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Social and economic costs of gambling problems and related harm among UK military veterans
  1. Shaun Harris1,
  2. R D Pockett1,
  3. G Dighton2,
  4. K Wood2,
  5. C Armour3,
  6. M Fossey4,
  7. L Hogan5,
  8. N Kitchiner6,7,
  9. J Larcombe8,
  10. R D Rogers5 and
  11. S Dymond2,9
  1. 1 Swansea Centre for Health Economics, Swansea University, Swansea, UK
  2. 2 School of Psychology, Swansea University, Swansea, UK
  3. 3 School of Psychology, Queen's University Belfast, Belfast, UK
  4. 4 Veterans and Families Institute for Military Social Research, Anglia Ruskin University, Chelmsford, UK
  5. 5 School of Human and Behavioural Sciences, Bangor University, Bangor, UK
  6. 6 Veterans’ NHS Wales, Cardiff, UK
  7. 7 Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
  8. 8 The Recovery Course, Tonbridge, UK
  9. 9 Department of Psychology, Reykjavik University, Reykjavik, Iceland
  1. Correspondence to Professor S Dymond, School of Psychology, Swansea University, Swansea, UK; s.o.dymond{at}


Introduction Military veterans are at heightened risk of problem gambling. Little is known about the costs of problem gambling and related harm among United Kingdom (UK) Armed Forces (AF) veterans. We investigated the social and economic costs of gambling among a large sample of veterans through differences in healthcare and social service resource use compared with age-matched and gender-matched non-veterans from the UK AF Veterans’ Health and Gambling Study.

Methods An online survey measured sociodemographic characteristics, gambling experience and problem severity, mental health and healthcare resource utilisation. Healthcare provider, personal social service and societal costs were estimated as total adjusted mean costs and utility, with cost-consequence analysis of a single timepoint.

Results Veterans in our sample had higher healthcare, social service and societal costs and lower utility. Veterans had greater contacts with the criminal justice system, received more social service benefits, had more lost work hours and greater accrued debt. A cost difference of £590 (95% CI −£1016 to −£163) was evident between veterans with scores indicating problem gambling and those reporting no problems. Costs varied by problem gambling status.

Conclusions Our sample of UK AF veterans has higher healthcare, social service and societal costs than non-veterans. Veterans experiencing problem gambling are more costly but have no reduction in quality of life.

  • health economics
  • mental health
  • adult psychiatry
  • public health

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  • Contributors SH, RP, CA, MF, LH, NK, JL, RR and SD designed the study. SH, RP, GD and KW collected the data and conducted the statistical analysis. SH, GD and SD completed the first draft of the manuscript and all authors contributed to and approved the final manuscript.

  • Funding This work was supported by a grant from Forces in Mind Trust (FiMT17/0510S).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.