Internet Gambling Among Community Adults and University Students in Macao

The prevalence of gambling and problematic gambling: a systematic review and meta-analysis

BACKGROUND

Gambling behaviours have become of increased public health interest, but data on prevalence remain scarce. In this study, we aimed to estimate for adults and adolescents the prevalence of any gambling activity, the prevalence of engaging in specific gambling activities, the prevalence of any risk gambling and problematic gambling, and the prevalence of any risk and problematic gambling by gambling activity.

METHODS

We performed a systematic review and meta-analysis. We systematically searched for peer-reviewed literature (on MEDLINE, Embase, and PsycInfo) and grey literature to identify papers published between Jan 1, 2010, and March 4, 2024. We searched for any gambling, including engagement with individual gambling activities, and problematic gambling data among adults and adolescents. We included papers that reported the prevalence or proportion of a gambling outcome of interest. We excluded papers of non-original data or based on a biased sample. Data were extracted into a bespoke Microsoft Access database, with the Joanna Briggs Institute Critical Appraisal Tool used to identify the risk of bias for each sample. Representative population survey estimates were firstly meta-analysed into country-level prevalence estimates, using metaprop, of any gambling, any risk gambling, problematic gambling, and by gambling activity. Secondly, population-weighted regional-level and global estimates were generated for any gambling, any risk gambling, problematic gambling, and specific gambling activity. This review is registered on PROSPERO (CRD42021251835).

FINDINGS

We screened 3692 reports, with 380 representative unique samples, in 68 countries and territories. Overall, the included samples consisted of slightly more men or male individuals, with a mean age of 29·72 years, and most samples identified were from high-income countries. Of these samples, 366 were included in the meta-analysis. Globally, 46·2% (95% CI 41·7-50·8) of adults and 17·9% (14·8-21·2) of adolescents had gambled in the past 12 months. Rates of gambling were higher among men (49·1%; 45·5-52·6) than women (37·4%; 32·0-42·5). Among adults, 8·7% (6·6-11·3) were classified as engaging in any risk gambling, and 1·41% (1·06-1·84) were engaging in problematic gambling. Among adults, rates of problematic gambling were greatest among online casino or slots gambling (15·8%; 10·7-21·6). There were few data reported on any risk and problematic gambling among adolescent samples.

INTERPRETATION

Existing evidence suggests that gambling is prevalent globally, that a substantial proportion of the population engage in problematic gambling, and that rates of problematic gambling are greatest among those gambling on online formats. Given the growth of the online gambling industry and the association between gambling and a range of public health harms, governments need to give greater attention to the strict regulation and monitoring of gambling globally.

FUNDING

Australian National Health and Medical Research Council.

Correlates of Problematic Gambling in Emerging Adult University Students in Ireland

INTRODUCTION

Understanding the correlates of problematic gambling among emerging adult university students is crucial for developing effective approaches to minimise harm.

METHODS

This cross-sectional survey study reports on 397 18-25 year old emerging adults studying at Irish universities who completed an online survey about problematic gambling and a range of biopsychosocial variables. Chi-square and binary logistic regression analyses explored the relationships between problematic gambling and the biopsychosocial variables measured.

RESULTS

Chi-square analyses showed that being male, having an online gambling account, having a mobile gambling app, novelty seeking (impulsivity), harm avoidance (fear of uncertainty), and high alcohol volume consumption were significantly associated with problematic gambling. Regression analyses showed that individuals were more likely to report problematic gambling if they were male (OR = 9.57 times), had an online gambling account (OR = 17.05 times), had a mobile gambling app (OR = 20.37 times), scored high in impulsivity (OR = 7.79 times), and reported high alcohol volume consumption (OR = 4.66 times). Individuals were less likely to report problematic gambling if they scored high in fear of uncertainty (OR = 0.26 times).

CONCLUSIONS

A high rate of problematic gambling was observed among the current study sample. Participants were more likely to reported problematic gambling if they were male, had online gambling accounts, mobile gambling apps, scored high in impulsivity, scored low in fear of uncertainty, or consumed high volumes of alcohol in typical drinking sessions. These findings have implications for Irish legislation and policy-makers, Irish higher education institutions, and young adult Irish university students.

