Journal of Gambling Studies

, Volume 15, Issue 4, pp 289–365 | Cite as

Gambling and the Health of the Public: Adopting a Public Health Perspective

  • David A. Korn
  • Howard J. Shaffer
Article

Abstract

During the last decade there has been an unprecedented expansion of legalized gambling throughout North America. Three primary forces appear to be motivating this growth: (1) the desire of governments to identify new sources of revenue without invoking new or higher taxes; (2) tourism entrepreneurs developing new destinations for entertainment and leisure; and (3) the rise of new technologies and forms of gambling (e.g., video lottery terminals, powerball mega-lotteries, and computer offshore gambling). Associated with this phenomenon, there has been an increase in the prevalence of problem and pathological gambling among the general adult population, as well as a sustained high level of gambling-related problems among youth. To date there has been little dialogue within the public health sector in particular, or among health care practitioners in general, about the potential health impact of gambling or gambling-related problems. This article encourages the adoption of a public health perspective towards gambling. More specifically, this discussion has four primary objectives:

1. Create awareness among health professionals about gambling, its rapid expansion and its relationship with the health care system;

2. Place gambling within a public health framework by examining it from several perspectives, including population health, human ecology and addictive behaviors;

3. Outline the major public health issues about how gambling can affect individuals, families and communities;

4. Propose an agenda for strengthening policy, prevention and treatment practices through greater public health involvement, using the framework of The Ottawa Charter for Health Promotion as a guide.

By understanding gambling and its potential impacts on the public's health, policy makers and health practitioners can minimize gambling's negative impacts and appreciate its potential benefits.

gambling addictions public health social policy mental health prevention public policy community health 

