Introduction

Gambling among Australian Indigenous peoples has been evident for over 300 years. Macassan traders and sailors introduced many northern Indigenous groups to cards and card gambling for recreation and economic exchange (Breen, 2008; MacKnight, 1976). Card games and gambling have evolved and spread to become an accepted part of Indigenous Australian history and culture (Berndt & Berndt, 1947; Christie & Greatorex, 2009). Today, card gambling is still widely practised in regional towns and remote Indigenous communities, although it has declined in urban areas (Breen, 2012b; Breen, Hing, & Gordon, 2010; 2011). The past 30 years of commercial gambling expansion has corresponded with growth in Indigenous gambling participation to levels well above those seen in the non-Indigenous Australian population (Aboriginal Health & Medical Research Council of NSW [AHMRC], 2007).

Gambling by Indigenous Australians occurs against a backdrop of social disadvantage. As Australia's original peoples, Indigenous Australians now make up only about 2.5% of the population (Australian Bureau of Statistics [ABS], 2012). British colonisation from 1788 resulted in dispossession of land they had occupied for up to 60,000 years. The structural disadvantage that continues today has led to a high burden of ill-health, disability, poverty, unemployment, social problems and poor living conditions (Australian Council of Social Services [ACOSS], 2010; Holland, 2011). As a traditional activity with numerous commercial options, gambling provides recreation, diversion and enjoyment, as well as being a source of problems and hardship.

Gambling on commercial forms

• Indigenous Australians participate in commercial gambling much more than the general Australian population.
• Gambling on electronic gaming machines (EGMs or the "pokies") is the most popular form.
• Gambling participation and frequency are similar to other Aboriginal and First Nation peoples internationally.
• Healthy and unhealthy gambling can be seen within Indigenous communities.

Commercial gambling includes electronic gaming machines (EGMs), wagering on horse and dog races, sports betting, keno, bingo, lotto and lottery-type games, instant scratch tickets, poker tournaments, and casino table games. Overall participation in commercial gambling is higher among Indigenous Australians than in the general population. A survey conducted in 2011 found that 80% of Indigenous participants reported gambling on commercial forms in the previous year compared to 64% nationally, with highest participation on EGMs (Hing, Breen, Gordon, & Russell, 2014a; Hing, Gainsbury et al., 2014). Similar indicators of high gambling involvement have been reported for Aboriginal and First Nations people in North America and New Zealand (Gray, 2011; Williams, Stevens, & Nixon, 2011). These similarities suggest Indigenous populations may share common attributes encouraging high gambling involvement.

On average, Indigenous Australians gamble on their highest spending activity about fortnightly, for two hours or less each session, with about one-third spending less than $20 and another two-fifths spending between $20 and $100 each time. Gambling on EGMs is popular for both women and men, and is often their highest spending activity. Younger gamblers prefer EGMs, table games and poker, while older gamblers prefer lottery-type games. The majority gamble in licensed clubs (Hing et al., 2014a).

Indigenous men tend to gamble more widely, frequently and intensively than women. They gamble more on card games, keno, races, sports, table games, online casino games and poker tournaments. This may contribute to men's higher problem-gambling rate (Hing et al., 2014a). Women are more likely to gamble on bingo than men.

Most Indigenous people gamble weekly or fortnightly with groups of family and friends, often using low stakes. They usually gamble on EGMs for a few hours or play bingo, sometimes pooling their funds. Gaming venues that provide easy access and equitable treatment of Indigenous peoples are preferred by Indigenous Australians. Socially motivated players gamble for recreation and relaxation with family and friends. In contrast, a minority of men and women are motivated by winning at gambling. When they have money (usually payday) they gamble heavily, frequently and in long sessions. They often seek loans to continue gambling, with some individuals pressuring others for money using cultural obligations as a lever (Breen, 2012a; Breen et al., 2011; Hing, Breen, & Gordon, 2012). Highly involved gamblers typically gamble alone, although they might be loosely connected to a social group in venues (Fogarty, 2009).

Card gambling

• Indigenous card gambling is historically an acceptable activity, often seen as a way to strengthen social and cultural networks.
• Card gambling participation and frequency are declining in urban areas.
• Learning to gamble early in a collectivist society supports gambling becoming an ingrained habit for some Indigenous Australians.¹

Many Indigenous Australians gamble occasionally on cards as a natural social activity (Christie & Greatorex, 2009). Card gambling using small stakes in long slow games is seen as women's gambling. Fast games with high stakes and an accumulating pool of winnings are more popular among men (Phillips, 2003).

Large card games are usually played on payday, but taper off as money is exhausted (Breen, 2012b; Breen, 2013). Some large games are organised for profit by entrepreneurs. In remote areas, large card games can attract numerous players and spectators. Spectators may wait for a loan from relatives to commence playing (Altman, 1985; McDonald & Wombo, 2006). Children and adolescents can play on the perimeter of the card ring. Sometimes, winners are expected to keep playing to allow losers an opportunity to win back a portion for living expenses. Some redistribution of winnings occurs in small trusted groups (Fogarty, 2009; Goodale, 1987).

