The relationship between gambling expenditure, socio-demographics, health-related correlates and gambling behaviour-a cross-sectional population-based survey in Finland

Association of gambling activities and modalities with problem gambling in Japan: A nationwide cross-sectional online survey-based study

Background and Aims

Problem gambling (PG) is a relevant public health concern. Thus, this study aimed to identify the association of specific gambling activities and modalities with PG in Japan.

Methods

A cross-sectional study using data from a large-scale online survey was conducted in Japan between February 6 and 27, 2023. Candidate gambling activities and modalities include sports betting (offline/online), casinos (offline/online), lotteries (offline/online), electronic gaming machines, and trading activities. PG was defined as a score ≥ 8 on the Problem Gambling Severity Index. All estimates were weighted using a nationally representative survey conducted in Japan in 2019. To estimate the association between gambling engagement and the prevalence of PG, multivariable logistic regression models were fitted after adjusting for 13 confounding factors representing demographic, socioeconomic, health-related, and geographic characteristics.

Results

A total of 12,955 respondents aged 15-82 years who had gambled in the past year were included. Among the respondents, 12.2 % (95 % confidence interval [CI] 11.4-13.1) were reported PG. The weighted multivariable logistic regression models revealed significant associations of PG with online sports betting (adjusted odds ratio [aOR] 2.41, 95 % CI 1.86-3.13), offline casinos (aOR 1.53, 95 % CI 1.16-2.02), online casinos (aOR 4.25, 95 % CI 3.09-5.86), and cryptocurrency trading (aOR 1.60, 95 % CI 1.22-2.10).

Conclusion

Experiences in online sports betting, online and offline casinos, and cryptocurrency trading demonstrated statistically significant associations with the prevalence of PG. These findings emphasize the need for legal awareness of casinos and restrictions on gambling access and betting amounts.

Methodologies and estimates of social costs of gambling: A scoping review

The definition and measurement of social costs has been debated in gambling literature. Predominant framings of gambling have depicted it as a leisure activity without significant costs other than those caused directly by problem gambling. This view has been recently challenged with a public health perspective, adopting a wider definition of social costs that span beyond issues related to treatment and crime. Definitional debates have resulted in highly heterogenous approaches to calculating the social costs of gambling. The aim of this review is, first, to assess the kind of costs that have been included in existing estimates; second, to compare overall estimates of social costs; and third, to compare methodological differences. We conducted a scoping review following the Joanna Briggs Institute guidelines for scoping reviews, using the PRISMA-SCR/P tool. The literature search included both peer reviewed publications and grey literature and was conducted in June 2023 and repeated in March 2024. After screening, 26 references were included in the review. Estimates in the included studies contained direct costs, such as crime and law enforcement, financial counselling, and treatment-related costs. Indirect cost included items such as health and social care, unemployment, and financial cost of divorce. Intangible costs included, for example, quantifications of suicide, emotional distress, and relationship problems. The number of included cost items varied across studies from 5 to 32. We identified seven different methodological approaches to calculating costs. Total estimates using different approaches varied greatly, ranging from 6 to 324,000 million int$ total, with an average of 3,980 int$ per adult and median 449 int$ per adult. We conclude that the high variation in available total estimates is due to differences in number of cost items and methodological approaches. The results highlight the need for consistent international guidelines for calculating the total social cost of gambling.

Insights into the temporal dynamics of identifying problem gambling on an online casino: A machine learning study on routinely collected individual account data

Background and Aims

The digitalization of gambling provides unprecedented opportunities for early identification of problem gambling, a well-recognized public health issue. This study aimed to advance current practices by employing advanced machine learning techniques to predict problem gambling behaviors and assess the temporal stability of these predictions.

Methods

We analyzed player account data from a major Swedish online gambling provider, covering a 4.5-year period. Feature engineering was applied to capture gambling behavior dynamics. We trained machine learning models, XGBoost, to classify players into low-risk and higher-risk categories. Temporal stability was evaluated by progressively truncating the training dataset at various time points (30, 60, and 90 days) and assessing model performance across truncations.

Results

The models demonstrated considerable predictive accuracy and temporal stability. Key features such as loss-chasing behavior and net balance trend consistently contributed to accurate predictions across all truncation periods. The model's performance evaluated on a separate holdout set, measured by metrics like F1 score and ROC AUC, remained robust, with no significant decline observed even with reduced data, supporting the feasibility of early and reliable detection.

Discussion and Conclusions

These findings indicate that machine learning can reliably predict problem gambling behaviors over time, offering a scalable alternative to traditional methods. Temporal stability highlights their potential for real-time application in gambling operators' Duty of Care. Consequently, advanced techniques could strengthen early identification and intervention strategies, potentially improving public health outcomes by preventing the escalation of harmful behaviors.

Gambling and other addictive behaviors among higher education students in Finland-insights from a large-scale survey

Introduction

Problem gambling forms a continuum of severity from mild to moderate and severe. While most young individuals who gamble do so responsibly, for some gambling becomes a problem with severe negative consequences. Excessive gambling is strongly linked with substance use and other behavioral addictions, particularly among students.

Methods

In this study we draw from a large sample of higher education students to evaluate the links between gambling behavior, socioeconomic status, mental health, alcohol use and other potentially addictive behaviors. We analyzed our data using post-stratification survey weighted logistic regression modeling.

Results

Our main findings were that (i) students in polytechnics were more prone to gamble and experience harms than university students, (ii) self-perceived problem gambling was significantly associated with alcohol use but not with drug use or smoking, and (iii) compulsive internet use predicted gambling problems but not increased gambling activity.

Discussion

Our results underscore the need for early detection of harmful behaviors among students, and early interventions for those with severe problems. Student health checks should be used to screen for harmful gambling habits and difficulties in handling finances.

Trends in Lower-Risk Gambling by Age and Net Income among Finnish Men and Women in 2011, 2015, and 2019

Lower-risk Gambling Guidelines (LRGGs) were developed in Canada to reduce the risk of gambling-related harm. The LRGGs, published in 2021, consist of three limits: gamble no more than 1% of household income per month; gamble no more than four days per month; and avoid regularly gambling at more than two types of games. All three limits should be followed at the same time. This study focuses on the situation in Finland before the LRGGs were published. The aim of this study is to investigate trends in lower-risk gambling by age and net income among men and women in the Finnish adult population in 2011, 2015, and 2019. Data were drawn from cross-sectional Finnish Gambling population surveys, including permanent residents in Mainland Finland aged 15-74 with Finnish, Swedish or Sámi as their mother tongue (2011; n = 4,484, 2015; n = 4,515, and 2019; n = 3,994). The results showed an increase in the prevalence of lower-risk gambling, rising from 29% in 2011 to 39% in 2019. This upward trend was observed among both men and women, with the prevalence among men increasing from 23 to 33%, and among women from 34 to 45%. The lowest prevalence of lower-risk gambling was found among individuals aged 60-74, especially regarding expenditure guidelines, as well as among women in the lowest income tertile. In conclusion, although the prevalence of lower-risk gambling has increased in Finland, there is still potential for further improvement to minimize harm.

