Video gaming – taking a gamble with young people’s health and wellbeing?

The world of video gaming has come some way from the early days of pixelated graphics and poor quality gameplay. Modern gamers have access to an inordinate choice of games, consoles, characters and in-game features. It is no wonder that the UK gaming industry was estimated to be worth £5.7 billion in 2019. ¹

The seemingly innocuous pastime of video gaming has various downsides that are potentially harmful for young people’s health and wellbeing. There is still debate around the reported negative consequences of increased screen time, ² but a shockingly high one in two young online gamers have described being bullied when playing games. ³ An emerging issue that is of particular concern from a public health perspective is the increasing incidence of gambling-like features within video games, that could act as a route for normalising gambling among young people, and therefore risk engagement with harmful gambling behaviour as adults. The 2019 Royal Society for Public Health (RSPH) report Skins in the Game revealed that young people see gambling-like activity as a normal part of their lives, ⁴ and this is evidence of how blurred gambling and gaming have become.

Loot boxes are one gambling-like feature within video games that have gained notoriety. Loot boxes have been defined as ‘items in video games that may be bought for real-world money, but which provide players with a randomised reward of uncertain value’. They often appear as chests, crates or card packs. ⁵ There have been numerous stories of young people getting into debt, blowing through their or their parents’ savings or spending their student loan on loot boxes. ⁶ Yet under current legislation, loot boxes are not classed as a form of gambling and are therefore not subject to regulation.

The 2005 Gambling Act describes gambling as betting, gaming or participating in a lottery. The Act defines gaming as only constituting gambling, if this activity includes an ‘element of chance and an element of skill’, in an attempt to win a prize of money or something of a fixed monetary value. ⁷ As the regulator, the Gambling Commission has stated that loot boxes do not fit the current definition of gambling because winnings cannot be ‘cashed out’. ⁸ However, it is possible for players to ‘cash out’ their prizes through unregulated third-party websites, ⁹ demonstrating a loophole in the law that essentially allows children to gamble.

Children who gamble are more likely to become adults who gamble, ¹⁰ so we are potentially creating a generation of gamblers, and for some this could have a serious impact on health and wellbeing. Polling for Skins in the Game found that nearly four in five (79%) respondents said that young people could find loot boxes to be addictive, and over half (54%) of young people saw the relationship between gambling and gaming as a negative one for young people. ¹¹ The COVID-19 lockdown may have exacerbated the negative impacts of gaming on health and wellbeing, with young people spending more time indoors playing video games whilst the schools were closed.

The Gambling Commission has been monitoring loot boxes amid increasing calls for them to be classed as a form of gambling. The House of Lords Select Committee on the Social and Economic Impact of the Gambling Industry released their report in July 2020, stating ‘loot boxes and any other similar games are games of chance’, and called for ‘any activity which … has the characteristics of gambling [to] be treated as gambling’. ¹² Similarly, the Gambling Related Harm All Party Parliamentary Group published their final report in June 2020, which specified that loot boxes should not be sold to children and require greater regulation. ¹³

Internationally, Belgium, The Netherlands and the Isle of Man are pioneers, officiating the link between loot boxes and gambling, and taking steps to protect children and those vulnerable to harm. In Belgium, loot boxes were banned from video games; ¹⁴ The Netherlands ruled that some loot boxes are a form of gambling and contravene the law; ¹⁵ and the Isle of Man changed the law to include loot boxes, requiring games providers to acquire a licence, preventing the sale of loot boxes to under 18s. ¹⁶

With increasing pressure to tackle the issue of loot boxes, and ahead of the review of the Gambling Act, the Department for Digital, Culture, Media and Sport (DCMS) launched a call for evidence on the impact of loot boxes in video games. ¹⁷ This consultation preceded the Government’s full response to the Online Harms White Paper and echoed the narrative of striving for the UK to be the ‘safest place to be online in the world’. ¹⁸

The call for evidence focused on the experience of gamers, the impact of loot boxes, potential harms, the scale of the market and consumer protection. The primary audience invited to respond were video gamers and video games businesses, but it was expected that the industry reaction would overshadow the player’s views.

RSPH and the Gambling Health Alliance (GHA) were concerned that the voice of young people would not be heard, and thus surveyed 13- to 24-year-olds to inform our response. We believe that loot boxes should be classed as a form of gambling and regulated to ensure that underage players are not exposed to them and the potential harm they cause. The Government response is expected to largely be determined by the review of the Gambling Act; the Act has been described as ‘unfit for the digital age’, ¹⁹ and if it is to be updated to be more in line with the current state of play in the digital world, loot boxes should be included.

In conjunction with the DCMS call for evidence, the GHA launched the campaign #LidOnLoots. The campaign aims to continue to apply pressure to have loot boxes classed as a form of gambling and regulated accordingly to protect children. In addition, the intention is to hear from young people in greater detail about loot boxes. We want to know how loot boxes could be made safer in games played by over 18s, and what the curriculum should cover now that gambling is part of the Relationships and Sex Education and Health Education curriculum. #LidOnLoots will also explore whether video gamers are being scammed when purchasing loot boxes.

Please do visit gamblinghealthalliance.org.uk to find out how you can support #LidOnLoots, or email gha@rsph.org.uk if you have particular views on this issue. We are on the cusp of an influential moment in reshaping gambling legislation from a public health standpoint, to ensure that video games do not gamble with young people’s future, health and wellbeing.