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REFERENCES

  1. Ackerman, D. (1999). Deep play. (First ed.). New York: Random House.Google Scholar
  2. American Academy of Pediatrics. (1998, August 3, 1998). Teen Gambling Epidemic Linked to Risky Behavior, [Press Release]. American Academy of Pediatrics. Available: http://www.aap.org/advocacy/archives/auggam/htm [1999, November 14].Google Scholar
  3. American Gaming Association. (1998). Guidelines for Children and Minors. Washington, D.C.: American Gaming Association.Google Scholar
  4. American Gaming Association. (1999). PROGRESS: Promoting Responsible Gaming Resources and Educational Standards. Washington, D.C.: American Gaming Association.Google Scholar
  5. American Medical Association. (1994). Resolution No. 430 Warning: Gambling Can Become Compulsive Behavior.Google Scholar
  6. American Psychiatric Association. (1980). DSM-III: Diagnostic and statistical manual of mental disorders. (Third ed.). Washington, D.C.: American Psychiatric Association.Google Scholar
  7. American Psychiatric Association. (1994). DSM-IV: Diagnostic and statistical manual of mental disorders. (Fourth ed.). Washington, D.C.: American Psychiatric Association.Google Scholar
  8. Annis, H. M., & Davis, C. S. (1989). Relapse Prevention. In R. K. Hester & W. R. Miller (Eds.), Handbook of alcoholism treatment approaches: effective alternatives (pp. 170–182). New York: Pergamon Press.Google Scholar
  9. Anthony, G. (1998). Report to the community. Egg Harbor Township, New Jersey: AtlantiCare Foundation.Google Scholar
  10. Ashley, M., Ferrence, R., Room, R., Rankin, J., & Single, E. (1994). Moderate drinking and health: report of an international symposium. Canadian Medical Association Journal, 151(6), 809–828.Google Scholar
  11. Avard, D. (1999, March). What does it take to be healthy? Families Health, 1, 1–2.Google Scholar
  12. Baer, J. S., Marlatt, G. A., & McMahon, R. J. (Eds.). (1993). Addictive behaviors across the life span: prevention, treatment, and policy issues. Newbury Park, CA: Sage.Google Scholar
  13. Benjamin, J., Lin, L., Patterson, C., Greenberg, B. D., Murphy, D. L., & Hamer, D. H. (1996). Population and familial association between the D4 dopamine receptor gene and measures of novelty seeking. Nature Genetics, 12(January), 81–83.Google Scholar
  14. Benson, H. (1984). Beyond the relaxation response. New York: Berkeley.Google Scholar
  15. Bergh, C., Sodersten, E. P., & Nordin, C. (1997). Altered dopamine function in pathological gambling. Psychological Medicine, 27, 473–475.Google Scholar
  16. Bland, R. C., Newman, S. C., Orn, H., & Stebelsky, G. (1993). Epidemiology of pathological gambling in Edmonton. Canadian Journal of Psychiatry, 38, 108–112.Google Scholar
  17. Blaszczynski, A., & Steel, Z. (1998). Personality disorders among pathological gamblers. Journal of Gambling Studies, 14(1), 51–71.Google Scholar
  18. Blaszczysnki, A. P., & McConaghy, N. (1994). Criminal offenses in Gamblers Anonymous and hospital treated pathological gamblers. Journal of Gambling Studies, 10(2), 99–127.Google Scholar
  19. Bondy, S. J., Rehm, J., Ashley, M. J., Walsh, G., Single, E., & Room, R. (1999). Low-risk Drinking Guidelines: The Scientific Evidence. Canadian Journal of Public Health, 90(4), 264–270.Google Scholar
  20. Boothroyd, P., & Eberle, M. (1990). Healthy communities: What they are, how they're made. Vancouver: University of British Columbia, Centre for Human Settlements.Google Scholar
  21. Botelho, R. J., Skinner, H. A., Williams, G. C., & Wilson, D. (1999). Patients with alcohol problems in primary care: Understanding their resistance and motivating change. Primary Care, 26, 279–298.Google Scholar
  22. Botvin, G. (1997, February 7). Prevention theory, methods and empirical findings. Paper presented at the Understanding Prevention, American Academy of Arts & Sciences.Google Scholar
  23. British Medical Association. (1995). Alcohol: Guidelines on Sensible Drinking. London: British Medical Association.Google Scholar
  24. Brown, J. (1987a). A review of meta-analyses conducted on outcome research. Clinical Psychology Review, 7, 1–23.Google Scholar
  25. Brown, R. I. (1987b). Pathological gambling and associated patterns of crime: Comparisons with alcohol and other drug addictions. Journal of Gambling Behavior, 3(2), 98–114.Google Scholar
  26. Bryant, K. J., Windle, M., & West, S. G. (Eds.). (1997). The science of prevention: methodological advances from alcohol and substance abuse research. Washington, D.C.: American Psychological Association.Google Scholar
  27. Campbell, C. S., & Smith, G. J. (1998). Canadian Gambling: Trends and Public Policy Issues. In J. H. Frey (Ed.), Gambling: Socioeconomic Impacts and Public Policy (Vol. 556, pp. 22–35). Thousand Oaks, CA: Sage.Google Scholar
  28. Carroll, T. (1999). Personal Communication with the President: National Association for Public Health Policy.Google Scholar
