The development of casinos across the UK could cause health problems for serious and novice gamblers alike, doctors have warned.

The government had said Manchester would have the first „super casino“, and 16 other cities would have casinos of a smaller scale.

But those plans are currently on hold after they were rejected by peers.

The British Medical Journal paper says the health effects of gambling must be considered if new casinos do open.

It follows this week’s annual conference of nurses in Harrogate, where concerns were raised that the opening of the extra casinos could lead to an increase in the number of problem gamblers – and that the NHS would be over-burdened.

The BMJ paper, by Dr John Middleton of Sandwell Primary Care Trust and Farid Latif, a doctor at Shrewsbury and Telford Hospital, warns the health impact of increasing the number of casinos had not been thoroughly thought through.

They write: „Gambling affects physical, social and mental wellbeing as well as creating debt.“

The doctors say social and mental effects predominate, but physical health can also be affected because gamblers eat badly and their preoccupation means they neglect the early signs of illness.

People with major gambling problems often turn to crime, and become violent towards their partners, they warned.

‚Hidden‘ effects

But they add: „Most casino customers will not be compulsive or problem gamblers.

„More pervasive will be minor effects on large numbers of the population previously exposed to casino gambling.“

They say poor communities would be hardest hit, and cite Sandwell – which has banned the construction of any new casinos – as an example of how local authorities can protect people.

Dr Middleton and Dr Latif say problem gambling is a serious addition that can have medical consequences.

But they add: „The wider public health effects of an increase in gambling in the population are even more hidden but ultimately more damaging.

„Anything that makes the poor people in Britain even poorer, especially if they do not derive benefits in kind, will damage their health, further increasing inequality.“

They say doctors must be aware of the effects of gambling, as they are of the effects of other additions.

And they call on the government to fully assess the health effects of a relaxation on gambling laws in further plans for new casinos.

‚Rare side-effect‘

A second piece in the BMJ reiterates the warning that people with Parkinson’s disease are at greater risk of becoming addicts, and are particularly vulnerable to the growth in online gambling.

Neurologists Sui Wong and Malcolm Steiger, of the Walton Centre for Neurology and Neurosurgery in Liverpool, say that of people with the condition, 3.4% are pathological gamblers, rising to 7.2% in patients taking drugs known as dopamine agonists.

People diagnosed at a younger age are particularly at risk, they said.

Dr Kieran Breen, director of research at the Parkinson’s Disease Society, said: „Many people with Parkinson’s in the UK are prescribed dopamine agonists, often in conjunction with another drug levodopa, as their standard therapy.

„Pathological gambling is a relatively rare side-effect of some anti-Parkinson’s medication and appears to be reversible if the drug is removed or changed.“

A spokeswoman for the Department of Health said: „Anybody with a gambling problem who seeks help from the NHS will be offered support and, if necessary, treatment to help them overcome their addiction.

„Specialised addiction services have a long history of helping people with gambling problems.

„Gamcare, which runs a national telephone helpline and provides face-to-face counselling itself, is able to refer gambling addicts to NHS-run services where appropriate.“