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Until the Federal Law on Games
of Chance and Casinos came into effect, the maximum stake in gambling
had been limited to CHF five per game. Slot machine gambling had different
cantonal note
2 (state) laws that controlled the management of the
amusement arcades (facilities with only machines) and small casinos. This
led to a total banishment of gambling in some cantons (e.g., Zurich) while
a relatively high number of machines were distributed to small casinos,
amusement arcades and public places such as bars and restaurants in other
cantons (e.g., Ticino). Additionally, many grand casinos note
3 in France, Italy, Austria and Germany are situated alongside
the Swiss border.
This new federal law distinguishes
between two kinds of gambling:
- games of skill (e.g., card
games like poker, as well as machine games where the outcome depends
to some degree on the skill of the player)
- games of chance that cannot
be influenced by the skills of the gambler (e.g., slot machines or one-armed
bandits; in the following text they are referred to as "chance amusement
machines").
Games of chance will be strictly
limited by law to special resorts like casinos and amusement arcades.
Every person or legal entity wanting to run a gambling enterprise must
apply for a concession from the federal government. The newly formed Federal
Swiss Casino Commission note
4 will review the applications and make recommendations to
the federal government.
The deadline for applications
was September 30, 2000. The commission has promised to take about a year
to review and make a decision on the applications. Two different types
of concessions will be granted: Type A concessions for grand casinos (these
will be taxed less), and Type B concessions for smaller casinos (these
will be taxed more). Type A casinos will be allowed to offer 14 different
table games with unlimited stakes, jackpots and maximum winnings at all
machines. Type B casinos will only be allowed to offer three kinds of
table games with limited stakes, jackpots and maximum winnings at all
machines.
Taxation will be regulated
as follows: Casinos of Type A pay 40% of their revenues up to CHF 20 million,
and for each additional million the taxation rises by 0.5%. Casinos of
Type B pay 40% of their revenues up to CHF 10 million, and for each additional
million the taxation rises by 1%. The plan is to evenly distribute the
concessions across Switzerland. Type A casinos will only be permitted
within a catchment area of a million people or more. Overall, the intended
result is to have about two to six Type A casinos and 15 to 20 Type B
casinos all over Switzerland.
Gambling via telecommunications,
especially the Internet, is forbidden. In Switzerland however, there are
no models for prosecution in case of violation, nor does the law or the
decree provide any. Cantonal law will control machines offering games
of skill (in contrast to machines that solely depend on chance).
A five-year transitional law
came into effect on April 1, 2000 for amusement machines depending solely
on chance in both public places (restaurants, bars, waiting lounges, etc.)
and amusement arcades, as well as for casinos that already exist. On April
1, 2005, operation of all games of chance amusement machines run by persons
or legal entities that have not been granted a concession will be stopped.
The Social Concept –
A Nationwide Approach
The legal basis for a social
concept
In order to obtain a concession
on the recommendation of the Swiss Federal Gambling Commission, each applicant
is required to meet certain standards concerning
- measures for prevention
and harm reduction of pathological and problem gambling,
- proper training of the casino
staff, and
- provision of data for research.
Each applicant must describe
in detail in a social concept how these criteria will be fulfilled.
These very strict requirements
laid down by federal law create a peculiar situation; systematic, preventive
and harm reduction measures have to be introduced nationally and at the
beginning of grand casino gambling in Switzerland. To our knowledge, these
are unique prerequisites in a nation legalizing gambling.
Experiences in other countries
Most countries that allow large-scale
gambling lack systematic, nationwide regulation for preventive measures.
Though internationally there has been an increase in gambling policy development
in both public and private sectors, the level of interest and the funds
available for education, prevention and treatment have not kept pace with
increases in legal gambling revenues or in the availability of gambling
.
In some Canadian provinces,
in Germany, Sweden and the U.S., as well as in some states in Australia,
the government grants money for prevention, treatment and research. For
instance, two U.S. federal health agencies: the National Institute of
Health, and the Substance Abuse and Mental Health Services Administration
have allocated funds for research and services. However, "the level of
funding is often minuscule compared to similar programs for mental health,
substance abuse, and other human services."
In other countries, governments
do not engage in funding prevention and harm reduction measures at all.
