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Examination of Chinese Gambling Problems through a Socio-Historical-Cultural Perspective

The aim of this review is to highlight emerging trends about Chinese people and gambling addiction over the last 15 years, and to provide a discourse on the potential link between gambling and Chinese culture and history. The authors reported on the phenomenon of gambling among Chinese people using relevant research studies and reports and traditional Chinese literature. Chinese people have elevated levels of gambling addiction compared to their Western counterparts. These elevated rates are coupled with the rapid expansion of gambling venues within the Pan-Pacific region. While there is an accumulated body of research on Chinese and gambling, a systematic cultural analysis of Chinese gambling is still under development. We undertook a brief comparison between two ancient civilizations, China and Rome, in order to gain better understanding about gambling among Chinese people. To effectively deal with gambling addictions among Chinese people, it is imperative to develop culturally responsive interventions.


INTRODUCTION
For the last 10-15 years, there has been a surging interest in studies of gambling behaviors among different ethnic groups, including Asian refugees and Hispanics in the U.S. [1,2,3]; Chinese in Canada [4,5,6,7]; Maori (indigenous people of New Zealand) and Chinese in New Zealand [8,9,10]; and Arabic, Chinese, Greek, and Vietnamese in Australia [11,12,13,14]. Closer examination of these published studies shows that a considerable amount of work has concentrated on Chinese people and gambling. Although some studies have investigated the prevalence rate and relevant risk factors of problem gambling among ethnic Chinese [4,5,6,7,11,15,16], and the links between gambling and traditional Chinese culture [8,9,10], few studies have examined gambling behaviors among the Chinese from a social-historical-cultural perceptive. In this paper, some emerging trends about gambling among the Chinese in the Pan-Pacific region are examined, followed by the comparison of Chinese history with another ancient culture, Rome, and a discussion on gambling in current Chinese societies. The paper concludes that there is a need for a culturally specific intervention strategy to address problem gambling for Chinese people.

ELEVATED RATES OF PROBLEM GAMBLING AMONG CHINESE PEOPLE
"Pathological gambling" refers to a condition in which individuals meet five or more Diagnostic and Statistical Manual IV (DSM-IV) criteria [17]. A person suffering from pathological gambling shows persistent and recurrent maladaptive gambling behavior, resulting in dysfunctions in the areas of work, studies, and social and family relationships. Whereas "problem gambling" refers to a condition in which a person meets three or four DSM-IV criteria, and the person has the following problems: high rates of gambling-related fantasy, lying, using gambling to escape, and preoccupation about gambling, "disordered gambling" is used to describe the combination of problem and pathological gambling. Disordered gambling is associated with substantial interpersonal, financial, and legal difficulties, coupled with increased levels of substance abuse, mood and anxiety disorders, and suicidality in some cases [3]. There is growing evidence to suggest that Chinese people exhibit elevated levels of problem gambling; estimates range between 2.5 and 4% of the adult Chinese population compared to between 1.5 and 2% in Western populations [18]. In the context of the present paper, Western populations refer to English native speakers and Europeans in the U.S., U.K., Canada, Australia, and New Zealand. A population-based study in Hong Kong found that up to 6% of the respondents met the diagnostic classification of probable problem and pathological gambling [19], whereas nationwide surveys in the U.S. [20] and New Zealand [21] invariably show lower rates of problem gambling for primarily Western participants (see Table 1). It is likely that a small portion of the variation in these problem rates is attributable to the use of different instruments. However, the measurement tools used in all three of these surveys are based on the assessment principles employed by the DSM-IV and have been demonstrated as valid and reliable measures of problem gambling. Arguably, it is possible that the problem gambling rates for Chinese communities are under-reported because of the fear of losing face under the influence of Confucianism within Chinese culture [5].
Not only do Chinese people have high rates of problem gambling in predominantly Chinese urban cities, the Chinese as an ethnic minority group also have a relatively higher prevalence rate than their counterparts in the host societies. Some studies have found that problem gambling rates in Chinese communities are between 1.5 and 5 times higher than those of local people [12,20,22]. For instance, the 2001/2002 National Epidemiologic Survey on Alcohol and Related Conditions confirmed that Asians, Blacks, and Native Americans have a significantly higher lifetime prevalence of disordered gambling than Whites by using the DSM-IV assessment on pathological gambling (see Table 2) [3]. Furthermore, there is  [22].
