Prevention when exclusion is lifted: Intervention models from the New Swiss Gambling Act

Background and aim: The Swiss gambling Law of 1 January 2019 stipulates that for casinos, as well for online betting, people who gamble can self-exclude via a national register. In addition, gambling operators have an obligation to exclude people who gamble beyond their means. In order to lift the exclusion, the operator is legally responsible for checking the individual`s financial situation. In addition, the person must undergo a preventive interview with an organisation specialising in excessive gambling, which is designated by the social health authority and independent of the gambling operator. The objective is to describe the implementation of this new provision in Switzerland`s six French-speaking cantons and to document the activity relating to the procedure adopted by the canton of Vaud (Lausanne and surroundings).

Method: Analysis of framework documents and semi-structured interviews with the responsible persons at the public authority, and the organisation in charge of the preventive interview in the six French-speaking cantons. Analysis of anonymised activity data relating to the demographics, motivations and gambling behaviour (Problem gambling severity index - PGSI) of people benefiting from the measure. The sample included a total of 207 people who were interviewed by professionals at Lausanne University Hospital, between January 2019 and August 2023.

Results: The methods for implementation vary considerably from canton to canton. In four cantons, the interview concluded with a recommendation to the gaming operator on the suitability of the planned lifting of the exclusion. In two cantons, including the Canton of Vaud, the interview is conducted according to the Brief Intervention Model, without a recommendation to the operator. For the Canton of Vaud, of the 207 people interviewed, 44.5% had been excluded for a reason identified by the operator as financial (excessive spending or debts) and 16% for a reason identified by the operator as indicating excessive gambling. At the time the exclusion was lifted, according the PGSI, 26% were categorized as low risk (score 1 to 2), 14% as moderate risk (score 3 to 7) and 2% as problem gambling (score>8).

Discussion: The authorities and professionals involved report that the provision is well understood and accepted by the beneficiaries, even in the most stringent implementation modalities. The scores recorded in the PGSI at the external interview site designated by the canton of Vaud appear to be lower than the observations previously made on a cohort of excluded persons in other cantons (Lischer & al., 2023). Longitudinal and controlled studies are needed, as well as an overall evaluation of the new law with regard to prevention and harm reduction for gambling-related problems.