Host: Online betting makes this province a lot of money every year, but experts say this big payday for the government could also be a threat to public health. Andrew Kim is an associate professor in the department of psychology at Toronto Metropolitan University and Canada Research Chair in Addictions and Mental Health Comorbidity, and we welcome you into our studio. How are you doing?

Andrew Kim: Good. Thank you for having me.

Host: Well, let's talk Ontario legalized online gambling in 2022 to bring existing unregulated, quote unquote grey market into a safe, more regulated market. However, since then, calls from young men contacting the province's mental health help line for gambling related problems shot up by nearly 300%. Can you explain the disconnect there? When the province is saying a safe market and we've got this rise?

Andrew Kim: Yeah, so it's a bit of a paradox, right? They're saying we want to make gambling a little bit safer, but we're seeing increases in harms. And just to clarify, online gambling has been legal in Ontario. What really changed is prior to 2022 and iGaming OLG was the only legal provider of gambling here. But that changed. Now you.

Host: OLG for people who aren't familiar.

Andrew Kim: Ontario Lottery Gaming Corporation. So your Lotto Max folks, right? What changed, though, was that now Ontario allowed private operators to pay a Licence fee and be legally allowed to offer gambling products to Ontario residents. That kind of opened the floodgates. So before, you only had, like the LCBO, just one place you can go to gamble. But now I think there's about 50 gambling operators in about 80 different sites.

Host: Okay. So options.

Andrew Kim: A lot of options, a lot of options. It's available on your mobile phones. And so now gambling, online gambling has become more accessible and widely available. So you increase access and availability to a potentially harmful product. And I say potentially an addictive product. And likely the result is going to be an increase in people experiencing gambling addiction. I think that's where we're seeing the increase in calls to the gambling help line, essentially.

Host: Now, we tend to see in that data as well. Young men does gambling specifically target young men.

Andrew Kim: Know things have changed? Actually, I've been hearing from colleagues that the people they're seeing in their office, who they're seeing in the office, has changed considerably. And I think part of that is not just the online gambling, but the other interesting thing that happened was changes to sports betting. So prior to its both three, four years ago, single event betting, where you can just bet on one outcome of a match was illegal. So you can only bet on parlays. So it has to be three plus outcomes like your typical proline, right? Okay. But with the change in federal law allowing single event betting, what I think happened is that the single event they didn't specify if it had to be at the macro level, simply put, didn't specify that it had to be the winner of a game. Okay, so what's an event in sport? Almost anything really. And so that I think opened the doors for in-play bets and micro bets, meaning that within, say we're watching a game of hockey, right? Saying the Leafs were watching it. Theoretically, you can make hundreds of bets while that game is happening, because you don't have to bet on who's going to win, right? You can.

Host: Bet who scored exactly assists all that.

Andrew Kim: So change sort of the structural nature of gambling. And that makes it a bit more risky. So sports betting is generally if we look at who bets on sports in Canada they're young men. And so with the legalization of single event betting, with opening up the gambling market, you get a flood of advertisements. And I think those were specifically a lot of them. The sports betting ads are targeted towards that demographic. And so I think that's what's accounting for the increase in that demographic.

Host: We know gambling is not just about losing money or winning money in some cases. What are some of the other ways that it can cause problems?

Andrew Kim: Yeah. So I just want to say that gambling is an addiction, like alcohol, like cannabis in the DSM, which is sort of the people call it the Bible of psychiatry, but it's the textbook that we use that tells us what are mental disorders, what are the criteria. And so gambling is classified as an addiction. And that's because there's decades of evidence suggesting that gambling like alcohol and cannabis can cause significant problems. So money is one, right? It's probably the most common harm that we see. But it could also be related to interpersonal difficulties, difficulties with your partner, with family. It can interfere with your schoolwork. It can cause problems at work. If you're spending so much time planning out your bets, you're preoccupied, you're researching who's playing tonight. Have they been doing. Imagine losing $2,000. You needed to pay rent. How much stress is that going to cause? And I think part of that is then it leads to depression. It could lead to anxiety. And I would also say that for some people, gambling is a way to cope with mental health difficulties, like alcohol, like cannabis gambling can sort of help with our distress, sort of that self-medication hypotheses to the harms of gambling, I think is just wider than finances.

Host: With that being said, does Ontario view gambling as a public health issue the same way substance abuse would?

Andrew Kim: I would say no, not yet. If they did, I think there would be a bit more controls into how they rolled out everything. And so we don't have as much tighter policies related to gambling as we do with alcohol and, say, cannabis. An example of that is advertisement. There is no federal law right now regarding advertisements for gambling, but we have one for alcohol. We have one for cannabis. Yet gambling we don't. So I don't think people view this as much of a public health concern as they would with substances.

Host: Now, one of that being one of the cases is this is quite a lucrative business. Are you concerned that this will translate into a lack of political will to sort of put in safeguards?

Andrew Kim: I guess that depends who you ask, right? If you're someone in the government that really wants to increase revenues, you're probably thinking, oh, this is good. Look how much money we're bringing into the province.

Host: Well, this is a government that is facing a $14 billion shortfall in the budget.

