5

A human problem that needs a human solution

The expansion of gambling in Australia in the late twentieth century was not unique, but part of a global pattern as governments across the Western world embraced free-market capitalism and snubbed moral conservatism. The ethos of deregulation and the sovereign consumer dominated, resulting in legal casinos, poker machines, and state-sponsored lotteries also appearing in the United States and the United Kingdom, and across Europe. But while Australia wasn’t alone in deregulating gambling, it did so most enthusiastically, particularly with regard to poker machines. According to gambling researchers Francis Markham and Martin Young, ‘Australia provides the example par excellence of Big Gambling ascendant.’

The global gambling industry enjoyed soaring profits immediately after it was deregulated en masse. It went from being low key and small scale to a commercial behemoth on a par with Big Tobacco and Big Alcohol; nowadays, it posts annual profits in excess of $380 billion. At the same time, however, it also faced a growing furore against the huge spike in gambling problems and gambling-related social harm. Many people and politicians accused it of maliciously profiting from human misery just like the tobacco industry, and called for it to be promptly reined in.

In a speech to industry heavyweights in Las Vegas in 1996, lawyer and Republican politician Frank Fahrenkopf — who shortly before had established the American Gaming Association (AGA) to protect and promote the gambling industry in America — indicated just how serious the crisis was. He labelled problem gambling the ‘Achilles heel’ of the industry, and said that the abundance of stories carried in the media about ‘the ruination of innocent people’ could persuade governments to impose tougher regulations on gambling. ‘The growth of our industry is certainly endangered by the issue, and it is not hyperbole to say that the industry’s very existence is at stake,’ Fahrenkopf said.

Fahrenkopf proposed a solution. Rather than copy their counterparts in the tobacco industry — whose initial strategy in response to public concerns about smoking was to aggressively deny that cigarettes were harmful — he suggested that the gambling industry not only fully accept that gambling did indeed cause harm, but also lead the public and academic discussion about the causes of and solutions to the problem. The advantage of this approach, as Fahrenkopf well knew, was that by taking a lead on these matters, the industry would be able frame them and strategically position itself in the debate.

Many in the industry in Australia agreed with Fahrenkopf, including Mark Fitzgibbon, the CEO from 1999 to 2002 of ClubsNSW — the peak lobby group for Australia’s club sector. ‘The dark clouds were starting to form around poker machines, and just like with alcohol, we had to be seen to be responding to those genuine community concerns with action,’ he tells me.

But other insiders were sceptical about adopting such a forthright approach. Fitzgibbon recounts how he was once attacked by the head of a poker machine manufacturing company (he refuses to name this person, or the company they headed) for simply discussing the subject of problem gambling. ‘Many industries will fight to protect their own patch, and this guy thought what I was doing to be a threat to his own patch,’ Fitzgibbon says. ‘He saw us engaging in that discourse as being detrimental to his long-term business interests. I saw it as being helpful to his long-term business interests.’

The narrative about problem gambling that the likes of Fitzgibbon and other industry representatives in Australia and around the world formulated back then explicitly dismissed the possibility that gambling products might bear any responsibility in someone developing a problem. Instead, it pathologised the individual, arguing that a person’s biological and psychological flaws were the main factors in them gambling to excess. As Professor Natasha Dow Schüll writes in Addiction by Design:

By the mid 1990s, the gambling industry had already grasped (as the alcohol industry had some decades earlier) that a medical diagnosis linked to the excessive consumption of its product by some individuals could serve to deflect attention away from the product’s potentially problematic role in promoting that consumption, and onto the biological and psychological vulnerabilities of a small minority of its customers.

Despite more recent findings about the science of gambling addiction, the industry continues to place blame for a gambling problem entirely on the driver, and none on the vehicle. In a 2011 online video, Anthony Ball, the CEO of ClubsNSW, said of problem gambling, ‘We think that it’s a human problem that needs a human solution.’ (I made repeated requests to interview Ball or another current ClubsNSW representative for this book. All my requests were denied.)

The industry uses several methods to attempt to inject this narrative with more credibility. One is to highlight the fact that the vast majority of Australians enjoy gambling for recreation and that only a very small minority gamble to excess. Another is being very careful with the language it uses. It prefers the term ‘gaming’ to ‘gambling’, and says that poker machines are simply a form of ‘entertainment’ — a term suggestive of benevolence and fun — akin to a novel, video game, or film that people can choose whether or not they wish to enjoy. Speaking to a Tasmanian parliamentary inquiry into poker machines in February 2017, David Curry, the corporate affairs executive of the Woolworths majority-owned venture, Australian Leisure and Hospitality Group, said, ‘They [gamblers] are enjoying that form of entertainment, it’s no different to me going to the movies — whether it’s a good movie or a bad movie — and buying an ice cream.’

The so-called ‘human solution’ to problem gambling endorsed by the industry is broadly referred to as ‘Responsible Gambling’. A testament to how successful the industry has been in framing the debate is the fact that state governments across Australia have adopted ‘Responsible Gambling’ as the best way to tackle gambling harm.

