Gambling-related suicide in East African Community countries: evidence from press media reports

Gambling is risking of money (or something of financial value) on an event at least partly determined by chance in the hope of winning something of higher financial value [1]. Worldwide, 26% of the population actively gamble [2]. Sports events have created a fertile ground for sports betting due to the popularity of games and the uncertainty of outcomes [3]. For decades, gambling has been traditionally been engaged in at designated venues such as bookmakers, casinos, among others, but has now moved to digital platforms [4]. The introduction of online gambling, esports, and betting via mobile devices such as smartphones is of potential concern to susceptible populations [3]. In sub-Saharan Africa, gambling is perceived as a source of income for many young people, and gambling, for this reason, may be a contributory factor for gambling disorder (GD) [3].

GD is a condition that describes a gambler’s inability to control their gambling despite the detrimental consequences of the behavior [5, 6]. Globally, the prevalence of GD ranges between 0.12 to 5.8% [7]. In addition, evidence from several studies conducted in Africa has shown the increasing numbers of youths reporting gambling-related problems, including financial difficulties (e.g., chronic poverty), domestic violence, family breakups, criminality, and mental health disorders (e.g., depression, anxiety, stress) [4, 8, 9]. However, to date, no African study has explored gambling-related suicide.

In East African Community (EAC) countries (comprising Uganda, Kenya, Tanzania, Burundi, Rwanda, and South Sudan), GD has become a growing public health concern. A study conducted in Uganda found 24.3% of individuals in an urban center gambled, with 20% involved in sports betting, with the main motivation for gambling in the whole sample being to win money (76.6%) [10]. Effects such as family dysfunction, divorce, alcohol, and substance use have been associated with gambling [11]. Also, similar issues have started to occur among neighbors to EAC countries, such as Malawi, where the odds ratios of alcohol and substance abuse, involvement in physical fights, theft, and vandalism were 4.17, 2.26, 3.26, and 3.96 times higher among gamblers, respectively [12]. In Uganda, evidence suggests that problem gambling is associated with mental health problems such as depression, anxiety, and suicidality [13]. Another study in Uganda reported 21 cases of suicide among university students, five of which were gambling-related [14].

Studies on gambling-related suicide in EAC countries are few, and there is no suicide database in these countries [15]. Therefore, the present study adopts a similar approach used by many researchers in other countries without suicide databases by utilizing media reports to investigate gambling-related suicide in EAC countries [14, 16‐19].

A total of 18 gambling-related suicides were collected, with the majority being from Kenya (10/18), followed by Uganda (7/18) and Tanzania (1/18), while the rest of the East African countries had no reported suicide-related to gambling. The suicides occurred from 2014 to 2020, with the majority occurring in 2018 (6/18) and 2016 (5/18). Most deaths occurred in the last quarter of the year. All participants were below the age of 40 years, and the youngest was aged 16 years. Two Ugandan gambling-related suicide victims were below the legalized age for gambling in the country (< 25-years). The majority of the participants had tertiary/university levels of education (10/11) and were never married (4/8). Seven victims were reported to be employed (Table 2). (Please note that where the denominator is less than 18 in the reported cases, this means that such information was not explicitly mentioned in the media report).

The deceased were most commonly involved in betting on soccer matches (n = 11/14), and two were casino gamblers (2/16). Only two individuals gambled online. The total amount lost in gambling by the deceased was the equivalent of $US 156,197, with the mean amount lost gambling immediately before death was $US 342, a median of $US 396, and ranged from $US 28 to $US 138,889. Hanging was the most common method of suicide (10/17), followed by poisoning (3/17). Suicide most commonly occurred at individuals’ homes (15/18), and the most common reason for suicide following gambling was the use of money for university tuition fees for gambling and losing it (4/17). Only one individual was reported to have been experiencing depression prior to suicide, and five individuals left a suicide note (Table 2).

The present study investigated the victims of gambling-related suicide in the six East African Community (EAC) countries using data from the press media reports. The EAC is a region with multiple gambling companies that heavily invest in persuasive gambling advertisements claimed by some to get more youth to gamble [81]. Gambling advertisements have been reported to increase gambling behaviors among sports fans [82]. However, the present study was not able to infer causality due to the descriptive nature of the results. The following subsections discuss the profiles of the suicide victims.

One of the key strengths of the study was the diverse language groups of the authors enabling the reading of a wide selection of of media reports. Moreover, many of the authors reside in different countries of the EAC and are therefore aware of the cross-cultural differences in the region which were important in data interpretation. Despite these strengths, numerous limitations should be considered when interpreting the findings. First, the form of gambling reported in each case may not have been the only form of gambling with which the individual was engaged (i.e., many gamblers engage in more than one type of gambling). Secondly, not every gambling-related suicide would necessarily have been reported by the media and therefore this is likely to underestimate the true incidence of gambling-related suicides. Third, there may be a bias in which types of gambling-related suicides are reported by the media (e.g., a tendency to report the suicides of young, well-educated men as opposed to other demographic groups as these may be deemed by editors to be more ‘newsworthy’). Consequently, media reports may only be reporting a minority of actual gambling-related suicides. Fourth, the data collected are totally reliant on what was reported and the information may not necessarily be totally accurate (e.g., the total amount of money lost gambling by the individual, the gambling pattern of the individual, the exact cause of death, etc.). Fifth, some of the information in the press reports may have been omitted due to reporters following guidelines of how suicides should be reported in the media (e.g., World Health Organization) given the research showing an increase in suicides and suicide attempts following media reporting. Sixth, the search strategy only included ‘gambling’ and ‘betting’ as these are the most commonly used words in the region to describe the focus of the present study. Other words such as ‘wagering’ were not included in the search and therefore there is a small possibility that some cases may have been missed.

Suicide is a complex multifactorial issue, where its completion consists of a combination of more than one factor, including biological, psychological, and environmental factors. Assessing the alleged suicide stressors from the press media reports can be useful because the EAC countries lack national suicide databases to retrieve information about suicide cases. Based on the press media reports, 18 males in the present study were identified as victims of gambling-related suicides. Moreover, the countries with the most widespread opportunities to gamble (i.e., Kenya and Uganda) had more gambling-related suicides, although the number of suicides as a percentage of the total population was very small and any causal association should be treated with caution given other factors are important (e.g., gambling participation rates in each country).