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		[This article prints out to about 18 pages] Minimising the impact of gambling in the subtle degradation of democratic systems 1 Peter James Adams University of Auckland Auckland, New Zealand E-mail: p.adams@auckland.ac.nz Abstract Gambling can harm a society's social and economic systems and negatively affect its political ecology. If not protected, democratic processes and institutions in jurisdictions with high levels of gambling are likely to undergo a progressive, cumulative degradation of function. These subtle, diffuse distortions result when a broad variety of individuals, working in isolation and reacting to pressures from gambling providers, incrementally compromise their roles and responsibilities. This article examines how these degradations can occur for people working in universities, government departments, media outlets, politics, and community organisations. It argues that any strategy to minimise harm from gambling should include explicit measures to protect the public from such distortions to democratic processes. The single most effective way to do this is to independently monitor people with public duties who have relationships to the beneficiaries of gambling consumption. The article concludes by proposing an international charter that sets benchmark standards for protecting a society from such degradations.

		Introduction The current rapid proliferation of gambling throughout the majority of Western-style democratic nations poses, in the long term, a range of threats to the vibrancy and integrity of the very base that supports their democratic structures and processes. One way is via the potential alliances that can form between gambling industry providers and sections of government. The opportunity for such alliances stems from the convergence of interest for both parties in the sizeable income available from increases in gambling consumption. Governments are lured by the prospect of convenient and sizeable taxation revenues and gambling industry providers are drawn in by opportunities to influence regulation in ways that open up new and lucrative markets (Costello & Milar, 2000; Goodman, 1995). These industry-government alliances can propel liberalisation in ways that override the wishes of the majority of the population. For example, casino licensing in Australia and New Zealand has proceeded in spite of majority opposition from local communities (Adams, 1999; Doughney, 2002). A second way in which democratic systems can be threatened relates to the opportunities for a globally interconnected gambling industry to marshal the linkages and resources to influence the choices of targeted governments and their publics. The processes and strategies used have been well documented with the expansion of the tobacco and alcohol industries. These include strategies such as target marketing to vulnerable populations, strategic commissioning of research, saturation promotion of international brands, technical refinements of products, and coordinated political lobbying (Jernigan, 1997; Studlar, 2002). These have had the net effect of diminishing the ability of populations to make informed decisions about the extent of their alcohol or tobacco consumption. When it comes to the emergent global networks of the gambling industry, it makes sense to expect that what has worked so effectively for the tobacco and alcohol producers is highly likely to emerge in similar ways as the gambling providers strengthen their interconnections. Whilst the above two threats to democracy are worthy topics for enquiry, the current paper shifts attention away from the macro processes of government-industry alliances and industry globalisation in favour of a narrower focus on the potential for gambling monies to subtly compromise the ability of individuals to participate in democratic systems. The paper argues that people at any level in society can find themselves influenced in ways that diminish their confidence to assert their views about gambling. A democratic society relies on the proactive and optimistic participation of citizens in its democratic structures and processes. People need to feel they have a say; that they have a right to take up moral stances, that their viewpoints matter and that their voices have some influence within the larger systems. Such participation in democratic processes extends well beyond the occasional opportunities to vote. It extends to a person's willingness to participate in public debates, protests, pressure groups, and government consultative processes. The rising availability of proceeds from gambling engages more and more people in a web of benefits that in their minds and in the minds of others progressively compromises their ability to openly question the way gambling is being provided. Individuals fulfilling a wide range of roles find themselves caught between the duties of their position and their moral views of gambling. They respond to these dilemmas in a variety of ways, but a common response is to withdraw from the debate altogether and thereby effectively endorse the interests of gambling expansion. This degradation of their confidence to participate in democratic processes applies initially to gambling alone, but over time could arguably extend to their willingness to participate in democratic processes as a whole. Gambling and harm minimisation Substances or processes with potential to foster dependency will lead to harm at multiple levels. The term "dependency" can be interpreted in a number of ways, but is understood here to refer in a general fashion to the emergence of an intense reliance on one relationship that overshadows the potential contribution of a range of other