In this episode of the Where Parents Talk podcast, host Lianne Castelino speaks with Dr. Shawn Kelly, pediatrician, adolescent addictions specialist, and father of two.
Dr. Kelly shares why he co-authored a Canadian Medical Association Journal editorial on gambling advertising, the moment his own young son confused sports stats with betting terms, and why he sees this issue as a “Wild West” for youth health.
The discussion unpacks:
Takeaways:
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Companies mentioned in this episode:
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Speaker B:Welcome to the Where Parents Talk podcast. We help grow better parents through science, evidence and the lived experience of other parents.
Learn how to better navigate the mental and physical health of your tween teen or young adult through proven expert advice. Here's your host, Lianne Castelino.
Speaker A:Welcome to Where Parents talk. My name is Lianne Castelino. Our guest today is a pediatrician and an adolescent addiction specialist.
Dr. Shawn Kelly is also co author of a recent editorial in the Canadian Medical Association Journal entitled Protecting Canada's Youth from the Risks of Exposure to gambling advertising. Dr. Kelly is also a father of two and he joins us today from from Ottawa. Thank you so much for taking the time.
Speaker B:Well, thank you for having me.
Speaker A:Leanne, curious as to what was the catalyst and the impetus for you to write this article.
Speaker B:Oh, thanks for asking.
So a few Years ago in:When I was watching sports highlights in the morning, I think we were watching the hockey highlights from the night before with my young hockey player and he was 7 at the time, and he asked me, dad, what's the difference between plus minus and over under and at that time been for listeners who aren't sports fans, plus minus is a pretty rudimentary hockey statistic and tells us a little bit about the player. And over under is a betting proposition.
But as he was learning and watching the great players of the game do their things and be inspired and sort of, you know, progress in his own little hockey career, if you can call it that, he was inundated with gambling advertisements and he was sort of conflating these two terms. And to me, that became a pretty stark alarm as to how these gambling advertisements were changing youth experience of sports.
And so that's where this all began.
And then I work with the Canadian Society of Addiction Medicine on their policy committee and it's been an issue we've been exploring and presenting on at conferences around some of the legislation and what are the impacts of this.
And so it's become a bit of a, I don't know if you'd call it a pet project or a growing concern, but something I've been trying to get some attention around for a little while and I'm really glad that day is here.
Speaker A:Well, it's interesting, the anecdote that you shared about your son, you know, also having the lens of, of being a pediatrician and the lens of being an addiction specialist as it relates to adolescence. How did you go about answering him, by the way?
Speaker B:You know, I, I, I wish I had had a great answer on day one, and I don't think I did. I think I explained the difference as to what those things were in a very factual and probably caught off guard way.
But since that time, we've continued to be inundated with gambling advertising.
And I, I think that now when we see a gambling ad, what we do is, is, well, I'm not sure that we can do it for everyone that we see, but often what we do is we call it out and we discuss and we use these as opportunities to discuss and, and try to promote some media literacy in this space that has become rather toxic.
So now whenever we see an ad, it can be an opportunity to start a discussion, and that can be a discussion around, okay, so what are they trying to sell you here? You know, and are sort of helping him recognize or her. My, my daughter too. We do this as well.
Recognize that this ad is trying to change your behavior. Okay. And what are they offering and what are they showing?
And if you know this company, X company can pay Y celebrity zed millions of dollars to do this, do you think that they're paying out a lot of these bets that come in, or do you think that they're taking money in?
And we sort of try to get in a few different ways, talking about what's being advertised, what kind of behavior change are they doing, and what's the reality behind that, be it financial or statistical or what have you. And so depending on the day, the conversation can go a lot of different ways.
But there's a lot of days that we have these conversations now, and, and I think that that's my attempt at promoting safety within my own home these days.
Speaker A:There's absolutely no doubt that if you watch sports broadcasts for even five minutes in the last several years that, you know, the advertising around sports betting is inc. It's even part of many shows in terms of they have features off the top of a show that promotes it as well.
Can you take us through how this repeated exposure can shape a child's perception of gambling as normal?
