The societal costs of problem gambling in Sweden
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RESEARCH ARTICLE
Open Access
The societal costs of problem gambling in Sweden T. Hofmarcher1, U. Romild2, J. Spångberg2, U. Persson1 and A. Håkansson3*
Abstract Background: Problem gambling is a public health issue affecting both the gamblers, their families, their employers, and society as a whole. Recent law changes in Sweden oblige local and regional health authorities to invest more in prevention and treatment of problem gambling. The economic consequences of gambling, and thereby the potential economic consequences of policy changes in the area, are unknown, as the cost of problem gambling to society has remained largely unexplored in Sweden and similar settings. Methods: A prevalence-based cost-of-illness study for Sweden for the year 2018 was conducted. A societal approach was chosen in order to include direct costs (such as health care and legal costs), indirect costs (such as lost productivity due to unemployment), and intangible costs (such as reduced quality of life due to emotional distress). Costs were estimated by combining epidemiological and unit cost data. Results: The societal costs of problem gambling amounted to 1.42 billion euros in 2018, corresponding to 0.30% of the gross domestic product. Direct costs accounted only for 13% of the total costs. Indirect costs accounted for more than half (59%) of the total costs, while intangible costs accounted for 28%. The societal costs were more than twice as high as the tax revenue from gambling in 2018. Direct and indirect costs of problem gambling combined amounted to one third of the equivalent costs of smoking and one sixth of the costs of alcohol consumption in Sweden. Conclusions: Problem gambling is increasingly recognized as a public health issue. The societal costs of it are not negligible, also in relation to major public health issues of an addictive nature such as smoking and alcohol consumption. Direct costs for prevention and treatment are very low. A stronger focus on prevention and treatment might help to reduce many of the very high indirect and intangible costs in the future. Keywords: Gambling, Societal costs, Cost-of-illness, Economic burden, Sweden
Background Gambling problems are a widespread phenomenon in many countries around the world. A recent review of prevalence rates across all continents found that adult past-year problem gambling rates ranged from 0.1 to 5.8% in the period 2000–2015 [1]. Country-specific estimates in Europe ranged from 0.1 to 3.4%, although different methodological procedures and instruments limit * Correspondence: [email protected] 3 Clinical Addiction Research Unit, Lund University, Malmö Addiction Center, 205 02 Malmö, Sweden Full list of author information is available at the end of the article
comparisons. These estimates are also in line with an older review of prevalence rates in Europe [2]. In Sweden, 1.3% of the population aged 16–87 experienced gambling problems according to the latest estimate from 2018, and an additional 2.9% experienced less serious sub-clinical problems [3]. Ga
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