There are a handful of statutory requirements for the responsible service of gambling — such as not offering inducements, providing mandatory clocks on machines, restricting advertising, limiting access to ATMs, shutting down machines for mandatory periods, and banning the use of credit to gamble. All poker machines must also be tested by an independent body before they are released, to ensure they satisfy all regulatory requirements. They must, for example, meet the minimum RTP in a jurisdiction, clearly display the win, credit, and bet meter, and must not have offensive or inappropriate artwork. However, the clear focus of government policy is on educating individuals about how to gamble within their means — or, in other words, to gamble responsibly.

Venues in all jurisdictions, for example, are now legally required to offer brochures containing information about how to access counselling and self-exclusion programs, and about the basics of how poker machines work. Warnings about excessive gambling must also be placed on poker machines. These warnings are generally small in size, and contain messages such as, THINK! About your choices, THINK! About your family, and‘Don’t chase your losses. Walk away.

Government-run media campaigns consisting of websites, and print and television advertisements, reinforce this message. A recent campaign by the New South Wales government was entitled ‘You’re stronger than you think.’ The television advertisement depicts a young man walking into his local club and taking a seat at a poker machine in the ‘Players Lounge’. He half-opens his wallet, and then closes it, before looking at an image of his children on his phone. The advertisement ends with the message ‘You’re stronger than you think’ appearing on screen.

The Victorian Responsible Gambling Foundation — established by the Victorian government — has recently launched a similar campaign called ‘Fight for the Real You’. It features four real gamblers who are fighting their gambling problems by not gambling for 100 days. Using a daily video diary, they record their experiences, which are then shared via internet films, as well as on television, in cinemas, online, and in radio commercials. The campaign aims to encourage people who might be struggling with their gambling to also attempt the ‘100 Day Challenge’ and ‘take control of your gambling’.

THINK! About your choices. Don’t chase your losses. Walk away. You’re stronger than you think. Take control of your gambling. These slogans may have been developed with good intentions, but they do make overcoming a gambling problem sound as easy as simply exerting more willpower and acting more rationally. The same can be said for much of the other government material about how to gamble responsibly. The New South Wales government’s Gambling Help website, for example, advises visitors that the three best ways to not ‘have a life dominated by gambling’ are to ‘limit your funds’, ‘get a helper’, and ‘keep a gambling diary’.

Unfortunately, however, the reality of recovering from a gambling addiction — as the stories above of Doug and others attest — is much more complex and much more difficult than governments and the industry suggest. What if — as is the case with people suffering from a physical addiction — some players cannot think properly because they are gripped by the allure of gambling? Will telling them to just think about the consequences of their choices and to be stronger — as if they haven’t already tried to be — really help them, when they have already demonstrated an inability to act according to their and their loved ones’ best interests? And what about those people suffering from mental-health conditions whose cognitive capacity and rationality is greatly reduced? How can they be reasonably expected to overcome a gambling problem by simply thinking about their choices or their families?

Perhaps more pertinently, how is it reasonable to expect someone to simply take control of their gambling when they are dealing with a product, such as a poker machine, that has been extensively researched and designed by vast creative teams to induce a complete loss of control by being as fast, immersive, and mesmerising as possible? Not to put too fine a point on it, this is a highly sophisticated device that has been deliberately engineered and presented to generate a potent, addictive response in a person’s brain that severely impacts their ability to think and act rationally.

Making life even harder for someone who is trying to gamble responsibly are the actions of gambling venues. The architecture and layout of venues is one part of this. Poker machines are prominently located near the entrance, in spaces without any windows or natural light, and ATMs are always close by. Mark Fitzgibbon, the ex-CEO of ClubsNSW, confirms what a reasonable person might guess from these features. ‘It’s nonsense to say that we don’t design our products or venues in a way that makes them more attractive,’ he tells me. ‘Parts of the venues — the gaming areas of venues — are designed for a more attractive and entertaining experience for the users. And I don’t think anyone should apologise for that.’

In 2004, Nerilee Hing, a gambling researcher from Southern Cross University, examined responsible gambling measures in New South Wales clubs. She found that among club patrons, aspects of gaming-room design such as dim lighting and the absence of windows, and the placement of ATMs close to gaming rooms, as well as the dominance of poker machines within the overall club environment, were ‘highly criticised as contributing to irresponsible gambling behaviour’.

Most clubs also offer loyalty programs for members. These act like frequent-flyer programs: the more a person spends gambling, the more points they accrue that entitle them to more discounts in other areas of the club.

In February 2017, The Sydney Morning Herald revealed the fine detail of Dee Why RSL’s ‘Ambassador Rewards’ scheme. Club members who accrue 30,000 status points every six months — the equivalent to $150,000 in gaming turnover — attain ‘diamond’ status and are eligible for reserved parking, red carpet entry into the gambling area from the carpark, 80 per cent discounts on food and drinks, and a personalised hosting service while in the venue. Although these programs seem very much like an incentive to encourage people to gamble more, those in the club industry say otherwise. The chief executive at Dee Why RSL, Grant Easterby, defended the Ambassador Rewards scheme on the basis that it is a ‘loyalty program, not an incentive’.

