NATIONAL GAMBLING EXPERIENCES
doi:10.1111/add.12884
Gambling in the Czech Republic Zdeněk Szczyrba1, Viktor Mravčík2,3, David Fiedor1, Jakub Černý2,4 & Irena Smolová1 Department of Geography at the Faculty of Science, Palacký University in Olomouc, Olomouc, Czech Republic,1 National Monitoring Centre for Drugs and Addiction, The Office of the Government of the Czech Republic, Prague, Czech Republic,2 Department of Addictology, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic3 and Department of Psychology, Faculty of Social Studies, Masaryk University, Brno, Czech Republic4
ABSTRACT Aim To provide an overview of gambling and associated problems in the Czech Republic, including an overview of the historical context, legislation, prevalence, treatment and research base and agenda. Methods A review of literature and relevant sources. Results The trajectory of gambling patterns in the territory of the Czech Republic in the 20th century reflected broad socio-political changes. Those included significant expansion between the wars, strict state control and bans on some gambling activities during the communist regime and finally dynamic development characterized by a boom in electronic gaming machines (EGMs) and increasing accessibility of gambling facilities after 1989, which aggravated gambling-related problems. Many municipalities have banned EGMs, which has created conflict in regulation at state and municipal levels. The draft gambling law prepared in 2014 aims to clarify the regulatory framework. Before 2012 there was only sporadic research interest in gambling, but in 2012 the first complex research on gaming and problem gambling in the Czech population took place. The estimated prevalence of problem gambling is currently 2% in the population aged 15–64 years. Preventive measures, counselling and treatment services for problem gamblers are limited. Conclusions Weak and ineffective regulation of the gambling market in the Czech Republic during the past 20 years, despite the large growth in gambling, has led to inadequate prevention and response to problem gambling which has become a considerable public health, social and political issue.
Keywords
Czech Republic, gambling, prevalence, problem gambling, regulation, research, treatment.
Correspondence to: Zdeněk Szczyrba, Department of Geography at the Faculty of Science, Palacký University in Olomouc, Czech Republic. E-mail: [email protected] Submitted 30 September 2014; initial review completed 8 December 2014; final version accepted 12 February 2015
HISTORY OF GAMBLING IN THE CZECH REPUBLIC Geographically, the beginnings of gambling can be found in India, Mesopotamia and Egypt (2000–4000 BC) [1,2]. By comparison, primitive dice found within the territory of today’s Czech Republic are associated with the discovery of a Celtic settlement in Stradonice (Central Bohemia), which dates back to the 5–6th centuries BC [3]. Archaeological evidence suggests that dice have been made in the Czech territory since the Early Roman era [4]. The Middle Ages were characterized by both the expansion of gambling and its restriction in Czech lands. Diceplaying was one of the most popular games, followed by gambling on board games, backgammon and cards, which gradually became part of the social life of all classes [5]. The expansion of gambling in medieval Czech lands led to the fact that the Code of the Emperor Charles IV, Majestas Carolina (1355), included provisions to restrict gambling for money. This Code was, in the end, not adopted by the nobility [6]. © 2015 Society for the Study of Addiction
A significant breakthrough in repressive state intervention against gambling occurred with the licensing of gambling shops operated directly by the State or by a lessee (in the 18th century). In the spirit of ideas of mercantilism of that time, a state-run cash lottery was established, which operated until the fall of the communist regime in 1989 [7]. The 20th century was a distinctive and dramatic time for Czech gambling. In the interwar period (1919–39) gambling was widespread in society, and thousands of original Czech slot machines were manufactured and operated throughout Czechoslovakia [8]. In the Communist period (1948–89), state-controlled scratch cards, lottery, sport and horse betting (totalizator) were allowed, while other forms of gambling were banned, forcing them underground [9]. The post-communist era has been characterized by seeking a balance between the free market and gambling regulation. After 1989, gambling met with fairly wide public acceptance, with loose state regulation—as in many Addiction, 110, 1076–1081