There may be some private funding either in addition to or instead of
public funding. In the U.S. and the Netherlands, the private enterprises
running casinos have started several initiatives. In the U.S., the gaming
industry became active in the field of underage and problem gambling during
the 1990s. The American Gaming Association (AGA) founded and financially
supports the National Center of Responsible Gaming (NCRG), which grants
funds to research projects carried out by academic institutions in North
America, and to organizations providing counseling for underage and problem
gambling.
In the Netherlands, gambling
was legalized in 1975 and the government granted Holland Casino's exclusive
rights to run casinos in the Netherlands. Part of the corresponding regulations
asked for a prevention concept. Holland Casino's and VAN (the Dutch amusement
machine industry) are co-operating with Jellinek Consultancy (a counseling
and prevention service linked to the Amsterdam Institute for Addiction
Research – Jellinekhuis) to provide prevention and harm reduction
measures.
Together, they worked out a
prevention plan that includes
- the possibility of suspending
people who have gambling problems, and
- a training program for casino
and amusement arcade employees, social workers and relatives on how
to deal with those who have gambling problems.
In addition to the legal casinos,
there are an estimated 40 to 50 illegal casinos ; most of the gambling
in Dutch casinos remains uncontrolled. Furthermore, innumerable slot machines
are located in eating establishments and amusement arcades throughout
the Netherlands. In an attempt to reduce uncontrolled gambling opportunities,
the number of amusement machines in public places was reduced, but interestingly,
the number of lotteries rose at the same time. Preventive measures for
amusement machines, lotteries and illegal casinos are carried out in a
non-standardized way, if they are carried out at all: meaning, they do
not co-operate with the Jellinek Consultancy.
The Dutch example seems to
indicate that government funding for prevention and harm reduction may
not be necessary and could be replaced by funding provided by the sector
itself. Such efforts have to be regulated; however, it is not only government
regulations that are important, but also their enforcement. If most of
the casinos are not participating in a standardized, national approach,
the result will not be effective.
The implementation of social
concepts in Switzerland
There will probably not be
a standardized concept for all casinos in Switzerland as the applicants
for a concession had to submit a fully developed social concept of their
own. Until the concessions are granted in fall of 2001, the applicants
are effectively in competition with each other, which makes exchanging
concepts and ideas highly unlikely. However, each submission is bound
to contain what's required by law since the granting of the concessions
will be based on quality, along with other factors such as location, local
traffic and size of the catchment area. Because competition is tough,
it is expected (and hoped by some) that a well-planned social concept
could mean winning the bid.
For each casino or for each
company representing several casinos, a social advisory board will supervise
the translation of its concept into action. Depending on the concept,
its members will often be independent experts from the therapy, social
services and research fields, but will also sometimes include casino executives.
The advisory boards will report directly to the Swiss Federal Casino Commission.
Last but not least, the law
in Switzerland creates a unique chance to collect research; providing
data for research is part of the social concept. Implementing grand casinos
in a country where gambling had been strictly limited has been rarely
evaluated until now (see Room, Turner & Iolamiteanu, 1999 for an exception)
and could be especially interesting for other countries that also wish
to legalize gambling. Furthermore, comparing development in cantons where
gambling had been totally abolished, and development in cantons where
gambling had already taken place might prove to be interesting. However,
most evaluations will require baseline data (e.g., the current level of
problem gambling) in order to be able to interpret results and make valid
conclusions. Unfortunately, such data has been lacking so far.
An Example of a Social Concept
in Switzerland:
The Social Concept of Grand Casino SA
The Addiction Research Institute
in Zurich has developed a social concept that the Grand Casino SA and
its partners (ACE Admiral Casino & Entertainment AG, Escor AG, German
Casino Management Group) will use to apply for concessions for 10 different
casinos (two of Type A, eight of Type B) all over Switzerland. To obtain
a concession, the casinos have agreed to subscribe to this social concept
outlined below.
After the legal requirements,
the social concept has the following components:
- plans for dealing with
problem gambling
- training program for staff
The preventive measures are
divided into primary and secondary prevention. Key elements for primary
prevention include information and sensitization campaigns for casino
customers and the public, a Web site with relevant information, media
prevention campaigns, information on odds and pathological gambling, and
contact information for professional help. Information brochures and advice
on responsible gambling will be openly available in the casinos. Advertising
for gambling will be strictly limited. In addition, structural changes
to the casino will be made: an ID control at the entrance will prevent
the admission of adolescents under 18 or suspended problem gamblers. Although
credit cards will be accepted, no cash dispensers will be placed in the
casino and no loans will be granted to customers. To prevent staff from
relying on tipping, a relatively high fixed wage will be administered,
increasing their monthly allowance and allowing them to be freer and less
biased when intervening with those who have problems.
