Gambling is an activity where a person bets something of value on a random event with the intention of winning something else of value. There are many types of gambling, including sports betting and poker. These games can be played online, in a land-based casino or in the form of a mobile phone app.

In the broader public health and clinical context, there is considerable concern about the negative impacts of gambling on individual and broader community wellbeing. However, there is little agreement on what exactly constitutes harm and how to best minimise this impact. This project aims to define harm from gambling in order to create a common understanding between treatment providers, policy makers and researchers.

Harm is any initial or exacerbated adverse consequence due to an engagement with gambling that leads to a decrement in the health or wellbeing of an individual, family unit, community or population.

This definition focuses on the consequences rather than causes and symptoms, which is important when trying to understand and treat gambling related problems. It also acknowledges that there is a range of gambling related harms, which can occur in different ways and at different levels of engagement or behavioural level.

To help identify what types of harms a person who gambles experiences, we created a set of thematic classifications that could be applied in parallel or sequentially. These initially included six thematic categories – financial harms, those relating to relationships, emotional or psychological harms, impacts on the person’s health, impacts on work, study or economic activity and criminal acts.

These categories of harms were based on the experiences of people who gambled, their family and friends and the wider community. It was not intended that these would be the only types of harms a person might experience, but that they were a useful first step in identifying the type of harms that a person may experience.

Relationships are a key dimension of harm associated with gambling, as is the impact of the loss of time a person spends with a loved one. These impacts tended to be more severe and longer lasting, and were strongly linked to a person’s personal or cultural perception of gambling as a deviant or unacceptable behaviour.

Loss of trust in a relationship was a particularly strong sub-theme within this dimension, and was a significant factor in the breakdown of relationships, especially where the person who gambled had withdrawn from or been unwilling to engage with their affected others. The data also identified instances of inequality in the amount of engagement or effort that was put into a relationship, both from the perspectives of the person who gambled and those affected by them.

The loss of a rational choice to engage with the activity was another key sub-theme and often a result of the automaticity or sense of loss of awareness or control that people who gambled experienced. This was often accompanied by a deterioration in their capacity to recognise and act on their own impulses or thoughts, and by the effects of other problematic behaviours.