Gambling in Connecticut adolescents: Prevalence, socio-demographic characteristics, trauma exposure, suicidality, and other risk behaviors

Adolescent gambling is a public health concern and has been linked to suicidality, various risk behaviors, and poor health outcomes. However, there is a limited understanding of specific risk and protective factors that may influence gambling behavior in Connecticut adolescents, especially in changing gambling environments. This study examines relationships between adolescents reporting gambling in the past-year and a range of health risk behaviors including vaping, traumatic experiences, academic performance, and receipt of social support. Data from the 2019 Youth Risk Behavior Survey in Connecticut high school students stratified by gambling status were examined in bivariate and multivariate analyses. Among 1,807 adolescents, past-year gambling was reported by 453 individuals [25.4%; 95% confidence interval [CI] = 22.7-28.1%]. Gambling prevalence was higher among older males and lower in adolescents of Asian origin. Gambling was further associated with suicidality and risk behaviors including substance use, smoking [traditional tobacco and electronic vapor use], risky use of digital technologies, unsafe sex, and aggressive behaviors. Gambling was also associated with traumatic experiences, depression/dysphoria, poor academic performance, and less familial social support. The results provide an up-to-date estimate of the current prevalence and correlates of gambling among Connecticut adolescents. The results provide recent estimates of the prevalence and correlates of gambling among Connecticut adolescents. The findings highlight the need for further investigation of specific factors like social support that help with designing and implementing tailored interventions.

Gambling-specific metacognitions, depression, and responsible gambling in Macao, China

The Self-regulatory Executive Function model elucidates how metacognitions link to the development and maintenance of gambling disorder, however whether, and how, metacognitions explain responsible gambling remains unknown. This study is the first to address this knowledge gap by: (a) examining whether both generic and gambling-specific metacognitions explain variances in responsible gambling; and (b) testing the mediating role of depression between generic/gambling-specific metacognitions and responsible gambling. A two-stage cluster random sampling method was used to obtain a probability sample of 837 Chinese adult gamblers (48.5 % men, mean age = 41.11, SD = 14.31) in Macao, China. Hierarchical regression analysis indicated that gambling-specific metacognitions contributed to an additional 23 % variance explained in responsible gambling after considering generic metacognitions and demographics. Path analysis further showed that the direct paths from generic, positive and negative gambling-specific metacognitions to responsible gambling were all significant while the positive type showing a stronger effect. Moreover, depression partially mediated the effects of both generic and gambling-specific metacognitions on responsible gambling. Findings suggest that responsible gambling campaigns should consider improving the awareness of metacognitions and emotion regulation in depression among Chinese adult gamblers.

From Clicks to Bets: How Social Media Engagement Influences Gambling Severity-Cross-Sectional Research

The evolving gambling environment, marked by increased accessibility and innovative promotions, has led to rising expenditures globally. Despite this, the relationship between social media use and problem gambling in the Czech Republic remains underexplored. To investigate the association between social media use and problem gambling severity among Czech adults using the Problem Gambling Severity Index (PGSI). Is there a difference in gambling severity based on demographic characteristics? (1); Is there a relationship between social media news consumption and gambling severity? (2); Is there a connection between negative motives for social media use and problematic usage? (3); Is there a link between problematic social media use and gambling severity? (4). Primary research, designed as a cross-sectional study, was conducted in the Czech Republic in November 2024 on a sample of 3093 respondents (48.4% male). All participants were aged 16 years or older. The sample was selected using quota sampling based on multiple identifying quota variables, with minimal differences in the proportions of quota indicators compared to the general population. Non-parametric tests and ordinal logistic regression analyzed relationships between demographics, social media use, and PGSI scores. Higher PGSI scores were found among males, younger participants, those with lower education, and the unemployed or students. Greater social media news consumption correlated with increased gambling severity. Disruptive social media behaviors, such as waking up to check notifications and interrupting activities, were significantly associated with higher PGSI scores. Problematic social media use involving deceit and family conflict substantially heightened the risk of severe gambling problems. These findings highlight the need for targeted prevention initiatives, regulatory policies, and enhanced digital literacy to safeguard vulnerable groups from the risks posed by digital gambling platforms. Addressing both gambling behaviors and problematic social media use is crucial in mitigating potential harms.

From the Flight Deck to the Trading Desk: Gamblified Investing Behavior in a Commercial Airline Pilot

The convergence of investing and gambling has accelerated with the proliferation of gamblified investment products characterized by high volatility. This case report examines a 42-year-old male commercial airline pilot who developed maladaptive engagement with high-risk financial instruments during the COVID-19 pandemic, resulting in significant financial losses. The patient's behavior, marked by an inability to adapt to market conditions and attempts to recoup losses through increasingly speculative investments, mirrors patterns observed in problem gambling. Notably, as demonstrated by proficient performance on the Big Three financial literacy assessment, the patient's elevated financial literacy level failed to serve as a protective factor against problematic speculative behavior. This case highlights potential risk factors in aviation professionals, including personality traits like high extraversion and elevated disposable income. Following cognitive behavioral therapy (CBT), the patient successfully transitioned to more conservative investment strategies, with improvements in psychometric scores. However, his posttreatment score on the National Opinion Research Center Diagnostic Screen for Gambling Problems, while improved, still indicated an at-risk status, necessitating ongoing monitoring. This case underscores the need for enhanced awareness, targeted screening protocols, and tailored interventions within occupational health settings, particularly in safety-critical professions like commercial aviation. Future research should focus on developing comprehensive screening instruments for the early identification of problematic financial behaviors, investigating the long-term efficacy of therapeutic modalities like CBT, and examining the prevalence and safety implications of high-risk financial behaviors among aviators.

Gambling Motives and Offshore Gambling: A Finnish Population Study

The rise of online gambling has drawn attention towards offshore gambling. Currently there is lack of evidence on reasons and motivations to gamble on offshore gambling sites. This study investigated the general gambling motives of onshore and offshore gamblers, and the reasons to gamble on offshore gambling sites. The study used binary logistic regression model to analyze the data from Finnish Gambling 2019 population survey including adult past-year online gamblers (n = 1,422). The validated measure for problem gambling severity (PGSI, Problem Gambling Severity Index) was used. Furthermore, data-driven qualitative analysis was used to form categories for the reasons to gamble on offshore gambling sites. Offshore gambling was more common among men and younger age groups than among women or older age groups. Offshore gamblers gambled less often for money or worthy causes than onshore gamblers. Furthermore, offshore gamblers had more different types of motives to gamble, they gambled more frequently and had higher problem gambling severity scores (PGSI) than onshore gamblers. Finally, the most common reasons to gamble offshore were: (1) larger game supply and game features, (2) benefits, bonuses, and the usability of the website, and (3) inner motivation. Offshore gambling is characterized with intensity and diversity of gambling behavior and motives, and it poses a risk especially for young men.

