Reducing risks and gambling in Switzerland
The concept of Harm Reduction (HR) was initially associated with the public health approach towards illegal drugs. This concept has been defined as programmes and practices to reduce the negative consequences of addictive drives upon health, social and economic functioning. Such reductions are based upon observations of scientifically relevant indicators. Regarding excessive gambling, the public health approach remains largely overlooked. The concept of RR has only been implemented in a marginal way, subordinate to policies concerned with maximizing the State’s income. In Switzerland, the revision of gambling legislation once again raises the question of applying HR to excessive gambling. By placing the protection of players as a projected primary objective, the Swiss government forces its prevention networks to return to HR foundation, to draw attention on the effectiveness of different prevention measures for excessive gambling, and to make a critical evaluation of pre-existing regulation practices. Today gambling addiction is recognized as an illness, and in doing so, an obligation for the State as a right to health issue. However, there is an existing structural conflict between the public health perspective and that of gambling operators, whose economic aim is to make profit. For public health, the economic freedom of operators is, by definition, restricted by the intervention of the State. The operators fulfill the role of auxiliaries, charged with the responsibility of providing a game with less risk, by State monopolies or grant licensing regimes. For the operators, such a vision hinders their hopes of economic freedom. A debate on the new regulating framework and a redefinition of the objectives of public policies towards gambling appears inevitable.