Gambling involves wagering something of value on an event with an uncertain outcome, such as a race, a game of poker or roulette. It requires three elements: consideration (the amount wagered), risk (the chance of winning), and a prize, often money.

Depending on the context, gambling can be an enjoyable activity or a problem that can impact on mental health, relationships, work performance and finances. It can also get people into trouble with the law, and can leave them in debt and at risk of homelessness.

Harms related to gambling are complex, subjective and can be influenced by a number of factors including social learning, beliefs and coping styles. It can also be exacerbated by underlying psychopathology, such as substance abuse and mood disorders.

The term harm is an intuitive one and has a strong association with damage and adverse consequences, however it remains under debate as to its precise definition in relation to gambling. This is due to the ambiguity in definitions in the literature, differences of approach and perspective between disciplines and a general lack of consensus on a coherent definition.

This research sought to develop a functional definition of harm that could be operationalised in the measurement of gambling related harms. It aimed to capture the breadth of harms experienced by the person who gambled, their affected others and the wider community from a social model of health framework.

It aimed to create a taxonomy of harms that could be used to support the development of harm prevention and treatment programs for both individuals and organisations. It also sought to understand how the occurrence of harm was connected to social determinants, such as education, employment and financial resources.

The research commenced with focus groups with people who had either experienced gambling related harm themselves or with someone else. The focus group sessions averaged around 90 min in length and were conducted in person. Participants were then contacted by telephone for semi-structured interviews.

Across the data, it was clear that harms were felt by all participants to some degree or another and that this was influenced by a range of factors. These included a sense of powerlessness where gambling had become problematic, distorted cognitions, emotional distress and desperation in trying to recoup losses.

These impacts were perceived to operate on a continuum and often resulted in significant second order harms that included relationship conflict or breakdown, job loss, incarceration and child neglect. These second order harms had an impact on a person’s ability to engage in other recreational activities, and their ability to lead healthy and fulfilling lives.

They were also accompanied by high levels of shame which can have an impact on the individual’s lifelong wellbeing and social connections. They were also linked to experiences of dissonance with the values and expectations of their cultural community and a loss of connection to that cultural group.

These impacts were also labelled as legacy harms as they occurred even when the person who gambled had ceased to participate in gambling. They had a lasting impact on the person’s social connections, reducing their ability to spend time with their family and friends.