Although the reported prevalence rates of problem gambling among different populations or cultural groups may not be conclusive because of different operational definitions of problem gambling or use of measurements, the aforementioned figures do raise the alarm about the seriousness of the problems among Chinese people. In order to better understand Chinese gambling problems and develop culturally responsive intervention strategies for Chinese affected by problem gambling, the authors suggest an examination of Chinese gambling behaviors from socio-historical and cultural perspectives.

SOCIO-PERSPECTIVE: EXPANSION AND PROLIFERATION OF GAMBLING IN THE PAN-PACIFIC REGION BETWEEN 1995 AND 2010
Gambling includes a wide range of forms, such as lotteries, betting on horse and dog (greyhound) races, betting on sports (e.g., football betting), mahjong houses, and casino games. In practice, casino games are favored by many Chinese patrons because of the variety of games, lack of time limits, attractive promotion programs, availability of credit, and unlimited odds of betting [18]. Currently, legalized gambling, such as lotteries, has been introduced into most countries or areas in the Pan-Pacific region, including China. Although casino games remain illegal in mainland China and Hong Kong, they have been legalized in Macau, Taiwan, Singapore, the Philippines, and South Korea.
The present authors tracked the change in the number of casino venues in the Pan-Pacific region between 1995 and 2010 through the revision of information available on the Internet and hard copies of relevant documents. Fig. 1 shows the numbers and location of casinos in 1995 (as depicted by yellow dots) and 2010 (depicted by black dots) in the region. It can be seen that a total of 16 casinos existed in the Pan-Pacific region in 1995, a figure that has risen to a total of 77 in 2010.
There has been an almost fivefold increase in the number of casinos over the 15-year span between 1995 and 2010, a comparatively short period of time. Although a substantial proportion of the growth in casinos over the last 1.5 decades can be attributed to the recent introduction and expansion of the Western gambling industry in Macau, the number of casino venues has also increased significantly in other locations, such as the Philippines and South Korea. The high concentration of gambling venues in the Pan-Pacific region in the 21st century echoes very much what was said almost 50 years ago: "Southern China and Southeast Asia is one of the most intensively gambling regions of the world" (Olmestead, 1962, cited in [24], p. 163). The authors contend that, first, this trend of intensified gambling activities will continue and that it is being reinforced by globalization, which is characterized by more affordable international travel both within the region and globally, and a strong economy in the Asian region despite the recent global economic crisis. Second, there is a rich body of research studies to suggest a positive relationship between proximity of casino venue and participation in gambling activities [25,26], thus it is plausible that the problem gambling rates in the Pan-Pacific region will be on the rise or remain at a relatively high level in the medium and long term.

HISTORICAL AND CULTURAL PERSPECTIVE: GAMBLING SANCTIONED BY RULERS THROUGHOUT CHINESE AND ROMAN HISTORY
The first account of gambling in China could be found in the feudal states in the late Chou Dynasty (800-256 B.C.), although some researchers have pushed the origin even further back to the Shang (1700-1027 B.C.) and the Xia (2000-1500 B.C.) Dynasties [27]. Throughout these times, there was a variety of gambling methods, such as Chinese football, cock fighting, duck fighting, goose fighting, horse racing, and dog racing. In order to illustrate the unique historical nature of Chinese gambling, comparison was made to the history of Roman gambling. As with China, different gambling games spread throughout almost every corner of the Roman Empire, including in the different public baths, the circuses, the taverns, and the imperial forums. Roman gambling activities included Tali and Tesserae, which were two types of dice games. The Tesserae dice had six sides, but the Tali dice had four sides only and the numbers were 1, 3, 4, and 6. Another example is the Duodecim Scripta, a word game that resembles Backgammon. Throughout Chinese history, only the Sung (960-1279), Yuan (1279-1368), and Ming (1368-1644) Dynasties were serious about outlawing gambling. However, legal actions against gambling only occurred in the beginning eras of those dynasties. After a while, not only were the laws no longer enforced, but some rulers themselves also practiced gambling. Zhu Yuan-zhang (1328-1398), the first Emperor of Ming, planned to launch bold construction projects and thus outlawed gambling in order to redirect manpower from this time-consuming hobby to more productive activities. However, Zhu failed to set a good example as he frequently gambled with his subordinates. A number of very similar incidences have been reported in Roman history. At one time, the only occasion during which the Roman population could legally gamble was the carnival feast known as Saturnalia. However, Emperor Augustus, as an obsessive gambler, did not limit his gambling to Saturnalia only. Emperors Nero, Claudius, and Commodous were also lovers of gambling, and Commodous even "turned the imperial palace into a regular Monte Carlo" ( [28], p. 104). As a result, similar to the Chinese history, the bad examples of some of the imperial courts or Emperors led to the practical abolition of the aforementioned antigambling laws.
