FOBTs and the review of the Gambling Act 2005

Gambling disorderOften dubbed the ‘crack cocaine of gambling’, Fixed Odds Betting Terminals (FOBTs) are electromechanical devices most commonly found in UK betting shops and allow players to bet on the outcome of various games, of which the most common are roulette and blackjack, and events with fixed odds.They have been in betting shops since 2002.

The Government recently announced a review into the legislation governing gambling adverts and FOBTs, and,more broadly, the functioning of the Gambling Act 2005. Tracey Crouch, the sports minister, said the review would consider the maximum stakes and prizes for gaming machines and, in particular, FOBTs because of concerns that they can be addictive. The Gambling Act had allowed betting shops to increase the number of FOBT machines allowed in betting shops, up to four, depending on size of shop. The review will also investigate the impact of advertising of betting websites on daytime television.

The Gambling Commission, set up under the Gambling Act 2005, is the body that regulates commercial gambling in the UK in partnership with licensing authorities. Its latest statistics show that in the 12 months to March 2016 punters lost a record £1.8 billion on FOBTS. Interestingly, the figures also show that online gambling is now the largest gambling sector in the UK.

FOBTs are also known as ‘electronic morphine’, because of their highly addictive nature. It is true that journalists often seek to sensationalise the story with such descriptions but the words are probably a fair portrayal because repeat players will become addicted to this form electronic gambling more rapidly than other forms of gambling such as sports betting and card games (reference: Dow Schull, Addiction by Design: Machine Gambling in Las Vegas 2014 Princeton University Press). The devices allow punters to bet £100 every 20 seconds. There are proposals that could see the minimum stake reduced to £2, as in the case of Australia. They are banned from betting shops in Ireland.

The extent of problem gambling

The British Gambling Prevalence Survey 2010 was the last bespoke gambling prevalence survey commissioned by the Gambling Commission.   From 2013 the body has pursued a decoupled approach to the collection of adult gambling prevalence data (i.e. the separate collection of participation and problem gambling data) through the Health Survey for England and the Scottish Health Survey. The rate of problem gambling in the adult population for England is estimated to be 0.5% or  0.4%, depending on how it is measured.   The latest combined data shows the overall problem gambling rate to be 0.7% but this would appear to be consistent with combined data from 2012 (0.6%). However, it should be noted that these are indicative figures and the new Health Survey data is due to be published in early 2017. (The incidence of problem gambling within the gambling population is far higher although it is difficult to give estimates).

Derek Webb, who provides funding for the Campaign for Fairer Gambling and the Stop the FOBTs Campaign, advocated in The Time’s Thunderer (“Lower the stake on betting machines for addicts’ sake“, Oct 7) that there should be such a minimum staking policy on FOBTs. He argues that whilst Ireland banned the machines, UK players can stake up to £100 per spin and this puts users are grave risk.

According to the Gambling Commission the problem gambling rate has increased from 0.4% in the year to June 2013 to 1.5% in year to June 2016 amongst the 16-24 age group (these are, however, indicative figures taken from quarterly short-form PGSI data, whereas the full health survey results will be released in 2017).

Views of the industry on FOBTs

The Association of British Bookmakers Ltd  (ABB) dispute the view that FOBTs cause gambling problems. They are also against cutting stakes on FOBTS as such a decision to potentially solve problem gambling would be akin, in their minds, to cutting the alcohol level in whisky in the hope that this might stop individuals from becoming alcoholics. The ABB disputes that there is any evidence to demonstrate that FOBTs create problem gambling. They claim that independent research clearly shows that most people who develop a problem with gambling use different types of products.  They also claim that the level of problem gambling in the UK have remained unchanged over the past 15 years.

I checked the ABB claims with the Gambling Commission who told me the following:

We do not have data collected to a consistent methodology covering the last 15 years. Our most robust estimates of problem gambling, based on the largest sample sizes and comparable to the BGPS 2007 and 2010, will be published next year (2017) in our combined report on gambling behaviour, where the data will be taken from the Health Survey for England 2015, the Scottish Health Survey 2015 and our own Welsh Problem Gambling Survey 2015”.

The industry might claim that they should not be held responsible for problem behaviour in the same way as licenced vintners should not have to restrict selling whisky in case a person becomes alcoholic. However, the Gambling Act 2005 places social responsibility requirements on UK based gambling operators who are also required to contribute to research, education and treatment of problem gamblers (the Act essentially enshrined the principle of ‘polluter pays’ regarding gambling treatment).