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other areas of life in countries gaining freedom after the 40-year period of the communist regime [10]. However, the situation has changed rapidly over the past several years. The public has started to evaluate critically both gambling operators and the imperfect regulatory mechanisms available to the state and municipalities in the field of gambling [11]. Non-governmental organizations (NGOs) such as Brnění [12] and Občané proti Hazardu (Citizens Against Gambling) [13], led by activists and ex-gamblers, have played an important role in raising public awareness of gambling-related harms. Their political pressure and public campaigns led to public debate about the wide accessibility of gambling and has led to the development of restrictive gambling policies in many municipalities throughout the country [14]. Currently there are more than 70 legal operators of lotteries and betting games in the Czech Republic [15]. In addition, large numbers of gaming machines are manufactured in the country not only for domestic use, but also for foreign markets. The annual production of one such plant (the Novomatic Group, a supranational corporation and one of the world leaders in the gaming industry) is up to 100 000 gaming machines [16]. This example also illustrates the fact that the Czech gambling situation is unique, and reflects problems caused by the lack of regulation and control that emerged as a counter-position to the previous era of a centrally planned economy, unlike in many Western European countries [17,18]. DEVELOPMENT OF A LEGISLATIVE FRAMEWORK FOR GAMBLING IN THE CZECH REPUBLIC The past 20 years have been characterized by a discrepancy between the dynamic evolution of types of gambling and their legislative regulation. Gambling has been evolving dynamically in the Czech Republic, mainly taking the form of EGMs, video lottery terminals (VLTs), and online gambling [19–21], as a result of technical progress. However, the basic legislative framework which regulates gambling in the Czech Republic—law no. 202/1990 Coll. on lotteries and other similar games—was adopted in 1990, and at the time of its inception it dealt with lotteries, raffles, slot machines and casino games. Although this law has been amended 15 times to date, the ‘improvements’ have always been very delayed reactions to developments in gambling. For example, VLTs and other central lottery systems were defined explicitly by the law only in 2012, online gaming has not yet had any special provision and both types of games have been licensed by the controversial general provision of the law for ‘other’ games only by the Ministry of Finance (article 50, paragraph 3). Since the law’s amendment in 1998, municipalities have had the authority to issue licences and to regulate availability or ban slot © 2015 Society for the Study of Addiction
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machines within their boundaries. However, this regulatory authority was not explicitly applicable to VLTs, although they constitute the majority of the total number of EGMs in the Czech Republic at present. In reaction, a number of municipalities have issued ordinances regulating or banning VLTs, although the Ministry of the Interior cancelled those ordinances initially because of their lack of legal authority. However, a series of verdicts issued by the Constitutional Court in 2012 confirmed the right of municipalities to regulate VLTs. This resulted in a situation in which thousands of VLTs were operating in contradiction to municipal ordinances, and regulatory authorities at the Ministry of Finance were overloaded by thousands of requests to revise the licences issued for VLTs to harmonize them with municipal ordinances. During the last 2 years, the number of generally binding ordinances regulating or even prohibiting the operation of gambling within the boundaries of a municipality has increased dramatically. To date, EGMs have been banned in more than 200 towns and villages, and hundreds of other municipalities have decided to regulate gambling, sometimes even through local referendums. Another important legislative element involves the taxation of gambling revenues. Until 2012, gambling operators paid taxes of 6–20% (based progressively on total revenue) for ‘public purposes’ without closer specification of receiving institutions; this system was criticized widely for lack of transparency. Since 2012, operators have been required to pay a 20% revenue tax to state and municipal budgets. There are two algorithms of tax distribution defined for two groups of games. The first algorithm includes all games except EGMs, and takes into account the number of citizens in the municipality. The second algorithm is related to EGMs, and is based on the number of EGMs operating within the municipality’s boundaries. This, together with the transferring of regulation, also led to a shift in the lobbying pressure of the operators of the gambling industry from the national to the local level. Moreover, the law as it existed from 1990 and its subsequent amendments do not respect the principles of European law [22], as the lottery law prohibits foreign capital participation in the activities of operators of gambling activities and permission may be granted only to legal entities established in the Czech Republic. A new law on gambling is now being prepared. Besides resolving the inconsistencies of the current law vis-à-vis European law, this new law should also simplify the currently complicated process of the cancellation of permits already issued for EGMs. As with other European countries (e.g. the Netherlands [23]), the Czech Republic is modernizing gambling policy, which primarily means modernizing gambling regulation and monitoring. The draft of the new law, the adoption of which is expected towards the end of 2015, also includes significant restrictions of the number Addiction, 110, 1076–1081
