Gambling is the action or practice of wagering something of value on a chance event with the intent of winning a prize. It can occur in a variety of places, including casinos, racetracks, gas stations and online. It can also involve playing games of skill, such as poker or blackjack, with a hope of winning large sums of money.

In the United States, four in five adults have gambled at least once in their lives. Some of these people have a gambling problem, which may interfere with their work and social life.

Harms associated with gambling include negative impacts on health, financial well-being and relationships. It has also been linked to problems with depression, anxiety and substance abuse.

A person who gambles may have an underlying mood disorder such as depression, which can trigger gambling or make the problem worse. In these cases, seeking help for the underlying disorder can be helpful.

When a person has a problem with gambling, they may lose control over their spending habits, have difficulty paying bills, and be at risk of bankruptcy. They may also struggle to stop gambling despite knowing it is harmful.

The harms experienced by those who gamble and those who are affected by their gambling can vary widely, from small, transient losses to lasting consequences that erode their wealth, relationships and social functioning. These harms are often exacerbated by the presence of other comorbidities or behavioural patterns that are unrelated to the gambling, such as a family history of mental health disorders.

First, we used focus groups to gather data from people who had experienced harms related to gambling, both from their own and/or another’s gambling activity. These participants were recruited via advertising on social media and interviewed both in-person and by telephone.

Harms relating to the loss of time were reported as being one of the more common themes in terms of harms experienced from gambling. The harms were typically accompanied by feelings of guilt or shame as a result of the loss of time and opportunities to engage in other pursuits and/or activities. The harms often impacted upon the relationship between the person who gambled and those who were affected by their behaviour or actions, whether those individuals were family members, friends or co-workers.

Second, harms relating to the loss of trust were consistently reported in both instances of harm from gambling. These harms were primarily a result of the lack of trust that people had in those who gambled and/or in their own ability to take responsibility for their own behaviour and choices.

Third, harms relating to the loss of control over the situation or circumstance were also regularly reported in both instances of harm from gambling. They were typically accompanied by feelings of insecurity, inability to control the situation or circumstance and/or feeling that there was no other option but to gamble.

The conceptual framework for gambling related harm is a broadened and more inclusive approach that captures the breadth of how harms can manifest for the person who gambles, their affected others and their communities. It is grounded in a public health approach to support the operationalisation and future measurement of gambling related harms that are consistent with standard epidemiological protocols.