Prevalence and Clinical Characteristics of Recreational and At-Risk/Problematic Gambling Among Low-Income U.S. Veterans: Results from the National Veteran Homeless and Other Poverty Experiences (NV-HOPE) Study

This study examined associations between recreational gambling (RG) and at-risk/problem gambling (ARPG), and clinical measures of mental illness and substance use, functionality, homelessness, in a nationally representative sample of U.S. military veterans. Data were analyzed from 781 veterans who participated National Veteran Homeless and Other Poverty Experiences (NV-HOPE) study conducted in 2021. Chi-square tests, analyses of variance (ANOVAs) and logistic regressions analyses were conducted to examine unadjusted and adjusted associations between gambling group status and sociodemographic, psychiatric, substance use, functioning, and homelessness measures. A significant minority of low-income U.S. veterans reported gambling, with 24.9% (95% confidence interval [CI] 95% CI 21.12-28.76%) exhibiting RG and 6.7% (95% CI 3.88-9.42%) screening positive for ARPG. The prevalence of ARPG was higher among younger, non-White veterans. ARPG was associated with greater symptoms of substance use and anxiety; poorer physical functioning; history of any mental illness; lifetime history of homelessness; and having any student or car loans relative to NG. Veterans who had RG were more likely to screen positive for drug use disorders relative to NG. Results of the current study provide an up-to-date estimate of the current prevalence of RG and ARPG among low-income U.S. veterans and underscore the importance of routine screening, monitoring, and development of interventions for problematic gambling severity, as well as interventions for ARPG in this population. These findings may inform targeted intervention strategies for this vulnerable subpopulation.

The risk and development of work disability among individuals with gambling disorder: a longitudinal case-cohort study in Sweden

BACKGROUND

This longitudinal register study aimed to investigate the association between gambling disorder (GD) and work disability and to map work disability in subgroups of individuals with GD, three years before and three years after diagnosis.

METHODS

We included individuals aged 19-62 with GD between 2005 and 2018 (n = 2830; 71.1% men, mean age: 35.1) and a matched comparison cohort (n = 28 300). Work disability was operationalized as the aggregated net days of sickness absence and disability pension. Generalized estimating equation models were used to calculate adjusted odds ratios (AORs) and 95% confidence intervals (CIs) for the risk of long-term work disability (>90 days of work disability/year). Secondly, we conducted Group-based Trajectory Models on days of work disability.

RESULTS

Individuals with GD showed a four-year increased risk of long-term work disability compared to the matched cohort, peaking at the time of diagnosis (AOR = 1.89; CI 1.67-2.13). Four trajectory groups of work disability days were identified: constant low (60.3%, 5.6-11.2 days), low and increasing (11.4%, 11.8-152.5 days), medium-high and decreasing (11.1%, 65.1-110 days), and constant high (17.1%, 264-331 days). Individuals who were females, older, with prior psychiatric diagnosis, and had been dispensed a psychotropic medication, particularly antidepressants, were more likely to be assigned to groups other than the constant low.

CONCLUSION

Individuals with GD have an increased risk of work disability which may add financial and social pressure and is an additional incentive for earlier detection and prevention of GD.

Predictors of pathological gambling behaviours in parents population in Nigeria

The increasing incidence of psychological pains, burnout, and anxiety among gamblers in Nigeria is high. This is because pathological gambling (PG) is on the rise and it is linked to many social vices such as stealing, drug abuse, and sexual abuse. It is important to investigate the trajectories of PG in Nigeria. A cross-sectional survey design was employed in our study with 197 participants sampled from 28 gambling venues in Nigeria made up the study's sample size. Of the 197, 131 (66.5%) were males and 66 (33.5%) were females. 50 (25.4%) were within the age range of 20-30 years, 42 (21.3%) were within 31-40 years, 40 (20.3%) were within 41-50 years, 35 (17.8%) were within 51-60 years, and 30 (15.2%) were within 61 and above. Using the hierarchical regression analysis, our finding revealed a significant association between psychological distress and our respondents' pathological gambling behaviour whereas none of the sociodemographic variables made a significant contribution to their pathological gambling behaviour. We concluded that gamblers' psychological well-being is crucial to understanding their problematic gambling behaviours in the context of a developing nation such as Nigeria, and that this could be similar among our respondents. Implications of our findings were highlighted.

Against the odds: exploring individuals' pushback mechanisms against commercialized football gambling

Introduction

The need for money, the pursuit of pleasure, and the liberalized access to gambling have been documented in several pieces of literature as the drivers of gambling. Such drivers are predicated on commercialized gambling, leading to the growth of the gambling industry and constituting a structural influence that normalizes the activity among young people.

Methods

Through a qualitative inquiry, this study investigates the social agentic factors of individuals who are susceptible to gambling. Fifteen non-gamblers were recruited across three commercial cities in Africa, namely Nairobi, Lagos, and Johannesburg. We first established the gambling susceptibility of the participants: their need for money, their passion for football, ownership of a smartphone, access to the internet, and exposure to football gambling marketing.

Results

Consequently, we probed for their agency, which is indicative of why they do not gamble, despite being susceptible to engaging in the activity. Four major agentic factors were identified from the participants; knowledge of the industry's business model, conserving the integrity of football, identity of self, morality and/or religion model.

Discussion

As such, these factors may be utilized to develop an intervention program for gamblers within the geographical context.

Prevalence and Possible Predictors of Gambling Disorder in a Sample of Students in the Healthcare Professions

The Italian version of the South Oaks Gambling Screen questionnaire (SOGS) and a socio-demographic questionnaire were administered to a sample of 275 healthcare professions students aged 19 to 58 years (mean age = 22.17; females = 81.1%) to address the research objectives: to examine the prevalence and correlates of problem gambling in a population of university healthcare professions students in Italy. Among the sample, 8.7% (n = 24) of participants showed problem gambling and 1.5% (n = 4) pathologic gambling. Lottery and scratch cards were the most frequent type of gambling in the sample, followed by cards and bingo. Compared to females, males tend to be more involved in problem gambling and pathological gambling. Males tend to be more involved than females in different types of gambling (such as cards, sports bets, gambling at the casino). Pathological gambling is positively associated with gender, being students lagging behind the regular schedule of exams and parents' level of education. These findings have important implications in terms of prevention and intervention on gambling and pathological gambling. Universities should make available educational programs and counselling services to address this issue.

Basic psychological needs in gambling and gaming problems

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Need frustration was related to the severity of gambling and gaming problems.

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Need satisfaction was not related to the absence of gambling or gaming problems.

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Higher mental health problems were related to the risk of any gaming problems.

Background and Aims

Studies on self-determination theory (SDT) have placed satisfaction of basic psychological needs (autonomy, relatedness, and competence) at the core of well-being, whereas frustration of these needs results in multiple potentially unhealthy mental and behavioral patterns. This study analyzed how need satisfaction and frustration relate to the severity of gambling and gaming problems.

Methods

A survey study with 18–75-year-old Finnish participants (N = 1530; 50.33% male) was conducted in April 2021. Basic psychological needs were measured with the Basic Psychological Need Satisfaction and Frustration Scale, mental health issues with the five-item Mental Health Inventory, gambling problems with the Problem Gambling Severity Index, and gaming problems with the Internet Gaming Disorder Test. Zero-inflated negative binomial analyses were conducted to examine how satisfaction and frustration of basic psychological needs, together with mental health issues, are associated with gaming and gambling problems.

Results

Mental health issues were associated with gambling and gaming problems, but this association became nonsignificant when basic psychological needs were added to the model. However, better mental health still was associated with the absence of gaming problems. While need satisfaction had no association with the absence of gaming or gambling problems, need frustration was associated with increases in the severity of both gaming and gambling problems.