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of gaming devices and facilities as well as some structural characteristics (e.g. maximum stake or loss allowed within 1 hour). Non-stop gaming galleries will be banned, and a register of excluded and self-excluded gamblers will be introduced. The new draft law on gambling also states that municipal councils will be responsible for issuing licences for technical gaming devices [24]. Although the number of casinos and gaming clubs has declined gradually since 2012, their prevalence is still disproportionately high in comparison with other European countries. According to a report by the Czech National Monitoring Centre for Drugs and Addiction [14], in 2013 there were approximately 76 000 EGMs in the Czech Republic, while in the previous year there were 100 000 EGMs (the highest number was in 2011: 104 000 EGMs). The Czech Republic is one of the leading countries in the world in terms of the number of EGMs per capita (7.47 per 1000 inhabitants). The survey [14] also shows that between 2008 and 2012, the structure of the ratio of the different categories of games on the betting market has changed. The share of internet betting and EGMs (without slot machines) increased (in the case of internet betting this is due mainly to better internet accessibility) [25], while the share of traditional betting and slot machines decreased. The share of lotteries and casino betting games remained unchanged. Although internet betting has been showing the fastest growth, it still does not equal the market share of VLT gambling, which is 50%. The trends of increasing online gambling and decreasing numbers of EGMs are expected to continue. PREVALENCE OF PROBLEM GAMBLING Until 2012, the Czech Republic did not have any surveys estimating the prevalence of problem or pathological gambling. Partial estimates have been performed by several experts using the results of the European School Survey Project on Alcohol and other Drugs (ESPAD) or extrapolating rates from abroad [26,27]. Only during the last 2 years has the National Monitoring Centre for Drugs and Addiction, along with other organizations, organized several surveys focused on gambling participation, patterns of gambling and problem gambling in the Czech population [14]. These surveys include a nation-wide study called the National Research Study on Substance Abuse 2012 [28]. A representative sample of the population, chosen by a stratified four-stage selection process, consisted of 2134 respondents aged 15–64 years. The results showed that the prevalence of playing betting games in the general population in the Czech Republic in the last 12 months stands at 25.5%. In comparison with developed European countries, the rate of participation in betting activity in the Czech Republic is significantly lower compared, for example, with 73% in Sweden [17] or other European countries [29]. © 2015 Society for the Study of Addiction
Higher participation in these other countries is caused mainly by the popularity of lottery games. Similar to recent results in western countries, the Czech Republic has experienced an increase in online gambling prevalence. In 2013 prevalence of online gambling was 12.5% in the Czech general population [14]. EGMs are generally considered to be the most problematic games in terms of the development of problem and pathological gambling, while lotteries and scratchcards are regarded as low-risk games. The correlation between the prevalence of problematic and pathological gambling and the density of the distribution of EGMs was confirmed previously by studies in Australia and New Zealand, as well as in other studies [30,31]. According to the aforementioned National Research Study on Substance Abuse in 2012 [28], the life-time and last-year prevalence of playing EGMs in the Czech Republic is 16.5 and 3.7%, respectively. Although the proportion of people with experience of EGMs is not high, it will be interesting to observe the change in the number of problem gamblers after EGMs are restricted significantly [32]. Research on problem gambling in the Czech Republic is still in its infancy, as evidenced by the scarcity of surveys on the prevalence of problem gambling. The screening of problem and pathological gambling is not the primary objective of the above surveys. Therefore, somewhat simple screening tools are used, e.g. the nine-item Problem Gambling Severity Index (PGSI) [33] or the two-item Lie/Bet scale [34]. Surveys conducted in late 2012 and 2013 [14] show that the rate of problem gambling in the 15–64-year age group in the Czech Republic is approximately 2% (2.3% according to the PGSI 3+ points, 1.8% according to the Lie/Bet screen). The rates for prevalence of substantial problems range from 0.6% (PGSI 8+) to 1.0% (survey of pathological gambling among general practitioners), which is slightly above the average in other European countries [35]. PREVENTION AND TREATMENT In the Czech Republic, an emphasis on prevention of problem gambling has only begun in the last few years, fuelled by the shift of regulatory functions in EGMs from the national to the local level and the appearance of a number of civic associations protesting strongly against gambling (see above). State policy in the area of prevention of addiction is focused on preventing risky behaviour among children and young people, but the main focus is on substance use prevention [36]. Since 2012, a technical standard for the operation of online gambling has required the application of measures to prevent the development of problem and pathological gambling. In 2013, Czech EGMs operators attempted to implement a complex programme called ProGam [37] that promotes responsible gambling [38]; however, its Addiction, 110, 1076–1081