Following on from the middle Ming period in Chinese history, many Emperors and civilians were obsessed with gambling. After the Qing (1644-1911) army forced the Ming government to retreat to South China, Ming's Chinese began to be fond of another form of gambling, cricket fighting, despite the Qing army posing a serious threat to the remaining Ming's region. Thus, some historians attributed the fall of Ming to paper mahjong and the fall of South Ming to cricket fighting [29]. Similar to the Chinese history of gambling, Romans were aware of the damages caused by gambling and, thus, antigambling laws were passed from time to time, but, generally speaking, these laws failed to contain the gamblingrelated harms. Cato attempted to restrict gaming by dice to adults only because it was thought that the young should be out in the fields practicing their military skills. For military training, there was a senatorial decree banning wagers except on one's own skill in throwing the spear, running, jumping, wrestling, or boxing [30]. However, it was suspected that these restrictions were neither enforceable nor enforced [30]. The laws entitled Lex Cornelia, Lex Publicia, and Lex Titia also forbade gambling of dice, and the offenders could be sent to jail or fined. The law named Lex Talaria prohibited the gambling of dice specifically at meal times, but it was ineffective. Cicero mentioned that some gamblers repeated the same offence over and over [28]. Additionally, Roman law did not recognize debts resulting from gambling. If a Roman citizen lost money to a slave or to a minor from gambling, the court would rule the winning against the master of the slave or the parent of the minor. Conversely, if the slave or minor were the loser, suit might be brought by master or parent to recover the sum. As part of the measure for problem gambling, Ulpian proclaimed that it was illegal for anyone who used force to compel another to play dice [30].

DIFFERENT PATHS TOWARDS GAMBLING: CHINESE AND ROMAN GAMBLING HISTORY
Given the startling similarities between the Chinese and Roman histories of gambling, one would ask why the two cultures turned out to have a quite different profile in terms of participation in gambling activities and problem gambling in the 21st century. Not only are patrons of Chinese descent very noticeable in most gambling venues, their level of disordered gambling is found to be higher compared to their European counterparts who had been influenced by Roman culture historically. The present authors propose three possible explanations.
First, there is a long history of Chinese rulers and governments using gambling as a means of financial support. In China, after the Opium War in 1840, Qing Emperors lost almost every single war to the Western powers. Because Western nations demanded a huge sum of reparations, the Qing government legalized gambling and sold casino licenses in order to collect sufficient funds for paying reparations. Some local officials disapproved of this short-sighted practice and proposed banning gambling again, but this did not progress as the central government then asked the local governments to find alternative ways to collect the same amount of money if gambling were prohibited. Besides paying reparations, supporting the defense budget was another justification for legalizing gambling. In 1884, China sent troops to Vietnam to fight against the French. In order to increase the military expenditure for this venture, the Qing general used legalized gambling as a means of making quick money [29]. During the late Qing period, gambling was more widespread in Canton (Guangzhou), a subprovincial city and the capital of Guangdong Province, which was arguably the number one region in gambling across the entire nation; thus Canton was nicknamed "the nation of gambling". Furthermore, from the middle of the 1800s to the early 1900s, with the arrival of the Westerners (since 1842) and the establishment of Special Economic Zones, sovereignty from Chinese law was decreed and these zones were divided into various parcels governed by different countries. Shanghai became a magnet that attracted many Chinese gamblers who engaged in a variety of local and foreign games, including roulette, in its large gambling complexes [31]. Western-style casino games were also brought to Macau in the 20th century [32]. Later, gambling spread to Hong Kong. The gambling custom scattered to every Chinese community around the globe as Chinese emigrated to overseas countries, e.g., to California in the U.S. and from the 18th century, to Queenstown in New Zealand [29,33].