relationships. Such reliance can occur at an individual level where an intensified relationship to, for example, alcohol eclipses the benefits of relationships with family members and friends. This amplifies the reliance, which over time emerges with features we identify as addiction. Dependency can also occur at social and societal levels. Groups, organisations, even whole societies can find themselves on a path of increasing reliance on one aspect of their development. For instance, taxation on tobacco could grow in such importance to state revenue that it is seen as a necessary part of state income (Godfrey & Maynard, 1988). The diversity and resilience of the economy is diminished and this further intensifies the reliance. While an organisation or state can benefit from the income, it carries with it associated harms that include the loss of other opportunities, losses in autonomy, and distortions in business and community relationships. Tobacco, alcohol, and gambling comprise the major dependency-forming consumptions legally supported in most Western-style democracies. Each of these consumptions confronts the host state with a common spectrum of harms, spanning physical, psychological, interpersonal, and broader social impacts. Tobacco use has social and cultural impacts by, for example, linking its promotion with the emerging identity of younger people (Pechmann & Shih, 1999). However, tobacco's main impact is unquestionably on physical health as evidenced by the high number of people who die from smoking-related illnesses (Doll, Peto, Wheatley, Gray, & Sutherland, 1994; Lopez & Peto, 1996). Alcohol has significant impacts on physical health (Edwards, et al., 1994), but it differs from tobacco in contributing more to harm at the level of psychological impacts and social relationships (Clark & Hilton, 1991; Devlin, Scuffham, & Bunt, 1997). For example, the impacts of alcohol dependence on family members, particularly children, can lead to enduring disruptions of psychological and social functioning (Cuijpers & Smit, 2001; West & Prinz, 1987). Gambling shares the potential for impacts on health and psychological wellbeing. For example, prolonged and intense episodes of gambling are accompanied by associated anxiety, stress, depression, and deteriorating self-care (Becona, Del, Lorenzo, & Fuentes, 1996; Crockford & el-Guebaly, 1998; McCormick, Russo, Ramirez, & Taber, 1984). The psychological processes of problem gambling lead to distortions in thinking and disrupted relationships (Blaszczynski & Silove, 1995; Lorenz & Yaffee, 1986; Williams, 1996). In addition to these, when it comes to comparing the impact of gambling with that of alcohol and tobacco, gambling stands out with a stronger zone of potential harm derived from its impact on social systems and processes (Doughney, 2002; Goodman, 1995). The principles of harm minimisation provide a high-level framework for governments to respond to alcohol, tobacco, and other drug problems (Single, 1995). Harm minimisation philosophy remains neutral on the morality of drug use, but recognises that since most societies accept the regular use of some form of mood-altering drug, policy efforts need to focus on ways to identify harm and reduce it to tolerable levels (Hamilton, Kellehear, & Rumbold, 1998). If a society chooses to accept, for example, alcohol as a part of daily life, the task then becomes one of finding ways that predictable harms are kept to a minimum. Alcohol intoxication is known to increase the probability of road injuries; accordingly, governments might choose to minimise such harm by recording incidence figures then evaluating the impact of strategies such as designated drivers, low alcohol beer, media campaigns, and so on. Gambling brings with it a range of predictable harms. The prevalence of problem gambling, property crime, and mental health problems is well documented (Brown, 1987; Lesieur, 2000; Volberg, 1996) and suitable intervention and prevention responses are in the process of development (Korn & Shaffer, 1999). A harm minimisation approach can also be usefully applied to gambling. In preparing populations for high levels of gambling, the challenge is to find ways to enjoy the benefits from gambling while at the same time minimising negative impacts. Despite recognition of gambling-related harm at an individual level, the broader harm gambling inflicts on social systems has so far attracted scant attention. This zone of predictable harm requires closer description before beginning the task of exploring appropriate remedies. Threats to democratic systems As gambling consumption rises, people with key democratic responsibilities are increasingly subject to influences associated with the profits from gambling. These influences are typically subtle, difficult to detect, hard to measure, and problematic to report on. For instance, politicians are unlikely to speak openly about the extent to which financial contributions from gambling industry sources might influence their approach to gambling policy. Open discussion would jeopardize their credibility both with the public and with their colleagues. Similarly, gambling counselling agencies are unlikely to admit that receiving funds from gambling industry sources influences whether they would speak out about the impacts on clients. Such an admission would affect their credibility with clients and with the broader community. Since open disclosure is problematic, discussion here will seek to point out the risks to democracy by presenting a set of hypothetical scenarios. The scenarios are based on the author's ten-year involvement in the gambling field, an involvement which has provided many opportunities to discuss these issues with people in different roles