Global public health action is needed to counter the commercial gambling industry

Youth perspectives on the promotional and public relations strategies of health harming industries

Public health researchers have investigated how youth are exposed to and influenced by traditional forms of commercial marketing from health-harming industries. Limited research has investigated youth opinions about the broader marketing and public relations strategies of these industries. This study aimed to understand youth perceptions of the impact and influence of a range of marketing and public relations strategies used by health harming industries. An online qualitative survey was conducted with n = 518, 16- to 24-year-olds living in Victoria, Australia. Participants were asked to consider the broad influence of marketing from health harming industries on youth, including the impacts of social media promotions, corporate social responsibility strategies including sponsorship and political donations, as well as their views on marketing restrictions. Reflexive thematic analysis was used to construct themes from the data. Participants stated that excessive marketing strategies had a significant influence on youth consumption of health harming products. Most felt that social media marketing had the most appeal and influence on youth. Most were critical of these strategies and were supportive of strong restrictions on marketing for health-harming products. However, many participants held more positive views about corporate social responsibility strategies, which they perceived could offset the negative impacts of these industries on health. Increased focus is needed from the public health and health promotion communities to ensure that youth are protected from the influence of the range of marketing strategies that are used by health-harming industries to promote their products and resist regulatory reform.

An assessment of cryptocurrencies as a global commercial determinant of health

Through the commercial determinants of health framework, gambling has been identified as a powerful threat to health. This research critically examines cryptocurrency, which is promoted and sold as a highly gamblified product. Using the commercial determinants of health framework, the multifaceted ways in which cryptocurrency firm operations may impact health outcomes are highlighted. Political influence is exerted through substantial donations, with high-profile cases illustrating the sector's attempts to sway policy, whilst cryptocurrencies often operate in unregulated markets. Marketing strategies mirror those of traditional harmful industries, deploying immense advertising budgets and celebrity endorsements to promote highly speculative and risky financial products. Cryptocurrency mining, demanding considerable energy consumption, causes significant environmental damage. Financial practices include hundreds of outright frauds targeting low- and middle-income countries. Cryptocurrency investment, with 24/7 access and promises of huge wealth, mirrors gambling and is likely to result in public health harms through the same mechanisms as other forms of gambling. Despite the supposed potential of blockchain technology for improving payment and contract systems, the lack of realization of these benefits contrasts sharply with the immediate and growing costs associated with cryptocurrency speculation. Cryptoassets are a case study for the need for health promotion professionals to critically evaluate new technologies and advocate for regulatory measures to protect public health in the face of novel, high-risk products that overlap gambling and finance.

Community sports leaders' perceptions of the risks and benefits of gambling sponsorship in community sport

Gambling sponsorship of professional sport, particularly relating to online wagering, has been a key focus of global regulatory reform efforts to address the normalization of gambling. In Australia, gambling companies and venues (including community clubs and hotels) also sponsor and develop relationships with community (non-professional) sports teams and clubs. In-depth interviews (n = 24) were conducted with senior leaders in community sporting organizations in Australia with an aim of understanding the factors that shape decisions about accepting or refusing gambling sponsorships and partnerships. A reflexive approach to thematic analysis was used to construct three themes from the data. First, participants considered the alignment of values between the sponsor and the community sporting organization. While most stated that gambling and sport should not be aligned through sponsorship, some forms of sponsorship (for example from community clubs) were perceived as less harmful than others (such as online wagering). Second, some thought that while there were ethical ways to engage with gambling sponsors such as not promoting sponsors' products, they were concerned about how gambling sponsorship might have an overall impact on the community. Third, was the impact of gambling sponsorships on the organization's reputation, and balancing this with a need for financial stability. Decisions to accept (or reject) gambling sponsorship were influenced by a range of perceived risks and benefits. Addressing the acceptance of gambling sponsorships among community sporting organizations could involve several approaches to interventions, including regulation, formal policies to guide sponsorship decisions and education about the risks of accepting these sponsorships.

Unhealthy and health promoting sponsorship of male and female professional sporting teams in Australia

ISSUE ADDRESSED

There are concerns that unhealthy industries may use sponsorships to align their brands with the increased popularity of professional women's sporting events. This study aimed to identify and compare the sponsors of Australian male and female professional sporting teams in relation to unhealthy industries (alcohol, gambling, discretionary food and drink, and venues) and health-promoting companies and organisations (charities, government departments, and educational institutions).

METHODS

A web-based scan was conducted from July to October 2021 to identify team and uniform sponsors, with descriptive statistics used to identify and compare results.

