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. 2020 Dec 18;20(1):1921.
doi: 10.1186/s12889-020-10008-9.

The societal costs of problem gambling in Sweden

T Hofmarcher  1 , U Romild  2 , J Spångberg  2 , U Persson  1 , A Håkansson  3
Affiliations

The societal costs of problem gambling in Sweden

T Hofmarcher et al. BMC Public Health. .

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: Cost-of-illness; Economic burden; Gambling; Societal costs; Sweden.

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Conflict of interest statement

TH, UR, JS, UP declare that they have no competing interests. AH declares research funding from Svenska Spel, a state-owned company operating in the gambling market in Sweden, from the research council of the Swedish alcohol monopoly (Systembolaget), as well as from the Swedish Sports Federation, the Swedish Enforcement Authority, and from the regional health care organization in southern Sweden.

Figures

Fig. 1
Fig. 1
Societal costs of problem gambling in Sweden in 2018
See this image and copyright information in PMC

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