Setting Limits: Gambling, Science and Public Policy-summary of results

Online gambling forums as a potential target for harm reduction: an exploratory natural language processing analysis of a reddit.com forum

OBJECTIVES

Globally, there has been a rapid increase in the availability of online gambling. As online gambling has increased in popularity, there has been a corresponding increase in online communities that discuss gambling. The movement of gambling and communities interested in gambling to online spaces presents new challenges to harm reduction. The current study analyses a forum from a popular online forum hosting website (reddit.com) to determine its suitability as a source for data to inform gambling harm reduction in online spaces.

METHODS

The current study provides an exploratory analysis of 1,141 unique posts and 11,668 comments collected from the online forum r/onlinegambling. The dataset covers posts and comments from August 5, 2015, to October 30, 2023. Natural language processing (NLP) techniques were used to identify common terms and phrases, identify topics with high rates of participant engagement and perform a sentiment analysis of posts and comments.

RESULTS

Sentiment analysis results showed that the majority of posts and comments were positive, but there were substantial numbers of negative and neutral content. Positive content was often congratulatory and focused on winning, neutral posts more commonly focused on practical advice, and negative posts were more commonly concerned with avoiding operators perceived as illegitimate by forum participants.

CONCLUSIONS

Results from this study show that there is a varied and robust discussion of different aspects of gambling on r/onlinegambling. Our exploratory analyses suggest that this reddit forum provides important information on how users communicate motivations to gamble, interpretations of gambling experiences, and define potential harms related to gambling online as well as how to avoid or remedy those harms. Reddit forums discussing gambling have great potential for future research interested in more specific aspects of harm reduction and prevention related to online gambling, particularly when using NLP techniques.

From policy to practice: assessing the impact of electronic gambling machines regulations on harmful gambling behaviour

BACKGROUND

Electronic gambling machines (EGMs) are among the most harmful forms of gambling. Their widespread availability has been linked to increased gambling activity and a rise in harmful gambling. However, it remains unclear whether restricting the availability and accessibility of EGMs is effective in reducing gambling harms at the population level. We investigate those issues by leveraging the natural experiment of the region of Piedmont in northwest Italy, which in 2018 set limits on the location and operating hours of EGMs.

METHODS

Data from the Gambling Adult Population Survey conducted in 2018 and 2022 were combined with information regarding the implementation of the policy in Piedmont municipalities and data on EGMs from the national monopoly holder. Our analysis uses a difference-in-difference design, which is appropriate given that only some municipalities in the region implemented the policy, each setting different operating time limits for EGMs. Sensitivity analyses were conducted to explore possible substitution effects towards bordering regions and online gambling.

RESULTS

Our findings reveal that policies aimed at reducing the operating hours of EGMs were effective in decreasing harmful gambling behaviour in the population, but only when a minimum daily operational suspension of 11 hours was implemented. No significant effect was observed from setting location limits, and no substitution effect was found.

CONCLUSIONS

While restricting EGM availability can help mitigate harmful gambling, it requires coordinated efforts across different levels of government to ensure uniform policy implementation, along with individual-level policies, such as banning advertising, and consideration of diverse gambling products and online gambling.

Significant wins and their impacts: Predictors of problem gambling in French and Polish national samples

AIM

We examined the role of significant win experiences alongside psychosocial factors in the risk of problem gambling.

PARTICIPANTS

The study involved adult pure-chance gamblers from representative Polish (n = 3143) and French samples (n = 5692).

MEASUREMENTS

The questionnaire encompassed socio-demographic details, gambling behaviours, significant win experiences, gambling motivation, and problem gambling.

DESIGN & SETTING

Logistic regression analyses unveiled universal and country-specific factors significantly linked to problem-gambling risk.

FINDINGS

Universal factors comprised gender (lower risk among females), age (higher risk for ages 35+), household income (negative association), current and past debt (positive association), type of gambling game (higher risk for games other than lotteries), and gambling frequency (positive association). Risk factors also encompassed heightened coping and social motivations to gamble, while the financial motivation inversely correlated with risk. Inter-country differences featured significant wins in the player's environment, associated with problem-gambling risk only among the French. Then, only the highest amounts spent on gambling in the French group correlated with problem gambling, while lower amounts in the Polish group also did. Notably, a higher problem-gambling risk was observed in the Polish group compared to the French.