Discussion

Frustration of basic psychological needs for autonomy, relatedness, and competence is associated with both gambling and gaming problems and should be considered when developing treatment and support for those who experience such problems.

Socio-Demographic Factors, Gambling Behaviour, and the Level of Gambling Expenditure: A Population-Based Study

The aim of this study was to examine the relationship between socio-demographic factors, gambling behaviour, and the level of gambling expenditure. The data were drawn from the population-based Gambling Harms Survey 2016 and 2017 conducted in Finland. The data were linked to register-based variables. Past-year gamblers were included (Wave 1; n = 5 805, both Waves; n = 2 165). The study showed that of the 4.2 % of gamblers that produced 50.0 % of the total GE in 2016, 33.1 % of the GE was produced by those with a gambling problem and 43.3 % by those with at-risk gambling pattern. Compared to gamblers in the lowest GE group, those in the highest GE group were more likely to be men, aged 25 or older, with upper secondary education, have a high income, be on disability pension or sickness allowance, be frequent gamblers, gambling at least six game types, and showing at-risk and problem gambling patterns. Cumulative weekly GE by income tertiles remained fairly stable between the years. The results suggest that GE is highly concentrated. Among the small group of high-intensity consumers, the majority of the revenue comes from at-risk and problem gambling. Participants in the low GE group differ from those in the intermediate and high GE groups in terms of socio-demographics and gambling behaviour.

Mental illness and socio-economic situation of women and men diagnosed with gambling disorder (GD) in Sweden - nationwide case-control study

The present study aimed to compare men and women with gambling disorder (GD) regarding presence of psychiatric comorbidity and socio-economic vulnerability, and to examine whether these factors appear before or after the gambling disorder. This is a retrospective case-control study, based on registers from The National Board of Health and Welfare and Statistics Sweden. A total of 3592 adults with GD were matched with two controls based on age and gender, including a total of 10776 individuals in the study. The study included psychiatric comorbidity through the presence of relevant diagnostic codes or pharmacological codes, and socio-economic vulnerability data through the presence of unemployment, social welfare payments and sickness/activity/rehabilitation compensation. Time between GD and psychiatric comorbidity/socio-economic vulnerability was calculated by subtracting dates between diagnoses/first incidence of socio-economic vulnerability factor and GD diagnosis. Women with GD were more likely to have a psychiatric comorbidity, compared to men. Overall, women were also more likely to receive their psychiatric diagnosis prior to GD diagnosis, while men were more likely to receive the diagnoses concurrently. Social welfare payments, and sickness support were more common among women, while there was no difference in unemployment between genders. Women were also more likely to receive sickness/activity/rehabilitation compensation prior to GD, than men who were more likely to receive these types of support after GD diagnosis. In conclusion, women appear to be at higher risk of psychiatric comorbidity and socio-economic vulnerability alongside GD. They are in general also more likely to receive have their psychiatric and psycho-social problems identified prior to GD, than men who are more likely to receive diagnoses concurrently.

Compulsory School Achievement and Future Gambling Expenditure: A Finnish Population-Based Study

Background: Gambling is associated with many conditions that can compromise young people’s health and wellbeing, such as substance use and poor school achievement. Conversely, low school achievement can be linked to lower socio-economic position. Thus, the aim of this study is to examine whether compulsory school achievement is linked with gambling participation and gambling expenditure (GE) later in youth and whether GE is linked with lower socio-economic position. Methods: The Finnish Gambling Harms survey data (n = 7186) were used. The data were collected in three regions during spring 2017. Participants aged 18–29 years old were selected from the data. Past-year GE was examined using two measures: weekly gambling expenditure (WGE, in €) and relative gambling expenditure (RGE, in %). Logistic regression and log-linear regression models for past-year gambling, WGE and RGE were created. Results: Persons who had no more than a mediocre grade point average (GPA) had a 25% higher WGE and 30% higher RGE in 2016 than those who had an outstanding GPA in the compulsory school. Compared with persons with an outstanding GPA, those with a satisfactory to very good GPA spent 13% more on gambling, and their RGE was 17% higher. Additionally, those with lower socio-economic status (SES) had a higher WGE and RGE compared with higher SES. Conclusions: Even after controlling for other crucial background characteristics, early life success, in the form of compulsory school outcomes, seems to correlate with gambling expenditures later in youth. This suggests that the gambling behaviour can be linked to the cognitive ability of an individual. Our findings also imply that gambling could be more heavily concentrated on individuals that are already more socially disadvantaged. However, it is worth noting that individual factors such as traumas, antisocial personality, anxiety and depression are all associated with gambling and poor academic achievement. Overall, this suggests that various educational tools at a younger age can be effective in preventing gambling-related problems in later life.

Loot box engagement: relationships with educational attainment, employment status and earnings in a cohort of 16 000 United Kingdom gamers

BACKGROUND AND AIMS

Loot boxes are purchasable randomised rewards in video games that share structural and psychological similarities with gambling. Systematic review evidence has established reproducible associations between loot box purchasing and both problem gambling and problem video gaming. We aimed to measure the association between loot box engagement and socioeconomic correlates.

DESIGN

The study was a cross-sectional online survey using the recruitment platform, Prolific.

SETTING

United Kingdom (UK).

PARTICIPANTS

A cohort of 16 196 UK adults (18 + years) self-reporting as video gamers.

MEASUREMENTS

Respondents were asked about their game-related purchasing behaviour (including loot boxes), recent monthly spend on loot boxes and gambling engagement (gambling in any form; gambling online; playing 'social casino' games). A range of demographic variables were simultaneously captured, including age, sex, ethnicity, earnings, employment and educational attainment.

FINDINGS

Overall, 17.16% of gamers in our cohort purchased loot boxes, with a mean self-reported monthly spend of £29.12. These loot box purchasers are more likely to gamble (45.97% gamble) than people who make other types of game-related purchases (on aggregate, 28.13% of non-loot box purchasers gamble), and even greater still than those who do not make any game related purchases (24.38% gamble P < 0.001). Loot box engagement (as binary yes/no or as monthly spend normalised to earnings) was significantly associated with younger age (P < 0.001 and P < 0.001; respectively, for binary yes/no and monthly spend, adjusted for false discovery rate correction), male sex (P < 0.001 and P = 0.025), non-university educational attainment (P < 0.001 and P < 0.001) and unemployment (P = 0.003 and P = < 0.001). Lower earners spent a higher proportion of monthly earnings on loot boxes (P < 0.001).

CONCLUSIONS

The demographic associations of video game loot box engagement (younger age, male sex, non-university educational attainment and unemployment) mirror those of other addictive and problematic behaviours, including disordered gambling, drug and alcohol misuse.

Differences in problem and pathological gambling: A narrative review considering sex and gender

Background and aim

A wide range of studies indicates that men and women with Problem (PrG) and Pathological Gambling (PG) differ in several clinical and sociodemographic characteristics. However, evidence for sex differences, such as the telescoping effect, is contradictory, and it is still unclear whether sex differences observed in offline gambling can also be found for online gambling. Furthermore, reviews have so far focused on binary sex differences but neglect gender aspects. In this study, an updated literature survey of sex- and gender-related differences in PrG and PG was conducted.

Methods

We searched PsyInfo, Medline/Pubmed, and the Web of Science databases from 2005 to 2020 for studies investigating sex and gender differences in gambling. A total of 126 papers were included in the literature survey.

