• Users Online: 598
  • Print this page
  • Email this page


 
 
Table of Contents
REVIEW ARTICLE
Year : 2022  |  Volume : 19  |  Issue : 1  |  Page : 32-36

The need for a nationwide epidemiological study on the gambling disorder caused by compulsive sports betting in Nigeria: A narrative review


Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy

Date of Submission29-Oct-2021
Date of Decision03-Nov-2021
Date of Acceptance01-Dec-2021
Date of Web Publication24-Jan-2022

Correspondence Address:
Chidiebere Emmanuel Okechukwu
Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, Rome 00185
Italy
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/am.am_124_21

Rights and Permissions
  Abstract 


There is a lack of detailed information on the epidemiology, prevention, and treatment of gambling disorder (GD) in Nigeria, a country that has the second-largest online sports gaming market in Africa. The objective of this review article was to emphasize the need for a nationwide epidemiological study on the GD caused by compulsive sports betting in Nigeria. The literature searches were carried out using the PubMed, Scopus, and Web of Science electronic databases regarding articles concerning sports betting, problem gambling, GD, and mental health in Nigeria using the following medical subject headings: Pathological Gambling AND Gamblings AND Federal Republic of Nigeria AND Social Epidemiology. A nationwide surveillance is necessary to determine the epidemiology, risk factors, and prevention and treatment measures for GD in Nigeria. To prevent negative public health consequences, sports gambling activities in Nigeria should be restricted and controlled. There is a need to set aside strict measures to control both legal and illegal online and offline sports betting activities in Nigeria. Moreover, the implementation of an effective mental health-care delivery policy to tackle gambling addiction and associated psychiatric comorbidities in Nigeria will enable efficient diagnosis and treatment of individuals with GD and improve relapse prevention. A well-funded and functional mental health-care system and research framework will facilitate effective mental health-care delivery among individuals at risk of GD and patients with GD in Nigeria. Expanding access to and use of mental health treatment services could substantially reduce the prevalence of GD and associated comorbidities in Nigeria.

Keywords: Addictive behavior, Nigeria, pathological gambling, social epidemiology


How to cite this article:
Okechukwu CE. The need for a nationwide epidemiological study on the gambling disorder caused by compulsive sports betting in Nigeria: A narrative review. Apollo Med 2022;19:32-6

How to cite this URL:
Okechukwu CE. The need for a nationwide epidemiological study on the gambling disorder caused by compulsive sports betting in Nigeria: A narrative review. Apollo Med [serial online] 2022 [cited 2022 May 22];19:32-6. Available from: https://www.apollomedicine.org/text.asp?2022/19/1/32/336566


  Introduction Top


Sports betting is experiencing substantial growth in Nigeria, with an estimated 60 million Nigerians actively involved.[1] As a result, sports betting is having a huge impact on Nigeria's economy. Nigeria has Africa's second largest online gambling market.[1] Nigerians now gamble online in the comfort of their homes on their phones and computers, compared to the early 90s when one needed to gamble at a gambling shop. Online sports gambling worsens the obsession with regard to gambling frequencies. Several epidemiologic findings show that young adults have higher rates of gambling-related issues compared to older adults.[1] The risk of gambling addiction was observed to rise with increased expenditure on sports betting and the multiplicity of gambling participation.[2] Impulsive reactions to sports betting events, including in-play live action betting, also known as virtual gaming, as well as stimuli from media publicity and sports gambling advertisements, are associated with increased gambling risk.[2] Gambling disorder (GD) is characterized as a persistent and recurrent maladaptive problematic gambling habit that creates considerable problems or discomfort and negatively impacts a person's everyday activities, mental and physical health, reputation, and relationships, as well as their finances.[2],[3] GD is associated with an increase in the prevalence of suicidal ideation and suicide worldwide.[3] The majority of people with protracted GD suffer from other mental disorders, most especially mood and substance use disorders.[4] Possible harm due to uncontrolled gambling is like the harm caused by depression.[5] With the exception of the illegal act criterion, at least four of the nine diagnostic criteria in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders should be met to confirm GD.[6] GD is characterized by a pattern of persistent or recurrent gambling behavior, which may be online or offline, that is demonstrated by impaired control over gambling. Patients with GD place more priority on gambling events to the extent that gambling activities become more important to them than their routine activities.[7] An addictive behavior can substantially ruin a person's relationships with friends and family members, marriage, education, and professional career. The pattern of gambling behavior among patients with GD may be constant or irregular. Addictive behaviors associated with gambling are usually noticeable over time, at least over a year, for a diagnosis to be defined, even though the requisite time may be reduced if all the diagnostic conditions are met, and symptoms are severe.[7] There are fewer studies on sports gambling in Nigeria and other African countries, despite the booming sports betting market in African countries.

