Unhealthy Gambling Amongst New Zealand Secondary School Students: An Exploration of Risk and Protective Factors

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.

Gambling and virtual reality: unraveling the illusion of near-misses effect

Introduction

Studying gambling behavior is a crucial element in reducing the impact of problem gambling. Nevertheless, most current research is carried out in controlled laboratory settings rather than real-life situations, which raises concerns about how applicable the findings are in the broader context. Virtual reality (VR) has proven to be a valuable tool and has been utilized in various experimental scenarios. A limited number of studies have employed VR to investigate gambling behaviors, and few have explored them in an older adolescent context.

Methods

This study examined the behavioral and physiological effects of gambling behavior, including problem gambling, gaming addiction, and risk-taking decision-making in a sample of 36 high-school students aged between 18 to 20 years using an ad-hoc constructed VR scenario designed to simulate a slot-machine platform.

Results

The behavioral results highlighted that participants reporting more problem gambling were sensitive to near-misses: i.e., they bet more after near-misses than after losses. This result may reflect the false belief that gamblers, after near-misses, are closer to winning. Physiological data showed that participants exhibited heart rate deceleration during the anticipation of the outcome, which has been suggested to represent a marker of feedback anticipation processing and hyposensitivity to losses.

Discussion

Overall, this study provides evidence for a new VR tool to assess gambling behaviors and new insights into gambling-related behavioral and physiological factors. Implications for the treatment of problem gambling are discussed.

Annual Research Review: Emergence of problem gambling from childhood to emerging adulthood: a systematic review

BACKGROUND

The risk for problematic gambling and associated high-risk behaviors is elevated during adolescence and emerging adulthood. Activities with gambling-like features and novel forms of gambling may place youth at an increased risk for problem gambling.

AIM AND METHOD

The aim of this review is to provide an overview of the association between both activities with gambling-like features and novel gambling activities and problem gambling among youth while examining the role of psychopathology and cognitive processes. Six databases (PsychINFO, MEDLINE, PubMed, Social Work Abstracts, Technology Collection, and Scopus) were searched in November 2021 for peer-reviewed articles investigating the association between the aforementioned variables among youth up to the age of 25 years. Risk of bias was assessed using the Observational Study Quality Evaluation.

FINDINGS

Forty-five articles were included in the review. Positive associations were observed between engagement in activities with gambling-like features (e.g., video games, social casino games, loot boxes) and problem gambling. Increased involvement with novel forms of gambling (e.g., online sports betting, fantasy sports, and esports betting) were also associated with a greater risk for problematic gambling. Males reported higher rates of engagement in these activities and a greater risk of problem gambling than females. Impulsivity, risk taking, cognitive distortions, and specific emotional vulnerabilities were associated with an increased risk of problem gambling.

CONCLUSIONS

Despite the need for additional longitudinal research controlling for relevant confounders, these findings underline how engagement in activities with gambling-like features are relevant in the developmental trajectory toward problem gambling.

Age of gambling onset and resultant gambling behavior during young adulthood in the United States

BACKGROUND AND OBJECTIVES

Previous research has examined how the age at which an individual first gambles (age of gambling onset) correlates with problematic behavior later in life, such as problematic alcohol or substance use; however, much less is known about how age of gambling onset, particularly as a child or as a young adult, might influence future gambling. We assessed how self-reported age of gambling onset may have shaped more recent gambling and propensity to take risks.

METHODS

We analyzed questionnaire data and neurocognitive assessment data collected from young adults in the United States (n = 579) and conducted ordinal logistic regression to model our study variables.

RESULTS

Upon examining three distinct age categories (under 18, 18-20, 21, and over), we found that earlier age of gambling onset was significantly associated with betting a higher overall proportion during a neurocognitive task. CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE: Gambling more points on a laboratory-based task was correlated to earlier age of gambling onset. There were no statistically significant associations between age of gambling onset and severity of recent pathological gambling, nor gambling expenditure in the past year, nor gambling frequency in the past week. Future longitudinal study should discern the causality of these findings in both directions and ascertain whether these findings can be extended to older and clinical populations. Future work should explore other variables, such as ethnicity and socioeconomic background, that may be relevant to understanding variations in age of gambling onset and its repercussions.

