"It Was Never-Ending…": Investigating Gambling Harm Reported by Affected Others.

Gambling-related harm can extend to family members, friends, and communities, however few population-representative studies explore affected other (AO) attributable harm measured with direct reference to gambling. Moreover, no study has employed the full 68-item Gambling Checklist for AOs to investigate harm according to the domains of harm outlined in a recent comprehensive harms taxonomy. Using data from a subsample of 197 AOs identified via a population-representative sample of 5000 respondents from the Fourth Social and Economic Impact Study of Gambling in Tasmania, this study employed a mixed-method design aiming to: (1) quantitatively estimate the rates of AO harms across each domain of harm; and (2) qualitatively analyse semi-structured interview data in a subset of 20 AOs to explore their lived experience of these harms. Overall, emotional/ psychological harm was the most commonly reported (90.36%, 95% CI: 85.32%, 93.79%), followed by relationship harm (75.63%, 95% CI: 69.10%, 81.17%), financial harm (60.91%, 95% CI: 53.87%, 67.53%), health harm (58.67%, 95% CI: 51.59%, 65.41%), work or study harm (32.63%, 95% CI: 26.29%, 39.68%), and other harm (19.17%, 95% CI: 14.18%, 25.40%). The qualitative narratives revealed the interconnected vulnerabilities experienced by AOs across the broad domains of harm. The findings emphasise the importance of targeted interventions, public health promotion, and comprehensive support services to address the diverse harms to AOs. Key areas for intervention include psychological and emotional support, financial guidance, and raising awareness to facilitate early detection of stress-related health conditions, with collaboration between services crucial for developing integrated support systems.