A view from the legislators

Carolyn Harris MP, chair of the FOBTs All-Party parliamentary Group (APPG), believes that there is evidence to suggest that reducing stakes on FOBTs can help to reduce instances of problem gambling and such steps should be implemented immediately.

There appears to be stand-off between the industry and legislators, however,  since the ABB failed to show up for the latest APPG meeting in November 2016 stating that it’s ‘nothing but a kangaroo court.’

Newham Council in London, has, along with many other local authorities,  proposed a £2 maximum stake under the terms of the Sustainable Communities Act.

The treatment of gambling addiction

The three most common models of addiction are disease, choice, and self-medication and the most effective recovery programmes are dependent on how addiction is viewed. The disease model is advocated by Gamblers Anonymous (an off shoot of Alcoholics Anonymous) and holds that ‘recovery’ must entail abstinence for good, albeit one day at a time. Dr David Sack, a leading advocate of the disease model, argues that addiction is a disease and needs to be treated as such. A big critic of the disease model for treating addictions is Marc Lewis and he argues that treatments based on this model are ineffective. The choice model takes the view that addiction is free choice and that treatment should address different choices. Vietnam vets stopped taking heroin when they returned to their families and to their safe environment, for example. Trauma is the root cause of the self-medication model. PTSD, depression and anxiety disorders all hinge on an overactive amygdala but drugs, booze, gambling and so forth take you out of yourself and calm the amygdala down.

According to the Royal College of Psychiatrists there is no medication that is licensed for the treatment of problem gambling in the UK. However, antidepressants can be prescribed to help with low mood. Cognitive Behavioural Therapy (CBT) has been cited by the College as showing some effectiveness in helping gamblers reduce the amount of time and money they spend gambling and once stopped to stay stopped. In therapy, the therapist can be the detoxifying agent for the gambler’s toxic mentations.

Psychiatrists, such as Dr Henrietta Bowden-Jones, lead psychiatrist of the NHS National problem Gambling Clinic, has called for all gambling treatment service provision to be integrated within the existing network of drug and alcohol treatment services since gambling disorder is now acknowledged as a valid psychiatric condition. She points to the particular vulnerability of young people to problem gambling. She believes that this could be due to later maturation of the prefrontal cortex which can lead to higher levels of impulsivity, poor decision-making and a preference for immediate gratification. Television gambling adverts, she claims, shown during sporting events could be seen as priming the brain of the young.

When Donald Winnicott said there was no such thing as an infant (a baby is his environment), perhaps there is no such thing as just a drug user. It could be fruitful to ask what is happening in the user’s world? Bion described drug addiction as a ‘hatred of reality‘ and I wonder if a similar description could be applied to gambling addiction. There is certainly a loss of connection when gamblers recount stories of feeling empty and lonely.

‘The zone’ has been described by Natasha Dow Schull, in her book Addiction by Design, which showed how an electronic slot machine random number generator provides a reinforcement schedule that keeps the user in a trance-like state.  She describes this state of mind in greater detail in the attached presentation below. The ‘zone’ is akin to nothingness where the user relies on the comfort that the machine is forever present.  Once in the zone, problem gamblers use the machines not necessarily to win but rather to keep playing, for as long as possible. They continue to stay in this state in spite of physical and financial exhaustion. In this state, users have described even forgetting the names of their children, such is the hypnotic-like environment in which they exist.  The machine and person enter a form of emotional intimacy where fear and worries appear to fade away.

Betting shop machines have been designed with the maths in mind and digital machines now offer multiple-line betting, unlike the traditional analogue gaming machines which did not offer such opportunities.  An FOBT random number generator provides a reinforcement schedule that keeps the user in ‘the zone’ as machine designers have worked out how to harness gaming productivity to the optimum.

It seems to me that an abstinence based approach should form part of a robust treatment plan for problem gambling regardless of one’s addiction model. Reconnecting to one’s creative and vibrant self could form the basis of one’s therapeutic journey.

The evidence to claim that FOBTs create problem gambling might not be conclusive. What is fair to say, in my opinion, is that there was no proper impact assessment carried out when the decisions were taken to allow the expansion of FOBTs in betting shops in 2005 (and for pre-watershed gambling television advertising). That is perhaps the core of the issue that the Government’s review will need to contend with. It will be interesting to see what the review comes up with.

See also my article on FOBTs and how they are the crack cocaine of gambling

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