The dangers of conflating gambling-related harm with disordered gambling

In their critical review of the prevention paradox (PP) applied to gambling-related harm, Delfabbro and King (2017) raise a number of concerns regarding specific assumptions, methods, and findings as well as the general conceptual approach. Besides discussing the PP, the review also considers the merits of considering a "continuum of harm," as opposed to the more traditional categorical approach to classifying problem gamblers. Their critique is carefully modulated and balanced, and starts a useful dialogue in the context of a public health approach to gambling. Unfortunately, some of Delfabbro and King's (2017) arguments rest on the treatment of gambling harm as a binary state and conflates gambling-related harm with disordered gambling. In this reply, we argue that the application of PP logic to gambling harm has not yet been addressed by us, and is only indirectly related to the more important objective of understanding how gambling can reduce ones' quality of life.