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implementation and coverage have been limited, because many gambling operators have suspended their activities until the new law comes into effect. Treatment for gamblers and their relatives is provided by both the state psychiatric system (out-patient and inpatient) and NGOs working primarily with drug users (mainly out-patient). All these services create a network of specialized addiction treatment and counselling centres (state and non-governmental). There are approximately 250 facilities [39], and of those fewer than 20 have specialized programmes for gamblers [40]. Attendance at the treatment services is generally very low. In 2012, state psychiatric care treated 1415 people in out-patient care, and 527 people were hospitalized in residential programmes [41]. This rate indicates that only 2.5–5% annually of the estimated number of pathological gamblers receive treatment and suggests that there are substantial barriers to seeking treatment for problem gambling, as described elsewhere [42,43]. Evaluation of the effectiveness of the treatment of pathological gambling in the Czech Republic has been rarely performed to date [44]. In addition to specialized addiction services, there are a number of other treatment programmes, including counselling and social services, focusing on the consequences of problem gambling such as homelessness, debts, and problems with relationships; however, these services provide often inappropriate and incomplete care for the complex needs of problem gamblers. The first self-help group, Czech Gamblers Anonymous, was founded in 2008. In 2010, this group was registered at the ISO Gamblers Anonymous headquarters [45] in the United States. THE RESEARCH BASE AND RESEARCH AGENDA Research in the field of gambling in the Czech Republic has a 10–12-year-long tradition; however, problematic gambling has been perceived historically as a marginal topic compared with addiction to substances such as alcohol and drugs [46]. Deeper interest in gambling has come with the massive expansion of VLTs in the Czech market and the increase of pathological gambling among VLT players. Existing research has focused on the impact of EGMs on playing habits and associated problems in different subgroups of the population [47,48]. Research on other forms of gambling, such as casino games or online betting, has been initiated recently and is reflected in recent diploma and doctoral theses [49,50]. Research on problem gambling is still the domain of a relatively narrow group of experts, mainly comprising psychiatrists and psychologists. The specialized Czech addictology journal (Adiktologie) has gradually engaged with the issue of gambling [51,52]. The Institute for © 2015 Society for the Study of Addiction
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Research on Children, Youth and Family at the Faculty of Social studies at Masaryk University in Brno is currently conducting research projects focused on online gambling. The National Monitoring Centre for Drugs and Addiction has coordinated a nation-wide research project commissioned by the government which consisted of several surveys of the general population, problem gamblers in treatment and communities [14]. Another possibility for the development of research on gambling in the Czech Republic is the Grant Agency, which is focused on basic research. Unfortunately, no such grant has yet been implemented explicitly. Conversely, the research base in the field of addiction in the Czech Republic, where gambling has gained a stable position in recent years, has changed qualitatively in the direction of greater cooperation and networking of scientific research capacities in addictology, including interconnections with the public, private and voluntary sectors. This creates networking projects, such as the NETAD Project, one of whose goals is to create a joint grant office in the field for the funding of science and research projects [53]. CONCLUSION Throughout a long period of social and economic transformation in the Czech Republic, gambling has been at the margin of the interests of politicians and the addiction treatment system. Only in the last 2–3 years have the first studies been carried out on gambling issues, finding a considerably high prevalence of problem gambling and its health and social correlates and consequences. In parallel, the continuous expansion of services for gamblers (medical, social, self-help), together with an increase in the general awareness of society about gambling, can be observed. Under pressure from the public, gambling operators are gradually introducing principles of responsible gambling into their business codes. The previous liberal phase of the development of gambling is coming to an end and a new period of modern regulation has started; the new law on gambling is currently under preparation. Declaration of interests None. Acknowledgements The paper is part of the outcomes of the Project no. P404/11/1811 of the Grant Agency of the Czech Republic ‘Urban and suburban quality of life: a geographical perspective’ and its preparation was supported by the institutional support programme of Charles University in Prague no. PRVOUK-P03/LF1/9. Addiction, 110, 1076–1081
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Addiction, 110, 1076–1081