Speaker B:Okay, so there's a couple of different ways that we can chat about that, but I think one of the ways that is important is sort of this idea that is being sold about augmented spectatorship. So gambling is a way to enhance the Enjoyment of sports. And that's one of the messages that's really being sold.
And any game can be exciting when you've got skin in it. And taking your spectatorship to the next level and the next leaf skull means a lot more if you picked who scored it.
And that sort of idea that we're missing out on some of the enjoyment, that is potential that this sport has the potential to deliver to us by not wagering. That seems to be this really strong message that's coming through. And I think youth are pretty susceptible to that kind of messaging.
You know, we're really enjoying the Blue Jays run right now and we watch a lot of Blue Jays in 30 in the morning. If the game's on to a little too late, we may even watch the Blue Jays in 33 times, which is about the length of the actual game.
But during that time we are getting pumped with bads from bet365 and other companies. And, and one of those taglines is never ordinary.
And, and, and that there's this, there's this sales of a real sense that we're missing out by just enjoying the game for what it is and was and has been. And, and so I, to me, I think that's an important part of, of, of what's changing about how we're enjoying youth sport.
And, and I, if it's okay, I'd like to talk to sort of the, the vulnerability that's inherent to youth as they're developing. Would that be okay?
Speaker A:Absolutely. Yeah.
Speaker B:Okay. And so one of the ways that we think about adolescence is we can talk about it as a gap between the maturity of two brain regions.
And so we know our brain doesn't all mature all at the same rate. And there are different things that come online at different ages.
You know, like very early on, some of that back of the brain stuff, your cerebellum comes on, that helps us with proprioception when we're walking around, you know, as a infant of 12 months and that sort of brain region. But as we get into adolescence, what we have is the nucleus accumbens, which we also call the reward center.
And that part of our brain becomes finely attuned. This is where kids start engaging in goal oriented behavior.
They get proud of bringing home the A test or whatever it is that drives your, your own children at that time. But we know that that region of their brain secretes dopamine. And it secretes dopamine in anticipation of large adolescents.
Brains actually secrete more dopamine in anticipation of the same large reward than does an adult brain or a younger child's brain. They're really primed to engage in risky behavior that may have a reward hanging at the end of it.
It's a very important distinction in their development.
Then unfortunately, the region of the brain that does that long term planning, thinks about the rationality of this, perhaps the statistics, even that prefrontal cortex that sits above our eyes, that part of the BR brain, doesn't reach full maturity till somewhere in our 20s.
So unfortunately, this gap between the maturation of the nucleus accumbens full bore and the prefrontal cortex, which is still a long way off, leaves us in this all gas, no break situation.
And that's been the setup where, you know, in the work that I do with a lot of youth experiencing substance use disorder, we've known this for a very long time, that there's a special vulnerability here. And most substance use disorder, if not all, has its roots in adolescence.
And now what we're seeing is that this same sort of brain mechanics and this developmental vulnerability is being exploited in creating an increased number of gamblers in our youth or people who engage in gambling and increased harms from gambling that come from that behavior.
Speaker A:So much to unpack there.
And I wonder if we could start with, in your practice, is there an example that comes to mind for you of a young person in this age group that we're talking about out that had this exposure to these betting ads that, you know, and you saw the impact of that in front of you, what did that look like? And how was that individual? Or could that individual been helped?
Speaker B:Okay, so it's interesting because I, I do have two hats. I have a general pediatrician hat where I see, you know, mostly, well, children with minor ailments or minor to major.
But it in, in the general pediatrics world from 0 to 18 years.
And then I also see adolescents, adults for addiction and the harms related to gambling that have come through the office have come through both sides of the practice. And so it's not just been exclusive to my relative area of expertise.
However, the first time that this walked through the door, it was brought to my attention by a young male, 13 or 14, if I can recall correctly, had made use of his father's credit card and placed some wagers online, mostly on sports, but also on some casino games, and had lost twelve hundred dollars. And so, and in the office we were dealing with.
Well, we're bringing this issue up, talking about the behavior and dealing with the fallout they're in. And so That's a very real financial fallout for that individual and for his family who were on the hook to cover it.
And in this day and age, it doesn't have to be $1,200, it could be a lot less than that. And that can make a major difference in a family's monthly budget for an unexpected expenditure.
