Tackling Gambling Harms

The project involves a team of researchers across multiple disciplines of Health Science, Law, Social Policy, Psychology, Mental Health and Community welfare.

The aim of the project is to optimise the delivery of an equitable public health approach to gambling, specifically related to assessing the effects of legal changes and population-based interventions intended to reduce harm.

Almost half of UK adults have gambled in the past month. Although gambling is often seen as harmless, when people experience an addiction or compulsion to gamble they may lose large amounts of money. Other harms include poor mental health, debt, damage to relationships with family and friends, and in some cases suicide. To deal with the problems caused by gambling, most people, including those who have been harmed themselves, agree that we should use a public health approach. This approach means that we work across different sectors, including health, education, and law, to identify and prevent the harms that gambling can cause. We will explore if laws which are meant to reduce harmful gambling work well, and if they help everyone equally.

Right now, our ability to take a joined-up approach to gambling, and to assess the effects of laws which are meant to reduce harm, is limited. We need to understand:

1. Whether the laws that are meant to prevent gambling problems are working. We want to make sure that they help everyone, and don't make things worse for some people.
2. How much harm gambling causes. To measure this, we need to identify the problems caused for individuals, families, neighbourhoods, and the whole society.
3. What improvements matter the most. If we plan a support service or new law, we don’t know what outcomes or improvements matter most to people or communities affected.

Step 1

We will look at research on laws intended to reduce the harms caused by gambling, to understand if they work as they are supposed to. Next, we will engage with people who are affected by gambling problems to get their thoughts about when and why laws work well, or do not work well. Then, we will combine this information to identify key lessons about what laws are most helpful in preventing gambling harm. We will share these lessons with people who make and enforce laws, as well as with researchers and the public. 

Step 2

To understand the harms caused by gambling, we will look at different sets of data to see who is most affected by gambling problems, and how big these problems are. We will also do a large UK survey to ask people in communities that might not have been heard from before. This way, we can learn more about the different ways that gambling can affect people. 

Step 3

Following the review of the laws, and identification of the problems, we will ask different groups of experts and stakeholders about the key outcomes that we should measure to help us in the future to reduce gambling harms. These experts and stakeholders will include people who are directly affected by gambling, and their family members, along with charities, and those who make laws around gambling.

Our project has strong public involvement and has been created following conversations with:

• members of the public (including people from groups who are often over-looked in health research)
• people affected by gambling harm
• people who work for gambling charities.

Our research team includes a person with experience of gambling harm, and people working in an organisation which is dedicated to supporting unheard voices in our communities be part of health research. Both experts have helped us design this proposal, and they will be involved throughout the study. They will help us to share the findings of our research so that it reaches a wide audience, including via short YouTube videos, and podcasts.

Chief Investigator

Professor Joht Singh Chandan

Joint Lead Applicant

Professor Kate Bedford

Co-Investigators

• Dr Ameeta Retzer
• Dr Edward Day
• Dr Francesca Crowe
• Professor Nicola Adderley
• Professor G.J. Melendez-Torres
• Professor Krishnarajah Nirantharakumar
• Professor Paul Montgomery
• Professor Caroline Bradbury-Jones
• Mr Graham Fewell
• Dr Christine Burt
• Professor Siddhartha Bandyopadhyay.

News and publications

• Effects of interventional public health laws and regulations intended to reduce gambling-related harms: a realist review study protocol, BMJ Open (2025).

This protocol sets out the methods for a realist review that will synthesise evidence on how laws and regulations intended to reduce gambling harms work (or don’t), for whom, and in what contexts, including potential unintended effects and equity impacts

• Legal and regulatory responses to online gambling harms: a scoping review of evidence, Harm Reduction Journal (2025)

This scoping review maps evidence on (1) the distinct challenges of regulating online gambling and (2) the evidence on legal/regulatory interventions intended to reduce online gambling harms. It identifies major evidence gaps, including limited evaluation of impacts across population subgroups and a tendency toward individual-level rather than systems approaches in the literature.

• High stakes: does the gambling White Paper go far enough? The Lancet (2024) — Comment/debate (short correspondence-style piece)

This short piece responds to the UK Government’s gambling White Paper, considering whether the proposed reforms are likely to be sufficient from a public health and health inequalities perspective. It highlights the importance of evaluating how regulatory changes affect harms across different population groups, and the need for stronger evidence on what legal and regulatory interventions achieve in practice.

• Gambling Control in a Cost-of-Living Crisis: An Analysis of the White Paper High Stakes: Gambling Reform for the Digital Age (2023), Modern Law Review (2024)

This peer-reviewed article provides a detailed academic analysis of the UK Government’s White Paper High Stakes: Gambling Reform for the Digital Age (2023). It explains the context and key proposals of the White Paper, focusing on efforts to reduce gambling-related harms and on the implications of mandated affordability checks for online gambling. The article situates regulatory reform within broader debates about consumer protection, surveillance, and public health.

Events

Effects of interventional public health laws and regulations intended to reduce gambling-related harms

Poster presentation, Bristol Hub for Gambling Harms Research – International Interdisciplinary Colloquium (2025)

This poster presents interim findings from a realist review examining how public health laws and regulations intended to reduce gambling harms operate in practice. Drawing on evidence from multiple disciplines, the review identifies interventions that reduce gambling behaviour, expenditure, and time spent gambling, while also highlighting unintended and inequitable effects for certain groups. The work explores how interventions function across different levels of intrusiveness and maps findings onto the Nuffield Intervention Ladder, noting the need for adaptation for gambling-related public health interventions.

WP1 Public Engagement Workshops — Interventional Public Health Laws & Regulations

Three public engagement workshops were completed as part of Work Package 1:

1. Initial synthesis of findings to co-produce preliminary interpretations with stakeholders.
2. Follow-up discussion exploring which laws are working well, which are not, and how they could be strengthened.
3. Data synthesis and planning session outlining next analytical steps and evidence integration.

These sessions support the contextual interpretation of evidence on legal and regulatory interventions.

Guest Lecture — Health Improvement Module, MPhil Public Health (University of Birmingham)

A lecture titled “Gambling as a Public Health Concern” was delivered to the Master of Public Health cohort, covering epidemiology, regulatory frameworks, and the public health implications of gambling harms.

Developing an equitable public health law approach to gambling harms

Workshop presentation by Kate Bedford (Birmingham Law School) and Joht Singh Chandan (Institute of Applied Health Research, University of Birmingham) — Health and Care Law: Addressing Health and Care Inequalities Workshop, Birmingham Law School (13 June 2024 / 13 November 2025)

This presentation outlined the case for a public health law framework for gambling harms, with emphasis on equity, regulatory design, and legal approaches to reducing health inequalities.

Gambling law and public health: the equalities angles

Conference presentation by Kate Bedford, Professor of Law and Political Economy, University of Birmingham — Workshop on “Reflections on Global Health Law, Public Health and Human Rights: From a time of turbulence to a more responsive future?”

This presentation examined how gambling regulation intersects with public health and equality considerations in both UK and global contexts.

This study is funded by the National Institute for Health and Care Research (NIHR).