CONCLUSIONS

A crucial finding was that significant wins were associated with problem gambling, even when controlling for other essential factors. Our study highlights the role of significant wins, construed as subjective gambler experiences, in fostering problem gambling. This insight suggests the need for a paradigm shift in understanding the role of winning in gambling, representing a risky experience regardless of the objective amount gambled.

Short-term effectiveness of gambling treatment in the Daily Clinic for Gambling Addiction

In response to the high prevalence of gambling addiction within the population, a specialised Daily Clinic for Gambling Addiction was established at the University Psychiatric Hospital "St. John" in Zagreb (Croatia). This clinic offers a unique three-month, semi-structured, intensive multidimensional and multidisciplinary treatment approach delivered by a team of specialised mental health professionals. Treatment interventions include individual and group psychotherapy, socioemotional skills training, family therapy, support groups and other modalities. In collaboration with researchers from the University of Zagreb Faculty of Education and Rehabilitation Sciences, the study team is conducting a scientific evaluation to determine the outcomes of the treatment. This study presents results on its' short-term effectiveness, based on a sample of N = 209 patients (Mean Age = 33.54; Males = 92.8%; Females = 7.2%) who underwent treatment between 2017 and 2021. To assess the effectiveness of the treatment, a research design incorporating two measurement sessions (pre-test and post-test) was employed. This design utilised a comprehensive battery of validated instruments, each targeting specific constructs or domains of psychosocial functioning that the intervention aims to address. The assessment tools included: (1) Problem Gambling Severity Index-PGSI, (2) Gambling Attitudes Scale-GAS, (3) Coping Inventory for Stressful Situations-CISS, (4) The Gambling Beliefs Scale-short version, (5) Problem Solving and Refusal Skills Scale, (6) Depression, Anxiety, Stress Scale-DASS-21, (7) Generalised Self-Efficacy Scale-GSE, and (8) Multidimensional Scale of Perceived Social Support. The results indicate significant positive improvements in gamblers' psychosocial functioning with the following large effect sizes: gambling-related consequences (r = 0.84), task oriented coping (Cohen's d = 0.79), emotion oriented coping (Cohen's d = 1.06), attitudes (r = 0.67), superstition (r = 0.61), illusion of control (r = 0.62), depression (r = 0.78), anxiety (r = 0.71), stress (r = 0.73), problem-solving skills (r = 0.73) and general self-efficacy (r = 0.61). The effects on refusal skills (Cohen's d = 0.48) as well as on alcohol (Cohen's d = 0.24) and marihuana (r = 0.26) were small to medium. Findings are discussed in terms of appropriate treatment approaches for gambling addiction, methodological challenges in measuring effects and implications for future evaluation research. In general, this treatment protocol provides promising effects for gambling addiction.

A review of Returned and Services League venues operating electronic gambling machines in Victoria, Australia and the level of funding contributed to veterans

OBJECTIVE

Globally, funding 'good causes' is a legitimation tactic for gambling operations. This research aimed to determine if an Australian system allowing tax concessions to not-for-profits (NFPs) meets its primary intention of funding community purpose.

METHODS

Not-for-profit (NFP) venues operating electronic gaming machines (EGMs) in the state of Victoria must submit records to the gambling regulator showing contribution to community purposes. The community benefit statements (CBS) of licensed Returned and Services League (RSL) venues were analysed, with an initial survey of the years 2010-19 and a more detailed analysis of the years 2017-19.

RESULTS

Veteran support constituted less than 10% of the total community contributions claimed, or 1.5% of electronic gaming machine (EGM) user losses. On average, business expenses exceeded the claims for veteran support by 12:1. Contributions for addressing gambling-related harm represented less than 0.002% of recorded claims.