There was a lot of heightened anxiety around that and there was a lot of hiding and sort of a bit of increase in reclusive behavior that was happening before this was discovered. And so there was anxiety for the individual and for the family.
And so those harms from gambling have been walking through the door with increased frequency. It's not happening every week, however, it used to happen never. And now it's become an important thing for me to ask about.
And so that's a, it's a been a pretty frightening trend that we are seeing. And we know from significant research that's been done for youth who do engage in gambling that there are more than just those harms.
There certainly are those financial harms, and there are significant harms to mental health like worsening anxiety, worsening depression. There is decreased school performance, there is increased criminality and delinquent behavior.
So sort of more rule breaking and even engaging in truly criminal behavior, be it theft or assault or otherwise. And the big thing that we really worry about is that increased risk of suicidality that accompanies increases in gambling behavior.
And that's the thing that truly, you know, if I think about this stuff a little too close to my bedtime, that's what makes it harder to go to sleep.
Speaker A:Absolutely. You've described the current situation as the Wild West.
What is most alarming to you through all the lenses through which you see this issue, if nothing changes?
Speaker B:Well, you know, to me it, it's that truly, is that suicide risk. That's the thing that worries me the most.
And, and it, it comes from all of these things that we've discussed already where we have this increase in risk taking behavior without the benefit of that prefrontal cortex that can think about the long term consequences and the long term consequences of the gambling or of the loss because we're seeing more youth engage in this behavior and continued inundation with advertising and continued normalization of the behavior is going to increase engagement in this kind of behavior.
My huge fear is that we're going to have to wait until we're seeing this increased wave of young male suicides and then we can eventually have enough data and accumulate it and get the research done to point directly to gambling advertising. If we can ever do that. Sometimes the data won't ever catch up to the reality on the ground.
But that's the big worry for me that we are going to, we're going to wait way too long, have this incredible damage and have these young people who make a big mistake, a series of big mistakes, but then make a permanent mistake because their brains aren't functional enough in the ways that look down the road to make a good decision around this. And suicide becomes a, a, I don't want to say a actionable solution to, to their problems as they, as they see them.
And that to me is, is the big worry.
Speaker A:So let's unpack then what you'd like to see done. What is the ideal state look like and who is responsible for the different aspects of addressing this current issue?
Speaker B:Yeah, so that's, that's a great question. And to me, I think the ideal, my ideals come from maybe an idealized concept of my own.
And so we know that sport is excellent for youth sport in all its forms. It's not, we're not just talking about broadcast NFL and broadcast hockey or anything like that, the popular ones in our country.
But in truth, we want kids to engage with sport. We want them to see high level athletes doing incredible things.
And we want to have the benefits that come from that, be it social benefits, be it physical health benefits and otherwise. And so having youth and families engage in that kind of spectatorship is a very good thing.
And we also have the situation where now when they're trying to consume that kind of media, they're exposed to incredible risk and so that risk will accumulate over time. And what I'd like to do is tease these two things apart. It's not necessary for them to be nearly as enmeshed as they are.
So for me what that is, is, and we're at a pretty hopeful spot if it's, if I can say that because you know, we have Bill S211 that has made its way through the Senate and will hopefully be coming to the House of Commons soon, which calls for a framework for the regulation of sports betting advertising across the country. And to me, I think that that regulation, I hope that that framework can accomplish a few different things.
I would like the content of the ads and including who can deliver those ads in terms of the celebrity to be greatly restricted. We can talk more about some changes that have been made there. But let's talk about content and who's delivering it as, as an area for change.
Number two is the Total number of ads that are being consumed. So it's actually even hard to calculate because the ads are embedded in the coverage.
As you said, they are on jerseys, they are on playing fields and they are during advertising breaks. Oh wow. Are they ever doing advertising breaks. But that total number of needs to be drastically reduced.
And the third is a time restriction on when these things can be shown. So gambling is, is legal. It has always existed. It will always continue to exist and people have been engaging in it for a long time.
However, when we have a youth intended audience, you know, we want to have young viewers and broadcasters and leagues alike would like to make young sports fans. When we have a youth intended audience that might be consuming this, there should be zero gambling advertising during that time.