Card games provide a neutral, Indigenous only space for discussions on family and community topics (AHMRC, 2007; Breen, 2012b). Winning, enjoyment and socialising are important card gambling motivations but reducing boredom, escaping stress and displaying status also motivate some card gambling (McDonald & Wombo, 2006; Nagel, Hinton, Thompson, & Spencer, 2011; Stevens & Bailie, 2012).

Children and youth are likely to learn the rules and strategies of different card games early (Goodale, 1987; Hunter, 1993). Learning to gamble while young in a collectivist society with strong cultural bonds may contribute to gambling becoming a deep-seated habit for some Indigenous Australians.

Gambling motivations

• Motivations for gambling are similar to those for non-Indigenous Australians, with the exception of heightened escape-based motivations.
• Escape-based motivations are similar to other Aboriginal and First Nation peoples internationally.

Pleasure and fun appear to be the most common and strongest reasons for gambling, followed by the chance to win extra money, to relax and to socialise (Hing, Breen, Gordon, & Russell, 2014f). These are generally similar to the motivations of the non-Indigenous Australian gambling population. The relative importance of these motivations varies somewhat between women and men (see Box 3).

Gambling motivations appear to be different for problem gamblers. Problem gamblers are more likely to be motivated to gamble as a form of relaxation or diversion or to escape from worries and stresses (Hing et al., 2014f). Substantially higher proportions of both Indigenous men and women report escape-motivated gambling compared to the wider Australian population. Escape-motivated gambling may explain some of the popularity of EGM gambling for Indigenous people (Hing, Breen, Gordon, & Russell, 2014d; 2014f). Escape-based gambling motivations are commonly reported among Indigenous groups in Canada, Greenland, New Zealand and South Africa (Belanger, 2011; Dyall, 2004; Larsen, Curtis, & Bjerregaard, 2013; Scott & Barr, 2013). They appear to be a factor that elevates the risk associated with Indigenous people's gambling.

Gambling problems

• Rates of problem and at-risk gambling among Indigenous Australians are higher than in the general Australian population and international Indigenous and First Nations populations.
• Problem gambling rates are higher among men than women.
• Many do not recognise gambling as a source of problems.

Rates of problem and at-risk gambling are high, with research reporting that up to one-fifth of Indigenous individuals have a problem with gambling (Hing, Breen, Gordon, & Russell, 2014b). Among those who gamble, nearly two-thirds have been found to be at-risk or problem gamblers (Hing et al., 2014b ). However, almost half (44%) do not think they have a gambling problem (Hing et al., 2014b). Indigenous women have lower rates of at-risk and problem gambling than Indigenous men, but much higher rates than women in the general population (Hare, 2009; Sproston, Hing, & Palankay, 2012). Proportions of moderate risk and problem gamblers in the Aboriginal Gambling Survey were much higher than those in the general Australian population, other estimates for Indigenous Australians, and estimates for international Indigenous and First Nations groups (Hing et al., 2014; Stevens & Young, 2009; Williams et al., 2011). This may be because other recent studies on Indigenous Australian gambling measured only reported gambling problems using a single question. Also, the Australian Gambling Survey did not involve a representative sample, so problem gambling rates may have been influenced by the type of people who took part in the study.

Risk and protective factors for gambling problems

• Common risk factors for gambling problems among Indigenous women and men are commencing gambling as a child, high gambling expenditure, gambling to escape, and use of alcohol and/or drugs while gambling.
• Common protective factors include family and social group assistance in controlling gambling, and respecting Aboriginal culture and traditional values.

Among Indigenous Australian men, risk factors for problem gambling have been identified as working part-time, being separated, divorced or widowed, commencing gambling when young, high expenditure, using alcohol and/or drugs while gambling, gambling to relax and a self-perceived addiction to gambling (Hing et al., 2014d).

For women, risk factors for problem gambling include commencing gambling when young, high expenditure, gambling on multiple activities, using alcohol and/or drugs while gambling, gambling to escape and a self-perceived addiction (Hing, Breen, Gordon, & Russell, 2014c).

Interviews focused specifically on card gambling revealed risk factors including generational encouragement to gamble, ignoring cultural boundaries, use of non-monetary stakes for bets, and use of traditional exchange systems for gambling (Breen, 2012b; 2012c; 2012d).

Distinctive risk and protective factors can be targeted by appropriate public health strategies to promote awareness and alternatives among Indigenous gamblers.

Consequences of gambling

• Gambling has both positive and negative consequences for Indigenous gamblers.
• Socialising and social acceptance are positive consequences.
• Financial problems are the most common negative consequences.
• Severe negative consequences may spread from problem and at-risk gambling, rippling through relationships, families and communities.
• Traditional Indigenous obligations underpin caring for others and sharing resources. This includes gamblers and their dependants.