CONCLUSIONS & IMPLICATIONS FOR PUBLIC HEALTH

This research demonstrates that the provision of charitable services derived from gambling revenue is very modest amongst Australia's principal veteran's organisation. Deficiencies in harm prevention and minimisation reinforce the need for changes to community benefit schemes. Regulatory reforms emphasising the vulnerability of veterans to gambling harm are required to ensure that this population is better protected.

Loss of resources and gambling during the COVID-19 pandemic: a three-wave longitudinal study

This study is based on the Conservation of Resources theory and investigates the impact of the COVID-19 pandemic and associated resource loss on gambling behaviour among Polish gamblers. The study surveyed 585 individuals engaged in land-based gambling before the pandemic. Participants completed computer-assisted web interviews, responding to questions regarding land-based and online gambling frequencies, the Problem Gambling Severity Index, and the Inventory of Loss of Resources in Pandemics. The findings revealed significant shifts in gambling behaviour due to pandemic-related restrictions. Land-based gambling declined during lockdowns and the third wave of the study, while online gambling surged as gamblers transitioned from land-based venues. Gamblers tended to return to land-based options as restrictions eased. Over consecutive waves, participants reported decreasing resource loss levels. Significantly, resource loss was influenced by gambling frequency rather than vice versa. Both types of gambling experienced parallel declines at the beginning of the pandemic, which subsided as the new situation became normalised. Players engaging more in gambling experienced more significant resource losses during the pandemic. Those with more resources at the pandemic's onset adapted more readily, whereas individuals with limited resources faced resource loss. Conclusions Even with stable gambling levels, heavy gamblers at baseline were at higher risk for issues. The dynamics between resource loss and gambling and problem gambling supported the resource loss spiral concept.

Gambling-related attitudes and dimensional structure of the GABS-15 in outpatient addiction care patients: associations with gambling disorder

Introduction

Individuals with gambling disorder (GD) harbor cognitive distortions and dysfunctional beliefs about gambling that may foster problematic gambling behaviour. Evidence on particularly detrimental attitudes and beliefs is however lacking. To close this knowledge gap, we analysed associations between gambling attitudes and beliefs (Gambling Attitudes and Beliefs Survey (GABS-15)) and severity of gambling disorder (DSM-5 criteria met) in a German cohort of 123 individuals receiving outpatient gambling treatment.

Methods

Data from the "Katamnese-Study" covering a 36-months timeframe with 5 assessment points was pooled. The multidimensional structure of the GABS-15 was examined using explorative and confirmatory factor analyses, followed by mixed-effect regression models using different operationalizations of the GABS-15.

Results

A three-factorial structure comprising "attitudes while gambling", "sensation-seeking / excitement", and "gambling fallacies" demonstrated better fit indices than the GABS-15 sum score. Only the "gambling fallacies " factor (1.00, p<0.05; 15.36, p < 0.01) was significantly associated with increased severity of GD.

Discussion

As a one-dimensional conceptualization of gambling-related attitudes and beliefs might not sufficiently guide staff of outpatient treatment facilities regarding priority setting in gambling care, evidence on attitudes with particularly detrimental associations is highly warranted. Here, focussing on mitigating "gambling' fallacies" by tailored treatment strategies appears promising.

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 relationship between the price and demand of alcohol, tobacco, unhealthy food, sugar-sweetened beverages, and gambling: an umbrella review of systematic reviews

BACKGROUND

The WHO highlight alcohol, tobacco, unhealthy food, and sugar-sweetened beverage (SSB) taxes as one of the most effective policies for preventing and reducing the burden of non-communicable diseases. This umbrella review aimed to identify and summarise evidence from systematic reviews that report the relationship between price and demand or price and disease/death for alcohol, tobacco, unhealthy food, and SSBs. Given the recent recognition as gambling as a public health problem, we also included gambling.

METHODS

The protocol for this umbrella review was pre-registered (PROSPERO CRD42023447429). Seven electronic databases were searched between 2000-2023. Eligible systematic reviews were those published in any country, including adults or children, and which quantitatively examined the relationship between alcohol, tobacco, gambling, unhealthy food, or SSB price/tax and demand (sales/consumption) or disease/death. Two researchers undertook screening, eligibility, data extraction, and risk of bias assessment using the ROBIS tool.

