Reframing gambling harms as the product of a predatory industry
A Critical Theory interpretation of a Lived Experience-led ‘counterpublic’
DOI:
https://doi.org/10.29173/cgs215Keywords:
gambling harms, community-centred gambling harms reduction, community mobilisation, policy advocacy, critical theory, commercial determinants of healthAbstract
The framing of public health challenges influences how societies and governments respond to them. This paper suggests that public health professionals counter the claims and influence of harmful community industries by amplifying the reframing efforts of progressive social movements. We engage with Jurgen Habermas’ Critical Theory, which lends theoretical support for this argument, while a practical example is presented of a network which sought to shift gambling harms narratives to focus on harmful industry products and practices. Habermasean constructs inform an analysis of 33 semi-structured interviews, including people with Lived Experience (LE) of gambling harms. Habermas’ ideas, notably his diagnosis of modern social problems as antagonism between the System and the Lifeworld, provide political-economic context to the emergence of a LE social movement. Habermas’ notion of communicative rationality underpins both the internal logic of this movement and public health professionals’ attempt to nurture a ‘counterpublic’ around it: i.e., a space for new ways of thinking and talking about social issues. Paradoxically, the findings reveal the importance and limitations of local collaborations with people affected by harmful industries in the face of those industries’ power, products and advertisements. The findings have implications for the theory and practice of commercial determinants research.
References
Allen, A. (2016). The End of Progress: Decolonizing the Normative Foundations of Critical Theory. Columbia University Press. https://cup.columbia.edu/book/the-end-of-progress/9780231173247/
Benford, R. D., & Snow, D. A. (2000). Framing Processes and Social Movements: An Overview and Assessment. Annual Review of Sociology, 26, 611–639. https://doi.org/10.1146/annurev.soc.26.1.611
Blaug, R. (1997). Between Fear and Disappointment: Critical, Empirical and Political Uses of Habermas. Political Studies, 45(1), 100–117. https://doi.org/10.1111/1467-9248.00074
Brook, A., Körner, K., van Schalkwyk, M. C. I., Barnes, A., & Petticrew, M. (2024). Overcoming doubt: Developing CDoH Essentials, a practical tool to introduce the commercial determinants of health. Health Promotion International, 39(6), daae166. https://doi.org/10.1093/heapro/daae166
Carlisle, S. (2000). Health promotion, advocacy and health inequalities: A conceptual framework. Health Promotion International, 15(4), 369–376. https://doi.org/10.1093/heapro/15.4.369
Clarke, Z., Stevely, A., McGill, E., Carters-White, L., Fryer, K., Beng, J., Hird, S., & Pickard, A. (2024). Sharing understanding of commercial determinants of health in Sheffield. NIHR: School for Public Health Research. https://sphr.nihr.ac.uk/research/developing-a-shared-understanding-of-the-commercial-determinants-of-health-between-residents-of-sheffield-researchers-and-sheffield-city-council/
Cosgrave, J. (2022). Gambling Ain’t What It Used To Be: The Instrumentalization of Gambling and Late Modern Culture. Critical Gambling Studies, 3(1), 12-23. https://doi.org/10.29173/cgs81
Cullerton, K., Donnet, T., Lee, A., & Gallegos, D. (2018). Effective advocacy strategies for influencing government nutrition policy: A conceptual model. International Journal of Behavioral Nutrition and Physical Activity, 15, 83. https://doi.org/10.1186/s12966-018-0716-y
David, J. L., Thomas, S. L., Randle, M., Daube, M., & Balandin, S. (2019). The role of public health advocacy in preventing and reducing gambling related harm: Challenges, facilitators, and opportunities for change. Addiction Research & Theory, 27(3), 210–219. https://doi.org/10.1080/16066359.2018.1490410
Edwards, G. (2004). Habermas and Social Movements: What’s ‘New’? The Sociological Review, 52(Suppl. 1), 113-130. https://doi.org/10.1111/j.1467-954X.2004.00476.x
Elwell-Sutton, T., Marshall, L., Bibby, J., & Volmert, A. (2019). Reframing the conversation on the social determinants of health. Health Foundation. https://www.health.org.uk/publications/reports/reframing-the-conversation-on-the-social-determinants-of-health
Fraser, N. (1990). Rethinking the Public Sphere: A Contribution to the Critique of Actually Existing Democracy. Social Text, 25/26, 56–80. https://doi.org/10.2307/466240
Freudenberg, N. (2021). At What Cost: Modern Capitalism and the Future of Health (1st ed.). Oxford University Press. https://doi.org/10.1093/oso/9780190078621.001.0001
Fitzgerald, N., Angus, K., Howell, R., Labhart, H., Morris, J., Fenton, L., Woodrow, N., Castellina, M., Oldham, M., Garnett, C., Holmes, J., Brown, J., & O’Donnell, R. (2025). Changing public perceptions of alcohol, alcohol harms and alcohol policies: A multi-methods study to develop novel framing approaches. Addiction, 120(4), 655–668. https://doi.org/10.1111/add.16743
Friel, S., Collin, J., Daube, M., Depoux, A., Freudenberg, N., Gilmore, A. B., Johns, P., Laar, A., Marten, R., McKee, M., & Mialon, M. (2023). Commercial determinants of health: future directions. The Lancet, 401(10383), 1229–1240. https://doi.org/10.1016/S0140-6736(23)00011-9
Friel, S., Townsend, B., Fisher, M., Harris, P., Freeman, T., & Baum, F. (2021). Power and the people’s health. Social Science & Medicine, 282, 114173. https://doi.org/10.1016/j.socscimed.2021.114173
Habermas, J. (1971). Toward a Rational Society: Student Protest, Science, and Politics (J. Shapiro, Trans.). Beacon Press. (Original work published 1968).