and to ask them about their perceptions of the risks posed by links to gambling funding sources. Hypothetical narratives such as these have been used effectively in other fields to help highlight issues on sensitive topics (Tobin, 1997). They assist in opening up qualitative inquiry into areas of perception and morality, zones that would be difficult to explore using quantitative methodologies. The following scenarios will focus on people in five different contexts: academic and research bodies, the media, community agencies, politicians, and government agencies. They have been composed to illustrate the potential for distortion rather than providing definitive evidence of its occurrence. They present a case for protecting democratic systems based on the plausibility of the risk. Academic and research bodies Universities have a major responsibility in modern democracies to support independent and critical academic scrutiny of changes and trends in social systems. Universities are also under enormous financial pressure to deliver quality teaching and research programmes. Tension persists between their duty as "conscience of society" and their need within a competitive research environment to establish stable funding. In the following scenario Jason finds himself caught in this tension: Jason has worked for thirteen years in a university department of psychology. He had applied unsuccessfully twice for promotion to associate professor. At the conclusion of each promotion round he was told his research profile was not strong enough to qualify. During the last five years he has been working with the support of the racing industry to develop an interesting series of small studies on the cognitions heavy track gamblers use when planning their betting. The racing industry funders were happy for him to publish the results as long as he acknowledged their contribution. Their funding had provided for two research assistants and for any material or equipment costs. Recently two representatives from the racing industry visited him to state how pleased they were with his work and to convey their willingness to fund a considerably larger three-year project. Jason is flattered by their comments and excited by the prospect of a larger project. He could begin comparing the cognitive repertoire of heavy and infrequent track gamblers. He could look more at the interplay between cognitions and perceptions of luck and skill. The research design opportunities would be enormous. He asks the racing representatives what they expect in return. They state that because the funding would, of course, be of a greater magnitude, they would prefer some control over what gets published and they would be particularly interested in research into cognitions that might have some relevance to marketing their product. Jason is faced with a difficult and common dilemma. On the one hand, combined with the pressure to increase his research productivity, he is attracted by the opportunity to apply his hard-earned research knowledge and skills. On the other hand, the stronger the relationship he develops with gambling providers, the more his work will be seen by others as influenced by the commercial interests of the industry. Not only this, his research output will come to rely more and more on their continued support, and he will over time adapt his focus in ways that are unlikely to jeopardize future funding (see Adams et al., 2003). Media The media play an important role in democracies by presenting information and issues to the public that enables citizens to form views and make informed decisions. As with universities, media outlets such as television and newspapers also seek to protect their major sources of revenue, and for most of them commercial advertising is a vital contributor to funds. The person in the following scenario is caught up in the tension between the role of public informer and being part of a viable business: A reporter, Melanie, is working late one night to meet the deadline for the morning edition of a daily newspaper. A press release is relayed by a sub-editor to her computer: "Casinos Targeting Local Asians." She pauses a moment to ponder the various angles from which she might explore such an issue. She could interview local Asian community representatives, she could examine casino practices regarding incentives such as free drinks and meals for Asian customers, she might enquire into the revenue casinos derive from Asian customers... but, hold on, putting energy into this area would be pointless if the editors were to chop it down and bury it deep into the back-pages, or, worse, if it was rejected outright. Melanie is aware how during the last four years their newspaper has derived increasing advertising income from gambling providers. Many of these advertisements declare recent contributions by gambling providers to the public good, in activities such as cultural, charity, or sports events. The newspaper now regularly runs a half-page and sometimes a full-page advertisement for the local casino. She had seen her editor express increasing anxiety regarding threats to this income. This came to a head when six months ago she was involved in a series of four articles reviewing the debate between pro- and anti-gambling-expansion lobbies. As the flow of letters to the editor subsided, the editor received a letter of concern from a casino executive claiming that the coverage was biased and as a result likely to affect their business. The editorial next morning extolled the virtues of the casino to the local economy and the editor spoke to the staff discouraging emphasis on negative publicity regarding gambling providers. What should Melanie do now? By not pursuing the article, she is surely