The distribution of harmful product marketing in public outdoor spaces and the effectiveness of marketing bans

Children's exposure to the marketing of harmful products in public outdoor spaces may influence their consumption of those products and affect health into adulthood. This study aimed to: i) examine the spatial distribution of children's exposure to three types of marketing-related 'harms' (alcohol, unhealthy food, and gambling) in outdoor spaces in the Wellington region, New Zealand/Aotearoa; ii) compare differences in the distribution of harms by socioeconomic deprivation; and iii) estimate the effectiveness of different policies that ban such marketing. Data were from 122 children aged 11-13y who wore wearable cameras and GPS devices for four consecutive days from July 2014 to June 2015. Images were analysed to identify harmful product marketing exposures in public outdoor spaces. Eight policy scenarios were examined to identify the effectiveness of marketing bans, for all children and by socioeconomic deprivation. Children's ratio of harmful marketing was higher for children from high deprivation households and was also found to cluster, with hots spots observed around city centers. The effectiveness of marketing bans depended on the target setting and ban area, with banning 400 m around bus stops leading to the largest reduction. Effectiveness varied also by type of harm and socioeconomic deprivation. For example, banning alcohol marketing in residential areas was estimated to have a larger effect on exposure reduction for children from high deprivation households. Our findings suggest that alcohol, unhealthy food and gambling marketing often cluster outdoors and that targeted bans of such marketing would likely improve child health and, for some banning scenarios, promote equity.

Racial Associations Between Gambling and Suicidal Behaviors Among Black and White Adolescents and Young Adults

Purpose of Review

Suicide is the second leading cause of death among Black youth ages 10-19 years. Between 1991 and 2017, rates of suicide among Black youth have been increasing faster than rates among any other race/ethnic group. There are many factors that may explain this increase, with gambling being suggested as one such potential risk factor. This review examines the association between gambling and suicide behaviors, and how these associations may vary between Black and White youth and young adults. The current review examines these associations using data from the Missouri Family Study (MOFAM).

Recent Findings

Recent findings have revealed distinct patterns of substance use initiation and gambling behaviors between Black youth and White youth. While strong links between gambling and suicide behaviors have also been reported, whether the associations were consistent across race/ethnicity groups was not investigated, nor in these cross-sectional analyses was it possible to determine whether the gambling behaviors preceded or followed suicidality. Thus, there is a need to investigate whether there are differences in the associations of gambling and suicide behaviors at the race/ethnicity level in tandem with data that examine the sequence of the behaviors. The current report focuses on racial/ethnic differences using data that allow for sequencing the occurrence of the behaviors via the age of first gambling experience, and of first suicidal symptom, to better distinguish the nature of the association.

Summary

The current findings revealed that gambling initiation predicted suicide ideation among Black youth, while no significant association was found among White youth. This is of major public health concern, given the rising rates of suicide among Black youth, and the increased availability of gambling. The report did not find a link between gambling and suicide attempts. Culturally tailored interventions should be considered among schools, families, and clinicians/providers, to highlight the risk of adolescent gambling, particularly among Black youth.

Contentious Issues and Future Directions in Adolescent Gambling Research

Background. There is currently considerable public policy and regulatory interest in the nature and prevalence of underage gambling. Research in this area has purported to show that adolescents are at elevated risk of problem gambling and that early exposure to gambling or gambling-like activities could be a potential precursor to future harm. Method. In this commentary, we provide a critical appraisal of these arguments with reference to major studies in the field of gambling studies. It is argued that adolescent gambling research is a contentious area. Some questions remain concerning the validity of adolescent problem gambling measures, the strength of the association between adolescent and adult gambling and the impact of simulated gambling activities. Results. The paper summarises the conceptual and methodological issues that should be considered and addressed in future studies to strengthen the validity of research in this area. Conclusion. The paper encourages the greater use of harm-based measures, longitudinal and individual-level transition analyses and questions that capture the influence of activities rather than just their temporal sequencing.

Pre-Teen Gang Involvement Is Associated With Teenage Gambling Behavior: Exploratory Findings From a Longitudinal Cohort Study of Pacific Youth in New Zealand

Pacific youth in New Zealand have a disproportionately high risk for gambling and gang involvement compared with New Zealand European youth. Limited evidence indicates that youth gang involvement is associated with problem gambling; no research shows if it is associated with gambling. We conducted exploratory secondary analyses of data from 1063 Pacific youth and their mothers using data from 2 time points (age 9 and 14 years) from a longitudinal cohort study. Gang involvement at age 9 years was significantly associated with gambling at age 14 years, with adjusted odds of 2.25 (95% CI = 1.16-4.37). Of confounders, having a mother with a partner and Cook Islands ethnicity appeared protective against gambling at age 14 years. Despite some study limitations, as youth gambling can lead to subsequent adult problem gambling, our findings highlight the importance of understanding why Pacific youth join gangs, to inform public health policies to reduce the potential for future development of harmful behaviors.

