Self-Exclusion among Online Poker Gamblers: Effects on Expenditure in Time and Money as Compared to Matched Controls

Who is Getting the Message? Sociodemographic Factors and Gambling Behavior Associated with Awareness of the Swedish National Self-Exclusion Registry Spelpaus.se

Awareness and utilization of health interventions can be influenced by sociodemographic factors. These factors play a role in information processing, particularly regarding health messaging. The aim of this study is to analyze how different sociodemographic factors and gambling behaviors are associated with awareness of a (Swedish) gambling self-exclusion register. The study used data from the Swedish longitudinal gambling study (Swelogs) and analyzed n = 6720 participants from a stratified random sample of the Swedish population aged 18-84 years. Logistic regressions were conducted to analyze associations between sociodemographic characteristics, gambling behavior and awareness. Males with middle (OR = 1.70, 95% CI = 1.32-2.19) and high income (OR = 1.58, 95% CI = 1.19-2.09) and females with high (OR = 1.35, 95% CI = 1.03-1.76) and middle-level education (OR = 1.35, CI = 1.04-1.76), had higher awareness of Spelpaus.se. Online gamblers with problematic gambling behavior were three times (OR = 3.69, 95% CI = 2.15-6.37) more likely to be aware than non-gamblers. Online gamblers born in Sweden were twice (OR = 1.95, 95% CI = 1.19-3.19) as likely to be aware compared to those born outside of Europe. Males with high level of awareness had higher PGSI scores compared to women. Education could increase awareness of potential health risks and opportunities for intervention, particularly among women. Future interventions should be tailored to cater to the specific needs of individuals with lower levels of awareness, to facilitate enhancing their awareness and ultimately promoting a more equitable utilization of self-exclusion measures.

Assessing the Risk of Online Gambling Products: A Replication and Validation of Behavioural Markers of Harm Using the Problem Gambling Severity Index

In this paper, we investigate the validity of objective operator data as proxy indicators for riskier gambling as based upon an independent self-report measure. Such work is important to strengthen the validity of gambling research involving objective behavioral indicators of harm used to detect higher risk gambling or product choices. To address these aims, a total of 21,464 individual customers from a single international operator completed the Problem Gambling Severity Index (PGSI). These data were then mapped to measures of player gambling activity and a range of objective behavioural markers of harm. The results confirmed that people scoring 8 + on the PGSI were found to have higher levels of gambling involvement (participation, days active and expenditure) on a range of gambling products, with differences generally larger for casino than wagering activities. Importantly, this group was also more likely to have a higher incidence of behavioural markers of harm (e.g., declined deposits). The data allowed for the replication of a previous study using such markers to detect differences in product risk, but further validated their use in a variety of analytical contexts by showing a concordance between self-reported and objective risk measures.

Gambling Harm-Minimisation Tools and Their Impact on Gambling Behaviour: A Review of the Empirical Evidence

The harms accompanying disordered gambling are well documented. Additionally, there is growing attention to the harms that arise from people who gamble heavily but do not meet the criteria for a gambling disorder. Accordingly, there has been an increasing interest in the effectiveness of consumer protection tools for consumers of gambling products. Subsequently, there is a need to properly evaluate the evidence for their effectiveness. This review aimed to conduct a narrative synthesis of empirical studies to identify gaps, weaknesses, and strengths in the existing evidence for the effectiveness of harm minimisation tools available to people who gamble. This review includes studies published between January 2015 to July 2022 and comprises 55 peer-reviewed studies for final synthesis. Findings reveal that while more research is needed to examine the effectiveness of active and passive consumer protection tools, uptake of tools is low in part because users view them as tools for individuals already experiencing gambling harm as opposed to protective tools for all users. Research is needed to determine effective ways of communicating the value of consumer protection tools for gambling.

Behavioural Tracking and Profiling Studies Involving Objective Data Derived from Online Operators: A Review of the Evidence

Studies involving the analysis of objective data from online operators attempt to address common concerns about biases in self-report research. This paper surveys the progress in this area of research over the last 15 years. The findings highlight many areas of achievement, including: the development of a set of behavioural markers that reliably differentiate variations in gambler risk. Online gamblers can be grouped into clusters based on the intensity and frequency of gambling; behavioural variability; or, signs of over-commitment (e.g., deposit frequency or expenditure patterns). Behavioural indicators have also been successfully used to predict proxies of harm such as self-exclusion or account closures. However, relatively few studies have combined objective data with self-report data to achieve independent validation of the risk-status of gamblers. Evidence also supports the potential value of short-term responsible gambling interventions involving the use of voluntary and mandatory limits, messages and behavioural feedback. Less work has, on the other hand, addressed the comparative risk of different online gambling products. The findings suggest the need for further validation of findings against independent measures of gambling risk; consistent definitions of indicators; a greater focus on the differentiation of product risk; and, on the long-term impact of RG interventions.

