AIM: Critically examine the nature of the relationship between gambling and debt by investigating the wider social issues associated with gambling-related debt. Examine the strategies used by individuals and families coping with gambling-related debt and explore the help-seeking strategies employed by problem gamblers and debtors. METHODS: A survey examined levels of awareness of gambling and debt support services and the links between gambling, expenditure and debt, in a control (n=246) and a non-control group (n=173) consisting of individuals with current or previous gambling or debt problems. In-depth, semi-structured interviews with problem gamblers and problem debtors (n=18) explored experiences of gambling-related debt, problem management and help seeking behaviour. Interviews with representatives from the credit and banking industry (n=3) established an overview of the working protocols for managing individuals presenting with problem gambling and debt. Two focus groups with gambling counsellors, debt advisors, healthcare professionals, representatives of the gambling industry and problem gamblers explored the ways in which problem gambling and debt is understood and approached in advice and help settings. Case study analysis was undertaken of the GamCare Users Forum, moneysavingexpert.com and debt.co.uk to provide insight into the daily lives and experiences of problem gamblers including gambling-related debt impacts, typical help-seeking behaviours and levels of debt for forty individuals with gambling problems. FINDINGS: Problem gambling caused significant debt, resulting in individuals taking out unsecured and secured forms of credit and experiencing debt action by creditors. Gambling-related debt was more likely than life-course debt to lead to relationship difficulties or breakdown and have more detrimental impacts on individuals and families than only problem gambling or only problem debt alone. Gambling-related debt also had impacts on employment and employability. Individuals with gambling problems and family members felt that they were ill-informed or unaware of available support services. Problem gamblers identified the importance of access points within the community as sources of information and advice. Lack of knowledge, misconceptions, shame and experiences of judgemental approaches by practitioners were significant barriers to accessing treatment. Similar barriers applied to self-exclusion, which was also often circumvented by switching gambling supplier. RECOMMENDATIONS: Additional research should examine 'directly gambling-related debt' and gambling-derived debt; identify access points for the delivery of information to non-gambling help-seekers, including families and professionals; and examine ways to improve help for young people. Financial literacy and gambling awareness education should be integrated into workplace learning. Awareness education on problem gambling and debt should target gamblers as well as the wider public. The development of non-specialist screening tools for gambling-related debt may provide means families and non-professionals to identify problem gambling earlier and expedite access to help. NHS professionals need to learn about problem gambling and help-provision. Self-exclusion should be offered through a national scheme such as "Empowering Communities - Count Me Out."