Habermas, J. (1984). Theory of Communicative Action, Volume One: Reason and the rationalisation of society (T. McCarthy, Trans.). Beacon Press. (Original work published 1981).
Habermas, J. (1987). Theory of Communicative Action, Volume Two: Lifeworld and system: A critique of functionalist reason (T. McCarthy, Trans.). Beacon Press. (Original work published 1981).
Habermas, J. (1997). Between Facts and Norms: Contributions to a Discourse Theory of Law and Democracy (W. Rehg, Trans.). MIT Press. (Original work published 1992).
Hawkins, B., & McCambridge, J. (2020). Policy windows and multiple streams: An analysis of alcohol pricing policy in England. Policy & Politics, 48(2), 315–333. https://doi.org/10.1332/030557319X15724461566370
Hoenink, J., Cerny, C., Mahoney, C., & Pajda, N. (2024). Fuel us, don’t fool us: Big Food & Our Communities: Where are food chains expanding? (Out-of-home #1). Bite Back. https://doi.org/10.17863/CAM.115571
Heaton, J. (2008). Secondary Analysis of Qualitative Data: An Overview. Historical Social Research, 33(3), 33–45. https://doi.org/10.12759/hsr.33.2008.3.33-45
Jay, M. (1996). The Dialectical Imagination: A History of the Frankfurt School and the Institute of Social Research, 1923-1950. University of California Press. http://www.jstor.org/stable/10.1525/j.ctt1pnwsg
Jenkins, C. L., Mills, T., Bland, C., Grimes, J., Reavey, P., Wills, J., & Sykes, S. (2024). Involving Lived Experience in regional efforts to address gambling-related harms going beyond ‘window dressing’ and ‘tick box exercises’. BMC Public Health, 24(384). https://doi.org/10.1186/s12889-024-17939-7
Jun, S., Park, H., Kim, U.-J., Choi, E. J., Lee, H. A., Park, B., Lee, S. Y., Jee, S. H., & Park, H. (2023). Cancer risk based on alcohol consumption levels: A comprehensive systematic review and meta-analysis. Epidemiology and Health, 45, e2023092. https://doi.org/10.4178/epih.e2023092
Kapilashrami, A., Smith, K. E., Fustukian, S., Eltanani, M. K., Laughlin, S., Robertson, T., Muir, J., Gallova, E., & Scandrett, E. (2016). Social movements and public health advocacy in action: The UK people’s health movement. Journal of Public Health, 38(3), 413–416. https://doi.org/10.1093/pubmed/fdv085
Kelleher, D. (2001). New social movements in the health domain. In Scambler, G. (Ed.). Habermas, Critical Theory and Health. Routledge. https://doi.org/10.4324/9781315008547
Kemmis, S. (2008). ‘Critical theory and participatory action research’. In Reason, P. & Bradbury, H. (Eds.). The SAGE Handbook of Action Research. SAGE Publications. https://doi.org/10.4135/9781848607934
Knai, C. & Sovana, N. (2023). A systems perspective on the pathways of influence of commercial determinants of health. In Maani, N., Petticrew, M., & Galea, S. (Eds.). The Commercial Determinants of Health. Oxford University Press. https://doi.org/10.1093/oso/9780197578742.001.0001
Laverack, G. (2013). Health Activism: Foundations and Strategy. (1st ed.). SAGE Publications.
