“All you’ve got to do is stop”: A Qualitative Examination of Gambling Stigma and Discrimination from the Perspective of Lived Experience
DOI:
https://doi.org/10.29173/cgs170Keywords:
lived experience, gambling stigma, gambling harm, gambling regulationAbstract
People with lived experience have drawn attention to gambling stigma as a harm in itself, justifying discrimination and exacerbating other harms. The gambling establishment’s response has reproduced individual responsibility by reducing stigma to a barrier to help-seeking. More recently, adapting to critiques of individual responsibility, the gambling establishment has expanded the issue to one of services and society. This paper identifies the structural dynamics that drive gambling stigma and discrimination from the perspective of lived experience. Semi-structured interviews were conducted with adults in Great Britain who had experienced gambling harm (n = 40). Several key themes were identified: (1) Harmless fun and individual responsibility; (2) Comparison with substance use; (3) The role of money; (4) Lack of parity in government policy; (5) Stereotypes of “typical” gamblers. The findings show the fundamental driver of stigma is the way commercial gambling functions and is enabled to function by the state, thus perpetuating the very conditions producing stigma in the first place. Stigma-reduction strategies that focus on changing individual behaviour or public information campaigns that tell people to get help early are insufficient: they are just another version of “responsible gambling,” where the individual is expected to do everything. Change requires addressing the unique features of gambling harm, stigma and discrimination, and the position the U.K. government allows commercial gambling to occupy.
References
Abbott, M. W. (2020). Gambling and gambling-related harm: Recent World Health Organization initiatives. Public Health, 184, 56–59. https://doi.org/10.1016/j.puhe.2020.04.001
Alexius, S. (2017). Assigning responsibility for gambling-related harm: Scrutinizing processes of direct and indirect consumer responsibilization of gamblers in Sweden. Addiction Research & Theory, 25(6), 462–475. https://doi.org/10.1080/16066359.2017.1321739
Bhattacharya, A. (2023, July). Carrots and sticks: Can governments do without public health regulation? (Briefing Paper). Social Market Foundation. https://www.smf.co.uk/wp-content/uploads/2023/07/Carrots-and-sticks-July-2023.pdf
Braun, V., & Clarke, V. (2019). Reflecting on reflexive thematic analysis. Qualitative Research in Sport, Exercise and Health, 11(4), 589–597. https://doi.org/10.1080/2159676X.2019.1628806
Braun, V., & Clarke, V. (2021). One size fits all? What counts as quality practice in (reflexive) thematic analysis? Qualitative Research in Psychology, 18(3), 328–352. https://doi.org/10.1080/14780887.2020.1769238
Brown, K. L., & Russell, A. M. T. (2020). Exploration of intervention strategies to reduce public stigma associated with gambling disorder. Journal of Gambling Studies, 36(2), 713–733. https://doi.org/10.1007/s10899-019-09888-3
Browne, M., Langham, E., Rawat, V., Greer, N., Li, E., Rose, J., Rockloff, M., Donaldson, P., Thorne, H., Goodwin, B., Bryden, G., & Best, T. (2016, April). Assessing gambling-related harm in Victoria: A public health perspective. Victorian Responsible Gambling Foundation. https://doi.org/10.11575/PRISM/9419
Canale, N., Vieno, A., & Griffiths, M. D. (2016). The extent and distribution of gambling-related harms and the prevention paradox in a British population survey. Journal of Behavioral Addictions, 5(2), 204–212. https://doi.org/10.1556/2006.5.2016.023
Cassidy, R. (2020). Vicious games: Capitalism and gambling. Pluto Press.