Student participation in gambling: the role of social cognition, past behaviour, and habit

The study examined the relationship between Theory of Planned Behaviour constructs, past behaviour, habit, and future behaviour relating to students' participation in gambling. Using a cross-sectional design, theory constructs, past behaviour, and habit were examined at T1 (N = 250), and gambling behaviour was assessed four weeks later at T2 (N = 180). Results showed attitude and perceived behavioural control (PBC) predicted intention, and intention and PBC predicted behaviour. The inclusion of past behaviour and habit attenuated the effects of attitude and PBC on intention and rendered the impact of intention on behaviour non-significant. The relationship between past behaviour and future behaviour was mediated by habit and PBC. Interventions should focus on attitude and PBC to attend to gambling intentions in addition to automatic processes to attend to student gambling behaviour.

Machine learning-based analysis of adolescent gambling factors

BACKGROUND AND AIMS

Problem gambling among adolescents has recently attracted attention because of easy access to gambling in online environments and its serious effects on adolescent lives. We proposed a machine learning-based analysis method for predicting the degree of problem gambling.

METHODS

Of the 17,520 respondents in the 2018 National Survey on Youth Gambling Problems dataset (collected by the Korea Center on Gambling Problems), 5,045 students who had gambled in the past 3 months were included in this study. The Gambling Problem Severity Scale was used to provide the binary label information. After the random forest-based feature selection method, we trained four models: random forest (RF), support vector machine (SVM), extra trees (ETs), and ridge regression.

RESULTS

The online gambling behavior in the past 3 months, experience of winning money or goods, and gambling of personal relationship were three factors exhibiting the high feature importance. All four models demonstrated an area under the curve (AUC) of >0.7; ET showed the highest AUC (0.755), RF demonstrated the highest accuracy (71.8%), and SVM showed the highest F1 score (0.507) on a testing set.

DISCUSSION

The results indicate that machine learning models can convey meaningful information to support predictions regarding the degree of problem gambling.

CONCLUSION

Machine learning models trained using important features showed moderate accuracy in a large-scale Korean adolescent dataset. These findings suggest that the method will help screen adolescents at risk of problem gambling. We believe that expandable machine learning-based approaches will become more powerful as more datasets are collected.

Psychosocial risk factors in disordered gambling: A descriptive systematic overview of vulnerable populations

BACKGROUND

Gambling is a behaviour engaged in by millions of people worldwide; for some, gambling can become a severely maladaptive behaviour, and previous research has identified a wide range of psychosocial risk factors that can be considered important for the development and maintenance of disordered gambling. Although risk factors have been identified, the homogeneity of risk factors across specific groups thought to be vulnerable to disordered gambling is to date, unexplored.

METHODS

To address this, the current review sought to conduct a systematic overview of literature relating to seven vulnerable groups: young people and adolescents, older adults, women, veterans, indigenous peoples, prisoners, and low socio-economic/income groups.

RESULTS

Multiple risk factors associated with disordered gambling were identified; some appeared consistently across most groups, including being male, co-morbid mental and physical health conditions, substance use disorders, accessibility and availability of gambling, form and mode of gambling, and experience of trauma. Further risk factors were identified that were specific to each vulnerable group.

CONCLUSION

Within the general population, certain groups are more vulnerable to disordered gambling. Although some risk factors are consistent across groups, some risk factors appear to be group specific. It is clear that there is no homogenous pathway in to disordered gambling, and that social, developmental, environmental and demographic characteristics can all interact to influence an individual's relationship with gambling.

Problem gambling in adolescents: what are the psychological, social and financial consequences?

BACKGROUND

The paper examines the roles of sociodemographic traits, family quality and risk behaviour in adolescent problem gambling, with focus on the psychological, social and financial consequences from the socio-ecological model approach. This model emphasizes the most important risk-protective factors in the development and maintenance of problem gambling on an individual level, a relationship level, as well as a community and societal level.

METHODS

The research was done using the Canadian Adolescent Gambling Inventory with a sample of 366 participants, 239 females (65.3%) using descriptive statistics and t-test, ANOVA, correlation and hierarchical regression analysis.

RESULTS

Males reported significantly higher gambling consequences on all scales (p < .001) and significantly more risk behaviour (p < .05). Age was significant for psychological consequences (p < .01), problem gambling (p < .01) and risk behaviour (p < .001) with older participants scoring higher. Students with lower school success reported significantly higher psychological consequences of gambling (p < .01), higher risk behaviour activity (p < .001) and lower family life satisfaction (p < .001). The psychological, financial and social consequences were positively correlated with problem gambling (p < .001). Age (p < .05), gender (p < .001), school success (p < .01) and the father's education level (p. < 05) were significant predictors of problem gambling, with older male adolescents who struggle academically and have lower educated fathers being at greater risk.

