Dr. Patrick Basham is back with his second editorial for CalvinAyre.com. This time this good doctor is joined by his Gambling: A Healthy Bet co-author John Luik as they discuss the lessons the gambling industry should learn from other industries’ experience with government-imposed health warnings.
– Bill Beatty
Tobacco’s Graphic Warning for the Gambling Industry
Patrick Basham and John Luik
Gambling is the new tobacco. Very belatedly, the gambling industry is waking up to the fact that the global public health establishment’s social engineers are turning their regulatory sights towards those who provide gambling products and services.
Fortunately, it is not too late for the gambling industry to learn invaluable lessons from the tobacco, alcohol, and obesity wars waging throughout the Western world. Exhibit A is the regulatory push for new and larger warnings on ‘unhealthy’ products and services, such as cigarettes, alcoholic drinks, Big Macs and gambling.
On the tobacco regulatory front, the Obama Administration has just announced plans to introduce graphic health warnings (GHW) on American cigarettes; the EU is considering similar measures. Last week, Australia’s Labor Government introduced a draconian parliamentary bill to require the plain packaging of cigarette products whose commercial branding would be replaced by very large, colourful GHW. In London, the Conservative-led coalition Government is seriously contemplating a comparable debranding-plus-enhanced-GHW intervention in the UK tobacco marketplace.
On the gambling regulatory front, the Australian Government is currently studying whether to extend its would-be crackdown on tobacco marketing to gambling machines, as the South African Government introduces its own restrictions on gambling advertisements on television and at the cinema. And, in deference to federal American regulators’ anti-gambling agenda, last year Facebook banned all gambling advertisements on its ubiquitous social networking site.
Foreshadowing the direction of British regulatory policy, Prime Minister David Cameron’s Conservatives, when in Opposition, argued in favour of health warnings on gambling advertisements.
Critically, the argument for marketing restrictions – and for health warnings, specifically – is consistently and conveniently applied (only the product-specific details differ) across all of the proposals to regulate the tobacco, food, alcohol, and gambling industries, respectively.
The anemic theory behind tobacco health warnings is two-fold. First, there allegedly exists a significant “information deficit” among the general public, especially among young people and potential smokers. Incredibly, the streets of London and New York are teeming with people who are completely unaware that smoking is bad for one’s health.
Second, in light of such widespread, if undocumented, public ignorance about the dangers of smoking, it is forecast that health warnings will educate such people that smoking is, in fact, dangerous and, consequently, many will quit smoking while others will never take up the dirty habit in the first place. And, we are assured, the scarier the warning, the better the outcome will be for public health.
All of which begs an obvious question. Do health warnings actually work? The equally obvious answer is no, they do not.
Although, according to the World Health Organization, more than 1 billion people in 19 countries are now covered by laws requiring large GHWs on cigarette packs (almost double the number of two years ago), several research studies published over the past year have found GHW to be a complete and utter policy failure.
For instance, a December 2010 US Food and Drug Administration study concluded that GHW have no influence upon quitting or smoking initiation, which confirmed earlier research by the Canadian Government, which found GHW neither reduce youth smoking nor youth initiation, nor do they reduce adult smoking levels. Similarly, Australian research published earlier this year found that GHW do not lead to any significant positive behavioural changes. Most recently, a team of German doctors found in a research study published June 21st that images of corpses and cancerous lungs on cigarette packs may do little to deter nicotine addicts.
These miserable results for tobacco health warnings occur for reasons that are clearly analogous to the gambling experience.
First, health warnings do not increase smokers’ information regarding the risks of smoking. The plain truth is that the information contained in health warnings is neither new nor useful to smokers and potential smokers. That is because, as Harvard University’s Kip Viscusi has documented, smokers actually over-estimate the risks of smoking to their health.
Second, most people respond to health warnings in a manner that the scientific literature refers to as “cognitive readjustment,” that is, we recognise the dangers contained in the warnings but we exempt ourselves from the potentially dire consequences, as we simply do not believe such bad things will happen to us.
Third, today most people suffer from “warning fatigue,” that is, we have been bombarded for so long with so many warnings about so many products and activities that we simply tune most of them out, including ‘new’ health warnings about tobacco products.
Fourth, low-income people disproportionately filter out ‘helpful’ public health information. Whereas high-income people are comparatively health conscious, such behaviour – and, hence, such information – is relatively unimportant to those with comparatively little disposable income. As modern-day smokers in Western nations are disproportionately low-income, the futility of new and larger health warnings is blindingly obvious. And, fifth, low self-esteem sufferers (who are disproportionately low-income people, too) also have a strong tendency to ignore danger warnings explicitly designed to influence their health and lifestyle choices.
Sixth, researchers have found that those potential smokers who possess less information about smoking’s risks are not more likely to start smoking than those who are better informed about the potential health dangers.
Seventh, many smokers have been brainwashed by public health propaganda into believing that their dangerous ‘addiction’ is so hard-core that it is beyond their own control and, therefore, beyond their own personal responsibility. They are convinced that nothing short of medical intervention will enable them to quit. As a result, they, too, simply ignore the warnings.
Finally, large, “scary” health warnings are usually counterproductive. Why? In the psychology literature, researchers employ the term “reactance” to explain people’s unintended response to such warnings. Put into common parlance, health warnings fail, in no small part, because they encourage rebellious acts, whereby teenagers in particular are attracted to risky behaviour that has been explicitly proscribed by adults in positions of authority.
In May, Oxford University’s Brian Earp informed a British Psychological Society conference that his research had found public health campaigns such as anti-smoking and anti-junk food advertisements can be counterproductive by encouraging the very behaviour they warn against.
There is plenty of other scientific evidence about such warnings’ failure with non-tobacco products. For example, a UK Government public health campaign in the 1980s to inform British teenagers about the risks of heroin use served primarily to attract risk-taking youths to the illegal drug. More recently, the US Centers for Disease Control found that alcohol consumption among pregnant women rose after the introduction of warnings about the dangers of drinking during pregnancy. Along these same lines, a US Department of Agriculture study concluded that food labelling is not an effective policy tool for altering consumer behaviour.
The international experience with health warnings on or about tobacco, food, and alcohol products suggests very strongly that health warnings on gambling advertisements, etc. would be ineffective, perhaps even counterproductive. Yet, rest assured, ‘new’ and ‘improved’ health warnings will be a part of the coming push to better regulate the gambling industry for the betterment of public health.
Nevertheless, by properly marshalling and appropriately communicating the wealth of warnings evidence, the gambling industry could strike a principled and powerful blow for regulatory common sense.