RESULTS

We identified 50 reviews from 5,185 records, of which 31 reported on unhealthy food or SSBs, nine reported on tobacco, nine on alcohol, and one on multiple outcomes (alcohol, tobacco, unhealthy food, and SSBs). We did not identify any reviews on gambling. Higher prices were consistently associated with lower demand, notwithstanding variation in the size of effect across commodities or populations. Reductions in demand were large enough to be considered meaningful for policy.

CONCLUSIONS

Increases in the price of alcohol, tobacco, unhealthy food, and SSBs are consistently associated with decreases in demand. Moreover, increasing taxes can be expected to increase tax revenue. There may be potential in joining up approaches to taxation across the harm-causing commodities.

Harmful types of gambling: changes and emerging trends in longitudinal helpline data

BACKGROUND

Gambling products differ in terms of their harm potential. Products are also constantly developing and changing. However, little research has addressed changes and trends in the types of gambling that are associated with harms. The current study explores trends in the gambling product categories identified as harmful in longitudinal helpline data from three Nordic countries.

METHODS

We use data collected by national helplines in Denmark (StopSpillet), Finland (Peluuri) and Sweden (Stödlinjen) in their daily operations (N = 46 646). The data consist of information collected on gamblers and concerned significant others who have contacted these helplines between January 2019 and December 2022. We analyse which gambling products are mentioned as harmful by clients. The analysis uses linear regression with the interaction term (country) times time regressed over the outcome variable (proportion per month).

RESULTS

The results show that an increased share of contacts concern online gambling. Online casino products have become the most harmful category across contexts. The share of reported harms from online betting and new emerging online forms is also increasing. The share of land-based products as a reported source of harms has decreased across 2019-22.

CONCLUSIONS

The results suggest that online gamlbing environments, and particularly online casino products, are associated with increasing harms to help-seekers. The harmfulness of different gambling products may not be stable, but change over time. Further harm prevention efforts are needed to address the online gambling field, including emerging formats.

Availability restrictions and mandatory precommitment in land-based gambling: effects on online substitutes and total consumption in longitudinal sales data

BACKGROUND

Gambling causes important harms in societies. According to the public health approach, the most effective policies to reduce harms target full populations. Availability restrictions and mandatory precommitment are among the most effective measures. However, restrictions on the availability of some gambling products or channels may also be offset by increased consumption in other products. Substitution effects can have negative public health impacts due to differing harm potential across different gambling products. This paper uses longitudinal sales data (2019-2022) from the Finnish gambling monopoly Veikkaus. During the observation period, the availability of gambling was restricted in Finland due to subsequent waves of Covid-19-related restrictions. In addition, the gambling monopoly introduced mandatory precommitment to land-based EGMs. We focus on how these restrictive policy changes impacted the total consumption of gambling and possible substitution effects.

METHODS

The Finnish gambling monopoly provided weekly theoretical loss data per gambling product category and gambling channel (online, land-based) for the period of January 2019 - July 2022 based on a statutory obligation. We analysed the effects of availability restrictions and other public health measures on the consumption of different products using descriptive time series and regression analyses. We compared the sale of land-based products to online equivalents at product category level and included main policy change periods in the models.

RESULTS

Total consumption of gambling declined during 2019-2022 mainly due to reduced land-based electronic gambling machine (EGM) consumption. Declines in land-based EGM sales were not offset by online alternatives or other close substitutes in the long term. However, during the first wave of Covid-19, there was an observable substitution of land-based table games by online alternatives and land-based horse betting and possibly sports betting by online horse betting. Overall, the results also show that Covid-19 functioned as a boost to an already existing trend of increasing digitalisation of gambling.

CONCLUSIONS

The study provides empirical support for the effectiveness of public health-oriented policies in reducing the total consumption of gambling. Availability restrictions and mandatory precommitment are therefore likely to also reduce the burden of harms of gambling to individuals and societies.

