Does the total consumption model apply to gambling? A review of theory and evidence

Previous research suggested that the total consumption model (TCM) which postulates a close link between total consumption and problem or excessive consumption in the population could be applied to gambling. This paper updates and extends this research by examining the strength of support for component elements which underlie the TCM. This includes i) understanding the shape of the risk curve associated with consumption, ii) the concentration of expenditure and iii) drawing from alcohol studies, collectivity theory. In addition, most recent evidence applying the TCM to gambling.

Four separate search strategies were conducted to identify studies published since 2010 relating to gambling risk curves; concentration of spend; collectivity and application of TCM in gambling using MEDLINE, Psychinfo and Web of Science databases between January 1, 2010, and January 25, 2022 will be reviewed.

Seventeen studies were identified. The risk of gambling related harm was either small at low levels of gambling consumption but increasing significantly after a certain threshold, rapidly increasing at low levels of consumption, or linearly increasing (n=8). The collectivity studies suggested that mean gambling frequency and gambling frequency at all levels of gambling are closely associated (n=2). The concentration literature indicated a strong positive relationship between concentration indices and the share of revenue derived from problem gamblers across different activities (n=3). The TCM studies showed a close association between average gambling in the population and prevalence of excessive gambling (n=4).

Understanding the shape and distribution of gambling harms and its relationship with total consumption among the population is a critical public health consideration, as this influences the type and nature of prevention activities recommended. Emerging research shows some support for applying the TMC to gambling, yet the evidence base remains sparse. Policy makers should focus on designing studies which would allow better assessment of the TCM to gambling.