Cassidy, R., Loussouarn, C., & Pisac, A. (2013). Fair game: Producing gambling research (Report). European Research Council and Goldsmiths University of London. https://research.gold.ac.uk/id/eprint/11731/1/Fair-Game-Web-Final.pdf
Charmaz, K. (2017). The power of constructivist grounded theory for critical inquiry. Qualitative Inquiry, 23(1), 34–45. https://doi.org/10.1177/1077800416657105
Cowlishaw, S., Merkouris, S. S., Dowling, N. A., Rodda, S., Suomi, A., & Thomas, S. L. (2019). Locating gambling problems across a continuum of severity: Rasch analysis of the Quinte Longitudinal Study (QLS). Addictive Behaviors, 92, 32–37. https://doi.org/10.1016/j.addbeh.2018.12.016
Crowhurst, I., & kennedy-macfoy, M. (2013). Troubling gatekeepers: Methodological considerations for social research. International Journal of Social Research Methodology, 16(6), 457–462. https://doi.org/10.1080/13645579.2013.823281
Denzin, N. K. (2017). Critical qualitative inquiry. Qualitative Inquiry, 23(1), 8–16. https://doi.org/10.1177/1077800416681864
Department for Culture, Media & Sport. (2023, April 27). High stakes: Gambling reform for the digital age. https://www.gov.uk/government/publications/high-stakes-gambling-reform-for-the-digital-age
Department for Culture, Media & Sport. (2024, February 23). Government response to consultation on proposals for the introduction of a maximum stake limit for online slots games in Great Britain. https://www.gov.uk/government/consultations/a-maximum-stake-limit-for-online-slots-games-in-great-britain/outcome/government-response-to-consultation-on-proposals-for-the-introduction-of-a-maximum-stake-limit-for-online-slots-games-in-great-britain
Fraser, S., Moore, D., & Keane, H. (2014). Habits: Remaking addiction. Palgrave Macmillan.
GambleAware. (2021, April). GambleAware organisational strategy 2021–26. https://www.begambleaware.org/sites/default/files/2021-04/GambleAware_Organisational_Strategy_2021-26.pdf
Gambling Commission. (2024, February). Industry statistics – February 2024 – Correction. https://www.gamblingcommission.gov.uk/statistics-and-research/publication/industry-statistics-february-2024-correction
Gambling Research Exchange (GREO). (2019, December). Stigma and gambling. GREO Evidence Exchange. https://doi.org/10.33684/2019.003
Gaventa, J., & Cornwall, A. (2001). Power and knowledge. In P. Reason & H. Bradbury (Eds.), Handbook of action research: Participative inquiry and practice (pp. 70–80). Sage Publications.
Goffman, E. (1963). Stigma: Notes on the management of spoiled identity. Prentice-Hall.
Hahmann, T., Hamilton-Wright, S., Ziegler, C., & Matheson, F. I. (2021). Problem gambling within the context of poverty: A scoping review. International Gambling Studies, 21(2), 183–219. https://doi.org/10.1080/14459795.2020.1819365
Hing, N., Holdsworth, L., Tiyce, M., & Breen, H. (2014). Stigma and problem gambling: Current knowledge and future research directions. International Gambling Studies, 14(1), 64–81. https://doi.org/10.1080/14459795.2013.841722
Hing, N., Nuske, E., Gainsbury, S. M., & Russell, A. M. T. (2016). Perceived stigma and self-stigma of problem gambling: Perspectives of people with gambling problems. International Gambling Studies, 16(1), 31–48. https://doi.org/10.1080/14459795.2015.1092566
Hing, N., & Russell, A. M. T. (2017). How anticipated and experienced stigma can contribute to self-stigma: The case of problem gambling. Frontiers in Psychology, 8, 235. https://doi.org/10.3389/fpsyg.2017.00235
Hing, N., Russell, A., Nuske, E., & Gainsbury, S. (2015, September). The stigma of problem gambling: Causes, characteristics and consequences (Research Report). Victorian Responsible Gambling Foundation. https://apo.org.au/sites/default/files/resource-files/2015-12/apo-nid60656.pdf
