Problem Gambling vs. Gambling Addiction

Throughout my career, I have constantly pointed out that I have met very few people that are genuinely addicted to playing weekly or bi-weekly Lotto games. When stating this, some people counter my assertion, claiming that they know people who spend far too much money on buying Lotto tickets and that it is a real problem in their life. However, this is a classic instance of confusing "problem gambling" with "gambling addiction." These two terms are not interchangeable. When I give lectures on gambling addiction, I always point out that "all gambling addicts are problem gamblers, but not all problem gamblers are gambling addicts."

Nowhere is this more relevant than in the print and broadcast media. For instance, I have been one of the co-authors on the last two British Gambling Prevalence Surveys (published in 2007 and 2011). In these surveys, we assessed the rate of problem gambling using two different problem gambling screens. Neither of these screens assesses "gambling addiction," and problem gambling is operationally defined according to the number of criteria endorsed on each screen.

For instance, in both studies, we have used the criteria of the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) to estimate the prevalence of problem gambling. Anyone that endorsed three or more items (out of 10) was classed as a problem gambler. Anyone that endorsed five or more items was classed as a pathological gambler. Pathological gambling is more akin to a gambling addiction, but we found that only a tiny percentage of our national participants could be classed as such. What we did report was that 0.9 percent of our sample were problem gamblers (i.e., they scored three or more on the DSM-IV criteria).

What we didn't say (and never have said) was that 0.9 percent of British adults (approximately 500,000 people) are addicted to gambling. However, many stories in the British media when they talk about problem gambling will claim "half a million adults in Great Britain are gambling addicts" (or words to that effect).

I am not trying to downplay the issue of gambling addiction. I know only too well the pain and suffering it can bring to individuals and their families. Also, just because I may not define a problem gambler as being genuinely addicted (by my own criteria as outlined in a previous blog post), that doesn't mean that their problem gambling might not be impacting in major, detrimental ways on their life (e.g., relationship problems, financial problems, work problems, etc.).

However, returning to the issue of being "addicted" to Lotto games, I have stated in many of my published papers on both addictions and (more specifically) gambling addiction that addictions rely on constant rewards. A person cannot be genuinely addicted unless they are receiving constant rewards (i.e., their behavior being reinforced). Playing a Lotto game in which the result of the gamble is only given once or twice a week is not something that can provide constant rewards. A person can only be rewarded (reinforced) once or twice a week.

Basically, Lotto games are discontinuous and have a very low event frequency (once or twice a week). Continuous gambling activities (like the playing of a slot machine) have very high event frequencies (e.g., a typical pub slot machine in the UK has an event frequency of 10-12 times a minute). Gambling activities with high event frequencies tend to have higher associations with problem gambling and are more likely to be associated with genuine gambling addictions.

That doesn't mean they can't spend too much money buying lottery tickets. Buying ticket after ticket can indeed lead people to have a gambling problem with Lotto. However, I know of no addiction criterion that relates to the amount of money spent engaging in an activity. Obviously, the lack of money can lead to some signs of problematic and/or addictive behavior (such as committing criminal activity in order to get money the person hasn't got to gamble), but this is a consequence of the behavior, not a criterion in itself. In most of the behavioral addictions on which I carry out research (exercise addiction, sex addiction, video game addiction, etc.), there is little money spent, but some of these behaviors for a small minority of people are genuinely addictions.

While I don't doubt that buying too many Lotto tickets can be problematic if the person buying them simply can't afford it, the resulting behavior is "problem gambling," not "gambling addiction." In relation to my own criteria for addiction, the only way someone could be addicted to Lotto was if they were actually addicted to the buying of the tickets rather than the outcome of the gamble itself. This is not as bizarre as it sounds, as some research that I carried out in the late 1990s and early 2000s with Dr. Richard Wood appeared to show that a small proportion of adolescents (aged 11 to 15 years) were addicted to playing both Lotto and scratchcard lottery games.

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While it is theoretically possible for kids to be hooked on lottery scratchcards (as individuals can play again and again and again if you have the time, money, and opportunity), we found it strange that adolescents should have "addiction" problems with the Lotto. However, in follow-up qualitative focus groups, some adolescents reported that they actually got a "buzz" from buying Lotto tickets and scratchcards, because it was an illegal activity for them (i.e., only those aged 16 years or older can play lottery games in the UK, so the buying of tickets below this age is a criminal offense). Basically, there was a small minority of kids that were high on the illegality of gambling rather than the gambling itself.

Along with Michael Auer, I published a paper in the journal Frontiers in Psychology, where we argued game type was actually irrelevant in the development of gambling problems. We provided two examples that demonstrate that it is the structural characteristics rather than the game type that is critical in the acquisition, development, and maintenance of problem and pathological gambling for those who are vulnerable and/or susceptible.

More specifically, a "safe" slot machine could be designed in which no one would ever develop a gambling problem. The simplest way to do this would be to ensure that whoever was playing the machine could not press the "play button" or pull the lever more than once a week. An enforced structural characteristic of an event frequency of once a week would almost guarantee that players could not develop a gambling problem. Alternatively, a problematic form of the lottery could be designed where instead of the draw taking place weekly, bi-weekly, or daily, it would be designed to take place once every few minutes. Such an example is not hypothetical and resembles games that already exist in the form of rapid-draw lottery games, like Keno.

Although many people (including those that work in the print media) may still use the terms "problem gambling" and "gambling addiction" interchangeably, hopefully I have demonstrated in this post that there is a need to think of these terms as lying along a continuum in which "gambling addiction" is at the extreme end of the scale, and "problem gambling" (while still of major concern) doesn't necessarily lead to problems in every area of a person's life.