Online Gambling: A Systematic Review of Risk and Protective Factors in the Adult Population

In recent decades, internet gambling has seen strong growth and diffusion due to intrinsic characteristics that make it particularly attractive to players (accessibility, anonymity, variety of games). This paper aims to present the current state of knowledge of the risk and protective factors of online gambling. A literature search conducted in the PubMed, PsychInfo, and Scopus databases found 42 articles, which were included in the review. Methodological aspects and risk and protective factors were analysed cross-sectionally. The results concerning risk and protective factors were distinguished by the level of analysis: individual, relational, and contextual. Two types of comparisons were considered: online vs. offline gamblers and online nonproblematic vs. problematic gamblers. The results of the two comparisons were juxtaposed to analyse their consistency and the different associations with factors. In general, the review showed that risk factors and variables at the individual level are investigated to a greater extent, while protective factors at the relational and contextual level need more in-depth study in future research. More specifically, this review found that even if online and offline gamblers shared most risk and protective factors, there are variables that they would not have in common. These factors could be important to consider in preventive interventions aimed at online gamblers and online problematic gamblers.

A Comparative Profile of Online, Offline, and Mixed-Mode Problematic Gamblers' Gambling Involvement, Motives, and HEXACO Personality Traits

Few studies have compared gamblers who play in exclusively online (i.e., Internet-based), exclusively offline (i.e., land-based), and mixed-mode contexts. In studies that have compared these groups, mixed-mode gamblers have consistently exhibited the greatest susceptibility to problematic gambling. In order to expand the scope of previous research that has compared gamblers based on their preferred mode of play, and to improve understanding of mixed-mode gamblers' proneness to problematic gambling, a sample of gamblers who play in exclusively online, exclusively offline, and mixed-mode contexts were compared on indices of gambling involvement, motives, and personality traits. Results indicated that mixed-mode gamblers played a wider range of games, and reported higher problematic gambling severity scores, higher scores on enhancement and social gambling motive scales, and lower and higher honesty-humility and extraversion personality scores, respectively. Associations between gambling motives and personality traits are discussed in relation to the role that these characteristics might play in mixed-mode gamblers' increased risk of gambling-related harm.

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.

Emerging Gambling Problems and Suggested Interventions: A Systematic Review of Empirical Research

The goal of the present systematic review is to identify emerging gambling problems and the harm minimization strategies proposed to address them. Our interdisciplinary research team conducted this systematic literature review in 5 nations between which there is significant gambling research exchange. A keyword search of the Scopus and Web of Science databases followed by filtering using inclusion criteria identified 1292 empirical gambling studies from peer-reviewed journals. The data obtained from the articles were analyzed using the content analysis technique. We then used a unique approach to identify relationships between harm minimization strategies and gambling problems. The findings reveal that the most frequently reported gambling problems are related to young gamblers, online gambling, electronic gaming machines, and children and adolescents (underage gamblers). Harm minimization strategies to address these included creating educational and awareness programs, further restrictions on gambling advertising, developing an intervention mechanism for online gambling, and remote gambling-related help (i.e., online counseling, online treatment).

Is the proposed distinction of gaming disorder into a predominantly online vs. offline form meaningful? Empirical evidence from a large German speaking gamer sample

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Disordered gaming is distinguished by predominantly online, offline, and unspecific gaming.

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Online gamers showed the highest tendencies towards disordered gaming.

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Gaming via desktop computers was linked with the highest disordered gaming levels.

In the eleventh revision of the International Classification of Diseases (ICD-11), Gaming Disorder (GD) is distinguished between disordered gaming occurring predominantly online, offline, and unspecified. Currently, no study has investigated whether such a distinction is meaningful in diagnosing disordered gaming. Therefore, a large group of gamers with varied tendencies towards disordered gaming was recruited to examine this issue. A large sample (N = 2,768) was recruited and data were collected on disordered gaming, along with information on their preferred gaming mode and device used to play. The present study shows that the distinction between online and offline gaming mode proposed by the WHO is meaningful because online gamers presented with the highest disordered gaming scores followed by mixed gamers (those stating to equally prefer online and offline gaming), and offline gamers. Finally, it was also observed that the type of device for gaming used associated with disordered gaming levels. Specifically, those reporting mostly to use their desktop computer for gaming showed the highest disordered gaming scores. The present study lends empirical support for the consideration of both gaming mode and gaming device in the study of disordered gaming.