Results

We are presenting our findings according to the categories 'prevalence' (offline, online, LGBTQI*), 'sociodemographic factors', 'preferred gambling type', 'gambling motives', 'severity', 'progression of gambling problems', 'use of professional help/motivation for treatment', 'comorbidity', 'trauma', 'violence and criminality/delinquency'. The studies indicate that, despite some robust sex differences (e.g., concerning prevalence rates), results for most areas were mixed or suggest no sex differences (e.g., violence, gambling motives).

Discussion and conclusion

To date, there is a lack of studies assessing gender, and not only sex, warranting further research in this area.

How gambling motives are associated with socio-demographics and gambling behavior - A Finnish population study

BACKGROUND AND AIMS

The aims were to examine how socio-demographics and gambling behavior relate to both primary and additional gambling motives, and whether the gambling motives change during a one-year-period.

METHODS

The Finnish Gambling Harms Survey data was used. Gambling motives were measured with a categorical question. Gambling severity was measured using the Problem and Pathological Gambling Measure (PPGM). Using the first-wave data including only past-year gamblers (n = 5,684), five logistic regression models were utilized to explore the associations of gambling motives with socio-demographics and gambling behavior. The stability of gambling motives was assessed with McNemar's test using longitudinal data (n = 2,078).

RESULTS

Gambling for positive feeling was associated with younger age, high income, high gambling involvement and at-risk gambling. Monetary motive was associated with female gender, high gambling involvement, online or mixed-mode and at-risk gambling. Supporting worthy causes was associated with older age, monthly and weekly gambling, and land-based gambling. Socializing was associated with younger age and gambling occasionally on land-based venues with multiple game types. Finally, the motive to escape was intensified among 25-34-year-olds, homemakers, and those with high gambling involvement and at-risk or problem gambling. Gambling motives remained relatively stable for one year.

DISCUSSION AND CONCLUSIONS

Gender and age profiles varied in different motives. Positive feeling, socializing and escape motive was heightened among younger respondents while supporting worthy causes was heightened among the oldest. Women gambled for money more often than men. Escape motive was associated with problem gambling. Longer follow-up is needed to confirm the longitudinal results.

Gambling motivation model for older women addicted and not addicted to gambling - a qualitative study

Objectives: This article presents the results of a study conducted on older women who have retired from work and who gamble regularly. The aim of the study was an in-depth analysis of the motivation to gamble in older professional inactive women addicted and not addicted to gambling.Method: In-depth interviews were conducted with 34 women aged 55+ years. Motivation factors for gambling among women addicted to gambling (n = 8) and those not addicted to gambling (n = 26) were subjected to in-depth thematic analysis of the content of the interviews.Results: Five major categories were distinguished: sensations, money, activity, socialisation and escape. The most important factors for the women who were not addicted to gambling were sensations and money, followed by activity and socialisation. Women addicted to gambling, on the other hand, were mostly motivated by sensations, escape and socialisation.Conclusions: The results show the need for an in-depth analysis of the motivational factors in this group. Models built on the basis of adults are not reflected in older women. For example, the financial motive, typical of addicted gamblers, is dominant among non-addicted female seniors. Qualitative analysis helps to understand this specificity.

Predictors and patterns of gambling behaviour across the COVID-19 lockdown: Findings from a UK cohort study

The negative impact of the COVID-19 pandemic on the economy has raised concerns about negative coping behaviours to offset financial losses. We used a subset of a longitudinal study of UK adults (N = 19,963) to examine a range of predictors of (i) gambling during the first strict lockdown, (ii) gambling more frequently during this strict lockdown compared to before lockdown, and (iii) continued increased frequency of gambling during the relaxation of restrictions. Results from logistic regressions indicated that amongst other factors, those with progressively lower levels of education, were stressed due to boredom, frequently drank alcohol, and had high risk-taking tendencies were more likely to gamble during strict lockdown. Individuals who were more likely to have increased their frequency of gambling during strict lockdown compared to before the lockdown were stressed by boredom, employed, frequently drank alcohol, and had depression and anxiety, whilst men and current smokers were less likely. As lockdown restrictions eased, individuals of ethnic minority backgrounds, who were current smokers, and with lower educational attainment were more likely to continue gambling more than usual. Findings contribute to knowledge of who is most at risk for increasing their gambling during the COVID-19 pandemic.

Social disadvantage and gambling severity: a population-based study with register-linkage

Background

Studies have found an association between problem gambling and poverty. However, there is relatively little research on social inequalities and problem gambling using population representative data.

Methods

A population-representative self-report web-based and postal survey with register-based linkage was conducted in the three geographical areas of Finland. Participants (n = 7186, aged 18 or older) were randomly selected from the population register. Sociodemographic factors and social welfare benefits were studied among gambling groups and their statistical difference were examined by χ² test. Seven logistic regression models were calculated, where unemployment, social security benefits and low income were treated as dependent variables and where sex, age, family structure and education were controlled as covariates. The results were presented as odds ratios (OR) with 95% confidence intervals (CIs).

Results

Problem and at-risk gambling (ARG) was more common among people who were unemployed [PG: χ²=6.4 (1), P < 0.01, ARG: χ²=12.4 (1), P < 0.001] or had received social security benefits [PG: χ²=41.6 (1), P < 0.001, ARG: χ²=22.9 (1), P < 0.001]. The OR for problem gambling was high as 5.6 (CI: 3.22–9.61) among respondents who had received social assistance even when covariates were taking into count. Almost a third of those experiencing problem or at-risk gambling received at least one form of social security benefit.

Conclusions

The most important task of gambling policy should be reducing gambling-related harms and diminishing social inequality. However, even in government organized system where gambling profits are used for common good, profits come from the most socially disadvantaged people thereby exacerbating inequality.

Casino Gambling in Adolescents: Gambling-Related Attitudes and Behaviors and Health and Functioning Relationships

Recreational and problem gambling have been linked with adverse health and functioning outcomes among adolescents. Youth may gamble and engage in other risk-taking behaviors in casinos. There are limited data available regarding casino gambling in high-school students, and factors linked to adolescent gambling in casinos have yet to be systematically investigated. To address this gap, we analyzed cross-sectional data from 2010 Connecticut high-school students with chi-square tests and logistic regression models to examine casino gambling in relation to at-risk/problem gambling (ARPG) with respect to sociodemographic characteristics, gambling perceptions & attitudes, health/functioning measures and gambling behaviors. Approximately 11 % of adolescents acknowledged gambling in casinos. ARPG was more frequent and gambling perceptions were more permissive among adolescents endorsing casino gambling. Stronger relationships between ARPG and heavy alcohol and drug use and weaker relationships between ARPG and engagement in extracurricular activities, gambling with friends, gambling with strangers and gambling for financial reasons were observed among adolescents endorsing casino gambling. In conclusion, gambling in casinos was endorsed by a sizable minority of adolescents who gamble, and prevention efforts should consider targeting permissive attitudes towards gambling, adolescent drinking and participation in extracurricular activities when addressing underage casino gambling.