Associations Between Heavy Episodic Drinking, Drinking While Gambling, and Risky Gambling

INTRODUCTION

Understanding how patterns of drinking are associated with risky gambling in Australia is needed to inform an effective approach to minimise harm.

METHODS

This cross-sectional questionnaire study reports on 2,704 subsampled participants who completed survey questions about their patterns of drinking. With logistic regressions, we examined whether frequency of heavy episodic drinking (HED) and alcohol use while gambling were associated with risky gambling while controlling for sociodemographic variables.

RESULTS

Occasional HED and monthly HED were associated with any gambling (versus no gambling), but frequent HED was not significantly associated with gambling. The opposite pattern was found when predicting risky gambling. Occasional HED (i.e. less than monthly) was not significantly associated, but a higher frequency of HED (at least weekly) was associated with a higher likelihood of risky gambling. Drinking alcohol while gambling was associated with risky gambling, over and above HED. The combination of HED and use of alcohol while gambling appeared to significantly increase the likelihood of risky gambling.

CONCLUSIONS

The association of HED and alcohol use while gambling with risky gambling highlights the importance of preventing heavy alcohol use among gamblers. The links between these forms of drinking and risky gambling further suggests that individuals who engage in both activities are specifically prone to gambling harm. Policies should therefore discourage alcohol use while gambling for example by prohibiting serving alcohol at reduced prices or to gamblers who show signs of being affected by alcohol and informing individuals of the risks associated with alcohol use while gambling.

Framing Slogans for Responsible Gambling Campaigns: A Tale of Two Models

This study investigates the persuasive mechanism of slogans employed in responsible gambling campaigns. We analyse slogans from official posters in the U.S., Singapore, and Macau, focusing on two domains. First, the Theory of Planned Behaviour is applied to examine the intention to gamble expressed in the slogans to reveal how gambling is positioned in social contexts. Second, two framing devices-i.e., conceptual metaphors and the frame of gains/losses-are examined to understand how these framing devices reinforce the persuasive message while interacting with each other. Two models of persuasion emerge from our data-one encouraged 'grounded games' for enjoyment, while the other discouraged gambling due to its potentially 'harmful' consequences. We advocate for a gestalt view on the theoretical constructs that contribute to the overall effectiveness of persuasive messaging. These constructs should be integrated into an analytical framework, with particular attention given to the framing effect of conceptual metaphors and the gain/loss frame, and their interplay.

The politics and fantasy of the gambling education discourse: An analysis of gambling industry-funded youth education programmes in the United Kingdom

Background

The provision of commercialised gambling products and services has changed radically in recent decades. Gambling is now provided in many places by multi-national corporations, with important implications for public health and policymaking. The United Kingdom is one of the most liberalised gambling markets globally, however there are few empirical analyses of gambling policy from a public health perspective. This study aims to provide a critical analysis of a core element of UK gambling policy, the provision of industry-funded youth gambling education programmes.

Methods

Adopting a commercial determinants of health lens, a discourse theoretical analysis was conducted using the logics of critical explanation. The data comprised resources provided by three gambling industry-funded charities (GambleAware, GamCare and the Young Gamers and Gamblers Education Trust) and their partners.

Results

The resources present a gambling education discourse that serves to reproduce the 'responsible gambling' agenda, while problematising children and young people. While the resources appear to offer educational content and opportunities for debate, the dominant focus is on teaching about personal responsibility and on the normalisation of gambling and gaming and their industries, while constraining the concept of agency. The resources encourage young people to act as individuals to control their impulses, and to correct what are portrayed as faulty cognitions with the aim of becoming responsible consumers. Our findings demonstrate how the gambling education discourse aligns with wider industry interests, serving to deflect from the harmful nature of the products and services they market while shifting responsibility for harm onto children, youth and their families.

Conclusions

Despite being delivered in the name of public health, the resources construct a discourse favourable to corporate interests. Educators, parents, policymakers, and others need to be empowered to address the conflicts of interest that exist in the delivery of gambling industry-funded resources. The promotion of such industry-favoured interventions should not be allowed to undermine efforts to implement regulations to prevent gambling harms.