Andrew Kim: So but if you if there are others who are seeing this and be like, no, we need to do something. So I do think it depends on who you ask. There are senators that are working like Senator Deakin, who's trying to pass some regulations related to advertisement. But I would also caution that $258 million is a lot. But what's the harm? What's the social and economic impact that is going to have to Ontario? So people that are experiencing gambling addiction can have significant impact to our economy, to our healthcare system, which I don't think they're factoring into their calculations. They're seeing 258 million generated. But what's the healthcare cost of that? What's the economic cost of that? What's the personal cost of people experiencing harms? And so I think it depends on who you ask. And that $258 million is only 20% of revenues generated. 80% goes back to private operators. That's a huge amount of money that's leaving the province. So I'm not sure if it's the best deal for Ontario.

Host: All right. Let's change gears a little bit. Let's talk about some potential fixes here. From your view. We talked about the uptick in young men contacting Ontario's mental health help line, one of them being Connects Ontario (C, O, N and X). Are these help lines beneficial? What is the experience for someone who is who's using one of these help lines?

Andrew Kim: They can be. They absolutely can be. I've done some research a while ago related to the effectiveness of help lines, and it really depends on the reason people use it for. For example, if it's for information Connects Ontario do a really great job of providing information related to gambling addiction and where they might be. Go to help some help lines across the world provide brief treatments. That seems to work. But yeah, it can be helpful. I think I would encourage people that are experiencing problems, needing help to reach out, because they're in a position that can connect you to the right people. The the gap is when you get that information, what's the next step? Do you actually then go to whatever the recommendations are? So there's a little bit of drop there, but I think it is it can be a helpful first step.

Host: Is there any treatment for online gambling that would be covered by the Ontario's medical system?

Andrew Kim: Yeah. So actually how I got into the field, I first started as a problem gambling counsellor at William Osler Health System in Brampton, and that was fully covered by OHIP. So if you if you contact Connects Ontario or access mental health and you say, I'm struggling with gambling, they can find you publicly available funded treatment services within your area. So there are services available. There's a lot of research suggesting that treatment for problem gambling can be effective. And so I think it's a really good resource, something that we have.

Host: I'm imagining in order to create sort of a safe gambling sort of ecosystem, ads and PSA are a part of that. And the Ontario government also currently just rolled out one. How effective are some of these PSA in terms of addressing the problem?

Andrew Kim: Let's see. I want to see the PSA. What I'll say is that for the responsible gambling advertisements that companies do, those are not effective. Why not? Because they serve as a brand awareness. So you have bet MGM having who's with Bet MGM let's go sports interaction. Maybe Mitch Marner saying bet responsibly. You're really just advertising your brand to people that like Mitch Marner, Connor McDavid, Auston Matthews it doesn't actually tell you what does Bet responsibly mean. How does one do that? And I actually went to the site to see okay, they're advertising Connor McDavid saying bet responsibly, gamble responsibly. I go on their site. I can't find McDavid. He's really hard to find. So it serves as more of a brand awareness rather than an ability to help people kind of moderate their gambling. It's actually kind of funny. We did a recent research study, and responsible gambling ads were frequently seen, but they're not that effective. They didn't help me reduce my gambling. It might have increased it actually. Whereas for other types of advertisements, people bet on sports perceive that yeah, it impacts their sports betting, whereas responsive gambling didn't impact reducing their sports betting.

Host: With that being said, if Health Minister Sylvia Jones was sitting across from us today, what were what are some policy changes that you would ask her to make? You know, online gambling, sort of a safer space?

Andrew Kim: Yeah. So one is herb the advertisements. I think it's incessant. I don't think a lot of Ontarians like how much we're being bombarded. The reason why I got into this space was because I'm a huge sports fan, and I noticed all these advertisements. So I have some restrictions around that. So it doesn't have to be a complete ban. I'm not sure if that would be something that's on the table, but there are things that you can do to reduce the amount and the content. Two universal Self-exclusion. So I think this was something that Ontario did consider. So for those that are wondering, what does that mean is if you're experiencing a problem with gambling, right? One of the symptoms of a gambling addiction is loss of control. You're having difficulties trying to control how much you gamble, how often you gamble. So you could go to OLG and say, look, I'm really having a difficult time right now. Could you help me make sure that I don't come to your casinos, ban me from your apps to give me a bit of that time that I need to try to figure this out. But now with 50 different operators, I can bet my I can ban myself or self-exclude on OLG. But in that moment where I'm really craving, there's all these urges. What's stopping me from signing up for another site? Right? I bet myself from there. But then again, there's so many different options, so universal Self-exclusion so in that time when I'm saying, you know, I really need help, you can ban yourself from one and just kind of carries through and then mandatory limit setting, having people set how much, when and where you can bet. I think that would be helpful as well. Right now, people can do it, but it's an opt in.

Host: Okay.

Andrew Kim: But again, most people don't use that.

Host: Andrew. This was really fascinating stuff, really important work as well. Really appreciate your time and insights on this. Thank you so much.

Andrew Kim: My pleasure. Thanks for having me.