The objective of this review article was to emphasize the need for a nationwide epidemiological study on the GD caused by compulsive sports betting in Nigeria.


  Methods Top


Search strategy

The literature searches were carried out using the PubMed, Scopus, and Web of Science electronic databases regarding articles concerning sports betting, problem gambling, GD, and mental health in Nigeria using the following medical subject headings: Pathological Gambling AND Gamblings AND Federal Republic of Nigeria AND Social Epidemiology.

Study selection

Inclusion and exclusion criteria

Well-detailed articles with aims similar to the objective of this study were selected for this review. Unrelated papers were excluded.

Types of selected studies

Original articles, reviews, conference presentations, and web surveys.

Data extraction and management

Studies were selected from the PubMed, Scopus, and Web of Science databases, after checking for relevance based on one or more of the following medical subject headings: Pathological Gambling; Gamblings; Federal Republic of Nigeria; Social Epidemiology. Papers listed as potentially relevant were downloaded and inclusions and exclusions were based on transparency and repeated publications/similarities, respectively.


  Results Top


Gambling disorder, sports gambling, and the mental health system in Nigeria

The prevalence of gambling-related issues in Nigeria may be triggered by the ease of access, dissemination, and promotion of gambling activities, mostly during popular sports events. Patients with GD mostly suffer from substance use disorders, cardiovascular disease, and mood disorders. The severe effects of GD on social and family life include economic hardship, domestic violence, divorce, loss of employment, lack of association with people, and mismanagement of funds. Patients with GD typically exhibit comorbid mental disorders, and they frequently experience psychosocial issues. The outcome of one survey conducted in Nigeria shows that sports gambling addiction is very prevalent in Nigeria, mostly among the increasing young population and sports fans.[8] The incidence of pathological sports gambling is on the rise in Nigeria. Remarkably, a significant proportion of Nigerians confirmed the increase in gambling activities in their locality, predominantly among respondents in the South-West geopolitical zone, which recorded the highest occurrence.[8] Sports betting has become a rising trend among young Nigerians aged between 18 and 35 years. According to the survey, many Nigerians admitted that they directly engage or have family members who engage in sports gaming activities. Most Nigerians prefer betting on platforms that offer quick redemption of earnings and favorable odds-on games. Nigerians typically engage in sports betting activities because of their quest for quick money, high rate of unemployment, and greed.[8]

Regarding the mental health-care workforce in Nigeria, the physician-patient ratio is extremely poor.[9] There is an enormous neglect of mental health care in Nigeria concerning the shortage of psychiatrists in Nigeria. Nigeria has an estimated population of 200 million people, with fewer than 5000 psychiatrists presently licensed and registered to practice in the West African country.[9] Online sports betting remains a social activity in Nigeria. Like other forms of gambling, the risk of pathological progression exists for gamblers who persist in betting despite the considerable financial losses incurred and already existing psychological challenges. Cognitive-behavioral therapy is an effective therapy for the management of GD among young Nigerians because it modifies flawed ideas and substitutes them with sensible ways of reasoning.[10] An increase in stress and anxiety levels plays a fundamental role in increasing gambling and substance abuse relapse.[11] However, efforts should be made to create public awareness of the deleterious effects of uncontrolled online gambling and substance use on an individual's physical and mental wellbeing in Nigeria.[12] Moreover, frequent psychiatric services should be offered to individuals who have a medical history of GD, or who are at-risk of GD, or who are currently suffering from GD.[13] The Nigerian government should endeavor to improve the mental health-care quality and standards in the country and ensure stringent regulation of online gambling activities.[14] However, apart from mental health interventions (e.g., cognitive behavioral therapy), lifestyle interventions (e.g., physical activity, smoking/alcohol cessation, and dietary modification) could help to improve the wellbeing and quality of life among patients with GD.[15],[16]