Hing’s 2004 study found that among gamblers themselves, these types of schemes that reward spending and encourage longer stays in a venue ‘were also seen as contributing to gambling problems’.

There is the added fact that most Australian pubs and clubs serve gamblers complimentary snacks and soft drinks to encourage them to stay. More unscrupulous venues also supply free alcohol to gamblers, despite this being highly illegal. Several gambling addicts I spoke with confirmed this happens, as did several people who have worked inside clubs and pubs. One has worked as a bartender and poker machine attendant in several Sydney pubs for over ten years. In the venue he is currently employed at, he has been instructed by his superiors that, ‘If you want to give people free alcohol, if you want to give ’em a free drink because they’re a big spender, you can.’ He adds that this has been standard practice at many of the other pubs he has worked in. Any beer, spirits, or wine that are given out for free, he says, are then recorded on the ‘Promotion/Complimentary Drink Sheet’ to ensure there are no discrepancies during stocktake. ‘That’s the little loophole,’ he explains.

Another bartender — this time, from South Australia — confirms that the same thing happened in the metropolitan and regional venues he worked at in the state over a ten-year period. He told me of another loophole used by venues to get around laws prohibiting free alcohol being served: give gamblers bar vouchers or venue vouchers. ‘That works around the legal issue, because you aren’t directly giving the alcohol away,’ he says.

Considering all of this, it’s not really surprising to discover that there is little empirical evidence to indicate that responsible-gambling signage and advertisements are effective in reducing the amount a person gambles.

A study conducted by the Queensland government in 2005 into signage found that ‘venue posters were shown to create some awareness, but in their current form have little ability to change both gambling behaviours and help seeking patterns. The takeaway cards have also been shown to have a restricted usefulness. The audience has very poor understanding of the meaning of the “Are you gambling with more than your money?” message and the imagery used lacks relevance.’

This validated other findings from Hing’s 2004 paper. Hing found that while awareness of signage and information was ‘reasonably high’ among club members, these measures ‘were perceived to be the least likely to encourage responsible gambling’. They had, Hing wrote, ‘little effect on the way the vast majority of respondents think about their gambling, feel about their gambling, how often they gamble, how long they gamble for and how much they spend.’

The Productivity Commission reported similar results from a survey it conducted of clients of gambling-counselling clinics. While most respondents noticed in-venue signage, only 12 per cent said it changed their gambling behaviour.

More worrying is the evidence that responsible-gambling messaging is not only ineffective, but it can also be harmful because it exacerbates the stigma that people suffering from gambling problems experience. As Luke tells me, ‘The fact that I had a gambling problem suggested that I was an irresponsible person. And the ‘Responsible Gambling’ mantra really rams that home for you when you’re in a critical incident with your family, and you’re about to lose your wife and kids. It does reinforce a certain element of your psyche that you’re irresponsible in your actions.’

Doug agrees, but speaks more bluntly. ‘All the messaging about gambling responsibly makes you feel like a selfish idiot.’

This anecdotal evidence is supported by a 2013 report into the stigma of gambling addiction conducted by researchers at the Australian National University’s Centre for Gambling Research. ‘Findings of this research indicate that the “gamble responsibly” message contributes to stigma,’ the report read.

Apart from educational measures, the other main responsible-gambling measures — counselling and self-exclusion — have also been shown to be of limited effectiveness. The first issue with them is that they are more an ‘ambulance at the bottom of the cliff’ approach rather than a ‘fence at the top of the cliff’ one. In other words, they are reactive instead of proactive, aimed not so much as preventing someone developing a problem in the first place, but helping them once they’ve already experienced significant harm. From a public-health standpoint, where prevention is the key, this makes little sense.

Then there is the problem that so few people who need and would benefit from either counselling or self-exclusion use these services. The Productivity Commission found that, of all gambling addicts, only 8 to 17 per cent seek professional help. Denial, a belief in being able to independently resolve problems, and the social stigma attached to gambling addiction were listed as some of the main reasons for this.

The Productivity Commission also reported that only 10 to 20 per cent of people with a gambling problem utilise self-exclusion programs offered by governments and industry.

The tedious sign-up process contributes to such low use rates. To self-exclude, someone has to either visit a counsellor who will apply on their behalf, contact a third-party company that provides self-exclusion programs, or go through the embarrassing process of personally approaching the manager of a club or hotel. Even then, they are only able to exclude themselves from a limited number of venues in any one application; there is no opportunity for somebody to independently self-exclude online at home, nor is there an opportunity for them to self-exclude from all gambling venues in a jurisdiction. In the highly advanced technological age we now live in — an age where it is possible to complete a tax return online in only a few minutes, and where it is possible to send gigabytes of information across the country in a matter of minutes — this process seems well and truly antiquated.

For some who do self-exclude, the scheme has proven effective. Luke is one gambling addict I spoke with for whom this is true. He self-excluded from multiple venues in Nowra while he was undergoing counselling, and says it assisted him significantly in controlling his gambling. ‘Having the knowledge that I could be thrown out of an establishment if I was caught in gambling areas was helpful,’ he tells me.