You know, save these ads for late night, you know, when, when, when, when we expect more adults to be watching their sports highlights or what have you. And really, you know, I don't, it doesn't have to be zero advertising ever, but it shouldn't should it should be zero advertising to young eyeballs.
Speaker A:So on the point about the changes and what you'd like to see, Ontario recently banned the use of athletes and gambling ads.
But companies quickly found looph that what does that reveal to you, if anything about, you know, the effectiveness of the current rules and you know, possible future rules?
Speaker B:Right. And so that was the regulatory body, the Alcohol Gaming Commission of Ontario, the agco. Hopefully I got that acronym right.
They made a well intentioned recognized that perhaps we shouldn't have not to call the individuals out but like the Wayne Gretzky or Connor McDavid of the World who have great youth appeal be advertising these services because of the messaging that is incumbent with somebody who does have that kind of youth appeal and the inability of youth to really make the distinction between that or really take home that little caveat at the beginning or the disclaimer that it may not be for youth under 18 years of age. And so and right. And unfortunately there was a loophole in that, in that regulatory change that came. That was a good one.
But the loophole was that celebrities could still appear, celebrities of that nature could still appear in gambling messaging that was promoting safe gambling.
Pardon my, my lack of smoothness on this, but the trouble is when my son sees an Advertisement From Connor McDavid Advertising Safer Gambling, he thinks he comes away with that thinking. Connor McDavid thinks there's a way for me to gamble safely. And it's, I think that we need to make further changes in that direction.
I do think that change Was well intentioned and we have to react to the realities of, you know, the companies that really do want to have this message promoted out there and they have big contracts signed with big names and they're going to try to make use of that. And I, I don't love it, but I, I do understand where they're coming from.
Speaker A:So in the list of different, you know, actions that you outline that you'd like to see take place on this issue, what consider things that could be implemented in the short term or quickly versus some of the, you know, mid to longer term potential solutions that may, you know, take longer to, to, to become reality.
Speaker B:Yeah, that, that's interesting because it's.
The enmeshment is already, it's pretty deep already and it's going to be hard to get all of these ads off the playing fields or boards or within the stadiums and jerseys and things like that. But to me, the low hanging fruit is what can be broadcast during commercial breaks. And this is the.
To begin where there is a significant amount of ads because we do know that youth form impressions when they do see logos and that that is an important form of advertising. However, the advertising that occurs during commercial breaks is that kind of culture changing calling us to increase or augment our spectatorship.
And that sort of.
Those type of ads I think are considerably more dangerous and they will be easier to regulate because we can just say you can't show these anymore during this time from next time of why that night.
Speaker A:Parents obviously play a critical role in what we are talking about here.
Let's unpack that in terms of what are firstly, some of the warning signs that parents may want to be aware of of their child who may be going down this road of being influenced by these betting and gambling ads that they're seeing.
Speaker B:Well, that's a, that's a great question. And you know, we always worry when our youth becomes more withdrawn and more secretive in their behavior.
And I, and I think that's a pretty good starting point for parents to be looking out for. Unfortunately there is some developmentally normal pushing off from parents that occur.
But if we're seeing an acute change in this regard, I think we need to think that something is up. It may be, it can be a variety of different problems.
This doesn't always mean that gambling is being engaged in, but, but it's always a warning sign worth exploring and worth trying to have conversations around. I think one of the ways that we can protect our youth is having some eyes on some of their finances. You know, we we don't.
We want to increase independence, and we want kids to learn how to save and spend and manage their own money. However, I don't think that needs to be done in the absence entirely of parental oversight.
And so this may be an opportunity for us to see things that are changing acutely.
And if we're seeing a bank balance get really close to zero in a hurry, there may be a discussion to be had about where that's going and how that's happening.
I think that because we see this as a bit of a cultural phenomenon and groups of friends kind of get into this thing, and we need to be on the lookout for what kind of language our kids are using around sports. Are they taking a greater interest in every single single football game that is happening?
And that is suspiciously increased from their previous engagement with a sport.