As part of secondary prevention,
checklists for self-diagnosis will be displayed and combined with the
offer of counseling by specially trained staff in each casino. A toll-free,
24-hour telephone hotline will provide the caller with information (e.g.,
where to obtain professional help). Customers who feel in danger of losing
control will be able to have themselves suspended from either their favorite
casino or every casino across the country.
To help deal with those who
have gambling problems, staff will be trained to speak with customers
who are obviously having trouble. A first counseling session may be held
in the casino and contact information for professional help will be provided.
Problem gamblers can be suspended nationwide, even if they do not agree
to that intervention. A fund supplied by the casinos' revenues and managed
by the social advisory board will be established for people with gambling
problems with financial problems, who wish to immediately enroll in therapy.
All casino staff will be trained
in a three-day workshop before starting their job. Training will include
information about pathological gambling, risk and protective factors,
different types and stages of gambling problems, preventive measures and
therapy for problem gamblers. Potential problematic behaviors because
of any addiction will be thoroughly examined, and social competencies
in dealing with problem gamblers will be practised in role-playing. Staff
will be retrained annually. Additionally, at least one supervisor will
receive extra training in how to interact with problem customers. He or
she will also receive regular professional supervision.
Research will focus on data
collection and interpretation of gambling frequencies, the socio-demographic
characteristics of casino customers, the frequencies and circumstances
of suspensions, and customer turnover in the casinos. Ideally, there would
be national or even international monitoring, which however, depends on
the co-operation of the other casinos and government regulations. Furthermore,
the effectiveness of the preventive measures and social consequences in
regions around the casinos will be evaluated by studying hotline usage,
co-operating therapy and counseling centers, social services and crime
rates.
The social advisory board will
consist of seven independent experts from the prevention, therapy, social
services and research fields. Up to two casino executives will be allowed
to participate in the meetings (without the right to intervene or vote).
The board's main function will be to supervise the implementation and
realization of the social concept and to report regularly to the Swiss
Federal Casino Commission. It will examine, authorize, order and control
the preventive measures, training, research and public relations. It will
decide upon suspensions and have authorization to grant funds for therapeutic
aids for pathological and problem gambling.
Until now, the phenomenon of
problem gambling has hardly been studied in Switzerland on a large scale.
With the financial support of Loterie Romande and Romande des Jeux SA
(i.e. representatives of the gaming industry in the French-speaking part
of Switzerland), one major study was carried out in 1998 that estimated
the existing prevalence of pathological and problem gambling in Switzerland
. The authors screened a representative sample of the adult population
for each Swiss region with the SOGS for current problem gambling and found
that 0.8% of the Swiss population were probable pathological gamblers
and another 2.2% were potential pathological gamblers. These prevalence
figures are slightly higher than the corresponding Swedish figures . This
comparison is justified as Sweden is also about to open casinos, with
the first expected to be opened in spring 2001.
In addition, the Swiss study
also found a relationship between gambling and alcohol problems; the latter
screened by the CAGE . The study showed a positive relationship between
the availability of gambling and the prevalence of problem gambling: the
higher the relative density of amusement machines per 1000 inhabitants,
the higher the prevalence of probable and potential pathological gamblers.
When comparing those with gambling
problems to the total population these statistics emerged; for all sets
of figures, the first percentage is that of problem gamblers and the second
percentage is for the total population: 73% of the group with gambling
problems were male, while only 49% of the total population was male. Those
under the age of 29 were 43% of those with gambling problems, but only
20% of the total population; 76% of problem gamblers were employees compared
to 55% of the total population; full time workers composed 79% of the
problem gamblers compared to 52% of the total population. Among people
with gambling problems 18% were of non-Swiss nationality, compared to
being 8% of the total population; and 48% of the problem gamblers were
unmarried, compared to 30% unmarried among the total population. A smaller
group of gamblers with problems was in the low-tax category (13% vs 29%),
Protestant (28% vs 46%) or spoke French as their mother tongue (7% vs
18%) compared to the total population.