  29. Centre for Addiction and Mental Health. (1999). Alcohol and your health: low-risk drinking guidelines (pamphlet). Toronto: Ontario: Centre for Addiction and Mental Health.Google Scholar
  30. Centre of Health Promotion. (1997). Proceedings from the International Workshop on Mental Health Promotion. Paper presented at the International Workshop on Mental Health Promotion, Toronto.Google Scholar
  31. Christiansen, E. M. (1998). Gambling and the American economy. In J. H. Frey (Ed.), Gambling: Socioeconomic Impacts and Public Policy (Vol. 556, pp. 36–52). Thousand Oaks, CA: Sage.Google Scholar
  32. Chu, C., & Simpson, R. (Eds.). (1994). Ecological Public Health: From Vision to Practice. Toronto: Participaction and Centre for Health Promotion, University of Toronto.Google Scholar
  33. Clotfelter, C. T., & Cook, P. J. (1989). Selling hope: state lotteries in America. Cambridge: Harvard University Press.Google Scholar
  34. Cole, P. (1998). Report on gambling as a public health issue (Report to Municipal Councils of Brampton, Missassauga, Caledonia). Missassauga: Peel Region Health Department.Google Scholar
  35. Comings, D. E. (1998). The molecular genetics of pathological gambling. CNS Spectrums, 3(6), 20–37.Google Scholar
  36. Crockford, D. N., & el-Guebaly, N. (1998). Psychiatric comorbidity in pathological gambling: a critical review. Canadian Journal of Psychiatry—Revue Canadienne de Psychiatrie, 43(1), 43–50.Google Scholar
  37. Cunningham-Williams, R. M., Cottler, L. B., Compton, W. M., & Spitznagel, E. L. (1998). Taking chances: problem gamblers and mental health disorders—results from the St. Louis epidemiologic catchment area study. American Journal of Public Health, 88(7), 1093–1096.Google Scholar
  38. DeCaria, C. M., Begaz, T., & Hollander, E. (1998). Serotonergic and noradrenergic function in pathological gambling. CNS Spectrums, 3(6), 38–47.Google Scholar
  39. Depape, D., Leonard, M., & Pollett, G. (1995, October 27). Health Benefits of Municipal Alcohol Policy: A Role for Public Health. Public Health & Epidemiology Report Ontario, 6, 262–265.Google Scholar
  40. Department of Public Health Science. (1999). CyberIsle, [World Wide Web]. University of Toronto. Available: http://www.cyberisle.org/cyberisle-welcome/isledawn.html [1999, November 2].Google Scholar
  41. Derevensky, J. L., & Gupta, R. (1998, June, 1998). Pathological gambling problems among a population of delinquent adolescents. Paper presented at the National Conference on Compulsive Gambling, Las Vegas.Google Scholar
  42. Douglas, R. R., Rylett, M., Norbonne-Fortin, C., & Gliksman, L. (1999, July). The evolution of municipal alcohol policy. Municipal World, 21–23.Google Scholar
  43. Driver, B., Brown, P., & Peterson, G. (1991). Benefits of Leisure. Pennsylvania: Venture Publishing Inc.Google Scholar
  44. Durch, J. S., Bailey, L. A., & Stoto, M. A. (Eds.). (1997). Improving Health in the Community: A Role for Performance Monitoring. Washington: National Academy Press.Google Scholar
  45. Eadington, W. R., & Cornelius, J. A. (Eds.). (1993). Gambling behavior & problem gambling. Reno, Nevada: Institute for the Study of Gambling and Commercial Gaming, College of Business Administration, University of Nevada, Reno.Google Scholar
  46. Ebstein, R. P., Novick, O., Umansky, R., Priel, B., Osher, Y., Blaine, D., Bennett, E. R., Nemanov, L., Katz, M., & Belmaker, R. H. (1996). Dopamine D4 receptor (D4DR) exon III polymorphism associated with the human personality trait of novelty seeking. Nature Genetics, 12(January), 78–80.Google Scholar
  47. Ellickson, P. L. (1995). Schools. In R. H. Coombs & D. Ziedonis (Eds.), Handbook on drug abuse prevention (pp. 93–120). Boston: Allyn & Bacon.Google Scholar
  48. Epstein, J. (1989). Confessions of a low roller. In R. Atwan (Ed.), The best American essays 1989 (pp. 98–113). New York: Ticknor & Fields.Google Scholar
  49. Evans, R. G., Barer, M. L., & Marmor, T. R. (Eds.). (1994). Why are some people healthy and others not? The determinants of health of populations. New York: Aldine de Gruyter.Google Scholar
  50. Ewing, J. A. (1984). Detecting alcoholism: the CAGE questionnaire. Journal of the American Medical Association, 252(14), 1905–1907.Google Scholar
  51. Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., Koss, M. P., & Marks, J. S. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The adverse childhood experience (ACE) study. American Journal of Preventive Medicine, 14(4), 245–258.Google Scholar
  52. Fessenden, F. (1999, May 22). Lottery cost is heaviest on the poor. New York Times, pp. A12.Google Scholar
  53. Fleming, A. M. (1978). Something for nothing: a history of gambling. New York: Delacorte Press.Google Scholar
  54. Foege, W. H. (1998). Adverse Childhood Experiences: A Public Health Perspective. American Journal of Preventive Medicine, 14(4), 354–355.Google Scholar