preventing public access to information on the issue. Even so, the newspaper still has the occasional informative article. There are plenty of other issues that are less trouble and less likely to complicate advertising revenue. Community agencies Sports clubs, charities, church and school committees, work social clubs, hobby groups; from small local groups to large national non-government organisations; these all comprise the intricate web of interconnections that provide the base for social involvements. It is often through interactions in community groups that people form their views on social issues. Consequently, financial influence at a community level could go a long way in shaping public views on gambling. The person in the following scenario is feeling the pressure exerted by industry contributions to community development: Robert is employed by a church organisation to coordinate a community project focused on youth at risk. He believes passionately in the positive impact of this project both for the many marginalized young people he encounters and for his community as a whole. He has applied each year for funding from a local gambling machine trust (a collective of several hotels with gambling machines, required by law to distribute a percentage of takings for community benefit). The amount awarded to his youth project has increased each year to such an extent that he is unsure whether the project could continue without the money. He has had little personal exposure to gambling or to problem gambling. He is aware that increasing numbers of young people in his community regularly play gambling machines. He has also heard that the government is currently conducting a fundamental review of gambling policy. In response to this, a member of the local gambling machine trust contacts him to speak about fears that the community benefit monies could be moved from local to central distribution. He is naturally concerned that the fruitful relationship he has built up with the trust will no longer continue and he would be forced to compete nationally with dozens of similar projects. He immediately considers volunteering to compile a submission to government opposing the central distribution and praising the work of the gambling machine trust. He pauses. He has difficulty seeing himself as an advocate for communities while at the same time promoting the interests of something that people claim will harm the community. In choosing to promote the interests of gambling machine providers he places himself in a conflicted position. He can no longer speak out credibly to question youth exposure to machine gambling. It would be inconsistent in one breath to praise their contribution and in another to criticise them. In this way the local gambling provider not only gains an advocate but also manages to effectively silence potential criticism. The charitable contributions of the gambling industry to public good activities quickly translate into community support for their developments and their recognition as responsible community benefactors. Politicians As elected representatives of the people, politicians have clear obligations to respond to threats to public wellbeing. This is not an easy task. Choice of the wrong issue could mean an early exit from the political arena. Judgement and skill is required in choosing social issues that are likely to attract public support while at the same time avoiding unnecessary conflict with other sources of power and influence. In the following scenario, a politician finds himself caught between the interests of the public and the influence of gambling provider contributions to political funds: Bill was first elected into parliament twenty years ago. His party is currently the major partner in a coalition government but, due to a series of internal spats, it is now scoring poorly in public opinion polls. During the last election he won by a very slim majority and he remains concerned that he may not be re-elected. A collective of the local hoteliers who own the majority of the electronic gambling machines in his electorate had contributed a reasonable sum to his last electoral campaign. They have also been very receptive to his suggestions as to suitable charities and other community groups they should fund with community benefit profits. This has endeared him to many organisations. A few days ago a group of local community leaders approach him regarding concerns about the spread of gambling machines throughout his electorate. They present alarming figures on increases in problem gambling, crime, and social disruption. He understands the issues and is sympathetic to their arguments. He promises to do what he can in parliament, but he stops short of openly challenging the expansion. It would be political suicide. Without the gambling machine money he would have very little chance of re-election, and, furthermore, his party would not welcome him complicating what they receive from gambling providers. Stirring up concern about gambling would most likely lead to central party bosses withdrawing any financial support for his campaign. Bill recognises that alone, as one politician, there is little he can do in terms of advancing public disquiet about gambling. Discussion with his colleagues produced little. They feel similarly vulnerable. Progress would really require a collective and concerted response within the party. Government agencies Multiple parts of the machinery of government are capable of forming key linkages with the activities of the gambling industry, particularly under conditions of managed expansion. The executive of government and its departments of finance and treasury will have a keen interest in the revenue it generates. In