In this blog, Professor Matthew Ashton, Liverpool’s Director of Public Health and James Grimes, Chapter One Director at Gambling with Lives highlight how gambling-related harms can be tackled innovatively by combining public health and lived experience expertise ahead of new local authority responsibilities and commissioning powers.
Gambling harms the health and wellbeing of many individuals, families and communities across the country. In Liverpool, of those who have gambled in the past year, almost 12 per centwere currently experiencing gambling related harm, and concerningly this is approximately double the national estimates. The impacts can be devastating, leading to hundreds of suicides every year in England. This pressing public health crisis is not being addressed to the level it deserves, with inquests concluding there has been insufficient and inadequate public information and support for those affected.
As Liverpool’s recently published city-wide Strategic Action Plan lays out, the primary driver for this harm is the design, availability and promotion of high-risk gambling products. Gambling is not what it was - these forms are engineered for prolonged engagement and are heavily marketed as safe. This has transformed who gambles, the way people do it and how quickly and intense harm can be felt. Although we know gambling can harm anyone at any time, a report from Liverpool John Moores University found that young men are most at risk.
In response, Liverpool City Council’s Public Health team partnered with Chapter One, a national gambling harm prevention programme created by Gambling with Lives, to develop a targeted public awareness campaign: “If only I knew.”
The campaign brought together lived experience and public health expertise. People who had experienced gambling harm – including those in recovery and families bereaved by gambling suicide – shared clear, evidence-based information effectively speaking to their past selves.
Delivered digitally and targeted at men aged 18 to 35, in line with the Men’s Health Strategy for England, the campaign aimed to reach those most at risk of harm. It:
- explained how gambling products are designed to be addictive
- highlighted the realities of loss, including that most people who gamble lose money over time
- showed the positive benefits of life without gambling
- signposted to independent information and support .
The messaging was grounded in emerging evidence on what resonates with those at risk, including research by Philip Newell, Jamie Torrance et al (2025), which informed key messages such as “Gambling is designed to be addictive” and “99 per cent of people who gamble lose in the long run.”
We commissioned an independent evaluation by London South Bank University and the young people interviewed in the study have shown some impact of this new approach. Although the evaluation involved a small sample, participants responded positively to the campaign’s focus on the commercial drivers of harm and its challenge to pervasive gambling marketing, describing its industry-focused messaging as thought-provoking and impactful. While the findings suggested some limitations in reaching a diverse audience, the campaign’s local imagery and relatable lived experience stories generally drove engagement and helped capture attention on social media.
Evidence shows that public education as an isolated approach is not enough to deal with the powerful industry drivers of gambling harm. That’s why we continue to need tougher action and greater powers to deal with the commercial determinants.
That being said, we are proud of “If only I knew”. In an absence of full information about gambling, there are early signs that this campaign has cut through locally.
Local authorities now have a significant opportunity to act, particularly through new Gambling Levy funding and commissioning responsibilities, including:
- investing in evidence-based public awareness campaigns
- embedding lived experience within prevention approaches
- integrating gambling harm into wider public health and inequalities strategies.
At the same time, local action must be matched by stronger national measures to reduce the availability and promotion of the most harmful forms of gambling. By combining public health leadership with lived experience insight, we can ensure that in future, society is not left thinking “if only we knew.”
Footnote
Chapter One and Gambling with Lives are attending the LGA Conference in Bournemouth. To learn more about their work and meet the team, please visit their stand or attend their conference fringe event on 9 July, 8.00am.