RESULTS

About one tenth of sponsors (team n = 269; 10.9%; uniform n = 62; 10.6%) were for unhealthy industries. Men's teams had a greater number of these sponsors as compared to women's teams. Just under 10% of sponsors were for health-promoting organisations (team n = 210; 8.5%; uniform n = 44; 7.5%), with women's teams more likely to have these sponsors as compared to men's teams.

CONCLUSIONS

Professional sport provides an important opportunity to facilitate health-promoting rather than -harming sponsors. Health-promoting sponsors are more prominent in women's sport, but as women's professional sport continues to grow in popularity, there is a need for policy, funding, and support to prevent engagement with unhealthy industry sponsorship and create a level playing field with men's sport. SO WHAT?: Mechanisms should be developed to help sporting codes, particularly women's sport, to adopt business models that are not reliant on industries that cause harm. Establishing strong relationships with health-promoting organisations may provide alternative sponsorship opportunities for sporting teams.

"It's changing our lives, not for the better. It's important that we have a say". The role of young people in informing public health and policy decisions about gambling marketing

BACKGROUND

Marketing has a significant impact on the normalisation of gambling for youth across the globe. This has included shaping positive attitudes towards gambling, as well as increasing the social and cultural acceptance of gambling - particularly aligned with valued activities such as sport. Because of this, public health experts argue that gambling marketing poses a significant risk to the health and wellbeing of youth. While young people are increasingly exposed to, and impacted by marketing for gambling products, they are rarely consulted about policy issues and options. This study aimed to explore young Australians' perceptions of current policy responses to gambling advertising, whether they thought young people should be involved in discussions and decisions about gambling marketing regulations, and their perceptions of the duty of governments to protect young people from gambling industry marketing strategies.

METHODS

Qualitative focus groups (n = 22) were held with n = 64, 12-17 year olds in the Australian states of Victoria and New South Wales. Participants were asked to reflect on current gambling policies, particularly relating to marketing, what they thought should be done about gambling marketing, and if and how young people should be included in public health responses to gambling. An interpretivist 'Big Q' approach to reflexive thematic analysis was used.

RESULTS

Young people highlighted the need for more effective regulations around the content and frequency of gambling marketing. They also wanted to see more realistic representations of the negative impacts of gambling to counter persistent positive commercial marketing messages. Most thought that young people should be given an opportunity to have a say about responses to gambling due to their unique experiences. Participants identified mechanisms to increase young people's engagement in decision making, such as direct lines of communication to different levels of government, involvement in research, and diversifying ways of engagement. Specific recommendations included more regulatory action such as bans on gambling advertising.

CONCLUSIONS

Creating formal structures that facilitate the inclusion of young people's perspectives in decisions made about gambling can result in more innovative and effective strategies to prevent the harms from gambling industry products, promotions, and practices.

How did the 'whistle-to-whistle' ban affect gambling advertising on TV? A live football matching study

Background

In 2019, the gambling industry introduced a voluntary partial advertising ban during live sports broadcasts in the United Kingdom known as the 'whistle-to-whistle' ban. This study explores the change in television advertising around live football games following the introduction of this ban.

Methods

Inverse Probability Weighted (IPW) matching models identified the change in the frequency of advertising associated with the implementation of restrictions in each section, and across the entire duration, of a live football game. Data on UK television schedules (Concise Media, TVSportsGuide) and gambling advertising (Nielsen Media) covered 3 months (1st September to 1st December) pre (2018), and post-ban (2019). There were 1049 live football games across the period studied: 468 in 2018 and 581 in 2019.

Results

The implementation of the ban was associated with a reduction in advertising (2.3 advertisements per-programme (p < 0.001, CI [-2.75, -1.84])), driven predominantly by reductions during half-time (2.18 advertisements per-programme (p < 0.001, CI [-2.32, -2.04])). It was associated with an increase in advertisements (0.34 advertisements per-programme (p < 0.001, CI [0.09,0.59])) during the pre-match section. In the post-ban period, an average of 3 (SD: 3.5) advertisements per-programme remained.

Conclusions

A voluntary partial gambling advertising ban in the UK was associated with reductions in television advertising during live football games during the restricted period. There is evidence of increased advertising in the unrestricted period due to the partial nature of the ban. Future research is needed to explore the impact of the ban on other types of advertising, and across other channels.

Involving lived experience in regional efforts to address gambling-related harms: going beyond 'window dressing' and 'tick box exercises'

BACKGROUND

Lived Experience (LE) involvement has been shown to improve interventions across diverse sectors. Yet LE contributions to public health approaches to address gambling-related harms remain underexplored, despite notable detrimental health and social outcomes linked to gambling. This paper analyses the potential of LE involvement in public health strategy to address gambling-related harms. It focuses on the example of a UK city-region gambling harms reduction intervention that presented multiple opportunities for LE input.

