Gambling addiction in the UK: the long road to public health recognition

Dear Editor,

I commend Metcalfe (1) on highlighting the burden of gambling addictions in the UK. Often, discussions around gambling addictions are centred around adults, leaving children forgotten from conversation. I want to highlight my concerns around gambling addictions in children and propose some possible solutions.

Importantly, age-restrictions do not adequately protect our children and young people from the dangers around gambling. The Gambling Commission’s (GC) 2022 annual report (2) suggests that most gambling that children (aged 11-16) engage with is legal or not age-restricted and so is out of the GC’s direct regulatory control. In the past year, 15% of children have made bets with friends or family and 22% engaged with arcade games, such as claw grab or penny pusher machines. The GC reports that 31% of children have spent their own money on gambling in the past 12 months. Furthermore, 0.9% of 11-16 year olds are classed as problem gamblers by the youth adapted problem gambling screen (DSM-IV-MR-J) and 2.4% are at risk gamblers. To put this simply, 1 child in every classroom of 30 in the UK is a problem or at risk gambler. Given the old adage that ‘prevention is better than cure’, it is vital that we invest in and advocate for child gambling prevention. If this growing issue not addressed soon, we risk allowing future generations of young adults to struggle with gambling addictions and its’ associated comorbidities, including substance misuse and mood disorders (3).

As Metcalfe (1) suggested, styles of gambling are changing, with our laws and regulations failing to adequately adapt to the online sphere. An estimated 93% of children play online games, and while many games are relatively harmless, regulations need to change to protect children from more harmful games that involve elements of gambling. A particularly prominent and controversial example of these forms of gambling is the rise of ‘loot boxes’. Loot boxes “allow players to spend real money to unlock unknown virtual rewards” (4). The odds of receiving a desired reward can be low, leading children to uncontrolled spending in an attempt to chase losses. For example, unlocking a FIFA Gold 84+ Player is 4.2% (4). The Gambling Act 2005 does not cover loot boxes as prize money cannot be converted into real-world money, however, it has been reported that accounts with large amounts of virtual money are often sold over the internet for real-world money (5). There has been pressure on the government to extend the Gambling Act to cover Loot Boxes; despite this, the government have chosen not to extend the act and instead keep its position under review (6). Loot boxes are currently illegal in Belgium and the Netherlands, while China demands that odds of loot boxes must be published (7).

If we are to have a meaningful long-term impact on tackling the gambling addiction epidemic, we must begin by educating our children. While it is suggested that gambling is covered in PSHE curriculums under personal finance topics, the GC suggest that only 21% (8) of children have had a conversation of the problems that gambling can lead to with a teacher. We need to advocate for better education and collaborate with education experts and gambling charities, such as YGAM, to ensure that the curriculum covers non regulated forms of gambling. Furthermore, we need to put pressure on our government to expand the powers of regulatory bodies so that we can better protect our children as gambling evolves with technology. Most importantly, we must act quickly.

1. Metcalfe C. Gambling addiction in the UK: the long road to public health recognition. BMJ. 2023 Apr 6;p748.
2. Gambling Commission. Young People and Gambling 2022.
3. Lorains FK, Cowlishaw S, Thomas SA. Prevalence of comorbid disorders in problem and pathological gambling: systematic review and meta-analysis of population surveys. Addiction (Abingdon, England). 2011 Mar;106(3):490–8.
4. Children’s Commissioner. Loot boxes and gambling. https://www.childrenscommissioner.gov.uk/blog/loot-boxes-and-gambling/.
5. Ash J, Gordon R, Mills S. Between Gaming and Gambling: Children, Young People, and Paid Reward Systems in Digital Games.
6. Woodhouse J. Loot boxes in video games.
7. Gambling Commission. Lootboxes: Advice to the Gambling Commission from ABSG. https://www.gamblingcommission.gov.uk/guidance/lootboxes-advice-to-the-g....
8. Gambling Commission. Young People & Gambling 2018.