Hing, N., Smith, M., Rockloff, M., Thorne, H., Russell, A. M. T., Dowling, N. A., & Breen, H. (2022). How structural changes in online gambling are shaping the contemporary experiences and behaviours of online gamblers: An interview study. BMC Public Health, 22, 1620. https://doi.org/10.1186/s12889-022-14019-6
Jackson-Best, F., & Edwards, N. (2018). Stigma and intersectionality: A systematic review of systematic reviews across HIV/AIDS, mental illness, and physical disability. BMC Public Health, 18, 919. https://doi.org/10.1186/s12889-018-5861-3
Jacobson, D., & Mustafa, N. (2019). Social identity map: A reflexivity tool for practicing explicit positionality in critical qualitative research. International Journal of Qualitative Methods, 18. https://doi.org/10.1177/1609406919870075
Keane, H. (2019, August 25). Rethinking stigma and gambling. Critical Gambling Studies Blog. https://doi.org/10.29173/cgs13
Langham, E., Thorne, H., Browne, M., Donaldson, P., Rose, J., & Rockloff, M. (2015). Understanding gambling related harm: A proposed definition, conceptual framework, and taxonomy of harms. BMC Public Health, 16, 80. https://doi.org/10.1186/s12889-016-2747-0
Link, B. G., & Phelan, J. C. (2001). Conceptualizing stigma. Annual Review of Sociology, 27, 363–385. https://doi.org/10.1146/annurev.soc.27.1.363
Livingstone, C., & Rintoul, A. (2020). Moving on from responsible gambling: A new discourse is needed to prevent and minimise harm from gambling. Public Health, 184, 107–112. https://doi.org/10.1016/j.puhe.2020.03.018
Livingstone, C., Rintoul, A., de Lacy-Vawdon, C., Borland, R., Dietze, P., Jenkinson, R., Livingston, M., Room, R., Smith, B., Stoove, M., Winter, R., & Hill, P. (2019, June). Identifying effective policy interventions to prevent gambling-related harm (Research Report). Victorian Responsible Gambling Foundation. https://researchmgt.monash.edu/ws/portalfiles/portal/314486477/278151473_oa.pdf
Lumivero. (2020). NVivo (Version 13, Windows Release 1). www.lumivero.com
Marko, S., Thomas, S. L., Pitt, H., & Daube, M. (2023). The lived experience of financial harm from gambling in Australia. Health Promotion International, 38(3), daad062. https://doi.org/10.1093/heapro/daad062
Marko, S., Thomas, S. L., Robinson, K., & Daube, M. (2022). Gamblers’ perceptions of responsibility for gambling harm: A critical qualitative inquiry. BMC Public Health, 22, 725. https://doi.org/10.1186/s12889-022-13109-9
McCartney, M. (2023). Gambleaware: What does “independence” from industry really mean? BMJ, 381, 1265. https://doi.org/10.1136/bmj.p1265
Miller, H. E., & Thomas, S. (2017). The “Walk of Shame”: A qualitative study of the influences of negative stereotyping of problem gambling on gambling attitudes and behaviours. International Journal of Mental Health and Addiction, 15(6), 1284–1300. https://doi.org/10.1007/s11469-017-9749-8
Miller, H. E., Thomas, S. L., Smith, K. M., & Robinson, P. (2016). Surveillance, responsibility and control: An analysis of government and industry discourses about “problem” and “responsible” gambling. Addiction Research & Theory, 24(2), 163–176. https://doi.org/10.3109/16066359.2015.1094060
Newall, P. W. S. (2019). Dark nudges in gambling. Addiction Research & Theory, 27(2), 65–67. https://doi.org/10.1080/16066359.2018.1474206
Orford, J. (2019). The gambling establishment: Challenging the power of the modern gambling industry and its allies. Routledge. https://doi.org/10.4324/9780367085711
Quigley, L. (2022). Gambling disorder and stigma: Opportunities for treatment and prevention. Current Addiction Reports, 9(4), 410–419. https://doi.org/10.1007/s40429-022-00437-4
Reith, G. (2014). Gambling and the contradictions of consumption: A genealogy of the “pathological” subject. In R. Granfield & C. Reinarman (Eds.), Expanding addiction: Critical essays (pp. 249–262). Routledge.