Virtual gaming is very popular in Nigeria because it is available 24 h a day, 7 days a week, and it is considered riskier by gamblers compared to staking on live fixtures.[17] Virtual gaming is commonly associated with entrapment. Gambling losses have been shown to arouse feelings of entrapment. Most Nigerians who gamble on sporting events seem to be entrapped when they are desperate to wager more money on sporting events because they want to recover their losses. The relationship between entrapment and gambling problems was high among football bettors in Nigeria, with increased impulsivity scores.[18] Some young and unemployed Nigerians believe that the easiest and fastest way to get rich is to gamble on sporting events. Therefore, there is a need to reduce gambling advertisements in Nigeria, increase employment opportunities and interventions to promote gambling cessation among Nigerian youths. There is a need to introduce tele–behavioral health services as part of the mental health-care delivery system in Nigeria to enhance treatments and periodic assessment for individuals at-risk of gambling problems and GD and to diagnose any associated psychiatric comorbidity (e.g., substance use disorders and depression).[19] The rise in online gambling has triggered an increase in gambling-related harm in Nigeria, and this has serious implications for the mental health system in the country.[20] In Nigeria, gambling research has mostly focused on the prevalence, pattern, and determinants of gambling among the country's various subpopulations.[21] Age, gender, financial stress, some personality traits, and depression have all been linked to GD. It has been suggested that monetary gain, increased by greed, unemployment, economic suffering, and poverty, are the most powerful motivators for gambling, and that they may serve as a springboard for misconduct in Nigeria. Other risk factors for GD in Nigeria include the pursuit of pleasure, sports passion, and peer group influence. Having friends who gamble and parental problematic gambling behavior increase the likelihood of gambling in some individuals.[22] Most health-care professionals are unaware of the prevalence of gambling-related problems in Nigeria. Most people with GD go unnoticed and untreated.[21] Individuals who are diagnosed with substance use disorder comorbid with GD in Nigeria receive treatment from drug abuse rehabilitation centers. In Nigeria, there is no recognized gambling addiction treatment center. Some rich Nigerians with gambling problems seek specialized addiction treatment overseas, which may include gambling therapy at rehab centers in developed countries.[21]

The disadvantages of gambling outweigh the perceived benefits because no matter how much money a gambler wins through a gambling platform, the gambler may use more than that amount to stake on another event and ultimately lose. Several Nigerian students in tertiary institutions gamble with the money meant to pay for their tuition fees and living allowances, making them go bankrupt and perhaps discontinuing their studies. Civil servants and other working-class individuals who need an extra income are caught in the web of sports betting in Nigeria. Moreover, employers are unlikely to observe gambling problems during the early stages, but they are likely to notice the problems associated with ongoing gambling activities (e.g., lateness to work, absenteeism, anxiety, daytime sleepiness, impulsiveness, decreased productivity, and embezzlement) over time. Nigerian males are at greater risk of GD than females, which may be due to peer pressure, sports fanaticism, obsessive gambling among Nigerian males and environmental factors. Being less busy and constant use of the internet, frequent visits to online betting sites and gambling advertisements may possibly increase the cue-induced craving for gambling even among individuals that have stopped gambling.

