Examination of Witnesses (Questions 234
- 239)
THURSDAY 8 JANUARY 2004
PROFESSOR MARK
GRIFFITHS, DR
EMANUEL MORAN
AND PROFESSOR
JIM ORFORD
Q234 Chairman: Good morning everyone.
May I begin by welcoming Professor Griffiths, Dr Moran and Professor
Orford to our proceedings; they will be answering questions in
just a moment. May I also make the point that Elliot Grant from
the Bill team is present and available to speak to us if spoken
to, should we be straying from some meaning in relation to the
Bill. May I ask you to note that this is a public evidence session
and the transcript will be produced and placed on the internet.
We think it unlikely there will be any division during this Committee,
but, were that to happen, we would suspend for 10 minutes and
clear the public gallery. May I also ask you to note that a full
declaration of interests from members of the Committee was made
at the beginning of the first meeting and information for witnesses
and a note of those interests is available. Could I confirm to
everyone that time is tight and they should not feel obliged to
answer a question if they have nothing to add to what other witnesses
have already said. This is particularly important where we have
three witnesses now and then four witnesses later on. Do you think
vulnerability to problem gambling is inherent in the very activity
of gambling? Or are some people especially vulnerable as the licensing
objectives appear to suggest?
Dr Moran: The first point I would
like to make is the notion of problem gambling is a rather dubious
one. The Royal College of Psychiatrists, whom I am representing
here, does not accept it as a valid concept. The condition really
that is agreed by the WHO is pathological gambling; that is, all
excessive gambling associated with disorder. I think we have to
recognise that pathological gambling is a behavioural disorder
and therefore it is heterogeneous: there are a variety of causes
which are responsible for the disorder and they broadly fall into
social and individual. Clearly, there are individual vulnerabilities.
Among the social factors, I think the most important is the availability
of facilities. Gambling does not occur in a vacuum; it is organised
on a commercial basis, with all the trappings that go with that,
and therefore there are commercial pressures. The availability
of facilities and the social pressures encouraging gambling are
very crucial to the disorder.
Professor Griffiths: I would add
that when it comes to problem gambling there are obviously vulnerable
individuals but there are also some activities which are inherently
more problematic and/or addictive than others. I am sure we will
be getting into the area of, for instance, slot-machines later
on, but we know for a fact that slot-machines are inherently more
addictive than, say, a weekly lottery. We know, therefore, that
the structural characteristics of how games are designed actually
do induce problems in some people. Added with that are the vulnerabilities
of individuals—we know there are vulnerable populations
like minors, problem gamblers, the intoxicated, for instance.
These are various segments of the population that do seem to be
more susceptible to problem gambling.
Q235 Chairman: To summarise, you
are saying, Dr Moran, that this is a behavioural problem. We are
having some difficulty ourselves in defining problem gambling.
We went to GamCare yesterday and were given about four different
definitions by four different people with a bad experience of
gambling, but I think the behavioural element is what came through
in what they had all said. Is there a vulnerability as well which
arises from ignorance of how gambling works or a general lack
of time-and-money management skills in individuals?
Professor Griffiths: However you
like to describe it, problem gambling is basically a syndrome.
There are lots of overlapping consequences of the behaviour. How
a person gets from being a non-gambler through to a social gambler
and to a problem gambler will be different in different people.
Some people will have a genetic susceptibility; for some people
it will be the environment in which they were brought up; for
some people it will be to do with the nature of the activity itself.
You can look at a problem gambler and say they are doing x,
y and z, and, even though how they got from a
to b may be very different, what they display is very,
very similar. So, yes, it is a behavioural outcome but there are
psychological, social and biological antecedents to that particular
behaviour.
Professor Orford: I would agree
with what has been said but I would say there is much clearer
evidence that the potential for addictiveness of gambling is inherent
in the activity itself. First year psychology undergraduates learning
the laws of how people acquire habits which are difficult to break,
are often shown a picture of a gambling machine because it is
an almost perfect mechanism for creating a habit that is difficult
to break. So, I would say, inherent in the activity, yes. Personal
vulnerability there are many ideas, many theories about, but on
the whole there is very little evidence for it. The main vulnerabilities
lie in some more obvious things. Being male (versus being female)
is one of the factors; being of low income is one of the vulnerability
factors; and having a parent who gambled heavily is another factor.
On some of the other personality ideas—whether it is to
do with genetics, self-esteem, being an impulsive personality—there
is very little evidence for that.