doi:10.1111/add.12884
Gambling in the Czech Republic Zdeněk Szczyrba1, Viktor Mravčík2,3, David Fiedor1, Jakub Černý2,4 & Irena Smolová1 Department of Geography at the Faculty of Science, Palacký University in Olomouc, Olomouc, Czech Republic,1 National Monitoring Centre for Drugs and Addiction, The Office of the Government of the Czech Republic, Prague, Czech Republic,2 Department of Addictology, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic3 and Department of Psychology, Faculty of Social Studies, Masaryk University, Brno, Czech Republic4
ABSTRACT Aim To provide an overview of gambling and associated problems in the Czech Republic, including an overview of the historical context, legislation, prevalence, treatment and research base and agenda. Methods A review of literature and relevant sources. Results The trajectory of gambling patterns in the territory of the Czech Republic in the 20th century reflected broad socio-political changes. Those included significant expansion between the wars, strict state control and bans on some gambling activities during the communist regime and finally dynamic development characterized by a boom in electronic gaming machines (EGMs) and increasing accessibility of gambling facilities after 1989, which aggravated gambling-related problems. Many municipalities have banned EGMs, which has created conflict in regulation at state and municipal levels. The draft gambling law prepared in 2014 aims to clarify the regulatory framework. Before 2012 there was only sporadic research interest in gambling, but in 2012 the first complex research on gaming and problem gambling in the Czech population took place. The estimated prevalence of problem gambling is currently 2% in the population aged 15–64 years. Preventive measures, counselling and treatment services for problem gamblers are limited. Conclusions Weak and ineffective regulation of the gambling market in the Czech Republic during the past 20 years, despite the large growth in gambling, has led to inadequate prevention and response to problem gambling which has become a considerable public health, social and political issue.
Keywords
Czech Republic, gambling, prevalence, problem gambling, regulation, research, treatment.
Correspondence to: Zdeněk Szczyrba, Department of Geography at the Faculty of Science, Palacký University in Olomouc, Czech Republic. E-mail: [email protected] Submitted 30 September 2014; initial review completed 8 December 2014; final version accepted 12 February 2015
HISTORY OF GAMBLING IN THE CZECH REPUBLIC Geographically, the beginnings of gambling can be found in India, Mesopotamia and Egypt (2000–4000 BC) [1,2]. By comparison, primitive dice found within the territory of today’s Czech Republic are associated with the discovery of a Celtic settlement in Stradonice (Central Bohemia), which dates back to the 5–6th centuries BC [3]. Archaeological evidence suggests that dice have been made in the Czech territory since the Early Roman era [4]. The Middle Ages were characterized by both the expansion of gambling and its restriction in Czech lands. Diceplaying was one of the most popular games, followed by gambling on board games, backgammon and cards, which gradually became part of the social life of all classes [5]. The expansion of gambling in medieval Czech lands led to the fact that the Code of the Emperor Charles IV, Majestas Carolina (1355), included provisions to restrict gambling for money. This Code was, in the end, not adopted by the nobility [6]. © 2015 Society for the Study of Addiction
A significant breakthrough in repressive state intervention against gambling occurred with the licensing of gambling shops operated directly by the State or by a lessee (in the 18th century). In the spirit of ideas of mercantilism of that time, a state-run cash lottery was established, which operated until the fall of the communist regime in 1989 [7]. The 20th century was a distinctive and dramatic time for Czech gambling. In the interwar period (1919–39) gambling was widespread in society, and thousands of original Czech slot machines were manufactured and operated throughout Czechoslovakia [8]. In the Communist period (1948–89), state-controlled scratch cards, lottery, sport and horse betting (totalizator) were allowed, while other forms of gambling were banned, forcing them underground [9]. The post-communist era has been characterized by seeking a balance between the free market and gambling regulation. After 1989, gambling met with fairly wide public acceptance, with loose state regulation—as in many Addiction, 110, 1076–1081
