Identification, assessment, and management of gambling-related harms: summary of NICE guideline
BMJ 2025; 388 doi: https://doi.org/10.1136/bmj.r323 (Published 11 March 2025) Cite this as: BMJ 2025;388:r323Linked Editorial
Tackling gambling harm requires a public health approach
Linked What Your Patient is Thinking
Offer me hope to overcome gambling harm
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Dear Editor
The summary of the NICE clinical guideline was a truly excellent summary of a complex piece of guidance in a difficult and emerging space. Most are clear that gambling causes harm that cuts across clinical, social, family and financial spheres. The guideline and BMJ summary set out a comprehensive approach with regard to clinical practice.
The associated editorial (1) highlighted the obvious point that the NICE guideline focused on clinical practice but was not a public health guideline, and the product and the nature and practices of the gambling industry escapes significant scrutiny from a population health perspective.
The editorial highlighted the need for “a public health approach”. This is an often mis-used phrase, however we do, on this occasion, agree. With the Faculty of Public Health, the UK Association of Directors of Public Health have set out what a definition of a “public health approach” (2), with the Faculty and the Royal Society of Public Health (3) we have set out recommendations to govt for change. ADPH has argued that the measures in the previous government’s White Paper didn’t go far enough and essentially we need a new Gambling Act (4).
A number of Public Health experts have argued (5) that the statutory levy would do more harm than good, and that the levy is not a substitute for reform and regulation of policy and product.
We encourage the government to play its hand in their plans with regard to policy interventions to reduce the harm from gambling. Meanwhile local authorities are making progress on this locally using the powers local government has (4), specifically including licencing (6), advertising and sponsorship (7), the development of comprehensive strategies locally (8) and regionally (9) (10).
Mr Greg Fell, President, UK Association of Directors of Public Health
Professor Kevin Fenton, President, Faculty of Public Health
Mr William Roberts, Chief Executive, Royal Society for Public Health
(1) Tackling gambling harm requires a public health approach | The BMJ https://www.bmj.com/content/388/bmj.r447
(2) Protecting the public from being harmed or exploited by gambling and the gambling industry | ADPH https://www.adph.org.uk/2022/06/protecting-the-public-from-being-harmed-...
(3) ADPH, FPH and RSPH call for tighter regulation on gambling | ADPH https://www.adph.org.uk/2023/02/adph-fph-and-rsph-call-for-tighter-regul...
(4) Why we need a new Gambling Act | ADPH https://www.adph.org.uk/2024/03/newgamblingact/
(5) Statutory levy on gambling may do more harm than good | The BMJ https://www.bmj.com/content/381/bmj-2023-075035
(6) Licensing Appeal for Adult Gaming Centre Dismissed https://www.ftbchambers.co.uk/news/news-view/licensing-appeal-for-adult-...
(7) Sheffield City Council Advertising and Sponsorship Policy https://democracy.sheffield.gov.uk/mgAi.aspx?ID=33968
(8) Gambling Harm Prevention Strategy for Sheffield 2024-2034 https://democracy.sheffield.gov.uk/mgIssueHistoryHome.aspx?IId=47561
(9) A Public Health Framework for Preventing and Reducing Gambling Harms in Yorkshire and the Humber https://yhphnetwork.co.uk/links-and-resources/coi/gambling-harms/a-publi...
(10) Greater Manchester Combined Authority Chapter One https://www.chapter-one.org/
Competing interests: GF has been part of a regional gambling harm reduction project funded by a Regulatory Settlement from the Gambling Commission.
Re: Identification, assessment, and management of gambling-related harms: summary of NICE guideline
Dear Editor,
I would like to support the recent summary of NICE guidelines regarding the many harms and suffering resulting from gambling:
"Adverse impacts of gambling, known as gambling-related harms, include loss of employment, debt, crime, breakdown of relationships, domestic violence, and suicide. They affect people who gamble, their families and others close to them, and society."
I would like too to support the idea of a "Public Health Approach" stated by NICE and by Fell and colleagues in their Rapid Response of 19th March. However, please allow me to raise and add "a new religious approach" in order to address and prevent this rising complex medical social financial problem / disaster (Gambling) in our society, especially as there will be more gamblers on the way now in our society as a result of the high cost of living, high cost of energy bills and the stopping of a lot of benefits, etc...
I humbly recommend to "utilise" some religious texts which will be effective on the behaviour of some believers who believe in these religious texts. Reminding them of these texts will work wonders and make them stop "THE Vices" they are doing especially when the medical social mental financial harms are exposed and shown to them.
Over the years, I have been using this approach successfully and effectively on many Muslim TV and Muslim radio stations to avoid smoking, drugs, alcohol, harmful unhealthy diets, unhealthy sexual behaviour etc.... This is by bringing them the health medical social data.
If I can give you one example in the issue we are discussing now: Gambling.
I like to mention some religious quotations against Gambling in Islam and in Christianity which will help and will motivate some believers to STOP GAMBLING altogether, especially as many believers are/were not aware of the prohibition and the opposition of their religions to what they are doing.
Gambling in Islam
Gambling is forbidden in the final Holy Book AL QUR'AN :
In the Name of GOD, the most Compassionate, the most Merciful
"O you who believe! Intoxicants (all kinds of alcoholic drinks), gambling, al-Ansab [sacrifices for idols, etc.] and al-Azlam [arrows for seeking luck or decision] are an abomination of Shaytan’s (Satan) handiwork. So avoid (strictly all) that (abomination) in order that you may be successful. Shaytan wants only to excite enmity and hatred between you with intoxicants (alcoholic drink) and gambling, and hinder you from the remembrance of GOD (Allah) and from al-Salah (the prayer). So, will you not then abstain?”
[Qur'an: Chapter 5-Verses 90-91]
Gambling in The Bible
(1) Gambling directly appeals to covetousness and greed “which is idolatry” according to the Apostle Paul (Colossians 3:5). Gambling breaches the 1st, 2nd, 8th and 10th commandments. It enthrones personal desires in place of God. Jesus warned: “you cannot serve both God and Money” (Matthew 6:24).
In 1 Timothy 6:10, which states, "For the love of money is a root of all kinds of evil."
(1 Corinthians 6:9, 10; Ephesians 5:3, 5) Gamblers hope to gain money through the losses of others, but the Bible condemns coveting other people's possessions. —Exodus 20:17; Romans 7:7; 13:9, 10. Gambling, even for small amounts, can arouse a destructive love of money. —1 Timothy 6:9, 10.
Dr Majid Katme
Retired Medical Doctor
Former President of Islamic Medical Association in UK
TV/RADIO broadcaster
Competing interests: No competing interests