Possible preventive measures against gambling disorder in Nigeria

A public health plan to reduce pathological sports gambling and to promote gambling cessation in Nigeria should emphasize the social, economic, and health status of numerous gamblers. Effective strategies are required for the prevention and treatment of GD in Nigeria. There is a need to design a framework which will include broad preventive interventions, harm reduction, and comprehensive treatment strategies. Efficient treatment policies and preventive plans that will limit the factors that increase gambling activities both online and offline in Nigeria should be established. Conducting regular surveillance studies just like Italy and setting up addiction clinics and facilities across the 36 states of the federation and the federal capital territory will enable the treatment of individuals who are seeking help for gambling addiction and the rehabilitation of patients with GD and other addictive disorders, thus improving their physical and mental wellbeing. There is an urgent need to increase awareness about the prevalence and consequences of uncontrolled gambling activities, the detrimental health effects of uncontrolled gambling, and the prospective strategies to reduce gambling addiction among numerous Nigerian youths and those at risk of GD. Nigerian gambling regulators should strive to promote responsible gambling, and this will help to reduce the long-term health complications caused by uncontrolled gambling activities in the country. A functional national gambling helpline should be set up in Nigeria to offer gambling therapy and support and facilitate referrals to specialized hospitals or addiction treatment clinics. The mental health workforce in Nigeria needs to be strengthened by encouraging junior doctors to specialize in psychiatry, and Nigerian psychiatrists should be encouraged to subspecialize in addiction psychiatry, and constant workshops should be provided for them alongside international collaborations and training. There is a need to encourage more Nigerian nurses to specialize in nursing care for the prevention and treatment of addictions. Graduates of psychology can be trained in addiction psychology to operate the national gambling helpline and to work as addiction counselors and therapists in psychiatric hospitals and addiction centers in Nigeria. There are fewer quality research studies on gambling behaviors and activities in Nigeria. Therefore, more epidemiological and experimental studies are required to assess the impact of legal online and offline gambling activities on public health and mental health-care systems in Nigeria. Collaborative efforts are required between the commercial and public health sectors to mitigate the negative impact of uncontrolled online gambling activities on the Nigerian youth population.


  Discussion Top


The cornerstone of immediate and long-term efforts to control GD in Nigeria is epidemiological surveillance. Public bodies are normally in charge of such monitoring in developed countries, which includes examining individual cases, determining the causative variables, and compiling population-based statistics to support public health policy. For GD control and prevention in Nigeria, creating an effective epidemiological surveillance system is necessary. GD, associated risk behaviors and comorbidities, are all measured in population surveys and surveys of health-care utilization in the United States. Most of the information needed to guide effective mental health awareness, mental prevention services, and treatment initiatives emerges from population-based surveys and surveillance systems.[22] Because of Nigeria's growing gambling sector, there is a need to collect, analyze, interpret, and disseminate data on gambling-related potential health risks and diagnosed incidences of GD for use in therapeutic interventions to minimize disease risk and promote mental health among Nigerians. Continuing to support early detection of GD, disease surveillance, and mental health interventions, predicting the impact of gambling, depicting the progression of GD in Nigeria, identifying the pattern of GD cases in various regions, creating theories, and boosting research, assessing prevention and control measures, and supporting strategy are all examples of effective epidemiological surveillance measures. Monitoring of uncontrolled sports betting activities and associated mental disorders should be a public health priority in Nigeria, mainly because of the country's young population and increasing sports fans, especially of football. Given the body of evidence on the relationship between gambling and disease and mortality indicators,[23],[24] the Nigerian government should prioritize gambling surveillance as a top public health concern. Nigeria should emulate countries like Italy, where some of its citizens have similar gambling issues and football fanaticism as Nigerians. Italy has a functional national surveillance system on GD,[25] which uses surveys to collect scientific evidence on nationwide statistics on gambling and GD such as the distribution of available public and private clinical facilities for treatment, public and private patient perspectives about gambling, and further prevention and health promotion measures. Gambling has become more accessible in Nigeria due to the internet, which houses online betting sites. The number of individuals severely impacted by gambling could increase as sports betting becomes more accessible to more people. There is a link between gambling and the occurrence of crime. Most of the criminal offenses are related to collecting funds to gamble or repay gambling obligations. Scams, falsification, theft, burglary, shoplifting, extortion, and pickpocketing are all frequent crimes associated with gambling addiction.[26] There is a link between increased criminal conduct and the intensity of pathological gambling. A review of gambling and crime rate information is required to comprehend this relationship. In terms of previous research in developed countries, males, young adults, low-income earners, and those who are not married are reported to be at higher risk of gambling-related issues. Aboriginal people and some ethnic minorities have high rates of incidence and prevalence. Living in high-poverty areas, a lack of formal education, and being unemployed have all been identified as independent predictors in several studies.[26] Most of these high-risk populations live in areas that are not only impoverished but also have a high proportion of gambling facilities and outlets. Residential closeness to gambling shops has also been linked to GD. In essence, it appears that an associated increase in susceptibility, economic and social deprivation, and high gambling exposure plays a significant role in the development of gambling problems.[26]

Limitations

The major limitations of the review were the lack of studies and information regarding the prevalence and clinical management of GD in Nigeria. The studies that reported GD and gambling problems in Nigeria were poorly conducted and did not represent a true description of gambling problems in Nigeria and the general population.