addition many governments have their own agencies that directly provide gambling products for public consumption (e.g., state casinos and horse racing). Departments that manage development and regulation of the industry will derive increasing leverage and kudos from successful growth. Departments that respond to potential harm (e.g., health, justice, social welfare) while seeking to develop remedial programmes will be mindful of how gambling revenue contributes to their other programmes. The following scenario epitomizes the individual dilemmas faced by civil servants when they become part of these gambling industry linkages: Karen has worked for the last year as a policy analyst for the government agency in charge of gambling policy, regulation, and enforcement. Another section of the same agency runs the national lotteries. She had previously worked in a government department in charge of social welfare. She has strong ambitions to perform well and advance in her public service career. Unfortunately profits from the national lotteries are in decline with the increase in competition from other products. Huge efforts are being made to increase participation — expensive TV advertising campaigns, promotion of large sports events, new lottery products, and special bonus events — but participation continues to drop. The managers in her agency are becoming increasingly worried, particularly since the profits have enabled them to fund a variety of cultural, sporting, and charitable activities and they are concerned about the public response to a dip in funding. Karen's current task involves reviewing legislation on gambling advertising. She is providing the detailed analysis for the review committee of the large number of submissions from a broad range of stakeholders that include community, government, and gambling provider organisations. She is personally persuaded by the submissions that a compulsory advertising code should be introduced but is concerned about her own agency's response. The most aggressive marketing occurs in the lottery advertising that comes from her agency. Clearly, advocating for tougher advertising standards will lead to tension with other parts of the agency and she is unlikely to receive support from her immediate superiors. It would be easy to bury her position in weaker recommendations. As with previous scenarios, Karen faces a difficult choice. If she stands up as one individual to contest positions of convenience to the organisation she risks being moved sideways and being replaced by a more compliant and perhaps less knowledgeable official. She is tempted to remain and console herself that her weakened recommendations are at least a step in the right direction, even though she knows the suggestions will be ignored. Effects of degradation Each of these individuals — Jason, Melanie, Robert, Bill, and Karen — shares a common dilemma. On the one hand they occupy positions of influence that could enable increased public responsiveness to the societal impacts of gambling. On the other, the small part they could play in strengthening the financial relationship of their organisation to the gambling industries in turn reduces the organisation's credibility and capacity to act on behalf of the public. Should they choose the former, they jeopardize financial gains for the organisation; should they choose the latter, they risk distortions of public awareness. They are each caught in a tangle of benefits and risks that pull them in both directions. On closer inspection, the balance in this dilemma is not evenly weighted. The incentives in favour of the industry are typically more immediate and attractive than incentives to serve the public. For example, the researcher, Jason, will receive stronger and more immediate recognition within the university for scoring a large research grant than he would for making a stand on refusing industry funds. A few colleagues might admire his resolve, but in the context of the broader university community, his ethical stance is likely to pass unnoticed. This contrasts with the highly visible presence of the products from industry funding. On the flip side and in a similar way, the disincentives to serve public interests are also typically stronger than those affecting industry involvements. For example, should the reporter, Melanie, choose not to write about casino targeting of Asian clients her decision is unlikely to be challenged, and even if questioned, she could easily rationalise it in terms of stronger stories elsewhere. It is hard to imagine her compliance sparking a formal investigation or a public scandal; it would be unlikely to attract even passing comments from colleagues. In contrast, an article critical of the industry is likely to prompt immediate and stern responses from the editor, casino executives, and possibly the newspaper owners. With incentives and disincentives favouring linkages with gambling provider interests, individual compliance with organisational-industry involvements becomes a more probable event than attempts to challenge such connections. Individual people within this interface will feel pressure to make choices that strengthen the involvements and build collectively towards more powerful societal effects. The researcher diverts energy from understanding impacts, the reporter avoids conveying information to the public, the community worker allows good work to reinforce the public image of a gambling provider, the politician misses opportunities to champion issues, and the government worker translates industry favour into policy recommendations. Each act in itself is small and largely untraceable, but taken collectively they add to the accumulating momentum of gambling expansion and to the