The Burden of Gambling Harms on Health‐Related Quality of Life in Great Britain.

BackgroundGambling-related harms are recognised as a public health issue, yet remain poorly integrated into health-economic frameworks. In Great Britain, national monitoring has relied largely on risk-based measures such as the Problem Gambling Severity Index (PGSI), limiting the ability to benchmark gambling harms against other health conditions. This study estimates impacts of gambling-related harm on health utility and capability using established health-economic methods.MethodsWe analysed cross-sectional survey data from people who gamble (n=2,335) and affected others (n=2,306) in Great Britain. Gambling harm was measured using Gambling Harms Severity Index (GHSI-10; GHSI-AO-10 for affected others) and PGSI. Outcomes were health utility (SF-6D) and capability wellbeing (ICECAP-A). Indirect elicitation was implemented using propensity-weighted regression models, adjusting for demographic/behavioural covariates. Population burden was estimated by scaling observed decrements with national prevalence data.FindingsIncreasing gambling harm was associated with significant, clinically meaningful decrements in health utility and capability. Severe harm (≥15) was associated with reductions of 31·7% (SF-6D) and 35·0% (ICECAP-A) – impacts similar in magnitude to long term conditions and substance related harms. Notably, affected others experienced impacts of a similarly substantial magnitude. At population level, substantive burden is driven by low- and moderate-severity harms, due to their greater prevalence.InterpretationGambling harm constitutes a population-level health burden with substantial impacts on affected others, who remain largely invisible to risk-based surveillance. When quantified using health-economic metrics, gambling harms warrant consideration alongside long-term conditions and other major public-health harms for prevention, commissioning, and resource-allocation decisions.