  Conclusion Top


There is a lack of comprehensive information regarding the epidemiology, prevention, and treatment of GD in Nigeria. Remarkably, sports gambling is quite popular in Nigeria, particularly among young people and sports lovers. The popularity and marketing of sports gambling activities contribute to the incidence of GD. To avoid negative implications in the future, the rate of sports betting activities in Nigeria should be restricted and monitored. Due to Nigeria's poor mental health system and insufficient data on GD, there are likely to be many cases of undiagnosed GD among the country's sports bettors. This contrasts with developed countries, which have an advanced mental health system, epidemiological data, and facilities for the treatment of GD. Poverty and unemployment are linked to an increase in the desire to gamble with one's money to gain more money. Unemployed Nigerian youths and those living in poverty are often keen on improving their financial situation by winning a jackpot. Money obsession is a crucial psychological and economic aspect of sports gambling, and it has contributed to the possible progression of problem gambling in Nigeria. There is a need for a nationwide study to determine the epidemiology, risk factors, preventive, and treatment strategies for GD in Nigeria. The government should set up specialized clinical treatments and resources (e.g., trained gambling addiction counselors, multilingual gambling helpline network (local Nigerian languages and English), online therapy/tele-mental health support, gambling therapy apps, screening tools, gambling addiction clinics, and treatment facilities) for the prevention and treatment of GD in Nigeria. To make GD treatments more accessible in Nigeria, tele-health platforms should be used to deliver mental health care. The use of tele-behavioral platforms enhances screening, diagnosis, treatment, recovery support, crisis support, and medication management for GD and can be made available in various tertiary and primary health-care settings.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Nigeria I-Gaming Focus an Accelerated Shift Towards the Online. Available from: https://www.btobet.com/wp-content/uploads/2020/09/Nigeria-iGaming-Focus-An-Accelerated-shift-towards-the-online.pdf. [Last accessed on 2021 Nov 03].  Back to cited text no. 1
    
2.
Hing N, Russell AM, Vitartas P, Lamont M. Demographic, behavioural and normative risk factors for gambling problems amongst sports bettors. J Gambl Stud 2016;32:625-41.  Back to cited text no. 2
    
3.
Moghaddam JF, Yoon G, Dickerson DL, Kim SW, Westermeyer J. Suicidal ideation and suicide attempts in five groups with different severities of gambling: Findings from the National Epidemiologic Survey on Alcohol and Related Conditions. Am J Addict 2015;24:292-8.  Back to cited text no. 3
    
4.
Kessler RC, Hwang I, LaBrie R, Petukhova M, Sampson NA, Winters KC, et al. DSM-IV pathological gambling in the National Comorbidity Survey Replication. Psychol Med 2008;38:1351-60.  Back to cited text no. 4
    
5.
Salonen AH, Alho H, Castrén S. The extent and type of gambling harms for concerned significant others: A cross-sectional population study in Finland. Scand J Public Health 2016;44:799-804.  Back to cited text no. 5
    
6.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders Fifth edition. Arlington, VA: American Psychiatric Publishing; 2013. Available from: http://doi: 10.1176/appi.books0.9780890425596 [Last accessed on 2021 Nov 03].  Back to cited text no. 6
    
7.
Potenza MN, Balodis IM, Derevensky J, Grant JE, Petry NM, Verdejo-Garcia A, et al. Gambling disorder. Nat Rev Dis Primers 2019;5:51.  Back to cited text no. 7
    
8.
Ngozi Okonjo Iweala-Polls; 2017. Available from: https://noi-polls.com/new-poll-reveals-rising-trend-of-gambling-in-nigeria. [Last accessed on 2021 Nov 03].  Back to cited text no. 8
    
9.
Okechukwu CE. A call for improved mental health workforce in low-income countries Int J Soc Psychiatry 2021. doi:10.1177/00207640211039255.  Back to cited text no. 9
    