  55. Garbutt, J. C., West, S. L., Carey, T. S., Lohr, K. N., & Crews, F. T. (1999). Pharmacological treatments of alcohol dependence: a review of the evidence. Journal of the American Medical Association, 281, 1318–1325.Google Scholar
  56. Gellert, G. A. (1998). Confronting Violence. Boulder CO: Westview Press.Google Scholar
  57. Gerstein, D., Murphy, S., Toce, M., Hoffmann, J., Palmer, A., Johnson, R., Larison, C., Chuchro, L., Bard, A., Engelman, L., Hill, M. A., Buie, T., Volberg, R., Harwood, H., Tucker, A., Christiansen, E., & Cummings, W. (1999a). Gambling Impact and Behavior Study: Report to the National Gambling Impact Study Commission: National Opinion Research Center.Google Scholar
  58. Gerstein, D., Murphy, S., Toce, M., Hoffmann, J., Palmer, A., Johnson, R., Larison, C., Chuchro, L., Bard, A., Engelman, L., Hill, M. A., Buie, T., Volberg, R., Tucker, A., Harwood, H., Christiansen, E., & Cummings, W. (1999b). Gambling Impact and Behavior Study: Final Report to the National Gambling Impact Study Commission: National Opinion Research Center.Google Scholar
  59. Goodman, R. (1995). The luck business: The devastating consequences and broken promises of America's gambling explosion. New York: The Free Press.Google Scholar
  60. Green, L. W., & Kreuter, M. W. (1991). Health Promotion Planning: An Educational and Environmental Approach. (Second ed.). Mountain View, CA: Mayfield Publishing Company.Google Scholar
  61. Greenhouse, L. (1999, June 15). Justices Strike Down Ban On Casino Gambling Ads: Broadcast Law Sacrificed ‘Truthful Speech.’ New York Times, p. 1.Google Scholar
  62. Hancock, T., & Duhl, L. (1986). Healthy cities: promoting health in the urban context. Copenhagen: World Health Organization Regional Office for Europe.Google Scholar
  63. Hancock, T., & Minkler, M. (1997). Communith Health Assessment or Healthy Community Assessment: Whose Community? Whose Health? Whose Assessment? In M. Minkler (Ed.), Community Organizing and Community Building for Health (pp. 139–156). New Brunswick, NJ: Rutgers University Press.Google Scholar
  64. Hanvey, L., & Kinnon, D. (1994). Violence in Society: A Public Health Perspective (Issue Paper). Ottawa: Canadian Public Health Association.Google Scholar
  65. Harrison, P. (1998). Royal College debates whether MDs should promote moderate consumption of alcohol. Canadian Medical Association Journal, 159(10), 1289–90.Google Scholar
  66. Hays, K. F. (1999). Working It Out: Using exercise in psychotherapy. Washington, D.C.: American Psychological Association.Google Scholar
  67. Heineman, M. (1989). Parents of male compulsive gamblers: Clinical issues/treatment approaches. Journal of Gambling Behavior, 5, 321–333.Google Scholar
  68. Hornblower, M. (1996, April 1). No dice: The backlash against gambling. Time, 29–33.Google Scholar
  69. Horvath, T. A. (1998). Sex, drugs, gambling, & chocolate: a workbook for overcoming addictions. San Louis Obispo, CA: Impact Publishers, Inc.Google Scholar
  70. Institute of Medicine. (1990). Broadening the base of treatment for alcohol problems: Report of a study by a committee of the Institute of Medicine, Division of Mental Health and Behavioral Medicine. Washington, D.C.: National Academy of Science.Google Scholar
  71. Jacobs, D. F., Marston, A. R., Singer, R. D., Widaman, K., Little, T., & Veizades, J. (1989). Children of problem gamblers. Journal of Gambling Behavior, 5, 261–267.Google Scholar
  72. Joubert, N., & Raeburn, J. (1997). Mental Health Promotion: What is it? What can it become? Paper presented at the Ayrshire International Conference on Mental Health Promotion.Google Scholar
  73. Kallick, M., Suits, D., Dielman, T., & Hybels, J. (1979). A survey of American gambling attitudes and behavior (Research report series, Survey Research Center, Institute for Social Research). Ann Arbor, MI: University of Michigan Press.Google Scholar
  74. Kandarian, P. (1998, July 12). Casinos seen as mixed blessing in Conn. Boston Globe, pp. B9.Google Scholar
  75. Kelly, J. (1982). Leisure. Englewood Cliffs, NJ: Prentice-Hall.Google Scholar
  76. Khantzian, E. J. (1997). The self-medication hypothesis of substance use disorders: A reconsideration and recent applications. Harvard Review of Psychiatry, 4(5), 231–244.Google Scholar
  77. Kindt, J. W. (1994). The economic impacts of legalized gambling activities. Drake Law Review, 43, 51–95.Google Scholar
  78. Klein, J. D., Brown, J. D., Childers, K. W., Oliveri, J., Porter, C., & Dykers, C. (1993). Adolescents' Risky Behavior and Mass Media Use. Pediatrics, 92(1), 24–31.Google Scholar
  79. Knapp, T. J., & Lech, B. C. (1987). Pathological gambling: a review with recommendations. Advances in Behavioral Research & Therapy, 9, 21–49.Google Scholar
  80. Kornblit, A. L. (1994). Domestic violence: An emerging health issue. Social Science & Medicine, 39, 1181–1188.Google Scholar