Socialising, enjoyment, acceptance, physical comfort, the opportunity to win money and some reduced alcohol consumption are common positive consequences of gambling (AHMRC, 2007; Breen, 2012d; Breen, Hing, & Gordon, 2010; 2014; Goodale, 1987; McDonald & Wombo, 2006; McMillen & Donnelly, 2008). The most common negative consequence of gambling is financial hardship, including debt and poverty (Breen et. al., 2014; Hunter, 1993; McDonald & Wombo, 2006; Nagel et al., 2011; Phillips, 2003; Stevens & Bailie, 2012). Financial difficulties are experienced by 90% of problem gamblers (Hing, Breen, Gordon, & Russell, 2013). In the largest study of Indigenous Australians to date, most of those who experienced gambling-related financial problems relied on family and friends or just went without. Nearly one-half did not pay or put off urgent bills and argued about gambling within their household. Smaller groups reported incidents of violence, separation, divorce, job losses, or eviction as a result of gambling. Other negative personal, relationship, family, community, legal and housing impacts were more prevalent among Indigenous problem gamblers with effects flowing on to others (Hing et al., 2013).

Help seeking

• Help-seeking rates for gambling problems are low.
• Personal, cultural and structural barriers deter Indigenous gamblers from seeking help.
• Indigenous Australians trying to reduce gambling problems typically try to help themselves first, then, and if this is unsuccessful, seek informal help from family, friends and community, and finally formal or professional help.

Help-seeking rates for gambling problems among Indigenous Australian gamblers are very low, as they are in the general Australian population (Hing et al., 2013). Only 5.4% of gamblers had received any kind of help for their gambling, including from informal sources such as family and friends (Hing et al., 2013).

As with the broader community of gamblers, Indigenous gamblers have indicated a preference for trying to help themselves. Self-help strategies are used to avoid the shame and stigma associated with problem gambling (Breen, Hing, Gordon, & Holdsworth, 2013). Self-help strategies include taking up new hobbies, learning new skills, taking care of health, learning budgeting skills, avoiding gambling venues and avoiding other gamblers.

Informal help provided by family, friends and community leaders is a second preference. This can include emotional care, food and shelter, and various forms of "tough love" such as refusing loan requests and hiding debit/credit cards. Seeking informal help demonstrates the meeting of reciprocal obligations within Aboriginal culture but is often in vain. Family and friends are often gamblers themselves, which can be problematic. Those seeking help often encounter other gamblers' non-recognition of the problem, as gambling is viewed as a normal social and cultural activity by many Indigenous Australians. Another barrier is the inappropriateness of suggesting that an Elder needs gambling help, due to cultural respect for Elders (Breen et al., 2013).

Professional help appears to be sought only after other options have been exhausted. Awareness of professional gambling help services is low and questions have been raised around the cultural appropriateness of online and telephone services, self-exclusion, peer support groups, and non-Indigenous help services (Breen et al., 2013).

Help services need to identify how Indigenous families and communities can best assist themselves and their loved ones to acknowledge and address gambling problems.

Implications

• The importance of initiatives to address gambling problems among Indigenous Australians cannot be overstated. Urgent prevention, harm minimisation and treatment strategies are needed to address the very high rates of gambling problems, their serious ripple effects through Indigenous communities, and their transfer to subsequent generations.
• Measures need to be developed in consultation with Indigenous communities, and in recognition of Indigenous social and cultural meanings of gambling, to ensure cultural appropriateness. Given similar rates of gambling participation and gambling problems to other international Indigenous populations, successful gambling policies, education and interventions used internationally should also be reviewed for potential use with Indigenous Australians.
• Based on our research findings, all socio-demographic groups would benefit from targeted measures, given the extent of problems and impacts. Community education could emphasise that taking up gambling is risky and can lead to problems for the individual. It could also focus on the risks of gambling on continuous forms, especially EGMs. Given strong kinship bonds, community education might emphasise the harmful effects of gambling on gamblers, family members and communities, the serious impacts on children, and the importance of preventing early gambling exposure and underage gambling.
• Given the preference for self-help, culturally appropriate self-help resources should be widely promoted and developed in collaboration with Indigenous groups.
• With reliance on informal help for gambling problems, Indigenous Australians would also benefit from guidance on how best to help significant others with gambling problems. Using Aboriginal kin and community networks, gambling awareness and education could be targeted to provide culturally based advice and strategies for gambling help within families and communities.
• Problem gambling recognition is low and requires awareness raising efforts, while culturally appropriate help services and resources are urgently needed. Integration of gambling help within existing Indigenous services may also be effective.
• Risk and protective factors associated with Indigenous Australians' gambling have cultural, social and structural foundations. Further research is needed to better understand risk and protective factors in shaping gambling motivations, behaviours and consequences to reduce stress and poverty associated with recurring cycles of gambling problems. Investigating and revealing the consequences of gambling and showing gambling as a cause of health and welfare problems can also assist gambling help services and others in their work.
• Gambling is an enjoyable social and culturally acceptable activity for many Aboriginal people. It is very important to investigate ways to build on the positive aspects of gambling to maintain cultural obligations towards others and historical links with land and ancestors. Equally, it is important to examine negative aspects of Aboriginal gambling activities to inform prevention of adverse consequences being recycled over generations of younger Aboriginal people.
• The above suggestions are, however, remedial. While severe structural disadvantage, neglect and discrimination continue, the Indigenous population of Australia is likely to remain much more vulnerable to the serious negative effects of gambling than the non-Indigenous population.

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