On Roda Viva, Hermano Tavares explains the rise in gambling addiction, the changing profile of bettors over the years, and advances in the regulation of betting.
The explosive growth of online gambling in Brazil has mobilized not only the health system but also public authorities. In an interview on TV Cultura's Roda Viva program, psychiatrist Hermano Tavares, coordinator of the Pathological Gambling Clinic at the Hospital das Clínicas of USP (University of São Paulo), offered a perspective that, while concerned about the seriousness of the phenomenon—which he classifies as a "tsunami"—also acknowledges concrete progress in regulating the sector.
The statement was made on Monday (27) during an interview on the Roda Viva program, on TV Cultura.
Unprecedented dialogue between health and regulation.
One of the points most highlighted by the expert was the proactive stance of the Prizes and Betting Secretariat (SPA) of the Ministry of Finance. Tavares revealed that, for the first time, the regulatory body approached the health sector even before the Ministry of Health, seeking to build solutions together.
"It wasn't the Ministry of Health that called us first. It was the Ministry of Finance, through the Secretary of the Prizes and Betting Department. And then we started having a discussion, a dialogue about what the first measures would be to try to contain the situation."
According to Tavares, this dialogue paved the way for concrete measures based on scientific evidence.
Self-exclusion: nearly 800 Brazilians have already opted in.
The main achievement of this joint effort was the creation of the self-exclusion system on the Ministry of Finance's website. This tool allows any citizen to register their CPF (Brazilian taxpayer ID) and request the blocking of bets on regulated platforms.
“We presented them with the proposal for self-exclusion. Nearly 800.000 Brazilians have already accessed the Ministry of Finance's website and requested self-exclusion.”
The impressive number indicates not only public acceptance but also the effectiveness of a mechanism that was previously controlled by the betting houses themselves—what Tavares compared to "letting the fox guard the henhouse." Now, with centralized management by the federal government, the measure has gained credibility and reach.
Self-assessment: scientifically supported screening
Another advancement enthusiastically cited by the psychiatrist was the incorporation of a self-assessment questionnaire within the same digital environment. Developed from population research conducted in partnership with Caixa Econômica Federal, the test consists of three questions that identify at-risk gamblers with high precision.
"These three questions weren't just pulled out of thin air. They're the result of population research to discover which questions could most easily and quickly identify who is a risk-taking gambler."
If the user answers “yes” to at least one of the questions — about loss of control, attempts to recoup losses, or conflict with personal values — the chance of being on the spectrum of problematic gambling exceeds 90%. The system then directs them to online treatment, currently offered in partnership with the Syrian-Lebanese Hospital.
What still needs to be done?
Despite the progress, Tavares was emphatic in stating that the work is far from over. He advocates for the creation of a maximum betting limit tied to the bettor's income—something around 1% of monthly income per day, up to four times a month—as well as cross-referencing data between the amount wagered and income declarations, as a way to identify both money laundering and serious cases of addiction.
The specialist also calls for the expansion of treatment within the public healthcare system. Currently, the outpatient clinic he coordinates at the Hospital das Clínicas attends to approximately 120 new cases per year, but the demand exceeds 600 requests. Tavares argues that CAPS (Psychosocial Care Centers) should be prepared to deal with gambling disorder, expanding access throughout the country.
"Call me an optimist"
When asked about the future, Tavares' assessment was surprisingly positive for someone who deals daily with the devastating consequences of addiction:
"Call me an optimist, but I think something has started to be done; more needs to be done."
He further highlighted that the issue of betting has managed to unite people from different ideological spectrums, which he considers a sign that the topic transcends partisan disputes and can move forward with cross-party support in the National Congress.
"If I actually see people, both on the left and the right, who are genuinely concerned about this, determined to unite for effective action."
Brazil is experiencing a "pandemic," says USP expert.
The psychiatrist stated that Brazil is going through a pandemic of gambling addiction. Tavares founded the clinic in 1998, when the country was still experiencing what he calls the "first wave" of the problem, linked to the proliferation of bingo halls and slot machines. The current scenario, driven by digital sports betting and massive advertising exposure, represents, according to him, a second wave of much greater proportions. "We are in the middle of the tsunami," he stated.
Tavares explains the change in the profile of bettors over the years.
The psychiatrist presented data from his own clinic to illustrate the transformation in patient profiles over the decades. In the 1990s, the predominant age range was between 45 and 47 years old. With the popularization of digital betting platforms, the average age dropped to individuals around 30 years old or younger. “In the 90s, it was one or two very sophisticated patients who placed bets online . Today, they represent 65% of the demand we receive,” said Tavares.
The accessibility provided by smartphones was cited by the psychiatrist as the main factor in this change. He explained that gamblers no longer need to travel; they can bet from their bedroom, at work, or "during a quick bathroom break," because the casino is "two clicks away or within arm's reach of their trouser pocket." This ease of access directly exposes a larger number of vulnerable people and overburdens the demand for medical and psychiatric treatment.
Given that the expert disputed
Tavares questioned the concept of "responsible gaming," comparing it to the "drink in moderation" warnings used in alcohol advertising campaigns. According to him, the mechanism is the same; it delegates responsibility for damages to the consumer, exempting those who promote or sell the product.
The psychiatrist explained that gambling activates the central nervous system through a psychological mechanism similar to that of alcohol, tobacco, or other drugs. Therefore, gambling is not "an ordinary product"; the very act of gambling generates a desire to gamble more. The expression "responsible gambling" is, in this context, an oxymoron. "Want to be responsible? Don't gamble. Want to be less irresponsible? Gamble less," he stated.
When addressing the topic, Tavares was careful to distinguish his positions. He presented himself in three roles: the individual who personally never had an appreciation for gambling; the doctor who, out of solidarity with his patients, has not gambled for over 30 years; and the technician-scientist, who advocates neither prohibition nor unrestricted liberalization, but for the need for a broad public debate that allows society to define the limits it wishes to impose on the activity.
Tripartite responsibility
According to the psychiatrist, responsibility for controlling addiction should be shared by three parties. The gambler is responsible for individual regulation and awareness. The State must inform the population, provide treatment in the public health system, and regulate the activity. The gambling industry, in turn, has an obligation not to promote gambling as a source of income and to remove mechanisms from its platforms that induce a false perception of control over the results.
Regarding the funding of the treatment, Tavares was direct when asked if the clinic receives resources from tax revenue on gambling; "Zero cents," he replied. According to him, 1% of the revenue goes to the Ministry of Health, without a known specific allocation for addiction treatment. The specialized service he coordinates within the Institute of Psychiatry at USP does not receive any portion of these resources.
Among the patients treated in the more than 3 cases handled by the outpatient clinic, 15% reported having attempted suicide due to problems with gambling; 80% stated that they had flirted with the idea at some point. Tavares emphasized that the most serious statistic is that of those who never reach treatment because they have already committed the act.