CONCLUSIONS

Results indicate an important relation between adolescent gambling behaviour and very serious psychological, social and financial consequences. There is a constellation of risk factors that likely place certain individuals at high risk for problem gambling.

Gambling Behaviors and Problem Gambling: A Population-Based Comparison of Transgender/Gender Diverse and Cisgender Adolescents

Most gambling research utilizes general youth samples and focuses on binary gender categories; few studies examine and compare gambling behaviors between transgender and gender diverse (TGD) youth and their cisgender peers. The current study used population-based data from the 2016 Minnesota Student Survey to compare the prevalence of gambling behaviors and problem gambling among TGD versus cisgender adolescents, in addition to examining differences by birth-assigned sex. The analytic sample consisted of 80,929 students (including, n = 2168 [2.7%] TGD) in 9th and 11th grades. Chi-square tests and Cohen's d effect sizes were used for all comparisons. TGD youth reported greater involvement in most gambling behaviors and problem gambling compared to cisgender youth. In comparisons by birth-assigned sex, TGD youth assigned male at birth were particularly at risk for gambling involvement and problem gambling. TGD youth assigned female at birth also reported higher rates of problem gambling than both cisgender youth assigned male and female at birth. Results suggest that examining rates of gambling behavior and problem gambling as well as identifying disparities in vulnerable youth populations is crucial in order to develop culturally responsive and gender inclusive prevention, intervention, and outreach programs.

Participation and attitudes towards gambling in Ghanaian youth: an exploratory analysis of risk and protective factors

PURPOSE

There is little information on youth gambling in Ghana even though there is an unprecedented emergence of various types of gambling and gambling venues throughout the country. The aim of this cross-sectional exploratory study was to examine the role of perceived social difficulties and perceived protective social factors in participation and attitudes of Ghanaian youth towards gambling using data from a school-based survey (n = 770).

METHODS

Participants completed measures on perceived social difficulties, perceived protective social factors, attitudes towards gambling and participation in four types of gambling.

RESULTS

Sports betting was the most common form of gambling. There were significant differences in gambling participation with males gambling more than females. Youth who reported more perceived social difficulties from family and friends had a more positive attitude and a negative attitude towards gambling, respectively. Youth who reported higher protective social factors from family and teachers were less likely to have a negative attitude towards gambling. In all situations, high frequency gambling resulted in a more positive attitude towards gambling.

CONCLUSION

Perceived social difficulties influences Ghanaian youths to have a positive attitude towards gambling, however, protective social factors from family and teachers may help youth to have a negative attitude towards gambling, gamble less and consequently achieve academic success.

Young people's recall and perceptions of gambling advertising and intentions to gamble on sport

BACKGROUND

There has been an increased international policy focus on the factors that may contribute to, and prevent, the normalization of gambling for young people. However, there is still limited research, which investigates the role of advertising in shaping young people's gambling attitudes and consumption intentions.

METHODS

Mixed methods study of 111 young people aged 11-16 years recruited from community basketball stadiums in Victoria, Australia, between May and July 2018. Interviewer-assisted surveys investigated recall and awareness of sports betting brands, perceptions of promotional strategies, intention to gamble, and reasons for betting on particular sports. Quantitative data were analyzed using descriptive statistics and χ² tests. Thematic analyses were used to interpret qualitative responses.

RESULTS

Young people had high recall and awareness of advertising, with most able to name at least one betting brand (n = 90, 81.1%), and many demonstrating a high awareness of the distinct characteristics (such as colors and appeal strategies) of different brands. A fifth of young people (n = 25, 22.5%) expressed intentions to gamble at 18 years, with boys significantly more likely than girls to state they would gamble (χ² = 10.90, p = .001). Young people perceived that advertising strategies associated with inducement promotions would be the most influential in encouraging individuals to gamble. While many young people took promotions at face value, there was evidence that some were able to critically engage with and challenge the messages within marketing.

DISCUSSION AND CONCLUSIONS

Current regulatory structures appear to be ineffective in limiting young people's recall and awareness of gambling advertising. Lessons from tobacco control support the application of precautionary approaches as a more effective way to limit young people's development of positive gambling attitudes and behaviors.

Gambling disorder in adolescents: prevalence, new developments, and treatment challenges

Research on adolescence gambling over the past twenty years has revealed significant incidence and prevalence rates and highlighted the possible negative effects on an adolescent’s well-being. Several risk and protective factors have also been identified. Over the course of the past few years, technological advances have heralded the advent of new avenues for gambling as well as new opportunities to gamble without any direct monetary exchange. This review article examines those established trends as well as the new issues that we are faced with, in order to accurately portray the current challenges in research, prevention, and treatment.