  81. Kraut, R., Patterson, M., Lundmark, V., Kiesler, S., Mukopadhyay, T., & Scherlis, W. (1998). Internet paradox: a social technology that reduces social involvement and psychological well-being? American Psychologist, 53(9), 1017–1031.Google Scholar
  82. Kretzmann, J. P., & McKnight, J. (1993). Building Communities From the Inside Out: A Path Toward Finding and Mobilizing a Community's Assets. Chicago: ACTA Publications.Google Scholar
  83. Ladouceur, R., Boisvert, J. M., Pepin, M., Loranger, M., & Sylvain, C. (1994). Social costs of pathological gambling. Journal of Gambling Studies, 10(4), 399–409.Google Scholar
  84. Ladouceur, R., & Walker, M. (1998). The cognitive approach to understanding and treating pathological gambling. In A. S. Bellack & M. Hersen (Eds.), Comprehensive Clinical Psychology (pp. 588–601). New York: Pergamon.Google Scholar
  85. Lakshmanan, I. A. R. (1996, Saturday, March 9). A woman's life lost to gambling: Suicide high-lights betting's dark side. Boston Globe, pp. 13, 20.Google Scholar
  86. Latour, F. (1996, September 21). Many teenagers doubt antidrug rhetoric: dire warnings seen as clashing with reality. Boston Globe, pp. B1, B3.Google Scholar
  87. Le Groupe Jeunesse in collaboration with Loto-Quebec and Ministere de l'Education. (1998). Awareness Program For The Prevention of Gambling Addiction [multimedia]. Montreal: Le Groupe Jeunesse.Google Scholar
  88. Lesieur, H. R. (1987). Gambling, pathological gambling and crime. In T. Galski (Ed.), The Handbook of Pathological Gambling. Springfield IL: Charles C. Thomas.Google Scholar
  89. Lesieur, H. R. (1998). Costs and treatment of pathological gambling. The Annals of The American Academy of Political and Social Science, 556(March), 153–171.Google Scholar
  90. Lesieur, H. R., & Blume, S. B. (1987). The South Oaks gambling screen (SOGS): A new instrument for the identification of pathological gamblers. American Journal of Psychiatry, 144(9), 1184–1188.Google Scholar
  91. Lesieur, H. R., & Heineman, M. (1988). Pathological gambling among multiple substance abusers in a therapeutic community. British Journal of Addiction, 83, 765–771.Google Scholar
  92. Lesieur, H. R., & Rothschild, J. (1989). Children of Gamblers Anonymous members. Journal of Gambling Behavior, 5, 269–281.Google Scholar
  93. Litten, R. Z., & Allen, J. P. (1999). Medications for alcohol, illicit drugs and tobacco dependence: An update of research findings. Journal of Substance Abuse Treatment, 16, 105–112.Google Scholar
  94. Littman-Sharp, N., Turner, N., Stirpe, T., & Liu, E. (1998, April). The Inventory of Gambling Situations: A newly revised instrument for the identification of problem gamblers' high risk situations. Paper presented at the Canadian Foundation on Compulsive Gambling Annual Conference, Ottawa.Google Scholar
  95. Lopes, L. L. (1987). Between hope and fear: the psychology of risk. In L. Berkowitz (Ed.), Advances in experimental social psychology (Vol. 20, pp. 255–295). San Diego: Academic Press.Google Scholar
  96. Lorenz, V. C. (1987). Family dynamics of pathological gamblers. In T. Galski (Ed.), The Handbook of Pathological Gambling (pp. 71–88). Springfield, IL: Charles C. Thomas.Google Scholar
  97. Lorenz, V. C., & Shuttlesworth, D. E. (1983). The impact of pathological gambling on the spouse of the gambler. Journal of Community Psychology, 11, 67–76.Google Scholar
  98. Lorenz, V. C., & Yaffee, R. (1988). Pathological gambling: Psychosomatic, emotional and marital difficulties as reported by the spouse. Journal of Gambling Behavior, 4, 13–26.Google Scholar
  99. Mann, J. M., Gostin, L., Gruskin, S., Brennan, T., Lazzarini, Z., & Fineberg, H. V. (1994). Health and human rights. Health and Human Rights, 1, 6–23.Google Scholar
  100. Marlatt, G. A., & Gordon, J. (1985). Relapse Prevention. New York: Guilford Press.Google Scholar
  101. Marshall, K. (1998). The gambling industry: raising the stakes. Perspectives on Labour and Income, 10(4), 7–11.Google Scholar
  102. Martinsen, E. W. (1990). Benefits of exercise for the treatment of depression. Sports Medicine, 9, 380–389.Google Scholar
  103. Mauricette, R. (1998). Action steps for taking a mental health promotion approach to program development, Toronto: Canadian Mental Health Association.Google Scholar
  104. McCleary, R., Chew, K., Feng, W., Merrill, V., Napolitano, C., Males, M., & Graffeo, B. (1998). Suicide and Gambling: An analysis of suicide rates in U. S. counties and metropolitan areas. Report to the American Gaming Association. Irvine: University of California Irvine, School of Social Ecology.Google Scholar
  105. 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.Google Scholar
  106. McGinnis, J. M., & Foege, W. H. (1993). Actual causes of death in the United States. Journal of the American Medical Association, 270(18), 2207–2212.Google Scholar