So sometimes, like an increased engagement even in spectating or checking scores or chewing down statistics, that sort of thing may be a good opportunity for us to see as a, maybe a yellow flag where we could, where we can explore, though, and have these real conversations. And I think that that's, that's what we have to do in this, in this space right now.
And even after there are some further regulations that I hope are coming with regards to advertising, there's going to be a lot of room for education right now.
You know, sort of the, the industry tagline is that youth are not allowed, and this should be an issue between parents and youth to educate around the safety or the illegality of engaging in this kind of gambling.
Unfortunately, the messaging that we do as parents, especially during adolescence, is not as powerful as the messaging that is external to the home sometimes. And so it's not fair to put the onus entirely on parents. And we need some support in keeping our kids safe in this regard.
But we do have to participate in that safety as well. So there's some shared responsibility here. It's not entirely on the parents, but it is also on the parents. If that's not clear enough for you.
Speaker A:Well, and you know, I was going to say that when we talk about sports, it unites all kinds of age groups across generations, etc.
Is there a particular age group of young person that you think parents need to be paying attention more to when we talk about gambling ads and sports betting ads before this becomes a problem?
Speaker B:So we do know that young males are at the greatest risk for this behavior for also, like, for engaging in this behavior and experiencing the harms related to it. So it's our teenage boys that we need to be most watchful for.
However, that doesn't, you know, I think young women and gender diverse youth also we need to have these conversations around, but the risk factors that we're seeing are leading to more harms in, in, in that particular demographic. So that, that's where my antenna are, are tend to be a little bit raised and pointed towards though. You know, I, I do have this conversation.
I have young twins and we have conversations with both of them as they, you know, male, female twins and so we, we have conversations with both of them. One tends to consume a little bit more sports media so we have more opportunities and.
But I, I do think it is, while there is clear indication that it is the young males that we should be most worried about, I think we, it's not. There are girls who gamble too. And so we got to be mindful of that.
Speaker A:So when you talk about having those conversations with your children, I mean that's a challenge on, on most topics, depending on how old your child is.
But when we talk about this, how does a parent go about having those honest, authentic conversations about the impact potentially of, of sports betting and gambling advertising without making it more tempting for that child? Because of course oftentimes they're doing the exact opposite of what you're telling them to do.
Speaker B:Right, Right. And I think it's important not to come with a message that begins with so you never bet on sports. Right.
And that sort of, that, that kind of thing that adolescents or youth can really push back against in that sort of authoritative instruction. I don't think is, or authoritarian instruction is particularly helpful in this space.
As I was alluding to earlier, sort of the messaging that I'm leaning into in my own home is around the reality of this and what is being asked of us and sort of trying to frame it as, you know, as in truth, you knowing my own rebellious streak when I was younger, I try to frame not engaging in acts of gambling as an act of rebellion. There are big companies with big interests that don't line up with yours.
And how we get back at this and how we push back and how we be independent is by not engaging in this sort of behavior. And so that's. That also extends to my conversation about cannabis these days, which is big business. And so we kind of try to put.
Paint big business as the bad guy and we're the, you know, our punk rock mentality has to get us through this sort of, this transition.
But, but to me, having that conversation where we're trying to inform as opposed to we're trying to dictate behaviors creates the situation where we may lead to a different thought process and a different decision for that youth rather than another rule from another source that they may lean against.
Speaker A:Apart from family conversations, what do you see, if at all, the role that schools should play in this conversation, the roles that sports organizations may play in this conversation in terms of actively and proactively addressing this issue?
Speaker B:Well, you know, schools have, have done and continue to do decent work in the substance use space these days. You know, there are attempts to educate and prevent some substance use and there's mixed data on the effect of some of these programs.
But there are opportunities for education and I think schools are trying their best and sometimes that works reasonably well and sometimes it doesn't.
But some gambling, gambling content should be added to those substance use curriculum to a certain extent because we know that we're talking about the same circuitry. And so I think that that's a really good place for that conversation to continue.
You know, and when we have counselors and guidance counselors in, in schools that are addressing already some of the substance use disorder problem, I think that that needs to be expanded to include gambling and wagering as part of their mandate for trying to support. And it's tough because the leagues and broadcasters specifically, I do think that they share some responsibility, responsibility here.
