The Department of Health and Social Care commissioned PHE to undertake a review of the evidence on gambling harms in 2019. The review includes the most comprehensive estimate of the economic burden of gambling on society to date, revealing that the harms associated with gambling cost at least £1.27bn in 2019 to 2020 in England alone.

This analysis includes the first estimate of the economic cost of suicide (£619.2m) and provides an updated cost of homelessness associated with harmful gambling (£62.8m).

The review also shows that people at risk of gambling harms are concentrated in areas of higher deprivation, such as the North of England, and may already be experiencing greater health inequalities.

The review found a clear link between higher levels of alcohol consumption and harmful gambling, with only 35.4% of non-drinkers participating in gambling compared to 74.4% of those consuming more than 50 units of alcohol per week. Alcohol use in children and young people was also found to be a risk factor for subsequent harmful gambling.

The review also highlights the link between gambling and mental health issues. The report found that gambling can increase the likelihood of some people thinking about, attempting, or dying from suicide.

The report found that men were 4.2 times more likely than women to be gambling at levels of elevated risk of harm, while people identified as having some mental health issues were twice as likely to participate in harmful gambling than people with no mental health issues.

Rosanna O’Connor, director of alcohol, drugs, tobacco and justice at PHE, said: “There is so much more at stake from gambling than just losing money – from the toll on mental health to the impact on those around the gambler.

“The evidence is clear – harmful gambling is a public health issue and needs addressing on many fronts, with an emphasis on preventing these harms from occurring as well as with help readily accessible for those directly and indirectly affected by the wide ranging and long lasting negative impacts of gambling.”

Gillian Keegan, minister for mental health, said: “Whilst the economic costs of harmful gambling are stark, the cost to individuals as a result of their addiction, and those around them, cannot be overstated.

“We are working to protect vulnerable people from the damaging impacts gambling can have, including through specialist NHS gambling addiction clinics and investing at least an extra £2.3bn a year by 2023 to 2024 to expand mental health services.”