Dear Mayor Ford and Toronto City Council,
RNAO is the professional association for registered nurses who practise in all roles and sectors in Ontario. Our mandate is to advocate for healthy public policy and for the role of registered nurses in enhancing the health of Ontarians. This letter from Ontario’s nurses, including those who live and work in Toronto, is to urge you to reject a new casino due to the evidence of negative health and social impacts associated with problem gambling.
Please heed the Toronto Public Health’s primary position statement recommendation: “The most reliable way to prevent problem gambling and its harms to health is not to increase access to gambling in the community.”1
As the Toronto Public Health’s technical report review of the public health evidence on this issue concludes: “a health-based approach would refrain from increasing local gambling opportunities altogether.”2 This study showed that the stakes are high for the approximate 11,000 adults who are problem gamblers and the roughly 129,000 adults at-risk for problem gambling in the Greater Toronto Area. The documented negative physical and mental health impacts of problem gambling include poor overall health, headaches, serious fatigue, sleep problems, stress, depression, anxiety, mood and personality disorders, and suicide. Other family members and communities are impacted by compromised child development, relationship/family breakdown, family violence, poverty, and alcohol-related traffic fatalities.
The key findings from our own Toronto Public Health and experts at the Centre for Addiction and Mental Health’s Problem Gambling Institute of Ontario are clear: “problem gambling increases with access to a casino, therefore any expansion in gambling access in the GTA over and above current levels will likely increase problem gambling rates and the associated health risks for Toronto and nearby communities.”3 Use this public health evidence to do the right thing and reject a new casino in Toronto.
Doris Grinspun, RN, MSN, PhD, LLD(hon), O.ONT. Rhonda Seidman-Carlson, RN, MN
Chief Executive Officer, RNAO President, RNAO
 Toronto Public Health (2012). Fact Sheet: Gambling and Health, December 2012, 2.
2 Toronto Public Health (2012). The Health Impacts of Gambling Expansion in Toronto: Technical Report, November 2012, 27. http://www.toronto.ca/legdocs/mmis/2012/hl/bgrd/backgroundfile-51873.pdf 
3 Ibid, iv.