Electronic gambling machines should have high-risk labels on them, casinos should stop or cutback on serving alcohol and schools should be teaching children about the hazards of gaming, according to a new health study in British Columbia.
Those were among the 17 recommendations put forward by Perry Kendall, the province's chief medical officer, in a report released Wednesday that looked at the public-health issues surrounding gambling.
The report, Lower The Stakes, comes against a background of growing concerns across Canada about the impact of gambling as the gaming industry pushes for more and bigger casinos, increased electronic gaming at race tracks and more online gambling.
Municipal governments in Toronto and Surrey have recently rejected proposals for new casinos, as Vancouver did in 2011. But there are still pressures for increased gambling. Toronto Mayor Rob Ford has said he'd like to see the casino issue revisited and, in Vancouver three weeks ago, Paragon Development, a Las Vegas-based company, unveiled a proposal to build a new $535-million resort near BC Place stadium that would house Paragon's Edgewater Casino. Gambling critics fear the new resort would lead to a larger gaming operation.
Dr. Kendall said governments are feeling "more pressure to get more revenue" out of gambling.
But he urged political leaders to bring balance to the equation by taking a hard look at the health risks.
"The time is ripe for a fulsome discussion on the costs and benefits [of gambling]," he said.
He was asked if he thought gaming providers could realistically be expected to embrace recommendations – such as putting warning labels on slot machines or cutting alcohol sales – that would hurt their businesses.
"I wouldn't if I was a casino operator," he said, "which is why I'm making the recommendation to the government, who make the rules."
B.C.'s Finance Minister, Michael de Jong, who is responsible for the B.C. Lottery Corp. and the Gaming Policy and Enforcement Branch, thanked Dr. Kendall "for his thoughtful review," but said the government is already doing a lot to address the issue.
"We take the social costs of gambling seriously and have designed several initiatives to address the potential social costs of gambling," he said in a statement.
Mr. de Jong said the government of B.C. this year gave a 30 per cent budget increase to a program aimed at reducing problem gambling. He said the effectiveness of that program will be reviewed before the government decides whether it needs to spend more money.
Dr. Kendall said that in 2010/2011 there were more than 170,000 problem gamblers in B.C. – but only 2,034 admissions to treatment programs.
He said provincial governments nationally are caught in a conflict of interest, because gaming has become such an important revenue stream. In the past decade, for example, total gaming revenue for the B.C. government increased from $1.1-billion to $2.1-billion. B.C. rakes in $552 per capita from gamblers, which is close to the national average; Saskatchewan ($849) has the highest per capita income and PEI ($384) sits lowest. Ontario ($451) is slightly ahead of Quebec ($412).
Dr. Kendall said it is more difficult to measure the health costs associated with gambling than it is to keep track of the economic benefits. But he noted that patients who have been identified with a gambling problem "are significantly more likely to be hospitalized with conditions related to mental illness, problematic substance use and other conditions." And on average, he said, problem gamblers incur over four times the medical expenses of hospital patients who don't have gambling problems.
"While the B.C. government deserves recognition for implementing various problem gambling prevention and treatment programs, its decision to expand access to more problematic forms of gambling in recent years is counterproductive from a public health perspective," the report concludes.