But as well as the tedious sign-up process, another problem with the self-exclusion scheme is how many breaches occur: multiple studies have shown that around half the gambling addicts who self-exclude breach their agreement. There is no technology-based system in place to detect breaches, nor an identity check prior to patrons entering a gambling area, nor anything preventing a person from simply visiting a venue they haven’t excluded themselves from. The success of the scheme therefore depends on self-enforcement or on the ability of venue staff to memorise these individuals’ photographs and recognise them when they come in.

A 2003 evaluation by the South Australian Centre for Economic Studies of the self-exclusion programs offered across Australia highlighted the problems with this process. ‘Identifying self-excluded patrons from photographic information is highly problematic from the venues’ perspective,’ it said. ‘If the police conclude it is difficult to identify someone from a photograph only, we have concerns as to whether this method is appropriate and realistic for gaming venues and their staff.’ The problems with current methods of enforcement, it added, ‘run counter to the expectations of self-excluded patrons, counsellors, the media and the community. A failure to detect seriously undermines the program.’

This is compounded by a failure of some venues to properly enforce the program. One bartender who worked at a Sydney pub told me that the folder containing the photographs of those who had self-excluded ‘never left the drawer’. He said staff were never instructed to study it, and if a self-excluded patron were to enter, it would be ‘very unlikely’ he or she would be detected.

The South Australian hospitality worker I spoke with agreed. In his view, having seen the actions of venues first-hand, self-exclusion was often offered just ‘to tick the regulatory box’. He added that he thought this was the case for ‘a lot of the responsible gambling measures’.

Recently, some states have made some attempts to improve their approach to addressing gambling-related harm. In March 2018, the New South Wales government announced changes that would freeze the number of poker machines in the state’s most disadvantaged suburbs. ‘About 20 per cent of the state will be a no-go zone for additional machines,’ Gaming and Racing Minister Paul Toole said. The new regulations would alter the Local Impact Assessment scheme that the government uses to determine applications for new machines, with the weight given to socio-economic factors increasing from 33 per cent to 70 per cent. ‘This is the biggest reform we’ve seen in a decade,’ Minister Toole said. ‘These reforms are going to focus regulations on high-risk areas.’

The reforms, however, weren’t met with universal applause, with critics accusing the government of simply entrenching the status quo. ‘These measures don’t stop the addictive features that exploit people, they don’t rein in predatory behaviour from clubs and hotels to maximise profits, and they don’t keep people and communities safe,’ the New South Wales Greens’ gambling spokesperson, Justin Field, said. ‘Any pokies plan that fails to rapidly reduce the total number of machines in NSW continues to lock in increasing harm to people and communities.’

In December 2015, the Victorian government implemented a voluntary pre-commitment scheme known as ‘YourPlay’ at a cost of $200 million — most of which was funded by the industry, which is in full support of voluntary pre-commitment. Players are not required to sign up to the scheme if they want to play a poker machine, but if they do, they are able to see their gambling history and set limits on the time and money they wish to spend gambling. Warning messages alert a player when they are approaching their limit, and once this limit is reached, the machine is momentarily disabled, prompting the player to choose if they wish to play on.

It is too early to determine whether this system has been a success in Victoria, but the limited evidence currently available about voluntary pre-commitment from elsewhere is not promising. Between August 2008 and February 2009, a trial of voluntary pre-commitment technology was launched in South Australia. Known as ‘PlaySmart’, it was linked to an existing loyalty-card system called ‘J-Card’ that was used in venues for gambling as well as drink and food purchases.

There was, however, one major problem: only 1 per cent of J-Card holders utilised the PlaySmart scheme.

Another trial of voluntary pre-commitment was conducted a year later in Adelaide. An equally small number of gamblers used the limit-setting features, and half the times a limit was set, it was exceeded.

In 2010, the Canadian province of Nova Scotia introduced a scheme called ‘My-Play’. During the first year, registration was voluntary, but from April 2012 all gamblers were required to register if they wished to gamble on the country’s poker machines. However, while registration was made mandatory, using the pre-commitment feature remained voluntary.

In August 2014, the Nova Scotian government announced it was scrapping the $19.5 million scheme. ‘This was something that was tried and the money was spent to do that, but it makes no sense for me to continue authorising spending millions of dollars on a system that is not actually helping,’ Andrew Younger, the responsible government minister, said at the time.

Even some in the industry express doubt about the effectiveness of the Victorian YourPlay scheme. ‘No one will use it,’ Ryan Jacobs, the industry insider and ex-gambling addict, tells me. ‘But what the government and industry has done is to say, “We’ve introduced voluntary pre-commitment in Victoria, and we’re responsible operators, and therefore politically you can’t beat us up.” It’s them being seen as responsible. Now that they’ve ticked the box, they can introduce all this other technology which increases revenue.’

Despite its flaws, Responsible Gambling has the strong support of a number of prominent and widely published academics. These include Alex Blaszczynski, a professor of clinical psychology, the director of the University of Sydney’s Gambling Treatment Clinic, and the editor-in-chief of the academic journal International Gambling Studies; Howard Shaffer, a professor of psychiatry at Harvard University; and Robert Ladouceur, an emeritus professor at the School of Psychology at the Université Laval de Quebec.

