Understanding and addressing problem gambling

1. Understanding and addressing problem gambling Plenary Session II: Policy/Measures to Address Problem Gambling

2. Measure 1: Gambling activities Pre 1987 TAB / Track Golden Kiwi Housie/Raffles (Community fund raising) 1988-1998 Lotto � national, weekly Gambling machines available in clubs/hotels/casinos Instant Kiwi Horse/dogs racing Casinos in Auckland and Christchurch Daily Keno, Powerball Sports betting managed by TAB Telephone gambling games

3. Measure 2: Gambling expenditure

4. Measure 3: Who are affected by G-harms 1.4% (0.8 PG & 0.6 PaG 12 mn) of the population is affected by problem or probable pathological gambling (DIA, 1999, highly conservative) Prevalence and incidence Affects 5-7 other people (family- local & overseas, friends, workmates) Only 10-15% of individuals with problem gambling seek help 80% clients said �pokies� were the primary cause of their problem

6. Cont�d Every year New Zealanders lose about $2 billion gambling or $5.5 million every day Every three dollars lost, only ONE dollar returns to the community

7. Measure 4: Clients presenting to PG services 2003/4 2004/5 2005/6 Maori 33.3% 29% 29.4% (14.6%) Pacific 8.8% 9.3% 9.2% (6.9%) European 52.7% 50.8% 48.6% (67.6%) Asian 3.5% 5.9% 8.1% (9.2%) Other 1.7% 5.0% 5.3% (10%) Source: Ministry of Health

8. Cont�d: dollars lost in 4 weeks

9. Cont�d: Gambling modes

10. Measure 5: Gambling in �general population� Low income households, one who are least able to afford (& high income too?) Maori and Pacific people are overrepresented in treatment statistics Prison inmates & individuals under probation Women Young people Older people Individuals working in gambling industry (Tse, Wong & Kim, 2004)

11. [Rotorua Daily Post] Rotorua leaders plan to ban any new pokies machine outlets in poorer parts of the city because the risk of problem gambling is so great. The majority of the city's problem gamblers are addicted.. [NZ Herald] SYDNEY - A former high-flying public relations consultant became involved in insider trading to help her son recover his gambling losses

13. Problem gambling among Asian peoples in New Zealand

14. eXtreme mystery Majority of Asian New Zealanders spend little or nothing on gambling. But a significant �minority� who spend substantial sums on a regular basis (eg VIP) Disproportionate level of presence in gambling venue

15. Cont�d: X-mystery Asian clients represented 6% of the total �face-to face counselling� clients population BUT contributed 35.4% of the amount of money lost (Ministry of Health, 2006)

16. Possible pathways Coping of post-migration adjustment difficulties Part of acculturation process

17. Policy: New Zealand's national strategy/approach to tackle problem gambling (Ministry of Health)

18. Cont�d: 10 principles Whole of government approach Cultural relevance Reducing health inequalities Continuum of harms and interventions

19. Cont�d

20. Cont�d Long term approach Population health approach Primary prevention: public health services & strategies Secondary and tertiary prevention: Intervention services Evidence-informed approach Workforce development

21. Summary: Policy & measure Compulsion Loss of Control Continue to gamble despite Consequence (see McCown & Howatt, 2007) Clinical intervention (evidence-informed) Counselling (professional, confidential & free, certification?) Coordinated approach (good buy-in, intersectoral approach)

22. Summary: Policy & measure Gambling or PG among Asian peoples Shame Stigma Secrecy Healthy lifestyle Harm minimisation: Regulation & enforcement Host responsibility Local & central government Health promotion: Empowerment & participation Strengths & capacity building Education & awareness raising Community action & development Ottawa Charter, Bangkok Charter (Raeburn et al., 2006)