Gambling Control and Public Health: Let’s Be Really Honest

This article examines Shaffer et al.’s (2020) reaction to a Lancet paper that called for an effective public health approach to gambling. The paper claimed policy responses are individually oriented and inadequately address corporate harm determinants. Shaffer et al. maintain these and related claims are incorrect, misleading and driven by personal, political and anti-gambling views. They contend that their Reno model (RM) of responsible gambling is science-based and ascribes responsibility to multiple stakeholders, not just individuals. While agreeing that the RM is not confined to individuals, multiple reviews indicate that the most widely studied and deployed responsible gambling (RG) measures are individually focussed and have low efficacy (RG-light). An individual emphasis is also identified in the content of Shaffer et al.’s paper and it is suggested that some might see this serving industry interests. While agreeing that people who consider a product to be objectionable may view scientific evidence selectively, it is contended that this probably also applies to people who benefit financially from or are enamoured with a product. Although agreeing with a number of statements made by Shaffer et al., it is concluded that others are not well-grounded in fact. This includes statements about problem gambling prevalence and the relative importance of gambling and other determinants of gambling-related harm. While there are points of tension, it is concluded that the RM and associated RG interventions, especially RG-heavy, can play a significant part within a comprehensive regulatory and public health framework that addresses major harm determinants.