In 2004, these three academics co-authored A Science-Based Framework for Responsible Gambling: the Reno Model. The paper, published in the Journal of Gambling Studies, was an initiative of the AGA and the Australian Gaming Council — though nowhere was this disclosed. It sought to develop, for the first time, a clear and concise harm-minimisation model that policy-makers could follow.

The authors asserted that ‘any responsible gambling program rests upon two fundamental principles: (1) the ultimate decision to gamble resides with the individual and represents a choice, and (2) to properly make this decision, individuals must have the opportunity to be informed.’ They go on to say that ‘unjustified intrusion is likely not the way to promote responsible gambling’, and that ‘responsible gambling is best achieved at the direction of the player by using all of the information available.’

Speaking in his office, Professor Blaszczynski reiterates the argument presented in the paper. ‘Ultimately, it’s the individual who makes a decision whether they gamble or not.’ This does not mean, he adds, that all the responsibility in gambling falls solely on the individual; the government also has a responsibility ‘because it sets the gambling environment through legislation, and monitors and regulates gambling’, as does the industry, because it must provide information to gamblers about the odds of winning and the return to player percentage so they can make an informed choice. For Professor Blaszczynski, this is the industry’s major responsibility. He says it is being upheld. ‘They make it quite clear … that in all but the most extraordinary cases, you’re going to lose if you continue playing in the long term.’

Blaszczynski doesn’t accept the idea that poker machines themselves are a causal factor in someone developing a gambling problem. ‘If you have anywhere from 65 to 90 per cent of player’s gambling responsibly, and a small percentage of people gambling to excess, then why isn’t everyone who plays the machine subject to losing control, if the machine causes impaired control?’ He explains this further by drawing an analogy to fast cars. ‘You can’t blame a Ford V8 car for causing someone to speed. It’s a necessary condition, but it’s not sufficient. You have laws in place about driving to the speed limit. If you break those laws, does the car make you do it? No. So how does a machine cause a person to gamble?’

In response to a question about whether poker machines pose any unique danger to gamblers compared to other forms of gambling, he says no, ‘Unless it falls on them.’

Professor Blaszczynski has a number of professional ties with the gambling industry. He is a regular attendee of and speaker at industry-organised conferences, and has written articles for industry magazines, and research of his has been financially supported over the years by various arms of the gambling industry in Australia and internationally. Most notably, in June 2014, ClubsNSW, along with the GTA and its members, donated $1.2 million to the University of Sydney for research to be headed by Professor Blaszczynski into problem gambling and harm-minimisation measures. ‘This donation reflects the growing trend internationally of industry actively supporting independent university research programs,’ Professor Blaszczynski said in a press release announcing the deed of gift.

In 2007, Professor Blaszczynski along with Lia Nower, a professor and director at the Centre for Gambling Studies of Rutgers University, and another vocal supporter of Responsible Gambling, co-authored a critique of an article that had challenged gambling-industry justifications for expansion. For this, they were paid $16,374 by the Australian Gaming Machine Manufacturers Association — the predecessor to the GTA.

The other authors of the Reno Model paper also have longstanding professional ties to the industry. Professor Ladouceur has been funded by gambling-industry bodies, including ClubsNSW, La Loterie Romande (a French company that operates lotteries and sports betting games), and Camelot (a UK company that operates the national lottery).

So, too, has Professor Shaffer. In fact, he was announced as the inaugural director of the Institute for Research on Pathological Gambling and Related Disorders — an institute set up in 2000 by the AGA, whose role is to review research applications and disburse funds from another academic institution founded by the AGA, the National Centre for Responsible Gambling. Since the centre was founded, major casinos and poker machine manufacturers have funded it to the tune of $26 million. The lion’s share of this money, writes Professor Natasha Dow Schüll in Addiction by Design, has supported ‘investigations into the genetic, neuroscientific, and psychological determinants of the addiction’, instead of investigations into ‘the industry’s products and the role they might play in problem gambling …’

Shaffer’s beliefs about gambling have changed drastically over the years. Before becoming the director of the Institute for Research on Pathological Gambling and Related Disorders, he had voiced some of the strongest warnings against the industry’s growth, and poker machines in particular. In fact, it was he who coined the phrase ‘the crack cocaine of gambling’ to describe video gambling machines. In another instance, he compared poker machines to ‘fast-acting drugs’.

Nowadays, not only does Shaffer advocate for responsible gambling, but he also argues that gambling can have worthwhile benefits for people. ‘It is quite likely that gambling serves a medicinal purpose in low doses,’ he said at a gambling conference in 2003. He also wrote in 2005 that, ‘the value of tempting activities (e.g. gambling, investing, engaging in sex) is that enticements provide the opportunity to learn self-control and build character’.

But support for responsible gambling among academics and gambling experts is far from universal. One of its chief critics in Australia is Dr Charles Livingstone, a senior lecturer in the School of Public Health and Preventative Medicine at Monash University, who has studied Australia’s gambling environment and poker machines for over 16 years.