METHODS

Three focus groups and 33 semi-structured interviews were conducted to hear from people with and without LE who were involved in the gambling harms reduction intervention, or who had previous experience of LE-informed efforts for addressing gambling-related harms. People without LE provided reflections on the value and contributions of others' LE to their work. Data analysis combined the Framework Method with themes developed inductively (from people's accounts) and deductively (from the literature, including grey literature).

RESULTS

Four themes were identified: (1) personal journeys to LE involvement; (2) the value added by LE to interventions for addressing gambling-related harms; (3) emotional impacts on people with LE; and (4) collective LE and diverse lived experiences. Two figures outlining LE involvement specific to gambling harms reduction in the UK, where public health efforts aimed at addressing gambling-related harms coexist with industry-funded programmes, are proposed.

CONCLUSIONS

Integrating a range of LE perspectives in a public health approach to gambling harms reduction requires local access to involvement for people with LE via diverse routes that are free from stigma and present people with LE with options in how they can engage and be heard in decision-making, and how they operate in relation to industry influence. Involving LE in gambling harms reduction requires enabling people to develop the affective and critical skills necessary to navigate complex emotional journeys and a challenging commercial and policy environment.

Children, young people and the Commercial Determinants of Health

The commercial determinants of health (CDoH) have a significant impact on the health and well-being of children and young people (subsequently referred to as young people). While most research has focused on the influence of harmful industry marketing on young people, more recent CDoH frameworks have emphasized that a range of commercial systems and practices may influence health and well-being. Focusing on the impact of traditional and digital media, contemporary marketing strategies and corporate production and consumption processes, the following article outlines the impact of the CDoH on the health and wellbeing of young people. The article also provides evidence about how young people conceptualize the impact of corporate actors on health, and their involvement in advocacy strategies to respond. The article recommends that when collaborating with young people to understand the impacts of and responses to the CDoH, we should seek to diversify investigations towards the impact of a range of corporate tactics, systems and structures, rather than simply focusing on the impacts of advertising. This should include considering areas and priorities that young people identify as areas for action and understanding why some young people are more vulnerable to commercial tactics than others. Youth are powerful allies in responding to the CDoH. Public health and health promotion stakeholders could do more to champion the voices of young people and allow them to be active participants in the decisions that are made about harmful commercial practices and health.

Young people's views about the use of celebrities and social media influencers in gambling marketing

Young people's exposure to gambling marketing has had a clear impact on their gambling attitudes, risk perceptions and consumption intentions. Celebrities and social media influencers (SMIs) are increasingly used by the gambling industry in a wide range of promotions. While there is evidence that these types of promotions are influential in shaping young people's attitudes towards other harmful products, there is limited evidence in relation to gambling. Qualitative focus groups (n = 22) with n = 64, 12-17 year olds were conducted in Australia. These investigated young people's exposure to celebrity and SMI marketing for gambling and the influence they perceived this marketing had on young people's gambling attitudes. Reflexive thematic analysis was used to construct four themes from the data. First, young people perceived that celebrities and SMIs created additional appeal and recall of gambling advertisements because they were attention grabbing and familiar. Second, young people thought that celebrities and SMIs increased the trust, legitimacy and social acceptance of gambling. Third, the use of celebrities and SMIs lowered the perceptions of risk associated with gambling. Lastly, there were suggestions to reduce the impact of celebrity and SMI gambling promotions on young people, such as bans and restrictions. This study highlights the importance of a comprehensive approach to preventing young people's exposure to gambling marketing, that not only considers imposing stronger regulations to restrict the way the gambling industry is allowed to promote its products, but also aims to counter the novel ways the gambling industry attempts to appeal to children and young people.

Setting the scene: a scoping review of gambling research in Ghana

Ghana, like many other African countries, has seen a rapid expansion in gambling industry activity in the last decade with sports betting becoming a popular pastime among young Ghanaian males. The proliferation of land based, and online gambling operations presents a significant public health threat to the citizenry. Yet little is known about gambling participation and harms, the size of the gambling market and the role of the gambling industry in influencing and perpetuating gambling behaviour in Ghana. The aim of this study was to contribute to understanding the extent of gambling research in Ghana by mapping out what the current literature indicates. Six databases were searched for peer-reviewed journal articles that focused on gambling in Ghana. The findings from this review demonstrate gambling research in Ghana is in a nascent state with a predominant focus on individual factors and limited consideration of public health. The implications for future research are highlighted, including the requirement for a nationally representative study to understand the prevalence of gambling participation and harm, and the role of the gambling industry. Public health action grounded in sound evidence is urgently required to address the individual and community level problems associated with this harmful commodity.