Gerda Reith

Background: Gambling is associated with serious social and health harms, including suicidal ideation and suicide attempts. The risk of these adverse effects increases with consumption and imposes a substantial economic burden to the National Health Service and wider society, beyond the negative impacts on individuals and their families. Sports betting is a major growth area for the gambling industry. Sports bettors are disproportionately male and younger, two risk factors for gambling harms. It is important to develop and implement preventative interventions that limit the escalation of gambling harms among this group. We report on the feasibility of an intervention delivered within and by professional football clubs, a setting which has proved highly successful in attracting men to other behaviour change interventions (e.g. weight loss). Methods: In what was originally designed as a three-phase study, a face-to-face group-based intervention (Football Fans and Betting) was refined in Phase 1, for delivery by trained community coaches at professional football club stadia. Eight 90-minute weekly sessions included interactive ‘classroom-based’ education around gambling behaviours, the industry and impacts, and group-based physical activity to promote social connectivity. Phase 2 assessed the feasibility of approaches to recruitment and retention and the acceptability of Football Fans and Betting to both coaches and participants. Phase 3 was intended to comprise a pragmatic, two-arm pilot randomised controlled trial of the Football Fans and Betting intervention at four professional football clubs in England. Results: Data collected from participants and coaches via one-to-one interviews, observations and focus groups revealed significant barriers to recruitment, despite considerable iterative efforts to optimise ‘branding’ and strategies. Many of our target population did not perceive themselves as needing support. Instead, Football Fans and Betting was attractive to those with more severe gambling symptomology but who were ineligible as they required more specialist safeguarding support than Football Fans and Betting offered. It proved problematic to promote Football Fans and Betting as a programme to prevent progression to more serious gambling harms to men who were embedded in social networks where gambling was perceived as normal. The irony that many professional football clubs partner with gambling companies was noted by participants and some expressed scepticism around club intentions for delivering Football Fans and Betting. Despite considerable efforts to run Football Fans and Betting at six English professional football clubs during 2022 and 2023, insufficient numbers were recruited and retained. Phase 3 did not take place as progression to a pilot trial was unviable. Despite low numbers participating in Football Fans and Betting, those who undertook the programme found it to be useful in supporting behaviour change and in providing greater insight into industry tactics. Football Fans and Betting was most successful in feasibility delivery when it was delivered within grassroots and local community contexts. Conclusions: In the current climate of gambling industry penetration into professional football, promoting a gambling harms prevention intervention proved an insurmountable challenge. Limitations: The study failed to attract sufficient numbers to the intervention. Future work: Embedding Football Fans and Betting or similar interventions within footballing communities that are not hampered by commercial gambling arrangements should be considered, along with an emphasis on the importance of early intervention to prevent progression to serious harms from gambling. Funding: This synopsis presents independent research funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme as award number NIHR127665.

In the digital age, gambling has evolved from traditional physical spaces to virtual platforms easily accessible via smartphones. This shift has significantly impacted the gambling industry's profits, particularly in sports betting, which is heavily intertwined with football. Gambling companies have strategically aligned their products with masculinity and football fandom, fostering what some call the "gamblification" of football culture. In this climate, research has highlighted the multitude of harms associated with gambling, especially among vulnerable groups like young men. Public health interventions, such as the Football Fans in Training (FFIT) program, have leveraged the cultural significance of football clubs to promote healthy lifestyles and behaviour change. We carried out research that aimed to adapt this kind of intervention to address gambling harm among men through a programme we named Football Fans and Betting (FFAB). However, despite its intentions, FFAB faced a number of challenges related to the normalization of gambling within football environments and the stigma associated with seeking help for gambling problems. This paper examines the intersection of masculinity, football, and gambling harm prevention through the lens of the FFAB program. It suggests that disrupting the harmful relationship between gambling, sports, and masculinity requires contesting entrenched cultural norms and industry practices. It calls for tighter regulatory control, challenging responsible gambling discourse, and creating discursive spaces where men can address gambling harm without stigma. By reframing gambling harm as a systemic issue, attention can be redirected toward industry accountability and the creation of safer environments for vulnerable individuals.