Maani, N., Petticrew, M., & Galea, S. (2023). The Commercial Determinants of Health. Oxford University Press. https://doi.org/10.1093/oso/9780197578742.001.0001
Marionneau, V., & Nikkinen, J. (2022). Gambling-related suicides and suicidality: A systematic review of qualitative evidence. Frontiers in Psychiatry, 13, 980303. https://doi.org/10.3389/fpsyt.2022.980303
Marko, S., Thomas, S. L., Pitt, H., & Daube, M. (2023a). The impact of responsible gambling framing on people with lived experience of gambling harm. Frontiers in Sociology, 8, 1074773. https://www.frontiersin.org/articles/10.3389/fsoc.2023.1074773
Marko, S., Thomas, S. L., Pitt, H., & Daube, M. (2023b). The lived experience of financial harm from gambling in Australia. Health Promotion International, 38(3), daad062. https://doi.org/10.1093/heapro/daad062
Miller, H. E., & Thomas, S. L. (2018). The problem with ‘responsible gambling’: Impact of government and industry discourses on feelings of felt and enacted stigma in people who experience problems with gambling. Addiction Research & Theory, 26(2), 85–94. https://doi.org/10.1080/16066359.2017.1332182
Miller, H. E., Thomas, S. L., & Robinson, P. (2018). From problem people to addictive products: A qualitative study on rethinking gambling policy from the perspective of lived experience. Harm Reduction Journal, 15, 16. https://doi.org/10.1186/s12954-018-0220-3
Mills, T., Evans, J., Jenkins, C. L., Grimes, J., Reavey, P., Wills, J., & Sykes, S. (2024). Galvanising innovation in community-centred approaches for gambling-related harms: A process evaluation of multi-component Community of Practice. Global Health Promotion, 17579759241293453. https://doi.org/10.1177/17579759241293453
Mills, T., Grimes, J., Caddick, E., Jenkins, C. L., Evans, J., Moss, A., Wills, J., & Sykes, S. (2023). ‘Odds Are: They Win’: a disruptive messaging innovation for challenging harmful products and practices of the gambling industry. Public Health, 224, 41–44. https://doi.org/10.1016/j.puhe.2023.08.009
Popay, J., Whitehead, M., Ponsford, R., Egan, M., & Mead, R. (2021). Power, control, communities and health inequalities I: Theories, concepts and analytical frameworks. Health Promotion International, 36(5), 1253–1263. https://doi.org/10.1093/heapro/daaa133
Power, M., Small, N., Doherty, B., & Pickett, K. E. (2020). The Incompatibility of System and Lifeworld Understandings of Food Insecurity and the Provision of Food Aid in an English City. VOLUNTAS: International Journal of Voluntary and Nonprofit Organizations, 31(5), 907–922. https://doi.org/10.1007/s11266-018-0018-7
Roberts, A., Rogers, J., Sharman, S., Stark, S., Dymond, S., Ludvig, E. A., Tunney, R. J., O’Reilly, M., & Young, M. M. (2025). Why it is important to conduct gambling research that is fair and free from conflicts of interest. Addiction, 120(4), 801–803. https://doi.org/10.1111/add.16729
Scambler, G., & Goraya, A. (1994). Movements for change: the new public health agenda. Critical Public Health, 5(2), 4-10. https://doi.org/10.1080/09581599408406280
Sim, F., Wright, J., & Ferguson, K. (2022). Creating a robust multidisciplinary public health workforce—almost there? Journal of Public Health, 44(Supp 1), i40–i48. https://doi.org/10.1093/pubmed/fdac090
Skivington, K., Matthews, L., Simpson, S. A., Craig, P., Baird, J., Blazeby, J. M., Boyd, K. A., Craig, N., French, D. P., McIntosh, E., Petticrew, M., Rycroft-Malone, J., White, M., & Moore, L. (2021). Framework for the development and evaluation of complex interventions: Gap analysis, workshop and consultation-informed update. Health Technology Assessment, 25(57). https://doi.org/10.3310/hta25570
Special Initiative on NCDs and Innovation. (2024). Commercial Determinants of Noncommunicable Diseases in the WHO European Region. World Health Organisation Regional Office for Europe. https://www.who.int/europe/publications/i/item/9789289061162
Sykes, S., van den Broucke, S., & Abel, T. (2024). The dark side of the moon: can critical health literacy offer solutions to the fundamental problems of health literacy? Global Health Promotion, 17579759241298255. https://doi.org/10.1177/17579759241298255
Sykes, S., Watkins, M., Bond, M., Jenkins, C., & Wills, J. (2023). What works in advocating for food advertising policy change across an english region – a realist evaluation. BMC Public Health, 23(1), 1896. https://doi.org/10.1186/s12889-023-16829-8
Thomas, S., Crawford, G., Daube, M., Pitt, H., Hallett, J., McCarthy, S., Francis, L., & Edmunds, M. (2023). Time for policies on gambling to benefit health—not the gambling industry. Health Promotion Journal of Australia, 34(2), 267–271. https://doi.org/10.1002/hpja.721
van Schalkwyk, M. C. I., Thomas, S., McKee, M., Fell, G., & Daube, M. (2023). Statutory levy on gambling may do more harm than good. BMJ, 381, e075035. https://doi.org/10.1136/bmj-2023-075035
van Schalkwyk. M. & Cassidy, R. (2023). The Gambling Industry: Harmful Products, Predatory Practices, and the Politics of Knowledge. In Maani, N., Petticrew, M., & Galea, S. (Eds.). The Commercial Determinants of Health. Oxford University Press. https://doi.org/10.1093/oso/9780197578742.001.0001
van Schalkwyk, M. C. I. & Cassidy, R. (2024). How we can solve the crisis in UK gambling policy. BMJ, 384, q16. https://doi.org/10.1136/bmj.q16
Williams, G. & Popay, J. (2001). Lay health knowledge and the concept of the lifeworld. In Scambler, G. (Ed.). Habermas, Critical Theory and Health. Routledge. https://doi.org/10.4324/9781315008547
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Thomas Mills, Catherine L. Jenkins, James Grimes, Jo Sampson, Paula Reavey, Susie Sykes
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Authors retain copyright of their work, with first publication rights granted to Critical Gambling Studies.