cumulative effect of public misinformation and, at the same time, to consequent missed opportunities for informed decision-making. The role of modern democratic governments in these processes is complex. They certainly play a pivotal role in protecting the public from gambling-related harm, but, in most nations, governments are also major recipients of gambling revenues. As this revenue increases, their focus on the public good competes with their interest in the funds. The balance between these opposing interests can reach a point where the need for money outstrips duties of public protection. Consequently, it is important that any government that embraces rapid expansion of gambling also recognise that their democratic structures are being placed at risk. In an environment of managed expansion, this calls for strategies that not only weed out blatant distortions but also establish procedures to counteract the less visible, low-grade threats. Minimising harm to democratic systems The current article has argued that in an environment of rapid gambling expansion, harm to democratic processes and institutions is highly probable. It further points out that distortions are likely to be subtle and diffuse, and are likely to remain unchecked. These distortions are generated by a broad scattering of individuals who, working in isolation, incrementally compromise their functions and thereby contribute cumulatively to a collective degradation of democratic systems. Part of a harm minimisation strategy targeting gambling should include explicit measures to protect the public from distortions to democratic processes. The key ingredient to reducing the risk of degradation will inevitably involve independent monitoring of people with public duties and relationships to the beneficiaries of gambling consumption. The following lists specific strategies that could be put in place to reduce the probability of these distortions: Academic and research bodies Universities and other research organisations develop policies that restrict acceptance of direct funding from gambling providers; Independent, intermediary bodies are set up to receive industry contributions and manage disbursements; Universities in their role as "conscience of society" actively pursue critical scrutiny of the role of gambling in communities. Media Media providers include within their charters a declaration of vigilance regarding independence from industry; National and international media organisations monitor provider adherence to standards of independence from gambling providers; An independent government agency is empowered to investigate complaints of undue influence on the media. Community agencies Charities include within their charters or constitutions a declaration, as part of their public-good function, that restricts receiving funds directly from gambling providers; Gambling providers are prohibited from contributing directly to charitable, sports or other community organisations; The proceeds from gambling for community benefit are managed independently of gambling providers. Politicians All political parties are required by law to declare sources of income for political purposes; Politicians are required to declare gifts and benefits received from gambling industries (shares in race horses, overseas trips, etc); An independent government agency is empowered to monitor funding for political purposes from gambling providers. Government agencies Formation of an independent monitoring body reporting directly to government (not through ministries or departments); Separation (ideally in different agencies) of the functions of policy development, regulation, and enforcement; Pro-active separation (subject to management audit) of agencies of government that manage or directly benefit from gambling tax revenue from those that regulate or manage associated harm. Benchmarking international standards Many of the strategies listed above rely on the integrity of the independence built into monitoring processes. This integrity is naturally the very subject of threat as governments step up their interest in gambling revenue. As tax revenue increases, motivation to adequately monitor systems decreases. In order to prevent progressive distortions to independence, nations undergoing rapid proliferation of gambling have a strong need for an external reference point by which they might gauge potential drifts in democratic integrity. As illustrated in the above scenarios, gradual distortions to democratic systems can be difficult to spot and consequently any remedial response is likely to come too little too late. There is, therefore, a role for an external agency to assist governments in identifying when their management of gambling is likely to compromise public interests. International bodies such as the World Health Organisation or the United Nations could perform an important function in identifying international benchmark standards and then monitoring the level of compliance of individual governments with these standards. In 1997, at the Tenth International Conference on Gambling and Risk-Taking in Montreal, the current author co-presented the original draft of an international charter that sets out expectations for responsible governments in the provision of gambling (Adams & Gerdelan, 1997). Similar to the European Charter on Alcohol (WHO, 1995), this proposed charter is built on a set of seven ethical principles. The first ethical principle is an overarching statement that: All people have the right to a family, community and working life protected from violence, property crime and other negative consequences of the consumption of gambling. Two other principles identify benchmark standards for protecting the functions of