Regulatory Resistance? Narratives and Uses of Evidence around "Black Market" Provision of Gambling during the British Gambling Act Review

Commercial gambling is increasingly viewed as being part of the unhealthy commodities industries, in which products contribute to preventable ill-health globally. Britain has one of the world's most liberal gambling markets, meaning that the regulatory changes there have implications for developments elsewhere. A review of the British Gambling Act 2005 is underway. This has generated a range of actions by the industry, including mobilising arguments around the threat of the "black market". We critically explore industry's framing of these issues as part of their strategy to resist regulatory change during the Gambling Act review. We used a predefined review protocol to explore industry narratives about the "black market" in media reports published between 8 December 2020 and 26 May 2021. Fifty-five articles were identified and reviewed, and themes were narratively synthesised to examine industry framing of the "black market". The black market was framed in terms of economic threat and loss, and a direct connection was made between its growth and increased regulation. The articles mainly presented gambling industry perspectives uncritically, citing industry-generated evidence (n = 40). Industry narratives around the "black market" speak to economically and emotionally salient concerns: fear, safety, consumer freedom and economic growth. This dominant framing in political, mainstream and industry media may influence political and public opinion to support the current status quo: "protecting" the existing regulated market rather than "protecting" people. Debates should be reframed to consider all policy options, especially those designed to protect public health.

Short-Term Effectiveness of the Youth Gambling Prevention Program "Who Really Wins?"-Results from the First National Implementation

As a response to significant adolescent gambling involvement, a Croatian team of researchers and practitioners developed a universal, comprehensive, evidence-based youth gambling prevention program called "Who Really Wins?". This study presents the results on its short-term effectiveness following the first national implementation in 18 Croatian cities, with a total of 629 high school students (66.5% male) who completed the program. A design with two measurement sessions (pre-test and post-test) was used to explore the short-term effects of the program on gambling-related knowledge and cognition, frequency of gambling, and various socio-emotional skills. The results showed significant effects when it comes to knowledge, cognitive distortions, and the frequency of sports betting and playing lottery games. Furthermore, the program had no harmful effects on any of the measured variables. The results are interpreted in terms of methodological challenges in measuring effects, possible improvements of the program, and implications for future evaluation research.

The Mediating Role of Psychological Distress in Excessive Gambling among Young People: A Four-Country Study

Background and aims: Loneliness and a low sense of mastery are associated with excessive gambling, but the underlying processes of these relationships remain unstudied. Because psychological distress can increase vulnerability to excessive gambling, we investigated its mediating role in these relationships among young people. To meet the need for cross-country research, we also observed how these relationships occur in four countries with different cultures. Design, setting, and participants: Demographically balanced cross-sectional survey data were collected from 15–25-year-olds in Finland (n = 1200; 50% male), the United States (n = 1212; 49.8% male), South Korea (n = 1192; 49.6% male), and Spain (n = 1212; 51.2% male). Measurements: Excessive gambling was measured with the South Oaks Gambling Screen, psychological distress was assessed with the 12-item General Health Questionnaire, loneliness was measured with the three-item Loneliness Scale, and low sense of mastery was assessed with the Pearlin Mastery Scale. Associations were examined first using zero-inflated negative binomial regression analyses with excessive gambling as the outcome. In addition, path analyses were performed to study how loneliness and low sense of mastery relate to excessive gambling, with psychological distress as the mediating variable. Findings: Loneliness and low sense of mastery were associated indirectly with excessive gambling via psychological distress in all country samples. Low sense of mastery was also directly associated with excessive gambling. There was a direct association between loneliness and excessive gambling only in samples from South Korea and Spain. Conclusions: Psychological distress is an important factor in understanding how loneliness and sense of mastery relate to gambling.

