The research found that experiencing gambling harm can result in a 16% reduction in a person's ability to carry out everyday tasks (referred to in the study as their capability wellbeing), and a 14% reduction in their quality of life (referred to as their health utility).
The percentages are comparable to those experiencing the highest levels of harm driven by cocaine and alcohol use, as well as those with health conditions including depression and opiate dependence.
Spouses, children, parents, families and close friends also experience substantial "second-hand" harms, the research found, with impacts on their health and wellbeing approaching those experienced by the people who gamble themselves.
And while cases of severe gambling harms (for example, those experiencing major relationship breakdowns and/or financial crisis) are the most affected individually, the largest share of population harm comes from low and moderate-severity gambling harms (from experiencing low mood and day-to-day financial issues because of their gambling) because they are far more common.
The work was led by academics at the University of Plymouth, in collaboration with Professor Sharon Collard at the University of Bristol, the National Centre for Social Research and others working across the sector.
The researchers involved say their results show how tools currently used to identify "problem gambling" underestimate the full extent of harm it causes to individuals and those close to them.
They also say gambling should be placed on an equal footing with other public health priorities, enabling it to be included in mainstream prevention, commissioning, and policy decision-making strategies.
Dr James Close, Associate Professor at the University of Plymouth, said: "Gambling is increasingly being recognised as a public health issue, but the need for better understanding and measurement of gambling-related harms is also widely acknowledged. Our findings, and the measures we have designed to reach them, represent a paradigm shift in how we understand and measure gambling harms. By directly capturing actual harm rather than risk, and by including the voices of affected others and those with first-hand experience, they provide a foundation for evidence-based policy and practice that is fully aligned with public health principles."
Dr Ryan Statton, Research Fellow at the University of Plymouth, added: "The health utility findings are particularly striking. Where people experience severe gambling harms, the decrease in quality of life is substantial, comparable to impacts seen in chronic health conditions. This establishes gambling harm as deserving recognition based on measured impact, and provides robust evidence for proportionate public health responses."
The study represents the first comprehensive trials of the Gambling Harms Severity Index (GHSI-10) and a companion tool for affected others (GHSI-AO-10), and they were validated through an assessment involving more than 4,500 UK residents.
The tools were developed by many of the researchers involved in this study – alongside people who gamble, their families and close others, and service providers – to take into account factors such as: the financial impacts of gambling (beyond just monetary losses); mental and physical wellbeing; relationships and family life; work, study and hobbies; social life and community connections; issues around secrecy, shame and stigma.
They align with practices and protocols applied across the NHS, World Health Organisation and other national and international health bodies.
The study was funded as part of the Gambling Commission's Regulatory Settlement Fund and represents the first comprehensive effort to measure and understand the true extent of gambling-related harms in Great Britain through a public health lens.