  107. Miller, W. R., Brown, J. M., Simpson, T. L., Handmaker, N. S., Bein, T. H., Luckie, L. F., Montgomery, H. A., Hester, R. K., & Tonigan, J. S. (1995). What works? A methodological analysis of the alcohol treatment outcome literature. In R. K. Hester & W. R. Miller (Eds.), Handbook of alcoholism treatment approaches: effective alternatives (Second ed., pp. 12–44). Boston: Allyn and Bacon.Google Scholar
  108. Miller, W. R., & Rollnick, S. (Eds.). (1991). Motivational interviewing: Preparing people to change addictive behavior. New York: Guilford Press.Google Scholar
  109. Moody, G. (1989). Parents of young gamblers. Journal of Gambling Behavior, 5, 313–320.Google Scholar
  110. Nadler, L. B. (1985). The epidemiology of pathological gambling: critique of existing research and alternative strategies. Journal of Gambling Behavior, 1(1), 35–50.Google Scholar
  111. National Assembly of National Voluntary Health and Social Welfare Organizations. (1994). Building Resiliency: What Works! Paper presented at the National Assembly, Washington, D.C.Google Scholar
  112. National Association of Attorneys General. (1996, May/June). Executive summary of Internet gambling report. NAAG Gaming Developments Bulletin, 12.Google Scholar
  113. National Council of Welfare. (1996). Gambling in Canada. Ottawa: National Council of Welfare.Google Scholar
  114. National Gambling Impact Study Commission. (1999). National Gambling Impact Study Commission Report. Washington, D. C.: National Gambling Impact Study Commission.Google Scholar
  115. National Research Council. (1999). Pathological gambling: A critical review. Washington D.C.: National Academy Press.Google Scholar
  116. North American Training Institute. (1999). In Search of Balance: A Problem Gambling Educational Kit Designed for Senior Citizens [World Wide Web]. North American Training Institute. Available: http://stores.inficonn.net/cgibin/nati.storefront [1999, November 12].Google Scholar
  117. Orford, J. (1985). Excessive appetites: a psychological view of addictions. New York: John Wiley & Sons.Google Scholar
  118. Phillips, D. P., Welty, W. R., & Smith, M. M. (1997). Elevated suicide levels associated with legalized gambling. Suicide and Life-Threatening Behavior, 27(4), 373–378.Google Scholar
  119. Politzer, R. M., Yesalis, C. E., & Hudak, C. J. (1992). The epidemiologic model and the risk of legalized gambling: where are we headed? Health Values, 16(2), 20–27.Google Scholar
  120. Prochaska, J. O., DiClemente, C. C., & Norcross, J. C. (1992). In search of how people change: applications to addictive behaviors. American Psychologist, 47, 1102–1114.Google Scholar
  121. Quinn, J. P. (1891). Fools of fortune. Chicago: The Anti-Gambling Association.Google Scholar
  122. Rado, S. (1933). The psychoanalysis of pharmacothymia (drug addiction). Psychoanalytic Quarterly, 2, 1–23.Google Scholar
  123. Raglin, J. S. (1997). Anxiolytic effects of physical activity. In W. P. Morgan (Ed.), Physical activity and mental health (pp. 107–126). Washington, D.C.: Taylor & Francis.Google Scholar
  124. Rehm, J. T., Bondy, S. J., Sempos, C. T., & Vuong, C. V. (1997). Alcohol consumption and coronary heart disease morbidity and mortality. American Journal of Epidemiology, 146, 495–501.Google Scholar
  125. Ringwalt, C. (1999). Personal Communication with the Chair, Alcohol Tobacco and Other Drug Section: American Public Health Association.Google Scholar
  126. Room, R., Turner, N. E., & Ialomiteanu, A. (1998). Community Effects of the Opening of the Niagara Casino: A First Report. Toronto: Centre for Addiction & Mental Health.Google Scholar
  127. Rose, I. N. (1986). Gambling and the law. (1st ed.). Hollywood, CA: Gambling Times; Secaucus.Google Scholar
  128. Rosecrance, J. (1985). Compulsive gambling and the medicalization of deviance. Social Problems, 32, 275–284.Google Scholar
  129. Rosecrance, J. (1988). Gambling without guilt: The legitimation of an American pastime. Pacific Grove, CA: Brooks/Cole Publishing Company.Google Scholar
  130. Rowan, M. S., Galasso, C., & Colbran-Smith, M. (1998). Substance Use & Pathological Gambling Disorders: Final Needs Assessment Report (Unpublished report). Ottawa: Canadian Medical Association.Google Scholar
  131. Rugle, L., & Melamed. (1993). Neuropsychological assessment of attention problems in pathological gamblers. Journal of Nervous and Mental Disorders, 18(2), 107–112.Google Scholar
  132. Sanchez-Craig, M. (1993). Saying When: How to Quit Drinking or Cut Down. Toronto: Addiction Research Foundation.Google Scholar
  133. Shaffer, H. J. (1987). The epistemology of “addictive disease”: The Lincoln-Douglas debate. Journal of Substance Abuse Treatment, 4(2), 103–113.Google Scholar
  134. Shaffer, H. J. (1991). Toward an epistemology of “addictive disease.” Behavioral Sciences & the Law, 9(3), 269–286.Google Scholar
  135. Shaffer, H. J. (1996). Understanding the means and objects of addiction: technology, the Internet, and gambling. Journal of Gambling Studies, 12(4), 461–469.Google Scholar