The Efficacy of Voluntary Self-Exclusions in Reducing Gambling Among a Real-World Sample of British Online Casino Players

Online gambling is a socially acceptable means of entertainment, but it can also have a negative impact on many areas of life and lead to problem gambling for a minority of individuals. In recent years, gambling operators have increasingly implemented responsible gambling tools to help at-risk gamblers control and limit their gambling. One such tool is voluntary self-exclusion (VSE), where gamblers can exclude themselves from the gambling platform for a self-selected period of time. Despite the widespread use of VSE, there are few published studies on the efficacy of VSE among online gamblers and none on whether (and what type of) gamblers return to gambling after self-exclusion and how VSE affects their wagering if they return. Using a secondary dataset, the present study empirically analyzed a real-world sample of 3,203 British online casino players who opted for a VSE between January 2021 and August 2022. Analysis showed that most players who took a short-term VSE (up to 38 days) started gambling again on the platform after their self-exclusion ended, while players who opted for long-term self-exclusion (more than 90 days) did not start gambling again on the platform. A return to the gambling platform after VSE was positively associated with (i) a shorter duration of the self-exclusion, (ii) being female, (iii) gambling on more days, (iv) placing more bets, (v) playing fewer type of games, and (vi) having a lower average number of deposits per day. Players who returned from VSE did not change their wagering compared to a matched control group. These results suggest that short-term VSE may not be as effective as long-term VSE in reducing gambling. Overall, the present findings suggest that gamblers returning from VSE should be closely monitored, especially if the reason for self-exclusion is related to problem gambling.

Predicting self-exclusion among online gamblers: An empirical real-world study

Protecting gamblers from problematic gambling behavior is a major concern for clinicians, researchers, and gambling regulators. Most gambling operators offer a range of so-called responsible gambling tools to help players better understand and control their gambling behavior. One such tool is voluntary self-exclusion, which allows players to block themselves from gambling for a self-selected period. Using player tracking data from three online gambling platforms operating across six countries, this study empirically investigated the factors that led players to self-exclude. Specifically, the study tested (i) which behavioral features led to future self-exclusion, and (ii) whether monetary gambling intensity features (i.e., amount of stakes, losses, and deposits) additionally improved the prediction. A total of 25,720 online gamblers (13% female; mean age = 39.9 years) were analyzed, of whom 414 (1.61%) had a future self-exclusion. Results showed that higher odds of future self-exclusion across countries was associated with a (i) higher number of previous voluntary limit changes and self-exclusions, (ii) higher number of different payment methods for deposits, (iii) higher average number of deposits per session, and (iv) higher number of different types of games played. In five out of six countries, none of the monetary gambling intensity features appeared to affect the odds of future self-exclusion given the inclusion of the aforementioned behavioral variables. Finally, the study examined whether the identified behavioral variables could be used by machine learning algorithms to predict future self-exclusions and generalize to gambling populations of other countries and operators. Overall, machine learning algorithms were able to generalize to other countries in predicting future self-exclusions.

A Systematic Review of Internet Delivered Interventions for Gambling: Prevention, Harm Reduction and Early Intervention

Internet delivered interventions are accessible and easy to access and can be used to deliver brief interventions. These interventions can be tailored according to individual need for the prevention and minimisation of gambling harm or early intervention for those that are displaying some signs of problems. The objective of this review was to summarise the existing literature on the effectiveness of prevention, harm reduction and early intervention programs when delivered online. A systematic review was conducted for peer-reviewed studies that evaluated internet delivered interventions for the prevention, harm reduction or early intervention for gambling problems. Four electronic databases were consulted in the past 20 years (2000-2020) resulting in a total of 15 included studies. Across identified studies just one study provided prevention with 7 harm reduction and 7 early interventions. The quality of the literature was variable with just 8 randomised controlled trials with the remainder matched controls or longitudinal cohort studies. The target group was predominantly gamblers accessing betting and casino websites (n = 8). Studies administered four types of interventions which included personalised and normative feedback, limit setting, self-directed cognitive and behavioural therapy and self-exclusion. These were delivered via customer gaming accounts, email, and self-learning packages. The available literature shows promise in the effectiveness of internet delivered interventions. However, the limited number of studies included in this review highlight significant lost opportunities to leverage technology in the prevention and reduction of gambling harm.

Responsible product design to mitigate excessive gambling: A scoping review and z-curve analysis of replicability

OBJECTIVES

Systematic mapping of evaluations of tools and interventions that are intended to mitigate risks for gambling harm.

DESIGN

Scoping Review and z-curve analysis (which estimates the average replicability of a body of literature).

SEARCH STRATEGY

We searched 7 databases. We also examined reference lists of included studies, as well as papers that cited included studies. Included studies described a quantitative empirical assessment of a game-based (i.e., intrinsic to a specific gambling product) structural feature, user-directed tool, or regulatory initiative to promote responsible gambling. At least two research assistants independently performed screening and extracted study characteristics (e.g., study design and sample size). One author extracted statistics for the z-curve analysis.

RESULTS

86 studies met inclusion criteria. No tools or interventions had unambiguous evidence of efficacy, but some show promise, such as within-session breaks in play. Pre-registration of research hypotheses, methods, and analytic plans was absent until 2019, reflecting a recent embracement of open science practices. Published studies also inconsistently reported effect sizes and power analyses. The results of z-curve provide some evidence of publication bias, and suggest that the replicability of the responsible product design literature is uncertain but could be low.