democratic institutions and processes. Ethical Principle Five states: All people have a right to participate in a democratic process in deciding the amount and type of gambling that occurs in their communities. Ethical Principle Six states: Governments have a duty to provide regulatory frameworks and social policy responses on behalf of citizens to maximise the enjoyment of and limit the harm from the provision of all gambling. These or a similar set of ethical principles could form the basis for specifying clear targets and identifying compliance indicators with which to monitor the performance of individual governments. International organisations are then able to provide independent monitoring by taking the compliance indicators and developing audit processes for evaluating government compliance. The publication of the outcome of such audits will provide a reference point for governments who wish to expand gambling opportunities while at the same time preventing harm to democratic institutions. References Adams, P., Raeburn, J., Brown, R., Lane, L., Tse, S., Manaia, W., & Gerdelan, R. (2003, February). Should gambling researchers receive funding directly from gambling industries? 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(2002). The poker machine state: Dilemmas in ethics, economics and governance. Melbourne, Australia: Common Ground. Edwards, G., Anderson, P., Babor, T. F., Casswell, S., Ferrence, R., Giesbrecht, N., Godfrey, C., et al (1994). Alcohol policy and the public good. Oxford, England: Oxford University Press. Godfrey, C., & Maynard, A. (1988). Economic aspects of tobacco use and taxation policy. British Medical Journal, 297, 339–343. Goodman, R. (1995). The luck business: The devastating consequences and broken promises of America 's gambling explosion. New York: Free Press. Hamilton, M., Kellehear, A., & Rumbold, G. (1998). Drug use in Australia: A harm minimisation approach. Melbourne, Australia: Oxford University Press. Jernigan, D. H. (1997). Thirsting for markets: The global impact of Corporate Alcohol. San Rafael, CA.: Marin Institute for the Prevention of Alcohol and Other Drug Problems. Korn, D. A., & Shaffer, H. J. (1999). Gambling and the health of the public: Adopting a public health perspective. Journal of Gambling Studies, 15, 289–365. Lesieur, H. R. (2000). Policy implications and social costs of problem gambling. In P. Adams & B. Bayly (Eds.), Problem gambling and mental health in New Zealand: Selected proceedings from the National Conference on Gambling, July 1999. Auckland: Compulsive Gambling Society of New Zealand. Lopez, A., & Peto, R. (1996). The future effects of current smoking patterns: Assessing the magnitude of the pandemic. In R. Richmond (Ed.), Educating medical students about tobacco: Planning and implementation. Paris: International Union Against Tuberculosis and Lung Disease. Lorenz, V., & Yaffee, R. (1986). Pathological gambling: Psychosomatic, emotional and marital difficulties as reported by the gambler. Journal of Gambling Behaviour, 2, 40–49. McCormick, R. A., Russo, A. M., Ramirez, L. F., & Taber, J. I. (1984). Affective disorders among pathological gamblers seeking treatment. American Journal of Psychiatry, 141, 215–218. Pechmann, C., & Shih, C. (1999). Smoking scenes in movies and antismoking advertisements before movies: Effects on youth. Journal of Marketing, 63, 13. Single, E. (1995). Defining harm reduction. Drug & Alcohol Review, 14, 287–290. Studlar, D. T. (2002). Tobacco control: Comparative politics in the United States and Canada. Peterborough, ON: Broadview Press. Tobin, J. J. (1997). Playing doctors in two cultures. In J. J. Tobin (Ed.), Making a place for pleasure in early childhood education. New Haven, CT: Yale University Press. Volberg, R. R. (1996). Prevalence studies of problem gambling in the United States. Journal of Gambling Studies, 12, 111–128. West, M. O., & Prinz, R. J. (1987). Parental alcoholism and childhood psychopathology. Psychological Bulletin, 102, 204–218. World Health Organisation (WHO). (1995). The European Charter on Alcohol. Copenhagen, Denmark: World Health Organisation Regional Office for Europe. Williams, A. (1996). Gambling: A family affair. London: Sheldon Press. This article was peer-reviewed. Submitted February 4, 2003; accepted June 22, 2004. For correspondence: Peter Adams, PhD, Director, Centre for Gambling Studies, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland, New Zealand. Phone: 64 9 3737-599 ext. 6538, Fax: 64 9 3737-493, e-mail: p.adams@auckland.ac.nz Competing interests: None declared. Ethics approval: Not required. Funding: Employed by the University of Auckland. No other funding. Peter Adams is a senior lecturer in the School of Population Health at the University of Auckland, where he heads the social and community health section and is academic director of the Centre for Gambling Studies. He practiced for 13 years as a clinical psychologist, specializing in addictive behaviour and violence. He initiated, developed, and teaches in post-graduate programmes on alcohol and other drugs and teaches a post-graduate course on interventions for problem gambling. His gambling research activities have focused on the societal impacts of gambling, clinical interventions and harm minimisation strategies. For five years he chaired the Board for the Problem Gambling Foundation of New Zealand (the largest provider of gambling services in New Zealand) and in 2001 led the formation of the Centre for Gambling Studies. Note: 1 The examples used in the article are composites contrived for the purpose of illustration. They point out possibilities in our current systems, and any resemblances to real people or situations are purely coincidental.
		issue 11 — july 2004