  136. Shaffer, H. J. (1997a). The most important unresolved issue in the addictions: conceptual chaos. Substance Use & Misuse, 32(11), 1573–1580.Google Scholar
  137. Shaffer, H. J. (1997b). The psychology of stage change. In J. H. Lowinson, P. Ruiz, R. B. Millman, & J. G. Langrod (Eds.), Substance abuse: a comprehensive textbook (Third ed., pp. 100–106). Baltimore: Williams & Wilkins.Google Scholar
  138. Shaffer, H. J., & Hall, M. N. (1996). Estimating the prevalence of adolescent gambling disorders: a quantitative synthesis and guide toward standard gambling nomenclature. Journal of Gambling Studies, 12(2), 193–214.Google Scholar
  139. Shaffer, H. J., Hall, M. H., & Vander Bilt, J. (1997a). Estimating the prevalence of disordered gambling behavior in the United States and Canada: A Meta-analysis. Boston: Presidents and Fellows of Harvard College.Google Scholar
  140. Shaffer, H. J., Hall, M. N., & Vander Bilt, J. (1997b). Estimating the prevalence of disordered gambling behavior in the United States and Canada: A meta-analysis. Boston: Presidents and Fellows of Harvard College.Google Scholar
  141. Shaffer, H. J., Hall, M. N., Walsh, J. S., & Vander Bilt, J. (1995a). The psychosocial consequences of gambling. In R. Tannenwald (Ed.), Casino Development: How Would Casinos Affect New England's Economy? (pp. 130–141). Boston: Federal Reserve Bank of Boston.Google Scholar
  142. Shaffer, H. J., LaBrie, R., Scanlan, K. M., & Cummings, T. N. (1994). Pathological gambling among adolescents: Massachusetts gambling screen (MAGS). Journal of Gambling Studies, 10(4), 339–362.Google Scholar
  143. Shaffer, H. J., & Robbins, M. (1995). Psychotherapy for addictive behavior: a stage-change approach to meaning making. In A. M. Washton (Ed.), Psychotherapy and Substance Abuse: A Practitioner's Handbook (pp. 103–123). New York: Guilford.Google Scholar
  144. Shaffer, H. J., Stein, S., Gambino, B., & Cummings, T. N. (Eds.). (1989). Compulsive gambling: theory, research & practice. Lexington, MA: Lexington Books.Google Scholar
  145. Shaffer, H. J., Vander Bilt, J., & Hall, M. N. (1999). Gambling, drinking, smoking and other health risk activities among casino employees. American Journal of Industrial Medicine, 36(3), 365–378.Google Scholar
  146. Shaffer, H. J., Walsh, J. S., Howard, C., Hall, M. N., & Wellington, C. (1995b). Science and substance abuse education: a needs assessment for curriculum design (SEDAP Technical Report #08295–300). Boston: Division on Addictions, Harvard Medical School.Google Scholar
  147. Shookner, M. (1998). The Quality of Life in Ontario. Toronto: Ontario Social Development Council & Social Planning Network of Ontario.Google Scholar
  148. Simpson, R. (1994). Integrating Health and Environmental Assessment. In C. Chu & R. Simpson (Eds.), Ecological Public Health: From Vision to Practice (pp. 62–74). Toronto: Participaction and Centre for Health Promotion University of Toronto.Google Scholar
  149. Single, E., Conley, P., Hewitt, D., Mitic, W., Poulin, C., Reiley, D., Room, R., Sawka, E., & Topp, J. (1996). Harm reduction: concepts and practice (Policy Discussion Paper). Ottawa: Canadian Centre on Substance Abuse.Google Scholar
  150. Skinner, B. F. (1969). Contingencies of reinforcement: a theoretical analysis. Engelwood Cliffs, NJ: Prentice-Hall, Inc.Google Scholar
  151. Skinner, H. A., Maley, O., Smith, L., & Morrison, M. (in press). New Frontiers: Using the Internet to Engage Teens in Substance Abuse Prevention and Treatment. In P. Monte & S. Colby (Eds.), Adolescence, Alcohol, and Substance Abuse: Reaching Teens through Brief Intervention, New York: Guilford Press.Google Scholar
  152. Skinner, H. A. (1990). Spectrum of drinkers and intervention opportunities. Canadian Medical Association Journal, 143, 1054–1059.Google Scholar
  153. Smart, R. G., & Ferris, J. (1996). Alcohol, drugs and gambling in the Ontario adult population, 1994. Canadian Journal of Psychiatry, 41, 36–45.Google Scholar
  154. Smith, G., & Abt, V. (1984). Gambling as play. The Annals of the American Academy of Political and Social Science, 474, 122–132.Google Scholar
  155. Smith, G. J., & Wynne, H. J. (1999). Gambling and Crime in Western Canada: Exploring Myth and Reality. Calgary: Canada West Foundation.Google Scholar
  156. Sobell, M. B., & Sobell, L. C. (1993). Problem drinkers: Guided self-change treatment. New York: The Guilford Press.Google Scholar
  157. Spunt, B., Lesieur, H., Hunt, D., & Cahill, L. (1995). Gambling among methadone patients. International Journal of Addictions, 30, 929–962.Google Scholar
  158. Steinberg, M., Kosten, T., & Rounsaville, B. (1992). Cocaine abuse and pathological gambling. American Journal on Addictions, 1, 121–132.Google Scholar
  159. Stokols, D. (1992). Establishing and Maintaining Healthy Environments: Toward a Social Ecology of Health Promotion. American Psychologist, 47(1), 6–22.Google Scholar