Exploring the Predictive Value of Gambling Motives, Cognitive Distortions, and Materialism on Problem Gambling Severity in Adolescents and Young Adults

Gambling motives and cognitive distortions are thought to be associated because both coping and financial motives to gamble appear to be predictors of gambling related cognitive distortions. Therefore, there is an argument to be made that gambling motives, cognitive distortions, and materialism share common attributes and might be related to problem gambling severity. The present paper aims to examine the relationship between these three variables, both in a clinical and community setting, to see if they can predict gambling severity. A sample of 250 participants from the general population and 31 participants from the clinical population was recruited. The results showed that the clinical sample scored higher on gambling severity, cognitive distortions, materialism, and gambling motives. It also showed that low scores in enhancement motives and higher scores in social motives and gambling related cognitions predicted gambling severity in older gamblers, whereas for younger patients, gambling severity was best predicted by higher scores in materialism and coping motives, and lower scores for enhancement and social motives. In the community sample, gambling severity correlated with gambling related cognitive distortions and with gambling motives (except for social and coping motives within the women subsample). These results testify to the importance of materialism, cognitive distortions, and gambling motives as risk factors for problem gambling both in community and clinical samples.

The prospective effect of purpose in life on gambling disorder and psychological flourishing among university students

BACKGROUND AND AIMS

Gambling disorder (GD) is a mental disorder with a relatively higher prevalence in university students compared to adolescents and adults. Its reciprocity with mental being indicators, such as psychological flourishing, would be expected, but prior to this study had not yet been empirically examined. In addition, the predictive value of purpose in life (PIL) on university students' GD and psychological flourishing also remained unknown. This 1-year longitudinal study was the first to test the potential bidirectional relationships among PIL, self-reported GD symptoms, and psychological flourishing.

METHODS

In this study, a total of 283 university students (39.6% females; age = 18-27 years, M = 20.47, SD = 1.15) completed an anonymous questionnaire at both baseline and a year later in a follow-up study.

RESULTS

The results of our cross-lagged analysis did not show the hypothesized reciprocity between GD symptoms and psychological flourishing (P > 0.05). However, PIL significantly predicted fewer GD symptoms (β = -0.23, P < 0.001) and higher levels of psychological flourishing (β = 0.30, P < 0.001) in the follow-up study. Moreover, psychological flourishing predicted PIL a year later.

CONCLUSION

The findings demonstrate the potential efficacy of purpose/meaning oriented interventions in gambling prevention and in well-being promotion programs.

The prospective effect of purpose in life on gambling disorder and psychological flourishing among university students

BACKGROUND AND AIMS

Gambling disorder (GD) is a mental disorder with a relatively higher prevalence in university students compared to adolescents and adults. Its reciprocity with mental being indicators, such as psychological flourishing, would be expected, but prior to this study had not yet been empirically examined. In addition, the predictive value of purpose in life (PIL) on university students' GD and psychological flourishing also remained unknown. This 1-year longitudinal study was the first to test the potential bidirectional relationships among PIL, self-reported GD symptoms, and psychological flourishing.

METHODS

In this study, a total of 283 university students (39.6% females; age = 18-27 years, M = 20.47, SD = 1.15) completed an anonymous questionnaire at both baseline and a year later in a follow-up study.

RESULTS

The results of our cross-lagged analysis did not show the hypothesized reciprocity between GD symptoms and psychological flourishing (P > 0.05). However, PIL significantly predicted fewer GD symptoms (β = -0.23, P < 0.001) and higher levels of psychological flourishing (β = 0.30, P < 0.001) in the follow-up study. Moreover, psychological flourishing predicted PIL a year later.

CONCLUSION

The findings demonstrate the potential efficacy of purpose/meaning oriented interventions in gambling prevention and in well-being promotion programs.

Public Awareness and Practice of Responsible Gambling in Macao

Responsible gambling (RG) is a relatively new concept to the Macao gambling industry. Although recent studies reported a heightened public awareness of RG, the prevalence of disordered gambling is still high. This discrepancy may suggest an existing gap between RG awareness and gambling practices, pinpointing aspects that need to be improved by different RG stakeholders. The gap may be attributable to people's limited knowledge toward practices favoring RG. To explore means for enhancing the RG campaign, we studied Macao residents' interpretation and adoption of RG practices. In Study 1, a random community sample was collected to assess the extent to which common RG practices were adopted. Results suggested that there was a fair proportion of gamblers not adhering to them and gambling disorder tendency was related to the adoption of RG practices. It implied a successful promotion of RG practices may reduce gambling problems. In Study 2, focus group discussions were conducted to explore how RG was conceptualized. Twenty-five participants (including 11 casino employees) took part in four focus group interviews. All participants were aware of RG but their knowledge of RG practices was limited. Very few of them were able to identify major practices such as putting constraints on gambling amount and time and the application for self-exclusion. We argue that future RG promotion needs to be more specific and behavior-oriented and it should also address various procedural concerns on how RG practices can be implemented.