According to him, responsible gambling is less a genuine attempt to address gambling-related harm and more a PR strategy to insulate the industry from a public backlash while maintaining its enormous profits — approximately 60 per cent of which, as the Productivity Commission reported, come from either addicted gamblers or those at risk. ‘Responsible gambling — which, by the way, is a term coined by the industry — is industry friendly, has no identifiable goals, and transfers blame on to individuals,’ Dr Livingstone tells me. ‘It lets the industry off the hook, and promotes what I and a colleague have called “the discourse of business as usual”. To say that it is a problem of individuals is to ignore most of the reason as to why people get in trouble.’

According to Dr Livingstone, Responsible Gambling also ‘masks a level of harm production that would not be acceptable in other consumer markets’ by misrepresenting the number of people who are harmed by excessive gambling. ‘You will see the industry time and time again saying, “99 per cent of the population gamble responsibly — why are we worried about this 1 per cent? We shouldn’t inconvenience the 99 per cent.” But if you look at the portion of the population who do gamble regularly, it’s not 1 per cent, it’s 30 per cent. 30 per cent of people who gamble weekly or more have a gambling problem at one level or another. They’re on a continuum of harm, of just starting to get into trouble to being really broken at the bottom of the barrel. This is not a trivial problem — we’re talking about hundreds of thousands of people.’

Dr Livingstone is equally critical of the supporters of responsible gambling in academia, and their acceptance of industry funding. He says academics in other fields collaborating with industries which do not cause such widespread harm is less problematic, as it can help advance knowledge in a practical way and achieve solutions to problems that have social benefits. ‘But the problem when you’re dealing with the tobacco, gambling, or alcohol industries,’ Dr Livingstone explains, ‘is that you’re helping them maintain and defend the status quo and keep their business model intact. Sure, you’re not helping them develop a new gambling product — if you did that, you’d be beyond the pale completely. But if you’re actually focusing on industry priorities, which are always about blaming individuals, you’re perpetuating the myth that gambling harm is because weak people succumb to temptation.’ The Reno Model in particular, he adds, is ‘so sympathetic to the industry’s articulation of what the nature of the problem is and what to do about it that it’s laughable.’

The main reason, according to Dr Livingstone, why so many academics working in the field of gambling studies accept industry funding to conduct research is simple. ‘It’s great for their careers,’ he says. ‘They get lots of money, lots of projects, and lots of publications. And the university rewards people who get grants and publications.’

In a 2015 paper, Dr Livingstone and Peter Adams, professor and associate director of the Centre for Addiction Research at the University of Auckland, called for a clear set of principles to be established for improving the quality, diversity, and independence of gambling research, arguing that the current knowledge base has been ‘compromised’ by the involvement of the industry. They say existing research ‘lacks quality and diversity’ and ‘focuses too often on peripheral topics that are acceptable to industry-influenced panels and research application processes.’ They add that it also ‘fails to take meaningful account of the experiences of those harmed by gambling or gambling products and acts to perpetuate a business-as-usual approach to industry operations and profit-making’.

Dr Livingstone and Professor Adams list five key principles for improving the academic landscape: research should not be funded by the proceeds of gambling; research priorities should not be influenced by the beneficiaries of gambling, including governments; conferences should not be influenced by industry; funding sources must be fully disclosed in journals and at conferences; and meaningful access to products and environments must be part of licensing.

Does Professor Blaszczynski support these principles?

‘Nope,’ he tells me. ‘I don’t mind if people take my methodology and point to any errors in it, but people are currently saying research findings are null and void because my funding is from the industry. Where’s the evidence that my research is biased?’ He says he has ‘vested interests in remaining independent and objective’, because if he was to start ‘writing Mickey-mouse stuff, someone else is going to replicate it and find I’m highly biased. Does that do my reputation any good?’

Professor Blaszczynski also defends accepting industry money on the basis that it allows ‘proper, ecologically valid research’ by providing access to real gamblers, in real venues, with real money — which is only possible, he says, with the ‘support of the industry.’

Another defence that Professor Blaszczynski invokes, as he did in a 2014 paper, against accusations of bias for accepting industry funding, is that there are a number of other ways a researcher can be influenced. ‘Research can also be influenced by personal experiences, religious and ideological/philosophical beliefs held by researchers,’ he wrote.

Blaszczynski’s colleagues also vigorously defend their acceptance of industry funding. In 2014, in response to an article by Dr Livingstone in The Conversation which criticised industry-funded research, Professor Lia Nower wrote:

What is disappointing about this article is the suggestion that an independent scholar necessarily compromises his or work because of a funding source. The gaming industry is routinely criticised as adversarial to rigorous scientific investigation. However, irrespective of the country, attempts by the industry to commission scholarly work routinely meets with suspicion and opens the scholar to assaults on his integrity. If a scholar is a sound scientist, then his work will speak for itself. Our field needs to spend more time bringing all the stakeholders to the table and less time fostering barriers between science and industry.

