Frameworks of gambling harms: a comparative review and synthesis

Figures & data

Figure 1. Prisma flow chart.

Table 1. Frameworks on gambling harms included in the review.

Reference	Name of framework	Context	Theoretical perspective	Methodology
Hilbrecht et al. (2020)	Conceptual framework of harmful gambling	Canada (international collaboration)	Multidisciplinary	Expert group, literature review. Updates to the core document are drafted every couple of years.
Abbott et al., (2013)
Abbott et al., (2015)
Abbott et al., (2018)
Langham et al. (2015)	Conceptual framework of gambling-related harm	Australia	Public health	Literature review, focus groups and interviews with support and treatment specialists, interviews with gamblers and their affected others, public forum discussions of gamblers and their affected others
Wardle et al., (2018)	Framework of harms	Great Britain	Public health; socio-ecological	Joint expertise, literature review
Latvala et al., (2019)	Public health impacts of gambling	Finland	Public health	Literature review

Table 2. Definitions and dimensions of harms in existing frameworks.

	Subjects	Severity	Temporality	Cause of harm
Abbott et al. 2018	individuals, families, social networks, communities	inconsequential, transient, significant	episodic, chronic	Harmful gambling behavior
Langham et al. 2015	individuals, families, communities, populations	general harm, crisis harm (overlap with temporality)	also legacy harm, life course / intergenerational harm	Engagement with gambling
Wardle et al. 2018	individuals, families, communities, society	n/a	short-lived, longer term or enduring consequences	Engagement with gambling
Latvala et al., 2019	personal, interpersonal, community/society levels	n/a	long-term impacts acknowledged	Impacts of problem gambling and general impacts

Table 3. Categories of harms associated with gambling, adapted from Langham et al. (2015).

	Individual and family	Community and society
Financial	Reduced disposable income, erosion of savings, basic needs not covered, financial insecurity, indebtment, bankruptcy, poor credit rating, homelessness	Welfare resilience, debt, business closures, impact on other industries, infrastructure, productivity loss, state dependence on gambling revenue, residential area degeneration and increased living costs
Relationships	Disengagement with relationships, family disruption, conflict, neglect, exploitation of relationships, family violence, victim of crime.	Cost of relationship breakdown, lack of social cohesion, social isolation and exclusion, increased inequalities, reduced social capital
Emotional and psychological	Emotional and psychological distress, mental health problems, lack of control, feelings of insecurity and lack of safety, shame and stigma, reduced wellbeing and happiness	Increased burden of disease, social care costs, prevention costs
Health	Physical symptoms, problem gambling, other risky consumptions, sleep patterns, noncompliance with medication, comorbidities, violence, self-harm and suicide, risk taking, neglected self-care	Increased burden of disease, Regulation and research costs, health care costs, prevention costs, research costs, long-term disability costs
Cultural	Gambling against cultural beliefs, reduced contribution and time to cultural engagement, exclusion, stigma	Cultural community and cultural identity degeneration, socio-cultural costs, disconnection of youth, normalization of gambling
Work and study	Criminal acts at work, reduced performance, termination of employment, unstable employment, absenteeism, relationships at work, school drop out	Economic costs of reduced productivity, unemployment, and crime
Crime	Engagement in criminal activity as consequence of gambling, anti-social behavior, incarceration	Costs of criminal activity

Hilbrecht M, Baxter D, Abbott M, Binde P, Clark L, Hodgins DC, Manitowabi D, Quilty L, SpÅngberg J, Volberg R, et al. 2020. The conceptual framework of harmful gambling: a revised framework for understanding gambling harm. J Behav Addict. 9(2):190–205.

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Abbott MW, Binde P, Hodgins D, Korn D, Pereira A, Volberg R, Williams R. 2013. Conceptual framework of harmful gambling: an international collaboration. Guelph (Canada): Ontario Problem Gambling Research Centre (OPGRC).

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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(1):1–23.

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Wardle H, Reith G, Best D, McDaid D, Platt S. 2018. Measuring gambling-related harms: a framework for action. Gambling Commission: Birmingham, UK.

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Latvala T, Lintonen T, Konu A. 2019. Public health effects of gambling–debate on a conceptual model. BMC Public Health. 19(1):1–16.

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