CONCLUSION

Greater transparency and precision are paramount to improving the evidence base for responsible product design to mitigate gambling-related harm.

Emerging Health and Education Issues Related to Internet Technologies and Addictive Problems

This timely editorial paper outlines some of the main emerging research on technological topics on health and education approaches to Internet use-related problems before and during the beginning of coronavirus disease 2019 (COVID-19). Background: The aim is to provide a brief overview to facilitate a rapid comprehensive and practical approach to these new trends to promote research, interventions, education, and prevention. Methods: The rapid review includes an analysis of both health and education technologies studies on Internet use-related addiction problems included in the Special Issue “Internet and Smartphone Use-Related Addiction Health Problems: Treatment, Education and Research” to extract recent findings and a few reflections about the development of the field before and during the first wave of the COVID-19. Results: Main findings highlighted studies which tended to be empirical, with a relational type associating specific addictive problems with individual and a few contextual factors in adult populations. Psychometric studies about scales are prevalent, but predictive and mixed methods ones are starting to emerge, together with reviews about conceptualisation, measure, treatment, and prevention. Conclusions: From the arrival of Internet, our societies have converged in a global culture which has impacted health and educational domains. Internet use-related addiction problems have globally emerged and common knowledge, advances, and strategies exist to overcome challenges which are starting to be tested, and prevention interest has arisen in a pandemic situation with global health problems holistically tackled.

Who chooses to enroll in a new national gambling self-exclusion system? A general population survey in Sweden

BACKGROUND

Self-exclusion from gambling is a common method for prevention and harm reduction in hazardous gambling. However, few national self-exclusion programs, involving a large number of gambling operators and activities in a country, have been assessed scientifically. This study aimed to examine characteristics of individuals who chose to enroll in a recently introduced (January, 2019) national self-exclusion system in Sweden.

METHODS

Adults and adolescents (from age 16 and above) were addressed with an online survey sent to members of the web panel of a market survey company (1940 respondents). Psychological distress, previous history of addictive disorders, sociodemographic data, and recent history of gambling patterns and over-indebtedness were recorded. Logistic regression tested associations with self-exclusion, with unadjusted analyses conducted for the sub-group of moderate-risk or problem gamblers.

RESULTS

Four percent reported having self-excluded using the new national self-exclusion system. In logistic regression, self-exclusion was significantly associated with younger age (OR 0.65 [0.54-0.79] for increasing age groups) and with the highest level of problem gambling (OR 2.84 [1.10-7.37]). In moderate-risk or problem gamblers, in unadjusted analyses, younger age (p < 0.05) and psychological distress (p = 0.02) were associated with self-exclusion. In none- or low-risk gamblers, 3% had self-excluded, which was significantly associated with younger age (p < 0.001) and self-reported over-indebtedness (p < 0.001).

CONCLUSIONS

In a national, multi-venue online and land-based self-exclusion system, aiming to reduce the harm of problem gambling, self-exclusion is expectedly more common in problem gamblers, but also occurs among people without recent gambling problems. Further efforts may be needed in order to increase gambling self-exclusion in problem gamblers, and research in reasons for self-excluding, even in non-problem gamblers, is needed.

Gambling Despite Nationwide Self-Exclusion-A Survey in Online Gamblers in Sweden

Background: Voluntary self-exclusion is a well-known harm reduction intervention in problem gambling, although primarily in operator-specific or venue-based systems. A nationwide overall self-exclusion system ("Spelpaus") for all licensed gambling was introduced in Sweden in 2019. However, gambling in overseas companies despite national exclusion may be a concern in online gamblers. The present web survey study aimed to study self-reported self-exclusion and gambling despite exclusion in a nationwide multi-operator land-based/online exclusion system. Methods: Web survey in web panel members of a market survey company, carried out in May, 2020 (co-occurring with the COVID-19 pandemic). Past-year online gamblers (n = 997) answered questions about gambling patterns, gambling problems, psychological distress, self-exclusion since "Spelpaus" introduction, and gambling despite self-exclusion. Results: Seven percent reported ever self-excluded at Spelpaus, and this was associated with younger age, female gender, gambling problems, and chance-based games and online poker. In logistic regression, Spelpaus remained strongly associated with past-year online casino gambling, gambling problems, and absence of past-year sports betting. Among those having self-excluded, 38 percent reported gambling despite self-exclusion, most commonly online casino. Conclusions: In online gamblers in a setting with a nationwide self-exclusion system, using this was associated with past-year online casino gambling and gambling problems. Gambling despite self-exclusion appears to be common, and more commonly involves online casino. Stakeholders should aim to increase rates of self-exclusion in high-risk online gamblers, both during and beyond the COVID-19 situation in which the study was carried out. Also, policy makers should use gambling regulation in order to decrease the risk of breaching self-exclusion online, such as through the prohibition of non-registered gambling operators. Further research should focus on in-depth analysis of the reasons for gamblers to enroll or not enroll in multi-operator self-exclusion.