The editors of the academic journal Addiction considered these matters in a 2014 editorial which announced that the journal was requiring authors to be more transparent in disclosing funding sources. ‘The conduct of science can be influenced,’ the editors wrote, ‘by biases introduced by conflicts of interest, whether they are financial, professional, intellectual or fuelled by academic competition.’

However, the editors pointed to a pile of evidence — over twenty academic papers — which indicated that financial conflicts of interest have had the largest influence on academic research. They wrote:

A growing number of studies … have found troubling correlations between financial relationships with industry and problems with research, including a tendency for funding sources to influence study design and hypothesis formulation. Industry funding increases the likelihood that researchers will produce pro-industry conclusions, publish biased interpretations of trial results and even suppress the publication of negative findings.

But the editors did not suggest that these findings were proof of something as insidious as widespread corruption or bribery within academia. As they said, ‘surrendering to a conflict of interest may often be a result of unintentional bias rather than intentional dishonesty’.

Nevertheless, the effects of surrendering — unintentionally or intentionally — to a conflict of interest are the same. As Dr Livingstone and Professor Adams write, ‘Experience of other dangerous product industries, especially tobacco and alcohol, indicate that reliance upon industry-funded or approved research will occlude important research activity until harms have become widespread and extensive.’

Dr Livingstone’s preferred model for helping people like Doug, Luke, and Debbie shifts the focus away from individuals and onto gambling products, and is grounded in public-health principles about prevention. He points to the model applied to road safety as a suitable one to replicate. As he explains, the reduction in the road toll wasn’t simply a result of telling people to drive safely. ‘That’s part of it, but it’s really only a legitimation tactic. What changes people’s behaviour is the likelihood of getting caught if you drink-drive; the certainty that there are speed cameras in all sorts of places; the fact that cars are much safer because we changed the Australian design rules to make them safer. Those material changes are what has made the roads safer.’

Dr Livingstone laughs at claims that implementing material changes to poker machines is impossible. ‘The gambling industry is very keen on presenting their product as something which is a force of nature, a God-given product, like the wind or the rain — it can’t be altered,’ he says. ‘That’s complete nonsense.’

There are two main material changes Dr Livingstone advocates: implementing a maximum $1 bet per spin, which would limit per-hour losses to around $120 per hour, and introducing a mandatory — not voluntary — pre-commitment scheme, which would require all poker machine gamblers to preset the amount they were prepared to lose in a gambling session, and would not allow them to continue gambling for a set amount of time if this limit was reached.

Dr Livingstone isn’t alone in advocating these changes; in fact, a $1 maximum bet and mandatory pre-commitment were two of the main recommendations of the Productivity Commission in 2010.

The value of these two measures, according to Dr Livingstone, is that they acknowledge both that rational thought is often difficult while a player is immersed in a gambling session, and that even recreational gamblers can quickly become problem gamblers — as the experiences of Doug and others in this book prove. ‘It is not possible to accurately predict who in the population will develop a particular problem or disease,’ he says.

The gambling industry is strongly opposed to both mandatory pre-commitment and $1 maximum bets. This opposition, it says, isn’t financially motivated, but based on an apparent lack of evidence that the recommended measures would be effective in reducing gambling-related harm. ‘In terms of pre-commitment, the reality is there is no clear evidence of its effectiveness,’ the Australian Hotels Association (AHA), the peak representative group for Australia’s pubs, wrote in its response to the Productivity Commission’s draft report. It also said that there is ‘no clear evidence the limiting of maximum bets will have a positive impact on problem gambling’.

Ross Ferrar, the CEO of the GTA, goes even further. Speaking to The Canberra Times in 2017, he said that ‘reducing the maximum bet beyond current levels will remove poker machines from recreational players’ entertainment options, and could exacerbate negative consequences for problem gamblers.’

Interestingly, however, the lack of evidence supporting voluntary pre-commitment does not seem to bother the industry. That aside, its claim that there is no evidence supporting $1 maximum bets and mandatory pre-commitment being effective measures to reduce harm is not entirely true.

In 2001, Professor Blaszczynski and colleagues at the University of Sydney — in a study financed by the gambling industry — examined the effectiveness of three potential harm-minimisation measures that were being considered by the New South Wales government at the time: slower reel speeds, reconfiguring note acceptors so they did not accept $50 and $100 notes, and reducing the maximum bet per spin to $1. For the study, the researchers took poker machines that had been modified to include these three measures into a number of actual gambling venues in New South Wales, and invited gamblers to play them and record their experience.

No evidence was found that reconfiguring note acceptors or slowing reel speeds would help problem gamblers. However, the findings about $1 maximum bets were very different. ‘The results of these studies,’ the report read, ‘suggest that reducing the maximum bet to $1 would have a relatively small negative impact on the enjoyment of recreational gamblers’ — most of whom, it was found, bet less than $1 per spin — and ‘might, for a small proportion of players, reduce both the development and the severity of gambling problems’.

‘This study’, the authors concluded, ‘provides preliminary evidence to support the effectiveness of reducing the maximum bet size from $10 to $1 on electronic gaming machines for at least a small proportion of players.’

