High Stakes

A dozen people have gathered inside the Industrial Evangelistic Fellowship's modest community center in Macau, where the Rev. Jimmy Tan strums his guitar and belts out Christian songs with the small group before him. Latecomers trickle in well past the meeting's 9:30 p.m. start time, but no one seems to mind — many of them work multiple jobs and are used to odd hours. Seated in a semicircle of plastic chairs, the engineers, police officers, health-care workers and casino dealers have something in common: they are all addicted to gambling. The group meets once a week to hear Tan speak, and to share stories of angry spouses, loan sharks and backsliding. A young nurse who hadn't placed a bet in six months admits she relapsed four days earlier after a fight with her husband. "He wanted money in order to grant me a divorce," says the mother of two. She lost $515 playing baccarat. A well-dressed engineer says that he's considered kidnapping children for ransom in order to pay off $500,000 in gambling debts. Tan has heard these stories before. He listens patiently and delivers a PowerPoint presentation about coping with addiction. "Don't read the racing papers and don't carry too much cash," he warns. "And stay out of the casinos."

Easier said than done. To get home after they leave the meeting, the afflicted must run Macau's gauntlet of gambling resorts, their mesmerizing neon and ritzy, come-hither ambiance carefully calculated to encourage a fling at the tables. Temptation seems to be everywhere. Since the city began issuing new gaming licenses five years ago, the number of casinos has more than doubled to 27, boosting tourism and investment and revitalizing Macau's economy (the city's gaming industry took in $6.95 billion last year, vaulting Macau past Las Vegas as the city with the most total annual wagering revenue). But for a small proportion of Macanese like those at Tan's meeting, the gambling boom has been a curse that has fed their addiction. For habitual gamblers and those prone to developing the habit, "Macau is really dangerous nowadays," says Ava Chan, former counselor at the Yat On Pathological Gambler's Counselling Centre in Macau. "Next to your house, there are slot machines. Across the street, there are casinos. Society doesn't realize the problem. They just think: Economic growth, no problem."

But Asia does have a gambling problem — and because the industry is expanding rapidly throughout the region, mental-health workers and researchers fear pathological gambling could reach epidemic proportions in coming years. Macau's success has inspired other Asian cities and countries to allow new casinos. In Vietnam, a $4 billion luxury gaming resort will open near Ho Chi Minh City in 2009. Ground has already been broken for a pair of casino complexes in Singapore. The Philippine government is planning to open a 100-acre (405,000-square-meter) gaming complex that will employ 40,000 Filipinos in Manila Bay. In an attempt to lure Chinese gamblers over the border, Kazakhstan is creating the "Las Vegas of the steppe" in Kapchagai and Shchuchinsk. Governments in Taiwan, Thailand and Japan are considering legalizing casinos. According to Merrill Lynch, gaming companies are expected to spend $71 billion in Asia over the next four years alone.

It's impossible to predict how many Asians will become addicted as their access to gambling increases, but "there are going to be victims," says Rachel Volberg, a U.S.-based sociologist and an expert in gambling addiction. Volberg was one of the authors of a 1999 study examining the impact of gambling in the U.S. that found the presence of venues such as casinos and horse-racing tracks roughly doubles the incidence of problem and pathological gambling in the surrounding community within a range of 50 miles (80 km). Throughout the world, Volberg says, the introduction of gambling typically results in a three- to four-fold increase in addiction rates within the first five years.

What's especially worrisome to mental-health experts is that, because of gambling's roots in the region's culture, Asians may be more vulnerable to habitual gambling. The cliché that Asians, and Chinese in particular, love to gamble appears to have anecdotal and statistical support. Hong Kong — which bars casinos but has a $13 billion horse-racing, lottery and sports-book industry — has one of the highest per capita betting averages in the world (about $2,000 annually), according to figures from the Hong Kong Jockey Club. And rates of addiction appear to be higher. A 2004 study by psychiatrists at the University of Queensland found that Chinese were almost 50% more likely to develop a gambling addiction than Caucasians. In the U.S., about 3.5% of people are classified as pathological and problem gamblers (more than the number of people who suffer from bipolar disorder, Alzheimer's disease or schizophrenia). In Hong Kong, 5.3% of the population suffers from problem and pathological gambling, according to the University of Hong Kong.