Discussions about gambling expansion, actual and virtual, are often emotion laden. Rarely do such conversations take place within a public health approach to the issue, which requires a consideration of both benefits and harms. Rather, advocates on both sides tend to gravitate toward evidence that supports only their position. For example, anti-gambling advocates might highlight instances of increased crime, and pro-gambling advocates might highlight instances of improved economics. Alternatively, considering both the pros and cons of such situations has the potential to expand the discussion to include existing theories and models of behavior related to gambling. When this happens, a full consideration of potential gambling outcomes prompts consideration of both exposure and adaptation effects.
Recently, like earlier work with intoxicant use (e.g., Shaffer & Zinberg, 1985; Zinberg & Fraser, 1979; Zinberg & Shaffer, 1985), research has made it apparent that the social context is extremely important to any understanding of exposure effects. Exposure-related research is often inconsistent. Depending on the sample, the location of a study, and the historical time at which a study occurred, very different patterns emerge. For example, areas that have had more exposure with greater intensity and for longer periods of time can evidence fewer problems than anticipated (Shaffer & Hall, 2002; Shaffer, Vander Bilt, & Hall, 1999; Volberg, 2002). Over time, gambling-related behavior patterns in the community appear similar to the prototypical adaptation curves apparent for numerous biological toxins (e.g., viruses and bacterial infections, LaPlante & Shaffer, in press). This is important because anticipating such patterns of infection can facilitate the development of prevention and/or catalyst public health strategies or public policies.
As researchers, public policy makers, and advocates of both stripes continue to consider this issue, they should keep in mind that social contextual factors make any one-size-fits-all approach to gambling expansion likely to be insufficient. Until we identify the many social contextual factors that moderate gambling exposure, however, it is important to progress in a conservative manner. Taking a conservative approach might create some inconveniences, but ultimately will provide a measure of protection for those who remain at risk.
LaPlante, D. A., & Shaffer, H. J. (in press). Understanding the influence of gambling opportunities: Expanding exposure models to include adaptation. American Journal of Orthopsychiatry.
Shaffer, H. J., & Hall, M. N. (2002). The natural history of gambling and drinking problems among casino employees. Journal of Social Psychology, 142(4), 405-424.
Shaffer, H. J., LaBrie, R. A., & LaPlante, D. A. (2004). Laying the foundation for quantifying regional exposure to social phenomena: Considering the case of legalized gambling as a public health toxin. Psychology of Addictive Behaviors, 18(1), 40-48.
Shaffer, H. J., Vander Bilt, J., & Hall, M. N. (1999). Gambling, drinking, smoking, and other health risk activities among casino employees. American Journal of Industrial Medicine, 36(3), 365-378.
Shaffer, H. J., & Zinberg, N. E. (1985). The social psychology of intoxicant use: The natural history of social settings and social control. Bulletin of the Society of Psychologists in Addictive Behaviors, 4, 49-55.
Volberg, R. A. (2002). Gambling and problem gambling in Nevada: Report to the Nevada Department of Human Resources. Northampton, MA: Gemini Research Ltd.
Zinberg, N. E., & Fraser, K. M. (1979). The role of the social setting in the prevention and treatment of alcoholism. In J. Mendelson & N. Mello (Eds.), The Diagnosis & Treatment of Alcoholism (pp. 359-385). New York: McGraw-Hill Book Company.
Zinberg, N. E., & Shaffer, H. J. (1985). The social psychology of intoxicant use: The interaction of personality and social setting. In H. B. Milkman & H. J. Shaffer (Eds.), The Addictions: Multidisciplinary Perspectives and Treatments. Lexington: Lexington Books.
 Related work suggests that the social setting moderates alcohol effects. Alcohol is a central nervous system depressant. However, in certain social situations, low dose alcohol use often results in stimulation rather than depression (e.g., the party effect). The same dose of beverage alcohol taken alone might encourage sleep.