(Professor Blaszczynski, Professor Ladoceur, and Professor Shaffer summarised the findings of this study in the Reno Model paper. Strangely, however, their summary was not entirely accurate. They said that all of the changes — including $1 maximum bets — ‘contained substantive cost-revenue implications for industry, and potential negative impacts on consumer satisfaction among recreational gamblers’. The empirical data, they added, suggested that each of the changes ‘did not represent effective harm minimisation strategies’.)

Unfortunately — and a little surprisingly — no further research to build on the preliminary evidence of the 2001 study has been conducted — either by Professor Blaszczynski or others. However, this one study alone contradicts the industry’s claim that there is ‘no evidence’ demonstrating that $1 maximum bets would help people like Doug.

The evidence for the effectiveness of mandatory pre-commitment is more limited, but still not completely absent. While there have been no trials or tests of the scheme in Australia, the experience of Norway offers some valuable insights.

In July 2007, the Norwegian government implemented a nationwide ban on poker machines in an attempt to reduce the harm caused by gambling. The banned machines were similar to Australia’s, but not entirely the same. They were widely accessible, located in train stations, kiosks, petrol stations, and pubs, but much less intense. They featured lower jackpots (a maximum of around $300) and lower maximum-bet limits (around $1.50), and only accepted coins following a ban on note acceptors in 2006.

In January 2009, new gambling machines — known as video lottery terminals (VLTs) — were introduced. Their distribution was heavily restricted, and they were configured with features to make them much less harmful than their predecessors, including a mandatory personal limit for money spent gambling, mandatory breaks in play after an hour, maximum jackpots of $230, and player-exclusion options. Punters could also no longer insert cash to play, but were instead required to register and use a player card so the new features could be properly enforced.

In a 2009 paper, Ingeborg Lund of the Norwegian Institute of Public Health assessed these reforms. She found that gambling participation and expenditure, gambling frequency, and gambling problems had all dropped following the nationwide ban. The most significant drop was among gambling addicts and at-risk gamblers — ‘a result,’ Lund writes, ‘that in itself suggests that the EGM’s reputation as a high-risk game is well deserved’.

Lund also found no evidence that these gamblers had shifted to online or illegal gambling, despite repeated claims by the industry of the opposite. While there was a very slight increase in online gambling participation rates, Lund wrote that this was part of a ‘shift from traditional gambling channels, and part of a general tendency in contemporary gambling, rather than as a substitution effect’.

After the introduction of VLTs, there has been no rise in the number of gambling problems. A report from 2010 by SINTEF, an independent Scandinavian research organisation, which surveyed Norwegian gamblers, said that the few gambling addicts who had tried the new machines found them ‘boring’, and believed that the mandatory time and money limits were positive features.

This evidence is far from definitive and, even if it was, it’s impossible to know whether the technology would have the same results in Australia — a country with a different culture and gambling environment. Gary Banks, the former head of the Productivity Commission, has articulated this problem. ‘Translating foreign studies to Australia can sometimes be perilous, given different circumstances and the scope for misinterpretation,’ he said in 2009.

That being said, there are some lessons to be extracted from Norway’s experience, as a 2011 Australian parliamentary paper highlighted. ‘The reduction in harm from gambling following the EGM ban in Norway strongly suggests that EGMs were significant contributors to these harms, and helps justify arguments for greater EGM controls,’ the paper says. ‘Given that the type of EGM that was banned displayed less intense game play features than those available in Australia, will add weight to this view. That Norway successfully replaced its popular slot machines with VLTs configured to reduce harm but which have still proven popular among players, may also reinforce the view that greater controls on EGMs can be achieved without significantly diminishing player enjoyment.’

Australian-based trials into mandatory pre-commitment would help clear the muddied waters. However, no state or territory government seems willing to do this. Nor are any interested in implementing $1 maximum bets.

This is strange, given the flaws of the current approach. It is even stranger when you consider the evidence demonstrating the likely effectiveness of a measure like $1 maximum bets.

It is stranger still when you consider the consistent public opposition to poker machines and public support for stricter regulation. In 1999, the Productivity Commission, in its first inquiry into the gambling industry, found that over 90 per cent of Australians did not want to see further expansion of the industry, and that 70 per cent believed gambling did more harm than good. Six years later, the Centre for Gambling Research found that over 70 per cent of Victorians believed poker machines had not been good for their local community.

More recently, in 2011, the Australian National Institute for Public Policy at the Australian National University found that over 80 per cent of Australians believe there are too many opportunities to gamble nowadays, and only 16 per cent believe gambling is good for society. It also found that over 70 per cent of Australians believed that gambling in Australia should be more tightly controlled and that people should be limited to spending an amount they nominate before they start gambling.

Doug is as baffled as he is angry by the ongoing failure of governments to reform gambling policy and reduce the harm caused by poker machines. As he tells me, ‘I feel so angry towards the government. How can they continue to allow these machines to be so accessible and cause so much harm? Why is it that I can go and ruin my life going and getting addicted to these machines, but I can’t go and smoke marijuana? What’s worse? It makes no sense.’