BackgroundSports betting is a growth area for the gambling industry, with football fans a key target ofadvertising. Men are particularly at risk from gambling harm. Prior research has shown thatthe delivery of health behaviour-related interventions through professional football clubscan attract and support health behaviour change among men. The 8-week Football Fansand Betting (FFAB) programme was designed as an early health behaviour changeintervention for delivery in professional football clubs by club community coaches toreduce their sports betting and other forms of gambling among men aged 18-55 with aPGSI score of 15 and under. This paper reports the acceptability and feasibility of delivering thisprogramme in football clubs in England.MethodsThe FFAB feasibility study’s objectives were to determine whether FFAB has the potentialto reduce gambling behaviour by assessing: 1) recruitment to and retention in theprogramme, 2) the acceptability of FFAB to both club coaches and participants, and 3) togather preliminary evidence on potential impact. To meet aim 1, we initiated recruitmentat 6 clubs and recorded recruitment data throughout, and conducted focus groups onrecruitment materials with fans of Club C-F. For aim 2, we collected data on retentionthroughout our programme deliveries. For aim 3, we completed delivery of FFAB at asmany clubs as possible (n=3); observed the delivery of sessions; completed semi-structuredinterviews with coaches, participants, and non-completers.Results1) Recruitment to the programmeRecruiting the intended number of participants proved highly challenging. This was partly dueto the commercial landscape, where sponsorship by gambling companies lessened club interestin the programme. Even in clubs without direct gambling sponsors, FFAB ads struggled forvisibility against more prominent gambling sponsorships in stadiums. Moreover, stigmasurrounding gambling harm hindered participant recruitment and retention, compounded bybroader commercial challenges. Engaging the target group of the FFAB model was difficultbecause they perceived gambling as normal, making it challenging to connect with FFAB'sobjectives.2) Retention in the programmeRetention to the programme faced similar challenges as recruitment – the commercial landscapeand stigma being key challenges FFAB did not overcome. Retention at our first two programmedeliveries struggled. The final delivery used a more local-hub approach to recruitment andbolted FFAB’s classroom element on to an existing social football game and was successful inretaining its small cohort from session 0-9.3) The acceptability of FFAB to both club coaches and participantsCoaches and participants reported that FFAB was acceptable and that there is a need forearly intervention delivered in this setting. Participants who went through the programmeand the coaches who delivered it reported positive experiences of FFAB.4) Gather preliminary data on potential impactAlthough we were able to carry out our research the FFAB programme facedchallenges. This meant that it was not possible to progress to an RCT to assess impactas intended. However preliminary data from men who completed the programmesuggest that 1) there is a need for an intervention to help men address gambling harm inthe sports space, 2) these men are an underserved population, with sometimes complexneeds, and 3) they often do not recognise the signs of gambling harm and experiencestigma around their behaviour.ConclusionsWe found that FFAB was acceptable to the coaches who delivered it and the participantswho attended. However, our model for recruitment did not work. We also faced difficultieswith retention. More feasibility work to develop a different approach to a gamblingreduction with men between 18-55 with a PGSI score of less than 15 is required.

This paper reviews the progress of geographical research on the gambling industry and presents a framework to comprehend the role of space in gambling consumption and harm. It covers two themes: the casino’s place in urban governance and the agency of gamblers, and how space impacts gambling consumption and harm. The paper introduces a conceptual framework of orientation, affective atmosphere, and intimacy to better comprehend how gambling practices can increase or decrease risk. Finally, the paper suggests that this framework can help to better understand online sports gambling consumption and harm in the context of market growth.

Gerda Reith, from the University of Glasgow, gives an overview of harms generated by commercial gambling.

This article argues that the framing of gambling is crucial for how it is dealt with at every level; from legislative, regulatory and commercial practice to the terms of media and civic debate. Whoever frames the debate has power over the ways that we can and cannot think about gambling, as well as what we can do about it.We take the example of Britain as a case study in which, despite recent repeated calls for gambling to be regarded as a public health issue, it continues to be framed primarily in terms of economic activity and consumerism. We argue that this framing is the product of a particular political-economic model and that it is embedded in legislation and regulatory practice. We go on to describe the commercial landscape of gambling that has been produced by this framework as one which produces harm. As such, we make the point that framing is a key component of the commercial determinants of harm in gambling. The final section of our paper considers the various forms of political and commercial influence that infiltrate and shape the framing of gambling in Britain. This work was funded by Wellcome Trust through a Humanities and Social Sciences Fellowship to Heather Wardle (grant number: 200306).