Financial Literacy and Gambling Behavior: Evidence from Japan

According to a survey by Japan's Ministry of Health, Labor, and Welfare in 2017, 3.6% of Japanese adults-equivalent to about 3.2 million people-have suffered from problem gambling at some point in their lifetime. This study examines the relationship between financial literacy, financial education, and gambling behavior (measured as gambling frequency) among the Japanese population. We hypothesize that financially literate and financially educated people who use their knowledge to make sound financial decisions are less likely to gamble. The data used in this study are from a nationwide survey in Japan from the Preference Parameters Study of Osaka University in 2010 (n = 3687). To control for endogeneity bias between financial literacy and gambling behavior, we use the education of respondents' fathers as an instrumental variable. The results from the probit-instrumental variable model show that financial literacy has a significantly negative relationship with gambling frequency, while financial education has no significant relationship with gambling frequency. Our findings suggest that problem gambling may be mitigated by promoting financial literacy, but no such conclusion can be drawn for financial education.

Financial Literacy and Gambling Behavior in the United States

Problem gambling is becoming a growing concern in the United States because of the proliferation of, and state support for, gambling opportunities. The economic cost along with the physical and mental health problems associated with problem gambling make it necessary to study how problem gambling can be reduced. Our study examines whether financial literacy could be a means to reducing gambling frequency in the United States. We use data from the Preference Parameter Study of Osaka University, Japan, and apply instrumental variable probit regression models. The results show that, generally, financial literacy does not have a relationship with gambling frequency, but the relationship is significant in the states where electronic gambling machines (EGMs) are available. The results imply that gamblers are irrational and fail to assess the risks of gambling as well as the probabilities that maximize expected payoffs. It appears that gamblers' psychological gain from gambling outweighs the negative expected utility when there is easy access to gambling. Thus, rationality with regard to gambling decisions does not work unless the easy access to EGMs is controlled. Our results further show that males, older people, people with higher household income, and people who have easy access to gambling are likely to be frequent gamblers.

Social Ecological Model of Problem Gambling: A Cross-National Survey Study of Young People in the United States, South Korea, Spain, and Finland

Problem gambling among young people is an emerging trend globally. The online environment in particular offers various possibilities for gambling engagement. This is the first cross-national survey study using the social ecological model to analyze problem gambling, especially in the online context. The study aimed to analyze how different social ecological spheres explain problem gambling. Participants were young people aged 15–25 in the United States (n = 1212), South Korea (n = 1192), Spain (n = 1212), and Finland (n = 1200). The South Oaks Gambling Screen (SOGS) instrument measured problem gambling. The regression models analyzed problem gambling with measures of intrapersonal, interpersonal, organizational, and societal spheres. Spanish participants had the highest SOGS score for problem gambling. In all countries, the variations in problem gambling were best explained by the organizational sphere measures (26%) when compared to the intrapersonal (11%), interpersonal (5%), and societal (3%) spheres. In the full model, the organizational sphere measures had strong associations with problem gambling. These included consumer debt, online gambling community participation, online casino participation, and exposure to online pop-up advertisements. Problem gambling was also associated with conformity to group norms in the interpersonal sphere, and male gender and impulsivity in the intrapersonal sphere. Cross-national results were similar in different countries. Within the final model, gambling community participation had the strongest association with problem gambling (β = 0.23, p < 0.001). The online context plays a major role in problem gambling behavior. The social ecological model is a useful tool for tackling problem gambling and developing preventative measures.

The Gambling Consumption Mediation Model (GCMM): A Multiple Mediation Approach to Estimate the Association of Particular Game Types with Problem Gambling

Bivariate associations of problem gambling with participation in particular game types often decrease when adjusting for demographics or consumption behavior (e.g., number of game types played). A summary of 14 peer-reviewed studies showed inconsistencies as well as conceptual and methodological challenges. The aim of this study was to expand previous research by a combination of (1) sophisticated feature-engineering, which disaggregates gambling intensity into facets within and beyond a game type of interest, and (2) the application of mediation models. Data comprised last year gamblers of three merged cross sectional Icelandic gambling surveys of 2007, 2011, and 2017 (N = 4422). For each of 15 game types (12-month time frame), a parallel multiple mediation model was applied to disaggregate bivariate associations of last year game type participation and problem gambling (Problem Gambling Severity Index) by six mediating mechanisms: (1) demographic problem gambling propensity, (2) number of game types played, (3) gambling frequency within the type, (4) maximum gambling frequency across all types beyond, (5) usual spending within the type, (6) maximum usual spending across all types beyond. Games showed two distinct profiles via which mediator they mostly impacted problem gambling: Electronic gaming machines offline, scratch cards offline, live betting online, and poker offline as well as online impacted problem gambling mostly via gambling frequency within, whereas all other types mostly impacted via the number of game types played. The applied mediation models answer the question by which mechanism game types impact problem gambling in a more exhaustive way than previous research.

Youth and gambling disorder: What about criminal behavior?

BACKGROUND AND AIMS

The commission of illegal acts has been associated with gambling disorder (GD). However, little is known about young adults with GD who commit GD-related crimes. Therefore, the main aim of this study was to compare sociodemographic, clinical, personality and psychopathological features among young adults with GD with and without a history of illegal behaviors. Our second aim was to analyze the specific associations between these factors through a path analysis.

METHODS

A total of 808 treatment-seeking young adults who met criteria for GD were assessed at a public hospital unit specialized in behavioral addictions. Participants completed self-reported questionnaires to explore GD, personality traits, and psychopathological symptomatology.

RESULTS

Of the total sample, 291 patients (36.0%) had committed GD-related offences. Illegal acts were related to younger age and unemployment status. Greater levels of psychopathology, as well as earlier GD onset, longer GD duration and greater GD severity were also associated with the presence of criminal behaviors. Differences in personality traits were also found between these two groups.

DISCUSSION AND CONCLUSIONS

The GD group with a history of illegal acts showed dysfunctional personality traits and higher levels of psychopathology. Therefore, specific GD treatments and harm reduction interventions should be designed for these patients.

Financial Literacy, Financial Education, and Smoking Behavior: Evidence From Japan

In this study, we examine the relationship between financial literacy, financial education, and smoking behavior among the Japanese population. We hypothesize that financially literate and financially educated people, who have the ability to make more rational decisions, are less likely to smoke. Using the Preference Parameters Study of Osaka University, conducted in 2010 (N = 3,706), the probit regression results show that both financial literacy (with an emphasis on knowledge of investments) and financial education (with an emphasis on savings behavior) have a significant negative impact on smoking behavior. In addition, gender, age, education, marital status, household income and assets, risky behaviors, a myopic view of the future, risk preference, and level of happiness also significantly predict the likelihood of a person being a current smoker. This study provides empirical evidence that enhancing the rational decision-making ability of individuals through financial literacy and financial education may curtail smoking behavior.