  160. Svendsen, R., & Griffin, T. (1998). Gambling: choices and guidelines (Booklet). Anoka, MN: Minnesota Institute of Public Health.Google Scholar
  161. Swift, R. M. (1999). Drug Therapy: Drug Therapy for Alcohol Dependence. New England Journal of Medicine, 340, 1482–1490.Google Scholar
  162. Taber, J. I. (1987). Compulsive gambling: An examination of relevant models. The Journal of Gambling Behavior, 3, 219–223.Google Scholar
  163. Topp, J., Sawka, E., Room, R., Poulin, C., Single, E., & Thompson, H. (1998). Policy Discussion Paper on Problem Gambling. Ottawa: Canadian Centre on Substance Abuse.Google Scholar
  164. Travis, J. W., & Ryan, R. S. (1981). Wellness Workbook. Berkeley, CA: Ten Speed Press.Google Scholar
  165. Trimeridian, I. (1999). Trimeridian, Inc.: Resources for problem gambling, [World Wide Web]. Trimeridian, Inc., Available: http://www.trimeridian.com/ [1999, November 2].Google Scholar
  166. Trout, D., Decker, J., Mueller, C., Bernert, J. T., & Pirkle, J. (1998). Exposure of Casino Employees to Environmental Tobacco Smoke. Journal of Occupational & Environmental Medicine, 40(3), 270–276.Google Scholar
  167. U.S. Department of Health, Education, and Welfare. (1964). Smoking and Health: Report of the Advisory Committee to the Surgeon General of the Public Health Service. Rockville, MD: Centers for Disease Control, 1964.Google Scholar
  168. Vaillant, G. E. (1983). The natural history of alcoholism: Causes, patterns, and paths to recovery. Cambridge: Harvard University Press.Google Scholar
  169. Vander Bilt, J., & Franklin, J. (in press). Gambling in a Familial Context. In H. J. Shaffer, M. N. Hall, J. Vander Bilt, & E. George (Eds.), Youth Gambling: Futures at Stake. Reno, NV: University of Nevada Press.Google Scholar
  170. WAGER, T. (1999). Epidemiological Measurement: DALY Issue & Prevalent Dilemma. The WAGER, 4(43), 1–2.Google Scholar
  171. Walsh, G. W., Bondy, S. J., & Rehm, J. (1998). Review of Canadian Low-risk Drinking Guidelines and Their Effectiveness. Canadian Journal of Public Health, 89(4), 241–247.Google Scholar
  172. WEFA Group, ICR Survey Research Group, Lesieur, H., & Thompson, W. (1997). A study concerning the effects of legalized gambling on the citizens of the state of Connecticut: State of Connecticut Department of Revenue Services, Division of Special Revenue.Google Scholar
  173. Weiss, M. R. (1995). Children in sport: An educational model. In S. M. Murphy (Ed.), Sport psychology interventions (pp. 39–70). Champaign, IL: Human Kinetics.Google Scholar
  174. Wildman, R. W. (1989). Pathological gambling: Marital-familial factors, implications, and treatments. Journal of Gambling Behaviors, 5, 293–301.Google Scholar
  175. Willinsky, C., & Pape, B. (1997). Mental Health Promotion. Toronto: Canadian Mental Health Association.Google Scholar
  176. World Health Organization. (1984). Report of the Working Group on the Concepts and Principles of Health Promotion. Copenhagen: WHO Regional Office for Europe.Google Scholar
  177. World Health Organization. (1986). Health promotion: a discussion document on the concepts and principles. Health Promotion, 1(1), 73–76.Google Scholar
  178. World Health Organization, Health and Welfare Canada, & Canadian Public Health Association. (1986, November 17–21). Ottawa charter for health promotion. Paper presented at the International Conference on Health Promotion: The Move Towards a New Public Health, Ottawa, Ontario, Canada.Google Scholar
  179. Wray, I., & Dickerson, M. (1981). Cessation of high frequency gambling and “withdrawal” symptoms. British Journal of Addiction, 76, 401–405.Google Scholar
  180. Wynne, H. J. (1997). Gambling as a public policy issue: Keynote address at the second Bi-Annual Conference on Problem and Compulsive Gambling. Paper presented at the Canadian Foundation on Compulsive Gambling Annual Conference, Toronto.Google Scholar
  181. Young, T. K. (1998). Population Health: Concepts and Methods. New York: Oxford University Press.Google Scholar
  182. Zinberg, N. E. (1975). Addiction and ego function. Psychoanalytic Study of The Child, 30, 567–588.Google Scholar
  183. Zinberg, N. E. (1984). Drug, set, and setting: The basis for controlled intoxicant use. New Haven: Yale University Press.Google Scholar
  184. Zitzow, D. (1996). Comparative study of problematic gambling behaviors between American Indian and non-Indian adolescents within and near a northern plains reservation. American Indian and Alaskan Native Mental Health Research, 7(2), 14–26.Google Scholar

Copyright information

© Human Sciences Press, Inc. 1999

Authors and Affiliations

  • David A. Korn
    • 1
  • Howard J. Shaffer
    • 2
  1. 1.Department of Public Health SciencesUniversity of Toronto; Division on Addictions, Harvard Medical SchoolUSA
  2. 2.Division on AddictionsHarvard Medical SchoolUSA

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