Reith, G. (2018). Addictive consumption: Capitalism, modernity and excess. Routledge.
Reith, G., & Wardle, H. (2022). The framing of gambling and the commercial determinants of harm: Challenges for regulation in the UK. In J. Nikkinen, V. Marionneau, & M. Egerer (Eds.), The global gambling industry: Structures, tactics, and networks of impact (pp. 71–86). Springer Gabler.
Rintoul, A., Marionneau, V., Livingstone, C., Nikkinen, J., & Kipsaina, C. (2023). Gambling, stigma, suicidality, and the internalization of the ‘responsible gambling’ mantra. Frontiers in Psychiatry, 14, 1214531. https://doi.org/10.3389/fpsyt.2023.1214531
Rolando, S., Ferrari, C., & Beccaria, F. (2023). “To me, it was just a vice”: Stigma and other barriers to gambling treatment in Piedmont, Italy. Journal of Gambling Studies, 39(4), 1909–1925. https://doi.org/10.1007/s10899-023-10214-1
Schüll, N. D. (2012). Addiction by design: Machine gambling in Las Vegas. Princeton University Press. https://doi.org/10.1515/9781400834655
Sweet, E., DuBois, L. Z., & Stanley, F. (2018). Embodied neoliberalism: Epidemiology and the lived experience of consumer debt. International Journal of Health Services, 48(3), 495–511. https://doi.org/10.1177/0020731418776580
Thomas, S., Bestman, A., Pitt, H., David, J., & Thomas, S. (2016, May). Lessons for the development of initiatives to tackle the stigma associated with problem gambling. Victorian Responsible Gambling Foundation. https://hdl.handle.net/10536/DRO/DU:30083800
van Schalkwyk, M. C. I., Petticrew, M., Cassidy, R., Adams, P., McKee, M., Reynolds, J., & Orford, J. (2021). A public health approach to gambling regulation: Countering powerful influences. The Lancet Public Health, 6(8), e614–e619. https://doi.org/10.1016/S2468-2667(21)00098-0
Waheed, W., Hughes-Morley, A., Woodham, A., Allen, G., & Bower, P. (2015). Overcoming barriers to recruiting ethnic minorities to mental health research: A typology of recruitment strategies. BMC Psychiatry, 15, 101. https://doi.org/10.1186/s12888-015-0484-z
Wardle, H., Degenhardt, L., Ceschia, A., & Saxena, S. (2021). The Lancet Public Health Commission on gambling. The Lancet Public Health, 6(1), e2–e3. https://doi.org/10.1016/S2468-2667(20)30289-9
Wardle, H., Reith, G., Langham, E., & Rogers, R. D. (2019). Gambling and public health: We need policy action to prevent harm. BMJ, 365, l1807. https://doi.org/10.1136/bmj.l1807
Williams, E. N., & Morrow, S. L. (2009). Achieving trustworthiness in qualitative research: A pan-paradigmatic perspective. Psychotherapy Research, 19(4–5), 576–582. https://doi.org/10.1080/10503300802702113
Wyllie, C., Killick, E., & Kallman, A. (2023, February 22). A review of gambling harm training materials for healthcare professionals. Tackling Gambling Stigma. https://tacklinggamblingstigma.com/wp-content/uploads/2023/04/A-Review-of-Gambling-Healthcare-Training-Tackling-Gambling-Stigma.pdf
Yücel, M., Carter, A., Harrigan, K., van Holst, R. J., & Livingstone, C. (2018). Hooked on gambling: A problem of human or machine design? The Lancet Psychiatry, 5(1), 20–21. https://doi.org/10.1016/S2215-0366(17)30467-4
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Copyright (c) 2024 Elizabeth Killick, Clare Wyllie, Alexander Källman, Michelle Potiaumpai
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