Second, to examine Chinese gambling successfully would require us to look beyond Chinese history. An increasing volume of studies has suggested that the Chinese tend to have a higher external locus of control than their Western counterparts regardless whether the research participants were university students or clients presenting to problem gambling services [31,34,35]. The higher external locus of control has a potential to lead to a higher illusion of control and distorted thinking, and may increase an individual's level of participation in gambling. If the gambler wins a lot of money, it will affirm the belief that he/she is destined to be a winner. However, if the person loses money, he/she would say, "One day my turn will come." Thus, it is often difficult for these individuals to stay away from gambling, making them vulnerable to problem gambling. Locus of control may explain why social gambling is a very common activity among Chinese societies. Superstition is another factor, indeed, that may increase the propensity for excessive gambling. Many Chinese believe that one's success and wealth depends on fate, luck, Feng Shui (certain architectural styles that could affect one's fortune), and/or accumulation of good deeds [30]. According to the Analects of Confucius, life and death are a matter of fate; riches and poverty depend on heaven. On the one hand, Chinese people admit that life is uncertain and events are driven by hidden fate and luck. On the other hand, for the Chinese, fate is not equated with passivity. Turning the tide of fortune, in Chinese thinking, is still possible as life events unfold. Some Chinese people are confident that they could change the course of fate and increase their chance of winning by practicing Feng Shui and/or seeking advice from fortune tellers and palmists. Most people believe that luck, destiny, and chance control their lives. Some Chinese believe that, through gambling, they can unmask their concealed destiny [5]. Although numerous past studies have indicated that superstitions, traditional values and beliefs, social class, socialization processes, peers, and family all influence and have impacts on one's level of participation in gambling, there has been very limited work to compare and contrast the impact between Chinese and non-Chinese cultures [16,36,37]. Therefore, no definite conclusion can be drawn.
Third, it was noted that gambling activities in the Roman Empire were not checked effectively until its end. Lancian (1892) [28] attributed this turnaround to the spreading of Christian values. Anderson (1997) [38] also asserted that Christian values counteract the gambling culture. In his view, the Bible urges humans to work creatively and for the benefit of others, but gambling promotes a "something for nothing" attitude. The Bible condemns materialism, but gambling promotes it. Using Weber's work on the role of the Protestant ethic in social control, Pontell and Geis [39] argued that Christianity provided some proscriptions against gambling in the European culture, while similar social-religious controls were not evident in the Chinese culture. In the modern context, there are a considerable number of Christian-or faith-based organizations that provide professional counseling services for individuals affected by problem gambling and their concerned significant others, e.g., Ray of Hope in Singapore, Industrial Evangelistic Fellowships in Hong Kong. It might be debatable whether the demise of gambling in the Roman Empire was due to the rise of Christianity or other causes; nonetheless, it is obvious that the two ancient civilizations, China and Rome, took different paths towards gambling.

CURRENT GAMBLING PRACTICES ACROSS CHINA
All forms of gambling, including lotteries, were outlawed in mainland China for more than 3 decades following the foundation of the People's Republic of China in 1949. Due to the lack of a public welfare system, the first charity-based lottery in the mainland was issued in 1987. This was in response to the suggestion by the Ministry of Civil Affairs that this would enable the state to collect funds to support welfare establishment in mainland China [40]. In 1989, a sports lottery was introduced in China for the first time in an attempt to raise funds for the 11th Asian Games. This was followed in 1994 by the establishment of a nationwide sports lottery-selling network. Since then, the sports lottery has played a more and more important role in raising funds to help China's western and less-developed regions supplement the budget of major sports tournaments[41]. These two lotteries were soon competing to attract more customers. As such, lottery tickets became more alluring in the 1990s with bigger prizes, such as apartments, houses, cars, color TVs, and laundry machines. Prizes were often showcased in public arenas, usually at large outdoor plazas, to attract punters [40]. Today, the lottery in China is more widespread than ever before. Recent times have also seen a trial of modern horse racing betting in Wuhan City and the Chinese government plans to open hotel resorts and casinos on Hainan Island.