Online Survey of Gambling Participation and Problem Gambling in Chiba City: Problem Gambling Rates May be Strongly Influenced by the Administration Mode

Prevalence studies on gambling participation and problem gambling in Japan have been limited. To obtain data showing the current status of gambling in Japan, we conducted an online survey on gambling participation and problem gambling among residents in Chiba City. The online data collection was conducted through an Internet research firm. Questionnaires were consisted of personal demographics, past-year gambling participation and severity of gambling risks. The Problem Gambling Severity Index (PGSI) was used as a survey instrument. Males (51.5%) were significantly more likely than females (25.5%) to have gambled in the past year. Problem gamblers (PGSI score ≧ 8) were 7.2% among males and 1.2% among females. Problem gambling was strongly correlated with frequent gambling, preference for Pachinko/Slot and smoking habit. The gambling participation rates were roughly lower than those reported in many overseas jurisdictions, whereas the problem gambling rates were considerably higher than those reported in the same jurisdictions. According to the total consumption model, it would be reasonable to consider that gambling participation rates show a positive correlation with problem gambling rates. The high levels of problem gambling may be due to the administration mode using online sampling, by which answers admitting unapprovable behaviors like problem gambling tend to increase. This suggests that the previous studies using conventional face-to-face or telephone methods may have underestimated problem gambling rates.

The Winners and the Losers: Tax Incidence of Gambling in Finland

Gambling markets have grown rapidly for the last few decades. As a result, gambling is also a very important and common source of tax income for many governments these days. This raises a question about the overall fairness of the gambling taxation systems. In this paper, we aim to study the tax incidence of gambling in Finland. First, we analyse who are the expected payers of the gambling taxes and second, who are expected to be the receivers of the gambling-tax based contributions. In the first part of the study, we analyse the demographic incidence of gambling taxation by using the Finnish gambling 2015 population survey combined with registry based variables. Our data contains 3776 individuals. In the second part of the study, we use data of county level gambling-taxation based contributions to different organisations to analyse how the gambling expenditures are distributed back to citizens in a form of public spending. This study shows that different socio-demographic factors have diverse association with the decisions whether or how much to gamble. The results also suggest that more disadvantaged, i.e. lower income, less educated and rural area living, individuals are expected to be the “losers” of the Finnish gambling taxation system. In other words, the Finnish gambling system is found to be regressive by nature.

Associations between Problematic Gambling, Gaming, and Internet Use: A Cross-Sectional Population Survey

Background

While pathological gambling, or gambling disorder, is an established diagnosis, a link to other potential behavioural addictions has been suggested. The present study aimed to investigate whether signs of problem gaming and problematic internet use are related to problem gambling in the general population, while including other potential risk factors.

Methods

A cross-sectional study design, using an electronical questionnaire, administered through a marketing survey company for relative representativeness with respect to age and gender. Potential correlates of problem gambling were measured in binary analyses, and significant associations were entered in a logistic regression analysis controlling them for one another. Problem gambling, gaming, and internet use were measured through established screening instruments (the CLiP, the GAS, and the PRIUSS).

Results

Statistically significant associations were found between problem gambling and both problem gaming and problematic internet use, as well as with male gender. In logistic regression, problem gaming, problematic internet use, and male gender remained associated with problem gambling.

Conclusion

After controlling for potential demographic risk factors, problem gaming and problematic internet use may be related to problem gambling, suggesting that these constructs may interact or may share similar risk factors. More research is needed to clarify factors mediating the links between these conditions.

Public health effects of gambling - debate on a conceptual model

BACKGROUND

Gambling for money is a popular leisure time activity in most countries, which has major social and economic impacts not only affecting the gambler, but his/her significant others, and the society. Gambling impact studies can help researchers and policymakers compare the health and social costs and benefits of different gambling policies and can be used when considering which gambling policies will reduce or increase costs or benefits the most. In a public health approach, the impacts of gambling, negative and positive, are assessed across the entire severity spectrum of the activity. Although some studies have created basic principles for conducting impact studies, a theoretical model is currently lacking. The aim of this debate is to review complementing and contrasting views on the effects of gambling to create a conceptual model, where a public health perspective is applied.

MAIN TEXT

The effects of gambling can be structuralized using a conceptual model, where impacts are divided into negative and positive; costs and benefits. Costs and benefits are categorized into three classes: financial, labor and health, and well-being. These classes manifest in personal, interpersonal, and societal levels. Individual impacts cause effects on a personal level to gamblers themselves. External impacts influence the interpersonal and society/community levels and concern other people. The temporal level refers to the development, severity and scope of the gambling impact. These include general impacts, impacts of problem gambling and long-term impacts of gambling.

CONCLUSIONS

The conceptual model offers a base on which to start building common methodology for assessing the impact of gambling on the society. While measuring monetary impacts is not always straightforward, the main issue is how to measure the social impacts, which are typically ignored in calculations, as are personal and interpersonal impacts. The reviewed empirical work largely concentrated on the costs of gambling, especially costs on the community level. The Model can be used to identify areas where research is scarce. Filling the gaps in knowledge is essential in forming a balanced evidence base on the impacts of gambling. Ideally, this evidence could be the starting point in formulating public policies on gambling.

Prevalence and covariates of problematic gambling among a US military cohort

The availability of and participation in gambling has increased substantially the past several decades, however studies of military members' gambling behaviors are limited. The present study aimed to investigate potential problematic gambling and its association with demographics and behavioral characteristics in a US military cohort. We analyzed cohort data from a telephone survey during 2015-2016 of 1553 Ohio Army National Guard members. We assessed potential problematic gambling by using the 3-item National Opinion Research Center Diagnostic Screen-Loss of Control, Lying, and Preoccupation Screen (NODS-CLiP). Potential correlates examined were demographics, depression, suicidal ideation, smoking status, alcohol use, legal and financial problems, perceived general health status, pain, and impulsivity. Results indicated past-year frequent gambling (at least once per week) and lifetime potential problematic gambling was reported by 13% and 8% of respondents, respectively. Problematic gambling and past-year gambling behaviors were associated in a dose-response relationship from 18% among soldiers gambling once per week to 44% among those gambling 4 or more times per week. Correlates of screening positive for potential problematic gambling included the following: being male, currently unmarried, having left the Guard or retired, minor depression, alcohol dependence, legal problems, and increased pain. Given the higher prevalence of frequent gambling in this military cohort (8%), nearly twice the US prevalence (5%), and the association with negative psychological and behavioral outcomes, routine screening of gambling frequency and problem gambling may be needed to ensure military and veteran populations live the healthiest lives possible.

What are we missing? The profile of non-respondents in the Finnish Gambling 2015 survey

Aims: Population-based gambling surveys provide important information about gambling frequency, problems, attitude and opinions of the general population. This information can be used by social and health care professionals, service providers and policy makers. However, low response rates may cause biased findings. The aim was to define the profile of non-respondents in the Finnish Gambling 2015 survey. Methods: The survey sample (N = 7400) was obtained from the national Population Information System and the survey was conducted using computer-assisted telephone interviews (response rate 62%). The study sample including individuals aged 18-74 was linked to administrative registers to obtain socio-demographic information (sex, age, marital status, education, socio-economic status, net income, residential area) about the respondents and the non-respondents. Register-based information was used to build a non-respondent profile for the survey. Results: The non-response was more prevalent among women, 18- to 24-year-olds, non-married, individuals with primary education, unemployed (vs. self-employed and students) and residents in urban areas. When net income was added to the model, the associations of women and unemployed (vs. self-employed) with non-response became non-significant, while the non-response was more prevalent among the lowest quintile of net income. Conclusions: Socio-economic position was associated with lower response rate which may cause bias while studying gambling behaviour of socio-economically vulnerable individuals. Obtaining additional auxiliary information through record linkage to administrative registers and use of more sophisticated methods for controlling bias caused by non-response, such as multiple imputation, would offer information about the impact of non-response to the results related to gambling and gambling problems.

