Cards on the table

As policymakers consider revising India’s 150-year-old gambling laws, it’s time for the country to take a public health perspective on the issue, Sanju George writes.

It is understood that the Law Commission of India is considering new gambling regulations in India. Few specifics are known, however, there is no doubt that gambling legislation in India, which is over 150 years old, needs to be made more relevant to the present day. The approach legislators are likely to take might be one of – ‘it can’t be stopped, so might as well try to regulate it’. The revenue that stands to be generated might interest the government enough to at least partially legalise gambling activities in India.

Types of gambling activities and the modes of gambling in India (and what Indians can access) have changed drastically since the 19th Century. But what is equally, if not more important is to have a wider debate about gambling-related research, education, treatment and policy in India.

Gambling was a popular pastime in ancient and colonial India and continues to be so in modern India. The Public Gambling Act of 1867 is the only law that regulates gambling in India. The central government has vested individual state governments with powers to make gambling legal or illegal within their states, and they do this by making state-specific amendments to the 1867 law.

Currently, the only legal forms of gambling in India are state-run lotteries (in some states only), horse racing, rummy card games and casinos (in two states). Lotteries are legal in 12 states and five Union territories, but are banned in 17 states. Anecdotally, India also has a huge illegal betting market and betting on sports such as cricket is extremely popular.

So with change on the horizon for India’s gambling laws, now is a good time for the country’s policymakers to look again at how to formulate India’s direction for gambling-related research, education, treatment and policy.

First, it is crucial for Indian policymakers to conceptualise gambling and problem gambling as a public health issue. This is essential for the prevention and minimisation of gambling-related problems.

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Such an approach consists of a three-level prevention strategy: primary prevention (measures aimed at preventing gambling from becoming a problem in the first place by raising awareness about the potential for harm), secondary prevention (measures targeted at early diagnosis and treatment, involving screening in settings such as primary care and mental health services, followed by brief specialist interventions for gamblers and their families), and tertiary prevention (measures such as specialist and intense psychological and psychiatric interventions for problem gamblers and support for their families).

Second, there must be consideration of the ethical aspects of funding gambling treatment and research. A debate needs to be had about who pays for research into gambling and treatment of gambling-related problems. Some purists may see money accepted from the gambling industry as ‘blood money’ and would reject this. In this scenario, research is exclusively dependent on the government for funding. Alternatively, one could be more pragmatic, and take the position that funding from the industry can be accepted but on the condition that it is subject to strict ethical scrutiny.

Third, India needs a national gambling strategy and a body to oversee it. This is also key to minimising gambling-related harm. This independent body should be comprised of experts from the fields of gambling research, treatment, policy and academia. Its function would be to advise the government on the research, education and treatment elements in a national responsible gambling strategy, and to determine both what is required to reduce harm from gambling as well as the levels of funding necessary to deliver the recommended priorities.

Finally, there needs to be more acknowledgement of the importance of research. There exists very little research on gambling in India, and an ideal starting point could be more epidemiological research such as community-based prevalence studies of gambling. Once there is a greater understanding of the socio-demographics and prevalence of gambling and gambling problems (including types, patterns, and frequency), further research into co-occurring additional diseases and necessary treatment can follow.

A revision of India’s archaic gambling legislation is long overdue. Right now there is a great opportunity to formulate a national-level policy and strategy into the research, education and treatment aspects of gambling in India. That requires more than just a roll of the dice to get right – it needs key stakeholders to come together.