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other areas of life in countries gaining freedom after the 40-year period of the communist regime [10]. However, the situation has changed rapidly over the past several years. The public has started to evaluate critically both gambling operators and the imperfect regulatory mechanisms available to the state and municipalities in the field of gambling [11]. Non-governmental organizations (NGOs) such as Brnění [12] and Občané proti Hazardu (Citizens Against Gambling) [13], led by activists and ex-gamblers, have played an important role in raising public awareness of gambling-related harms. Their political pressure and public campaigns led to public debate about the wide accessibility of gambling and has led to the development of restrictive gambling policies in many municipalities throughout the country [14]. Currently there are more than 70 legal operators of lotteries and betting games in the Czech Republic [15]. In addition, large numbers of gaming machines are manufactured in the country not only for domestic use, but also for foreign markets. The annual production of one such plant (the Novomatic Group, a supranational corporation and one of the world leaders in the gaming industry) is up to 100 000 gaming machines [16]. This example also illustrates the fact that the Czech gambling situation is unique, and reflects problems caused by the lack of regulation and control that emerged as a counter-position to the previous era of a centrally planned economy, unlike in many Western European countries [17,18]. DEVELOPMENT OF A LEGISLATIVE FRAMEWORK FOR GAMBLING IN THE CZECH REPUBLIC The past 20 years have been characterized by a discrepancy between the dynamic evolution of types of gambling and their legislative regulation. Gambling has been evolving dynamically in the Czech Republic, mainly taking the form of EGMs, video lottery terminals (VLTs), and online gambling [19–21], as a result of technical progress. However, the basic legislative framework which regulates gambling in the Czech Republic—law no. 202/1990 Coll. on lotteries and other similar games—was adopted in 1990, and at the time of its inception it dealt with lotteries, raffles, slot machines and casino games. Although this law has been amended 15 times to date, the ‘improvements’ have always been very delayed reactions to developments in gambling. For example, VLTs and other central lottery systems were defined explicitly by the law only in 2012, online gaming has not yet had any special provision and both types of games have been licensed by the controversial general provision of the law for ‘other’ games only by the Ministry of Finance (article 50, paragraph 3). Since the law’s amendment in 1998, municipalities have had the authority to issue licences and to regulate availability or ban slot © 2015 Society for the Study of Addiction
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machines within their boundaries. However, this regulatory authority was not explicitly applicable to VLTs, although they constitute the majority of the total number of EGMs in the Czech Republic at present. In reaction, a number of municipalities have issued ordinances regulating or banning VLTs, although the Ministry of the Interior cancelled those ordinances initially because of their lack of legal authority. However, a series of verdicts issued by the Constitutional Court in 2012 confirmed the right of municipalities to regulate VLTs. This resulted in a situation in which thousands of VLTs were operating in contradiction to municipal ordinances, and regulatory authorities at the Ministry of Finance were overloaded by thousands of requests to revise the licences issued for VLTs to harmonize them with municipal ordinances. During the last 2 years, the number of generally binding ordinances regulating or even prohibiting the operation of gambling within the boundaries of a municipality has increased dramatically. To date, EGMs have been banned in more than 200 towns and villages, and hundreds of other municipalities have decided to regulate gambling, sometimes even through local referendums. Another important legislative element involves the taxation of gambling revenues. Until 2012, gambling operators paid taxes of 6–20% (based progressively on total revenue) for ‘public purposes’ without closer specification of receiving institutions; this system was criticized widely for lack of transparency. Since 2012, operators have been required to pay a 20% revenue tax to state and municipal budgets. There are two algorithms of tax distribution defined for two groups of games. The first algorithm includes all games except EGMs, and takes into account the number of citizens in the municipality. The second algorithm is related to EGMs, and is based on the number of EGMs operating within the municipality’s boundaries. This, together with the transferring of regulation, also led to a shift in the lobbying pressure of the operators of the gambling industry from the national to the local level. Moreover, the law as it existed from 1990 and its subsequent amendments do not respect the principles of European law [22], as the lottery law prohibits foreign capital participation in the activities of operators of gambling activities and permission may be granted only to legal entities established in the Czech Republic. A new law on gambling is now being prepared. Besides resolving the inconsistencies of the current law vis-à-vis European law, this new law should also simplify the currently complicated process of the cancellation of permits already issued for EGMs. As with other European countries (e.g. the Netherlands [23]), the Czech Republic is modernizing gambling policy, which primarily means modernizing gambling regulation and monitoring. The draft of the new law, the adoption of which is expected towards the end of 2015, also includes significant restrictions of the number Addiction, 110, 1076–1081