10.
Ede MO, Omeje JC, Ncheke DC, Agah JJ, Chinweuba NH, Amoke CV. Assessment of the effectiveness of group cognitive behavioural therapy in reducing pathological gambling. J Gambl Stud 2020;36:1325-39.  Back to cited text no. 10
    
11.
Salerno L, Pallanti S. COVID-19 related distress in gambling disorder. Front Psychiatry 2021;12:620661.  Back to cited text no. 11
    
12.
Ssewanyana D, Bitanihirwe B. Problem gambling among young people in sub-Saharan Africa. Front Public Health 2018;6:23.  Back to cited text no. 12
    
13.
Manning V, Dowling NA, Lee S, Rodda S, Garfield JB, Volberg R, et al. Problem gambling and substance use in patients attending community mental health services. J Behav Addict 2017;6:678-88.  Back to cited text no. 13
    
14.
Tang N, Eisenberg JM, Meyer GS. The roles of government in improving health care quality and safety. Jt Comm J Qual Saf 2004;30:47-55.  Back to cited text no. 14
    
15.
Abbott MW. Professionally delivered interventions for gambling disorder. Curr Opin Psychiatry 2019;32:313-9.  Back to cited text no. 15
    
16.
Ribeiro EO, Afonso NH, Morgado P. Non-pharmacological treatment of gambling disorder: A systematic review of randomized controlled trials. BMC Psychiatry 2021;21:105.  Back to cited text no. 16
    
17.
Adebisi T, Alabi O, Arisukwu O, Asamu F. Gambling in transition: Assessing youth narratives of gambling in Nigeria. J Gambl Stud 2021;37:59-82.  Back to cited text no. 17
    
18.
Awo LO, Amazue LO, Oko CA. Moderating Effect of Impulsivity on the Association Between Entrapment and Problem Gambling. J Gambl Stud 2021. doi:10.1007/s10899-021-10047-w.  Back to cited text no. 18
    
19.
Oesterle TS, Kolla B, Risma CJ, Breitinger SA, Rakocevic DB, Loukianova LL, et al. Substance use disorders and telehealth in the COVID-19 pandemic Era: A new outlook. Mayo Clin Proc 2020;95:2709-18.  Back to cited text no. 19
    
20.
Nweze T, Agu E, Lange F. Risky decision making and cognitive flexibility among online sports bettors in Nigeria. Int J Psychol 2020;55:995-1002.  Back to cited text no. 20
    
21.
Aguocha CM, George S. An overview of gambling in Nigeria. BJPsych Int 2021;18:30-2.  Back to cited text no. 21
    
22.
Currie SR, Hodgins DC, Williams RJ, Fiest K. Predicting future harm from gambling over a five-year period in a general population sample: A survival analysis. BMC Psychiatry 2021;21:15.  Back to cited text no. 22
    
23.
Geng F, Tu L, Zhan N, Zhang Y, Wang J. Associations of substance abuse histories and gambling addiction history with post-traumatic stress symptoms and depressive symptoms among Chinese prisoners. Eur J Psychotraumatol 2021;12:1906022.  Back to cited text no. 23
    
24.
Rogier G, Picci G, Velotti P. Struggling with happiness: A pathway leading depression to gambling disorder. J Gambl Stud 2019;35:293-305.  Back to cited text no. 24
    
25.
Gambling Adult Population Survey Sampling Epidemiological Study on the Prevalence of Social and Problem Gambling. Available from: https://www.epid.ifc.cnr.it/project/gaps/. [Last accessed on 2021 Nov 03].  Back to cited text no. 25
    
26.
Calado F, Griffiths MD. Problem gambling worldwide: An update and systematic review of empirical research (2000-2015). J Behav Addict 2016;5:592-613.  Back to cited text no. 26
    




 

Top
 
  Search
 
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
    Access Statistics
    Email Alert *
    Add to My List *
* Registration required (free)  

 
  In this article
Abstract
Introduction
Methods
Results
Discussion
Conclusion
References

 Article Access Statistics
    Viewed656    
    Printed15    
    Emailed0    
    PDF Downloaded24    
    Comments [Add]    

Recommend this journal