Measuring harm from gambling and estimating its distribution in the population

For some time, a focus on “problem gambling” has strongly coupled the behavioural and cognitive symptoms of addiction to the negative outcomes that result from excessive consumption. For policymakers, this has the twin disadvantages of (1) encouraging the assumption that the experience of harm is restricted to only those with a clinical disorder, and (2) a focus on treating “pathological” individuals, rather than on how best to handle an intrinsically hazardous product. Further, recent evidence suggests that harms are widely distributed amongst the gambling population. This chapter describes an alternative perspective of harm from gambling, as a quantifiable impact to the individual’s quality of life. In this model, addiction, consumption, and harm are understood as related but distinct constructs. The implication of this view is that there should be a new focus on directly assessing and minimising harm across the spectrum of excessive consumption.