And the reality is revenue streams are changing all the time. Bottom lines are what they are. And there is incredible money to be made from gambling.
I believe the estimated profits for between the private gambling platforms and tax revenue and the provincially run gambling platforms in Ontario was estimated at like $1.4 billion last year. So we're talking about an incredible amount of money.
So I would love it if there could be a moral argument made to broadcasters that, that we need to protect our youth here and leagues to get out of bed with the, the gambling apps. Because this is a pretty toxic thing for us to be exploring here.
And you know, it's, it's scary when the cat's out of the bag or the horses left the barn or what have you.
And so because those financial incentives are so strong in those particular spaces, broadcasters le and online platforms as well as governments, I think there's, to me, this is where that sweeping regulation has to come in because I, I don't know that the shareholders will be interested in my moral urging and argument to the corporations who are responsible to those shareholders. So to me, that's where we can have these organizations on our side.
But it is going to require significant regulation In Monterey, you've outlined some of.
Speaker A:The potential impacts of this when you talk about, you know, suicide, suicidal ideation, suicidality, you know, follow through on that in, in the most extreme cases. But what does it look like across the lifespan?
If, if you've, you know, looked into that in terms of when this type of, let's call it an addiction start, starts in a teen, how can that carry through across the lifespan? And you know, what does that look like?
Speaker B:So that's a good question.
And, and you know, I don't know that we have great longitudinal data that tells us about the course of how gambling addiction really begins and where it goes to. I don't think we know that. And I think we have to lean heavily into what we do know from the substance use disorder space.
And we know that later initiation of that kind of activity, be it later introduction of alcohol, nicotine, cannabis, other drugs, the later that we engage in this, the better. Okay. And there, there's certain cutoffs where we can say there's significantly increased risk.
So if youth alcohol exposure is before 15, the chance of developing alcohol use disorder increases two or three fold or even more than that. I don't want to, to misquote the statistics, so I'm going under what I know it to be.
But so, so essentially we know that early initiation of those substance use or substances leads to more diagnoses of substance use disorder. So worse addiction because or, or true addiction that that does occur later in life.
And so we assume that this gambling behavior will have a similar trajectory. I don't know that we have that data though, yet.
But that being said, we can follow the model that says the longer we delay initiation and the longer we delay heavy use, the less addicts we're going to have on the, on the far side. And that's sort of a big argument I'm trying to make the substance use debate about.
We're in a dire place and we need to, we call tie off the bleeders in medicine when we're talking about these things, things. And so to me that I, I, I, I think I would be repeating myself if I say delaying onset of this behavior again, but I'll, I'll do that one more time.
Speaker A:Yeah.
Dr. Kelly, we're almost out of time, but I did want to ask you, what would you say to parents who maybe feel powerless against the sheer volume of ads that they themselves are exposed to and now their kids are exposed to? What would you say to them, them in terms of one message that you'd like them to leave with from our conversation today.
Speaker B:Well, you're not alone.
There are many people in the boat with you seeing this and feeling the pressure that is causing and, and worried about the damage it may be causing their youth.
I think that we're at a place where there is an appetite for change and there is an appetite for hopefully some significant help for parents who are experiencing this harm and trying to decrease the risk for their youth. We're never going to make childhood a risk free endeavor. It's, it's, it's going to be risky and especially adolescents.
But this situation here where we've had this deregulation and, and wanton advertising it, to me it feels a lot like we had a nice guard rail at the side of a cliff and we could look over, but we were protected from fall. And what we've done is taken down the guardrail and put up a play structure right at the edge. And now we're just waiting for the harms to accumulate.
And what I see is, is all of us working together, reaching out to our MPs, talking to our youth and talking to other parents about this. This is the time for change. And I really think that if we work together, we might be able to achieve it.
And it's fun to be hopeful and it's nice to be able to, to have some optimism about how people are feeling about this and if we work together, what we can achieve.
Speaker A:Dr. Shawn Kelly, pediatrician and an adolescent addiction specialist, really appreciate your time and your perspective today. Thank you so much.
Speaker B:Well, thank you very much for having me here. To learn more about today's podcast, guest and topic, as well as other parenting themes, visit whereparents talk.com sa.