Gambling behavior among Macau college and university students

This survey investigated gambling behavior among Chinese students studying in Macau colleges and universities. It also aimed to examine the relationship between problem gambling, affect states and sensation seeking propensity. A convenience sample of 999 students (370 men, 629 women) filled a self-administered questionnaire consisted of the Problem Gambling Severity Index (PGSI) (Ferris and Wynne in The Canadian problem gambling index: User manual. Canadian Centre on Substance Abuse, Toronto 2001a), the 8-item Brief Sensation Seeking Scale (BSSS-8) (Hoyle et al. Pers Individ Diff 32(3): 401–414, 2002), Bradburn’s Affect Balance Scale (BABS) (Bradburn in The structure of psychological well-being. Aldine, Chicago 1969) and questions on gambling activities. The response rate is 65%. Results indicate 32.3% (n = 323) of the survey participants wagered on mahjong (61.8%), soccer matches (40.2%), Mark Six lottery (37.2%), card games (28.1%), land-based casino gambling (13.1%), slot machines (7.5%) and online casino games (2.0%). The average monthly stake was MOP $411. Seeking entertainment (18.7%), killing time (12.5%) and peer influence (11.1%) were the three main reasons for gambling. Using the PGSI, 3.6 and 5.3% of the students could be identified as moderate-risk and problem gamblers respectively. Men were significantly more vulnerable to gambling problems (X2(1) = 35.00, p < 0.01) than women. Most of the problematic gamblers (76%) made their first bet before 14 years. The PGSI scores are significantly correlated with the BSSS-8 scores (r = 0.23, p < 0.01) but not with the overall ABS scores (r = −0.06, p > 0.05). The study findings inform campus prevention programs and future research.

"We want the world and we want it now": Materialism, time perspectives and problem spending tendency of Chinese

Chinese consumers' spending has been expanding rapidly in the past decade, and along with it household and credit card debt. The present research collected evidence to triangulate the contention that materialism is positively related with Chinese's problem spending tendency (PST), and that present-time-perspective (PTP) and future-time perspectives (FTP) interact systematically with materialism to affect PST. A survey of the general population in Macao, China (Study 1; N = 239) confirmed that materialism was positively correlated with PST. An interaction between materialism and PTP intensified the relationship, whereas an interaction with FTP weakened the relationship. Another survey with a sample of university students (Study 2; N = 223) again found positive relationships among PST, materialism, and PTP, as measured by temporal discount rate. But further exploration showed that PST was only related with temporal discounting among high materialists, but not among low materialists. Study 3 experimentally examined the causal effects of materialism and FTP on PST. When being primed of an orientation towards materialism (n = 33), the participants' planned consumption doubled that of the control group (n = 31). A FTP prime interacted with materialism prime and put a "damper" on participants' planned spending (n = 29), compared to their counterparts who were not primed of such a time perspective.

Gambling in China: socio-historical evolution and current challenges

AIMS

This paper provides an overview of gambling issues in China, including historical development, governmental responses and social consequences.

METHODS

Based on materials written in Chinese or English available at academic databases and other online resources, historical, cultural and policy analyses were conducted. The focus is on mainland China, but reference is made to Hong Kong and Macao to illustrate differences.

RESULTS

Throughout Chinese history, gambling was strictly prohibited by law. In contrast, small-stakes betting for entertainment instead of monetary gain, defined as 'gaming' in this paper, has been culturally acceptable and tolerated by governments. After banning gambling for three decades, the Chinese government attempts to meet public demand for 'gaming' and to confine gambling to 'gaming' by issuing national lotteries. In response to increased economic wealth, gambling opportunities were allowed to develop, but were restricted to Macao. Social problems such as illegal and youth gambling are, however, emerging. The 'gaming' perception may predispose Chinese individuals to wagering activities and increase the risk of gambling disorder, which has been widely seen as misconduct rather than a mental disorder. Currently, the country has a dearth of gambling research and limited prevention and rehabilitation services, almost none at national level.

CONCLUSIONS

A distinction between small-stakes 'gaming' and large-stakes 'gambling', which has cultural roots, plays an important role in relevant governmental policies and social responses in mainland China. Gambling disorder prevention and treatment is not yet on the national agenda. The country's knowledge and services gaps on gambling problems need to be filled out.