Effects of prevention and harm reduction interventions on gambling behaviours and gambling related harm: An umbrella review

BACKGROUND

Harms related to gambling have been found not only to affect problem gamblers, but also to occur amongst low- and moderate-risk gamblers. This has resulted in calls for a public health approach to address a possible 'prevention paradox' in gambling related harm. The aim of this study was to evaluate the systematic review evidence base on the effects of prevention and harm reduction interventions on gambling behaviours, and gambling related harm. We also aimed to examine differential effects of interventions across socio-demographic groups.

METHODS

Systematic methods were used to locate and evaluate published systematic reviews of prevention and harm reduction interventions. We designed the review using the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) Equity extension Guidelines. Four databases were searched from their start date until May 2018. The quality of the included articles was determined using A MeaSurement Tool to Assess systematic Reviews (AMSTAR 2).

RESULTS

Ten systematic reviews were identified reporting 55 unique relevant primary studies. Much of the review evidence-base related to pre-commitment and limit setting (24%), self-exclusion (20%), youth prevention programmes (20%), and machine messages/feedback (20%). The effectiveness of harm reduction interventions are limited by the extent to which users adhere to voluntary systems. Less than half of studies examining youth prevention programmes demonstrated positive effects on behaviour. No review extracted data or reported on the differential effects of intervention strategies across sociodemographic groups. The quality of the included reviews (and their primary studies) were generally poor and clear gaps in the evidence base have been highlighted.

CONCLUSIONS

The evidence base is dominated by evaluations of individual-level harm reduction interventions, with a paucity of research on supply reduction interventions. Review conclusions are limited by the quality and robustness of the primary research. Future research should consider the equity effects of intervention strategies.

Women's gambling behaviour, product preferences, and perceptions of product harm: differences by age and gambling risk status

Background

Women’s participation in, and harm from gambling, is steadily increasing. There has been very limited research to investigate how gambling behaviour, product preferences, and perceptions of gambling harm may vary across subgroups of women.

Methods

This study surveyed a convenience sample of 509 women from Victoria and New South Wales, Australia. Women were asked a range of questions about their socio-demographic characteristics and gambling behaviour. Focusing on four gambling products in Australia—casino gambling, electronic gambling machines (EGMs), horse betting, and sports betting—women were asked about their frequency of participation, their product preferences, and perceptions of product harms. The sample was segmented a priori according to age and gambling risk status, and differences between groups were identified using Chi-square tests and ANOVAs. Thematic analysis was used to interpret qualitative data.

Results

Almost two thirds (n = 324, 63.7%) of women had engaged with one of the four products in the previous 12 months. Compared to other age groups, younger women aged 16–34 years exhibited a higher proportion of problem gambling, gambled more frequently, and across more products. While EGMs were the product gambled on most frequently by women overall, younger women were significantly more likely to bet on sports and gamble at casinos relative to older women. Qualitative data indicated that younger women engaged with gambling products as part of a “night out”, “with friends”, due to their “ease of access” and perceived “chance of winning big”. There were significant differences in the perceptions of the harms associated with horse and sports betting according to age and gambling risk status, with younger women and gamblers perceiving these products as less harmful.

Conclusions

This study highlights that there are clear differences in the gambling behaviour, product preferences, and perceptions of product harms between subgroups of women. A gendered approach will enable public health researchers and policymakers to ensure that the unique factors associated with women’s gambling are taken into consideration in a comprehensive public health approach to reducing and preventing gambling harm.

Gambling participation, gambling habits, gambling-related harm, and opinions on gambling advertising in Finland in 2016

Background:

This report is an overview of results from the 2016 Finnish Gambling Harms Survey covering the population and clinical perspectives. It summarises the main findings on gambling participation, gambling habits, gambling-related harm, and opinions on gambling advertising.

Methods:

The population sample (n = 7186) was collected from three regions and the clinical sample (n = 119) in a gambling help clinic.

Results:

Frequency of gambling in the population sample was characteristically once a week, while in the clinical sample it was daily. Men gambled more often than women only in the population sample. The most common gambling environments were kiosks, grocery stores or supermarkets, and home. The most typical gambling-related harms were financial or emotional/psychological harms; the amount of experienced harm was considerable among the clinical sample. The clinical sample also perceived gambling advertising as obtrusive and as a driving force for gambling.

Conclusions:

The results of the clinical sample imply that when gambling gets out of hand, the distinctions between gamblers’ habits diminish and become more streamlined, focusing on gambling per se – doing it often, and in greater varieties (different game types). There is a heightened need to monitor gambling and gambling-related harm at the population level, especially amongst heavy consumers, in order to understand what type of external factors pertaining to policy and governance may contribute to the shift from recreational to problem gambling.

The relationship between gambling expenditure, socio-demographics, health-related correlates and gambling behaviour-a cross-sectional population-based survey in Finland

AIMS

To investigate gambling expenditure and its relationship with socio-demographics, health-related correlates and past-year gambling behaviour.

DESIGN

Cross-sectional population survey.

SETTING

Population-based survey in Finland.

PARTICIPANTS

Finnish people aged 15-74 years drawn randomly from the Population Information System. The participants in this study were past-year gamblers with gambling expenditure data available (n = 3251, 1418 women and 1833 men).

MEASUREMENTS

Expenditure shares, means of weekly gambling expenditure (WGE, €) and monthly gambling expenditure as a percentage of net income (MGE/NI, %) were calculated. The correlates used were perceived health, smoking, mental health [Mental Health Inventory (MHI)-5], alcohol use [Alcohol Use Disorders Identification Test (AUDIT)-C], game types, gambling frequency, gambling mode and gambling severity [South Oaks Gambling Screen (SOGS)].

FINDINGS

Gender (men versus women) was found to be associated significantly with gambling expenditure, with exp(β) = 1.40, 95% confidence interval (CI) = 1.29, 1.52 and P < 0.005 for WGE, and exp(β) = 1.39, 95% CI = 1.27, 1.51 and P < 0.005 for MGE/NI. All gambling behaviour correlates were associated significantly with WGE and MGE/NI: gambling frequency (several times a week versus once a month/less than monthly, exp(β) = 30.75, 95% CI = 26.89, 35.17 and P < 0.005 for WGE, and exp(β) = 31.43, 95% CI = 27.41, 36.03 and P < 0.005 for MGE/NI), gambling severity (probable pathological gamblers versus non-problem gamblers, exp(β) = 2.83, 95% CI = 2.12, 3.77 and P < 0.005 for WGE, and exp(β) = 2.67, 95% CI = 2.00, 3.57 and P < 0.005 for MGE/NI) and on-line gambling (on-line and land-based versus land-based only, exp(β) = 1.35, 95% CI = 1.24, 1.47 and P < 0.005 for WGE, and exp(β) = 1.35, 95% CI = 1.24, 1.47 and P < 0.005 for MGE/NI).

CONCLUSIONS

In Finland, male gender is associated significantly with both weekly gambling expenditure and monthly gambling expenditure related to net income. People in Finland with lower incomes contribute proportionally more of their income to gambling compared with middle- and high-income groups.