Dr Moran: The notion that pathological
gambling is either an illness or just plain ignorance I think
ignores the fact, as Professor Orford has just indicated, that
ultimately the activity of gambling inherently is habit forming.
We see it illustrated in terms of the gaming machine which used
to be known the "one-armed bandit". It speaks for itself.
There are these elements to gambling which encourage participation
and, going to extremes, ultimately leading to what has been referred
to as "chasing losses". I think we have to recognise
that at the end of the day we talk about "gamblers who lose"
but ultimately all gamblers lose because the gambling industry
has to make a profit. Where does it come from other than from
the pool that goes into it via the punter? There is a variety
of factors. I am quite prepared on behalf of the college to submit
another paper to you which will spell these things out in a bit
more detail, in terms of personal characteristics and broader
issues.
Q236 Chairman: We would be very happy
to have that. Could I ask you to make one other observation. Some
of the people we met yesterday who admitted to having a gambling
problem slightly surprised us in the sense that their definition
of a problem was not necessarily that they were losing a lot of
money. In other words, they had not fallen into financial ruin:
the problem was to do with the addiction in the sense that they
had lost all enjoyment from gambling but they felt compelled to
do it on a daily basis. Does that come within your scope of definition?
Dr Moran: Certainly, Mr Chairman.
Basically pathological gambling is excessive gambling which leads
to social and psychological and financial difficulty. It can be
any combination of these. Like all human behaviour, it is heterogeneous.
Take crime, for instance: there is no one explanation for crime.
Similarly, with pathological gambling there is no one explanation.
In helping people with difficulties, one of the first things one
has to do is to dissect out the elements of the disorder and one
pathological gambler will be different from others. One can categorise
them. I have made some attempt to do this in different varieties,
from the individual factors at one extreme to social factors at
the other end. But, as Professor Orford has indicated, the issue
is very much in the same league as, say, crime, where there is
a variety of factors and most of the factors are socially determined.
Professor Griffiths: May I add
one thing, Mr Chairman? We talk about addiction. Financial ruin
is not the basis of any addiction that I know. Most of us on this
panel who have studied addictions for many years would say that
addictions are really about the activity being the single most
important thing in that person's life and compromising everything
in their life to do that particular activity, getting withdrawal
symptoms if they cannot do that activity, having cravings for
that activity if they are unable to do it, and using that activity
as a reliable and consistent way of modifying their mood. Financial
ruin does not come into that. You can find gamblers who fulfil
all those criteria. Unfortunately, most gamblers do lose a lot
of money along the way, but you will get gamblers who have maybe
not lost money along the way but are still addicted.
Q237 Lord Faulkner of Worcester:
Do you accept the figures contained in the Gambling Prevalence
Survey of the number of people who are affected either by a pathological
disorder or problem gambling (depending on how you want to define
it) of between 0.6 per cent and 0.8 per cent? If the figure is
as low as that, it means that 99 per cent of the population does
not have a problem.
Professor Orford: May I, as one
of the authors of the British Gambling Prevalence Survey, immediately
come in. I think people have been rather naughty, I have to say,
in interpreting the figures as saying that we have a low gambling—
Q238 Lord Faulkner of Worcester:
Which people?
Professor Orford: The Government
for a start.
Q239 Lord Faulkner of Worcester:
I thought that was what you meant but I felt the need to clarify
it.
Professor Orford: There are several
points I would like to make about this. From a public health point
of view, any disorder which was thought to affect one-third of
a million people in the country would be considered to be a very
serious public health issue. That is the first point. The second
point is that the estimate is only an estimate and there is a
confidence interval scientifically around that estimate. All you
can say is that there are two other countries in the world that
have done national surveys that appear to be statistically different
from Britain, and one is higher and one is lower. Australia is
significantly higher. That is clear. The other European country—and
the only European country where a survey has been carried out—is
Sweden, and that is just significantly lower. It is not possible
statistically to say that the British rate that we found is significantly
lower than the American rate or than the New Zealand rate, for
example. That is the second point I want to make. The other point
is that 0.6 or 0.8 is of course just the percentage of everybody
in the country. That includes millions of people who do not gamble
at all; millions of other people who only gamble on the National
Lottery. As soon as you start to express it as a percentage of
all people who gambled on anything last year or as soon as you
start to express it as a percentage of young people between the
ages of 16 and 35 or as soon as you start to express it as the
percentage of people who bet on fruit machines last year, of course
the percentage goes up.
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