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of gaming devices and facilities as well as some structural characteristics (e.g. maximum stake or loss allowed within 1 hour). Non-stop gaming galleries will be banned, and a register of excluded and self-excluded gamblers will be introduced. The new draft law on gambling also states that municipal councils will be responsible for issuing licences for technical gaming devices [24]. Although the number of casinos and gaming clubs has declined gradually since 2012, their prevalence is still disproportionately high in comparison with other European countries. According to a report by the Czech National Monitoring Centre for Drugs and Addiction [14], in 2013 there were approximately 76 000 EGMs in the Czech Republic, while in the previous year there were 100 000 EGMs (the highest number was in 2011: 104 000 EGMs). The Czech Republic is one of the leading countries in the world in terms of the number of EGMs per capita (7.47 per 1000 inhabitants). The survey [14] also shows that between 2008 and 2012, the structure of the ratio of the different categories of games on the betting market has changed. The share of internet betting and EGMs (without slot machines) increased (in the case of internet betting this is due mainly to better internet accessibility) [25], while the share of traditional betting and slot machines decreased. The share of lotteries and casino betting games remained unchanged. Although internet betting has been showing the fastest growth, it still does not equal the market share of VLT gambling, which is 50%. The trends of increasing online gambling and decreasing numbers of EGMs are expected to continue. PREVALENCE OF PROBLEM GAMBLING Until 2012, the Czech Republic did not have any surveys estimating the prevalence of problem or pathological gambling. Partial estimates have been performed by several experts using the results of the European School Survey Project on Alcohol and other Drugs (ESPAD) or extrapolating rates from abroad [26,27]. Only during the last 2 years has the National Monitoring Centre for Drugs and Addiction, along with other organizations, organized several surveys focused on gambling participation, patterns of gambling and problem gambling in the Czech population [14]. These surveys include a nation-wide study called the National Research Study on Substance Abuse 2012 [28]. A representative sample of the population, chosen by a stratified four-stage selection process, consisted of 2134 respondents aged 15–64 years. The results showed that the prevalence of playing betting games in the general population in the Czech Republic in the last 12 months stands at 25.5%. In comparison with developed European countries, the rate of participation in betting activity in the Czech Republic is significantly lower compared, for example, with 73% in Sweden [17] or other European countries [29]. © 2015 Society for the Study of Addiction
Higher participation in these other countries is caused mainly by the popularity of lottery games. Similar to recent results in western countries, the Czech Republic has experienced an increase in online gambling prevalence. In 2013 prevalence of online gambling was 12.5% in the Czech general population [14]. EGMs are generally considered to be the most problematic games in terms of the development of problem and pathological gambling, while lotteries and scratchcards are regarded as low-risk games. The correlation between the prevalence of problematic and pathological gambling and the density of the distribution of EGMs was confirmed previously by studies in Australia and New Zealand, as well as in other studies [30,31]. According to the aforementioned National Research Study on Substance Abuse in 2012 [28], the life-time and last-year prevalence of playing EGMs in the Czech Republic is 16.5 and 3.7%, respectively. Although the proportion of people with experience of EGMs is not high, it will be interesting to observe the change in the number of problem gamblers after EGMs are restricted significantly [32]. Research on problem gambling in the Czech Republic is still in its infancy, as evidenced by the scarcity of surveys on the prevalence of problem gambling. The screening of problem and pathological gambling is not the primary objective of the above surveys. Therefore, somewhat simple screening tools are used, e.g. the nine-item Problem Gambling Severity Index (PGSI) [33] or the two-item Lie/Bet scale [34]. Surveys conducted in late 2012 and 2013 [14] show that the rate of problem gambling in the 15–64-year age group in the Czech Republic is approximately 2% (2.3% according to the PGSI 3+ points, 1.8% according to the Lie/Bet screen). The rates for prevalence of substantial problems range from 0.6% (PGSI 8+) to 1.0% (survey of pathological gambling among general practitioners), which is slightly above the average in other European countries [35]. PREVENTION AND TREATMENT In the Czech Republic, an emphasis on prevention of problem gambling has only begun in the last few years, fuelled by the shift of regulatory functions in EGMs from the national to the local level and the appearance of a number of civic associations protesting strongly against gambling (see above). State policy in the area of prevention of addiction is focused on preventing risky behaviour among children and young people, but the main focus is on substance use prevention [36]. Since 2012, a technical standard for the operation of online gambling has required the application of measures to prevent the development of problem and pathological gambling. In 2013, Czech EGMs operators attempted to implement a complex programme called ProGam [37] that promotes responsible gambling [38]; however, its Addiction, 110, 1076–1081
