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It remains irrefutable that electronic gaming machines are associated with gambling-related harms. Although research on electronic gaming machines has predominantly focussed on their structural characteristics and to a lesser extent, situational variables contributing to the emergence of gambling-related harms, the precise causal mechanisms of these variables in the aetiology of gambling disorders remains inconclusive. In addition, it remains debatable as to whether or not electronic gaming machines have higher rates of problem gambling as a proportion of participants compared to other forms. Contributing to this state of uncertainty are methodological difficulties related to jurisdictional differences in the geographical location, distribution, density, and configuration of machines (payback percentages and volatility), socio-cultural and demographic features, and availability of and involvement in other gambling modes typically associated with gambling disorders. In addition, questionnaire and survey items have tended to elicit information on preferred or identified problem forms of gambling. Accordingly, gambling-related harms tend to be attributed to such identified forms without taking into consideration intensity (expenditure and frequency) and involvement in gambling modes in aggregate. It is therefore postulated that directing attention to electronic gaming machines over other forms equally capable of causing harm is not an optimal approach to harm minimisation. It may prove to be more fruitful to investigate the complex interaction between cultural/social values, accessibility and availability of all gambling products in aggregate within a community and the factors that promote participation in multiple forms rather than a narrow focus on a limited range of products.

A CRITICAL EXAMINATION OF THE LINK BETWEEN GAMING MACHINES AND GAMBLING-RELATED HARM