Commercial gambling is increasingly viewed as being part of the unhealthy commodities industries, in which products contribute to preventable ill-health globally. Britain has one of the world’s most liberal gambling markets, meaning that the regulatory changes there have implications for developments elsewhere. A review of the British Gambling Act 2005 is underway. This has generated a range of actions by the industry, including mobilising arguments around the threat of the “black market”. We critically explore industry’s framing of these issues as part of their strategy to resist regulatory change during the Gambling Act review. We used a predefined review protocol to explore industry narratives about the “black market” in media reports published between 8 December 2020 and 26 May 2021. Fifty-five articles were identified and reviewed, and themes were narratively synthesised to examine industry framing of the “black market”. The black market was framed in terms of economic threat and loss, and a direct connection was made between its growth and increased regulation. The articles mainly presented gambling industry perspectives uncritically, citing industry-generated evidence (n = 40). Industry narratives around the “black market” speak to economically and emotionally salient concerns: fear, safety, consumer freedom and economic growth. This dominant framing in political, mainstream and industry media may influence political and public opinion to support the current status quo: “protecting” the existing regulated market rather than “protecting” people. Debates should be reframed to consider all policy options, especially those designed to protect public health.

The COVID-19 pandemic led to unprecedented restrictions on people’s movements and interactions, as well as the cancellation of major sports events and social activities, directly altering the gambling landscape. There is urgent need to provide regulators, policy makers and treatment providers with evidence on the patterns and context of gambling during COVID-19 and its aftermath. This protocol describes a study addressing the following three questions: (1) How has COVID-19 changed gambling practices and the risk factors for, and experience of, gambling harms? (2) What is the effect of COVID-19 on gambling marketing? (3) How has COVID-19 changed high risk groups’ gambling experiences and practices? This mixed-method study focuses on two groups, namely young adults and sports bettors. In workpackage-1, we will extend an existing longitudinal survey of gambling in young adults (aged 16–24 years) (first wave conducted June–August 2019), adding COVID-19-related questions to the second wave (July–August 2020) and extending to a third wave in 2021; and undertake a survey of sports bettors in the UK (baseline n = 4000, ~July–August 2020), with follow-ups in ~October–November 2020 and ~February-March 2021. In workpackage-2, we will examine changes in expenditure on paid-for gambling advertising from January 2019 to July 2021 and undertake a mixed-method content analysis of a random sample of paid-for gambling advertising (n ~ 200) and social media marketing (n ~ 100) during the initial COVID-19 “lockdown”. Workpackage-3 will involve qualitative interviews with a purposive sample of (a) young adults (aged 18–24 years) and (b) sports bettors.

Background: Gambling is now a well-recognised public health issue and forms the focus of extensive harm reduction initiatives. Recent developments in policy, practice and technology, such relaxation of regulations, the increasing influence of global gambling corporations, and the development of devices such as mobile phone apps and fixed odds betting terminals (FOBTs) mean that the landscape is a complex, dynamic, and fast moving one. Gambling is now practiced using new technologies, in various spaces and places, and features in a range of social surroundings. Therefore, research is needed to inform appropriate gambling harm reduction strategies that can respond to this complex domain. Yet, research and policy approaches to the reduction of gambling harm are predominantly framed through psychological and economic models of individual behaviour, addiction, and ‘rational’ action. This is beginning to change, with a growing corpus of socio-cultural approaches to gambling research now emerging.Method: In this article, we argue the case of recognising gambling as a social practice, the performance of which draws upon multiple elements such as technology and materials, spaces and places, language and discourse, and structures and agency. We call for a practice theory approach to gambling research that joins efforts to move beyond individual gamblers and their behaviour, to also acknowledge the interaction of multiple elements shaping gambling practices. To achieve this, we suggest that research methods such as visual ethnography can be helpful.Conclusion: We set out how a social practice perspective to gambling research can generate different insights and help inform more nuanced and appropriate gambling harm reduction initiatives.