The number of probable pathological
gamblers in Switzerland is estimated to be between 33,000 and 78,000;
the number of potential pathological gamblers is between 107,000 and 180,000.
These numbers are at the lower end of the international problem gambling
statistics (Evans & Hausamann, 1998), (Henriksson in press), (Petry
& Armentano, 1999), (Shaffer, Hall & Vander Bilt, 1999), (Ladouceur,
1996), (Volberg, 1996), (Osiek, Bondolfi, et al., 1998), although grand
casino gambling has not yet started in Switzerland. Thus, problem gambling
already exists in Switzerland despite the strict restrictions that have
been in force until now.
Although there are exceptions,
international and Swiss results show higher rates of problem gambling
in regions with more gambling opportunities. This leads to the expectation
that there will be rising numbers of problem gamblers following the implementation
of grand casino gambling in Switzerland. We believe that a well-founded
harm reduction policy should be in place to deal with this expected increase.
Conclusion
The new legislation has created
a unique situation in Switzerland regarding grand casino gambling. While
gambling with unlimited stakes will become daily business in Switzerland
in the near future, the casinos themselves will be legally required to
implement effective prevention methods and to establish a network of consultation
and therapy for problem gambling. The Swiss law limits gambling activities
strictly to casinos and forces each of the casinos to implement and carry
out a social concept with detailed a priori stated prevention measures,
measures for dealing with problem gamblers, training of staff, and associated
evaluation research. An independent social advisory board will control
the actual implementation and realization of the measures.
In spite of these precautions,
an increase in the prevalence of pathological gamblers is expected in
Switzerland. So far, this prevalence rate is at the lower end of the international
statistics, but national and international research has shown that the
number of people with pathological levels of gambling problems tends to
rise with more gambling opportunities.
This calls for a thorough harm
reduction approach. To optimize its effectiveness, standardization of
the measures and strict evaluation will be very important. It also requires
commitment from the government to continue the regulation and control
of all the steps. As we learned from the Dutch example, not only will
control and regulation be necessary, but also enforcement of the regulations.
There are currently different
social concepts in Switzerland that may differ in their effectiveness.
It would be in the interest of the Swiss government to put the onus on
the casinos to provide evidence for the effectiveness of their concepts.
This seems to be particularly possible in a situation when a new law is
being implemented.
Traditional medicine and public
health have often encountered the problem that evidence of effectiveness
is often established post hoc, taking into account many historical
aberrations. These problems could be avoided if evidence of the effectiveness
of countermeasures is presented at the beginning of the implementation.
By routine monitoring and conducting standardized comparative evaluations
of the effectiveness of different social concepts, such concepts could
be shaped, and ineffective concepts could be abandoned or improved. Therefore,
social and public health problems related to gambling in Switzerland might
be less dramatic than would otherwise be expected.
References
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This brief policy report
was peer-reviewed.
Submitted: November 6,
2000
Accepted: March 16, 2001
Address for correspondence:
Daniela Dombrowski
Addiction Research Institute
Konradstr. 32
Postfach 1617
8031 Zürich, Switzerland
Phone: ++41/1 448 11 69
Fax: ++41/1 448 11 70
E-mail: dombro@isf.unizh.ch
Daniela Dombrowski, Dipl.-Psych.,
graduated in clinical and pedagogical psychology from the University of
Constance, Germany. She has worked with delinquent adolescents, at a graduate
school of business administration and in several research projects. Since
1999 she is a project manager at the Addiction Research Institute in Zurich,
Switzerland. She and her colleagues developed the social concept for the
Grand Casino S.A., Switzerland.
Ambros Uchtenhagen, MD,
PhD, Professor Emeritus in social psychiatry at Zurich University, is
chair of the Board for the Addiction Research Institute at Zurich University.
He is a member of the WHO Expert Panel on Drugs, and a board member of
the European Association on Substance Abuse Research. He has numerous
publications in the fields of social psychiatry and the addictions and
is co-editor in chief of European Addiction Research.
Jürgen Rehm, PhD, is
currently research director at the Addiction Research Institute at Zurich,
Senior Scientist on a part time basis at the Centre for Addiction and
Mental Health and professor at the Public Health Sciences Department of
the University of Toronto. He has published widely on epidemiology, policy
and the economics of substance use and abuse.
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