoms associated with problem gambling. Gambling-related harms may result in a number of individual challenges, including: health-related harms (including substance-use problems); emotional or psychological distress; relationship disruption, conflict or breakdown; reduced performance at work; financial harm; and criminal activity. These gambling-related harms may also affect family members, broader communities and the population as a whole, for example by placing strain on relationships or by negatively influencing the financial situations of families.

The changes to both the gambling industry (including online gaming and venue expansion) and to the mental health and addictions sector provide a unique opportunity to consider what changes could be made to reduce gambling-related harms and better support those at risk of problem-gambling behaviours.(4; 5)

What the research tells us

There is a body of research evidence that could inform ways to improve the availability and accessibility of gambling services to reduce gambling-related harms, particularly through approaches that focus on entire communities and population (as opposed to focusing on individuals). This could mean pursuing any of the following:

Using tools to screen individuals for gambling problems

There is a wide variety of reliable tools available to screen individuals for gambling problems. However, there is some uncertainty about whether these can be relied on to identify problem-gambling behaviours in those who gamble online due to a limited number of studies and different characteristics of online gamblers such as poker players.(6; 7)

Using new technologies to deliver programs and services

Using internet and mobile technologies, such as cellphones and tablets, to deliver programs and services to help reduce gambling-related harms have shown promise, and have been found to be both time- and cost-effective.(8; 9)

Restricting access, changing prices and altering gambling environments to support healthy behaviours

Different forms of gambling are more and less responsive to changes to the cost of playing (for example, requiring an entrance fee, increasing the price of a lottery ticket or increasing the price per play). Research evidence shows that when the cost of lottery tickets and horse racing increases, less people participate in these activities. However, this was not found to be the case when the cost of casino-based gambling increased.(10)

Warning messages that pop-up over a player’s screen and require them to close the message can be used to reduce risky gambling behaviour.(11)

In addition, research evidence shows that each of the following approaches supported healthy behaviour changes among individuals who gamble:
- mandatory limit setting on the amount to be spent in one session;
- individual bet limits when set as a low dollar value, such as $1;
- mandatory shut-down at a certain hour or reducing casino operating hours; and
- on-screen clocks that display cash spent rather than credits.(12)

Know the signs

Gambling is not always just a game. The Centre for Addiction and Mental Health has identified key signs of problem gambling,(13) which include :

Behavioural signs: the person stops doing things he or she previously enjoyed; misses family events; changes patterns of sleep; ignores self-care or family tasks; or has conflicts with other people over money.
Emotional signs : the person withdraws from family and friends; seems anxious; or has mood swings and sudden outbursts of anger.

Financial signs : the person often borrows money; cashes in savings accounts, retirement savings, or insurance plans; alternates between being broke and flashing money; or has family members complaining that valuables are disappearing.

Health signs : the person complains of stress-related health problems (for example, headaches, stomach and bowel problems, difficulty sleeping, or overeating or loss of appetite).

If you recognize these signs, seek help. Contact your provincial or territorial helpline for information on available programs and services. The Centre for Addiction and Mental Health has also developed self-help tools which are available online.

The content of this blog post is based on a citizen brief prepared by the McMaster Health Forum on strengthening collaboration to optimize efforts addressing gambling-related harms in Ontario.

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Author Details


  1. Waddell K, Moat, KA Lavis JN, Bullock H. Citizen brief: Strengthening collaboration to optimize efforts addressing gambling-related harms in Ontario. Hamilton: McMaster Health Forum, 2 February 2018.

  2. Ontario Lottery and Gaming Corporation. 2014-15 Annual Report. Toronto: Ontario Lottry and Gaming Corportation; 2015.

  3. Centre for Additction and Mental Health. Gambling policy framework. Toronto: Centre for Addiction and Mental Health.

  4. Smith G. The nature and scope of gambling in Canada. Addiction 2014; 109(5): 706-10

  5. Ministry of Health and Long-Term Care. Open minds, healthy minds: Ontario's comprehensive mental health and addictions strategy. Toronto: Queen's Printer for Ontario; 2011.

  6. Spice C. The effectiveness of interventions and social support for families affected by addiction: University of Birmingham; 2014.

  7. Moreau A, Chabrol H, Chauchard E. Psychopathology of online poker players: Review of literature. Journal of Behavioural Addictions 2016; 5(2): 155-68.

  8. Chebli JL, Blaszczynski A, Gainsbury SM. Internet-Based Interventions for Addictive Behaviours: A Systematic Review. Journal of Gambling Studies 2016; 32(4): 1279-304.

  9. Danielsson AK, Eriksson AK, Allebeck P. Technology-based support via telephone or web: a systematic review of the effects on smoking, alcohol use and gambling. Addictive Behaviour 2014; 39(12): 1846-68.

  10. Gallet C. Gambling demand: A meta-analysis of the price elasticity. The Journal of Gambling Business and Economics 2015; 9(1): 12-22.

  11. Ginley MK, Whelan JP, Pfund RA, Peter SC, Meyers AW. Warning messages for electronic gambling machines: Evidence for regulatory policies. Addiction Research & Theory 2017; 25(6): 495-504.

  12. Tanner J, Drawson A, Mushquash C, Mushquash A, Mazmanian D. Harm reduction in gambling: A systematic review of industry strategies. Addiction Research & Theory 2017; 25(6).

  13. Centre for Addiction and Mental Health. Problem gambling, 2010.

DISCLAIMER: These summaries are provided for informational purposes only. They are not a substitute for advice from your own health care professional. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the McMaster Optimal Aging Portal (

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