Changes of Gambling Patterns during COVID-19 in Sweden, and Potential for Preventive Policy Changes. A Second Look Nine Months into the Pandemic

Gambling has been suggested as one of the potential mental health consequences of the COVID-19 pandemic. In earlier self-report studies, increased gambling has been reported by a limited proportion of respondents characterized with a high degree of problem gambling. The present study, carried out with the same methodology and in the same geographical setting, around seven months later in the pandemic, aimed to repeat and to extend the understanding of potential gambling changes in the population during COVID-19. An anonymous sample of web panel members was assessed, altogether 2029 individuals (52% women, 10% moderate-risk or problem gamblers). Results indicated that 6% reported increased gambling, and 4% reported decreased gambling during the pandemic. Having increased gambling was associated with more severe gambling problems (OR 2.78, 95% confidence interval 2.27–3.40), increased alcohol consumption (OR 2.92, 1.71–4.98), and psychological distress (OR 3.38, 1.83–6.23). In the group reporting increased gambling during COVID-19, moderate-risk/problem gambling was very common (62%). Recent governmental policy interventions in the area were known to a minority (30%) of respondents, but awareness of the regulations was markedly more common in individuals with at least moderate-risk gambling (56%) and in self-excluders (78%). Reporting of any perceived influence from policy changes was low (3%), and divided between those reporting an increasing and decreasing effect, respectively. Increased gambling may be a consequence of COVID-19-related changes in everyday lives of individuals with problematic gambling patterns. Thus, a vulnerable group demonstrates higher rates of gambling migration and psychosocial problems, and may require particular attention in screening and treatment contexts, and further scientific evaluations.

The Development of Empirically Derived Australian Low-Risk Gambling Limits

This study derived a set of Australian low-risk gambling limits and explored the relative and absolute risk associated with exceeding these limits. Secondary analysis of population-representative Tasmanian and Australian Capital Territory (ACT) cross-sectional (11,597 respondents) and longitudinal studies (2027 respondents) was conducted. Balancing sensitivity and specificity, the limits were: gambling frequency of 20–30 times per year; gambling expenditure of AUD $380–$615 per year (USD $240–$388 per year); gambling expenditure comprising 0.83–1.68% of gross personal income; and two types of gambling activities per year. All limits, except number of activities, predicted subsequent harm, with limits related to gambling expenditure consistently the best-performing. Exceeding the limits generally conferred a higher degree of relative and absolute risk, with gamblers exceeding the limits being 3–20 times more likely to experience harm than those who do not, and having a 5–17% risk of experiencing harm. Only 7–12% of gamblers exceeding the limits actually experienced harm. Gambling consumption lower than the limits also conferred a considerable amount of harm. Using a relative risk method, this study derived similar limits from disparate Australian states and territories. These limits can serve as working guidelines for the consideration of researchers, clinicians, and policy makers, but need to be subject to further rigorous empirical investigation.

Regulatory Measures' Effect on Gambling Participation: Experiences From Norway

The purpose of gambling regulation can be to ensure revenue for the public, to prevent crime and gambling problems. One regulatory measure involves restriction of what games can be offered in a market. In this study, the effects of two regulatory market changes are investigated: First, a restriction of availability when slot machines were banned from the Norwegian market in 2007, and second the introduction of regulated online interactive games to the same market in 2014. Data collected from the general population in the period from 2005 through 2018, comprising 2,000 respondents every year, are used to investigate how participation in gambling changed over time. The respondents were asked if they took part in various games or lotteries. Logistic regression analyses were used to predict the proportion participating in five groups of games and if changes in participation coincided with major market changes. The first change was associated with a reduction in gambling on slot machines as well as a reduction in gambling participation overall. Following the slot machine ban, results show an increase in women participating in games offered in land-based bingo premises. A general increase in gambling on foreign websites was also seen, albeit much smaller than the reduction in slot machine gambling. The increases can partly be explained as substitution of one type of gambling with another. New regulated online interactive games were introduced in 2014. Despite the relatively large growth of such games internationally, Norway included, increased online gambling in general and an increased marketing of foreign gambling websites, the participation on foreign websites seemed stable. However, the overall participation in online interactive games increased. The introduction of the regulated alternative seems to have had a channelizing effect. Overall, the changes in gambling participation coinciding with two major regulatory changes can be explained by transformations of physical and social availability, and in terms of mechanisms outlined by the model of total consumption.