Along with legal lotteries, illegal gambling has proliferated in mainland China in the past 2 decades, resulting in a significant increase in the rates of problem gambling [42]. The gambling takes place in card and mahjong schools on street corners, in underground casinos in the cities, through unofficial lotteries in the countryside, and on websites catering to Internet gamblers. Around US$150 billion are wagered illegally each year in mainland China, approximately 10 times the amount of the two officially sanctioned lotteries in mainland China [42]. In recent years, illegal gambling has emerged as a serious social problem in mainland China. Increased income inequalities, progressive differentiation between rich and poor, and an illusion of getting rich quickly has driven some individuals to gamble problematically.
Unlike mainland China, gambling in Macau, an ex-Portuguese colony off the Southern coast of China, has been legalized and heavily promoted [32]. Gambling has been a significant contributor to the city's economy since the 1850s. The handover of Macau from Portugal to China in 1999 saw a boom in the number of casinos. Nowadays, Macau has become well known as the "Oriental Las Vegas". In addition to casinos, a number of other forms of gambling are also now available, including horse racing, greyhound racing, sports betting, and a number of lotteries [43]. In 2003, the Macao Gaming Inspection and Coordination Bureau reported that the gambling tax contributed 74% to the Macau fiscal revenue. In 2004, the percentage rose to almost 78% of the Macau total public revenue, which amounted to 15.2 billion Macau Patacas (or approximately US$1.9 billion). Macau has a population of 463,000 in 2010 [44].
The gambling history of Hong Kong has many parallels to that of Macau, a city in close proximity.

CONCLUSION
Overall, the influences on Chinese gambling are variable, but there is a possibility that socio-historical and cultural factors may have a considerable impact on the phenomenon. Although this paper review does not offer conclusive evidence on the links between those factors and Chinese problem gambling, there are important issues worthy of further discussion. The Chinese gambling problem should be a concern for social services and health professionals. Not only does problem gambling lead to individual loss of money and health, it also results in many social problems. For instance, numerous news or, indeed, scandals emerging from mainland China have illustrated some of the wider impacts associated with problem gambling: When a member of the government Party experiences an addiction to gambling, not only is their promising career ruined, but the reputation of the Communist Party is also damaged [49]. To date, there is a lack of empirical data or theory-driven studies on Chinese perceptions related to problem gambling and how interventions affect the well-being and recovery prospects of service users.
Previous studies and reviews on gambling among the Chinese concluded that individuals affected by problem gambling are reluctant to seek professional help [18,50]. Currently, the theories, assessments, and interventions developed in the West are still the dominant approaches for explaining the phenomenon of Chinese gambling and developing treatments for Chinese problem gamblers [18,51]. While cognitivebehavioral therapy is widely used in providing psychological interventions to problem gambling [50], this approach may not be effective without taking into account the attitudes, beliefs, and values within the context of different cultures. Thus, there is an urgent need for theory-based interventions specifically tailored to meet the needs of Chinese problem gamblers. Evidence is gathering that suggests that cultural differences exist in patterns of gambling (e.g., cognitive scheme, decision-making and risk-taking patterns) and general responses emerging in psychotherapy (e.g., interdependency among family, expectation for directive therapy) when compared with Western samples [18,52,53]. The examination in this paper of gambling behaviors from multiple perspectives, such as historical background, social environment, and locus of control, can assist with moving the focus on Chinese gambling so that it is more appropriate and compatible for use with Chinese people; moving beyond risk analyses to a focus on early help-seeking behaviors, fundamental character strengths, and personal inspirations, which act as protective factors and motivate one to refrain from excessive gambling. For instance, Shek [54] and colleagues [55] have developed a positive youth development framework to prevent problem gambling among Chinese adolescents. The key elements of the framework include promotion of bonding, resilience, social competence, emotional competence, cognitive competence, behavioral competence, moral competence, self-determination, spirituality, self-efficacy, beliefs in the future, development of a clear and positive identity, provision of opportunities for exercising positive behaviors, prosocial involvement, and prosocial norms.
Gambling has been performed by the Chinese people for thousands of years and has become a preferred social activity among various Chinese communities. To address gambling problems among the Chinese people, a culturally sensitive psycho-socio-spiritual strategy has to be considered. The directions for future research are: What are the specific strategies that have influenced the success of an intervention or counseling program for the Chinese and their concerned significant others affected by problem gambling? What are the medium-and long-term impacts of intervention programs on service users?