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implementation and coverage have been limited, because many gambling operators have suspended their activities until the new law comes into effect. Treatment for gamblers and their relatives is provided by both the state psychiatric system (out-patient and inpatient) and NGOs working primarily with drug users (mainly out-patient). All these services create a network of specialized addiction treatment and counselling centres (state and non-governmental). There are approximately 250 facilities [39], and of those fewer than 20 have specialized programmes for gamblers [40]. Attendance at the treatment services is generally very low. In 2012, state psychiatric care treated 1415 people in out-patient care, and 527 people were hospitalized in residential programmes [41]. This rate indicates that only 2.5–5% annually of the estimated number of pathological gamblers receive treatment and suggests that there are substantial barriers to seeking treatment for problem gambling, as described elsewhere [42,43]. Evaluation of the effectiveness of the treatment of pathological gambling in the Czech Republic has been rarely performed to date [44]. In addition to specialized addiction services, there are a number of other treatment programmes, including counselling and social services, focusing on the consequences of problem gambling such as homelessness, debts, and problems with relationships; however, these services provide often inappropriate and incomplete care for the complex needs of problem gamblers. The first self-help group, Czech Gamblers Anonymous, was founded in 2008. In 2010, this group was registered at the ISO Gamblers Anonymous headquarters [45] in the United States. THE RESEARCH BASE AND RESEARCH AGENDA Research in the field of gambling in the Czech Republic has a 10–12-year-long tradition; however, problematic gambling has been perceived historically as a marginal topic compared with addiction to substances such as alcohol and drugs [46]. Deeper interest in gambling has come with the massive expansion of VLTs in the Czech market and the increase of pathological gambling among VLT players. Existing research has focused on the impact of EGMs on playing habits and associated problems in different subgroups of the population [47,48]. Research on other forms of gambling, such as casino games or online betting, has been initiated recently and is reflected in recent diploma and doctoral theses [49,50]. Research on problem gambling is still the domain of a relatively narrow group of experts, mainly comprising psychiatrists and psychologists. The specialized Czech addictology journal (Adiktologie) has gradually engaged with the issue of gambling [51,52]. The Institute for © 2015 Society for the Study of Addiction
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Research on Children, Youth and Family at the Faculty of Social studies at Masaryk University in Brno is currently conducting research projects focused on online gambling. The National Monitoring Centre for Drugs and Addiction has coordinated a nation-wide research project commissioned by the government which consisted of several surveys of the general population, problem gamblers in treatment and communities [14]. Another possibility for the development of research on gambling in the Czech Republic is the Grant Agency, which is focused on basic research. Unfortunately, no such grant has yet been implemented explicitly. Conversely, the research base in the field of addiction in the Czech Republic, where gambling has gained a stable position in recent years, has changed qualitatively in the direction of greater cooperation and networking of scientific research capacities in addictology, including interconnections with the public, private and voluntary sectors. This creates networking projects, such as the NETAD Project, one of whose goals is to create a joint grant office in the field for the funding of science and research projects [53]. CONCLUSION Throughout a long period of social and economic transformation in the Czech Republic, gambling has been at the margin of the interests of politicians and the addiction treatment system. Only in the last 2–3 years have the first studies been carried out on gambling issues, finding a considerably high prevalence of problem gambling and its health and social correlates and consequences. In parallel, the continuous expansion of services for gamblers (medical, social, self-help), together with an increase in the general awareness of society about gambling, can be observed. Under pressure from the public, gambling operators are gradually introducing principles of responsible gambling into their business codes. The previous liberal phase of the development of gambling is coming to an end and a new period of modern regulation has started; the new law on gambling is currently under preparation. Declaration of interests None. Acknowledgements The paper is part of the outcomes of the Project no. P404/11/1811 of the Grant Agency of the Czech Republic ‘Urban and suburban quality of life: a geographical perspective’ and its preparation was supported by the institutional support programme of Charles University in Prague no. PRVOUK-P03/LF1/9. Addiction, 110, 1076–1081
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