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Jonsson J, Carlbring P, Lindner P. Offering an auto-play feature likely increases total gambling activity at online slot-machines: preliminary evidence from an interrupted time series experiment at a real-life online casino. Front Psychiatry 2024; 15:1340104. [PMID: 38370561 PMCID: PMC10869439 DOI: 10.3389/fpsyt.2024.1340104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 01/16/2024] [Indexed: 02/20/2024] Open
Abstract
Auto-play is a ubiquitous feature in online casino gambling and virtual slot machines especially, allowing gamblers to initiate spin sequences of pre-set length and value. While theoretical accounts diverge on the hypothesized causal effect on gambling behavior of using the auto-play feature, observational findings show that this feature is used to a higher degree by problem and/or high-intensity gamblers, suggesting that banning this feature may constitute a global responsible gambling measure. Direct, experimental research on causal effects of offering auto-play at online casinos is however lacking. Here, we report the findings of an interrupted time series experiment, conducted at a real-life online casino in Sweden, in which the auto-play feature was made available during a pre-set duration on 40 online slot machines, with 40 matched slots serving as control. Aggregated time series on daily betted amount, spins and net losses were analyzed using a structural Bayesian framework that compared observed developments during the peri-intervention period to modeled counterfactual estimates. Results suggest that offering an auto-play feature on online casinos likely increases total gambling activity in terms of betted amount (approx.+ 7-9%) and (perhaps) number of spins (approx. +3%) but has no effect on net losses. Limitations of studying auto-play effects on a population-level, as well as the complexities of banning this feature within a complex ecosystem of non-perfect channelization to licensed providers, are discussed, including suggestions for future research.
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Affiliation(s)
- Jakob Jonsson
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Per Carlbring
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Philip Lindner
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
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Hakansson A, Franklin K, Dahlström M, Lyckberg A. Motivational telephone intervention to risk gamblers by a state-owned gambling operator in Sweden. Front Psychiatry 2024; 15:1343733. [PMID: 38352656 PMCID: PMC10861775 DOI: 10.3389/fpsyt.2024.1343733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 01/05/2024] [Indexed: 02/16/2024] Open
Abstract
Background and aims Few studies have tested the effect of a motivational telephone intervention from a gambling operator to clients with high-risk gambling practices. This study aimed to study subsequent limit setting, self-exclusions and gambling post-intervention, compared to controls. Methods The study assessed a motivational, personalized telephone intervention by the state-owned Swedish gambling operator AB Svenska Spel within its subsection of sports, poker, online casino and bingo gambling. Clients successfully reached with the telephone intervention (n = 1,420) were compared to clients who could not be reached (n = 1,504). Gambling practices during 8 weeks pre-intervention were assessed, and outcome measures limit setting, self-exclusion, and gambling 4 weeks post-intervention. Results The telephone intervention was associated with increased limit settings (10 vs. 5 percent, p < 0.001), self-exclusions (11 vs. 8 percent, p < 0.01), lowered theoretical losses (p < 0.001), but not significantly associated with gambling abstinence (18 vs. 15 percent, p = 0.07). In unadjusted analyses of sub-groups, significant associations of the intervention with full gambling abstinence were seen in people who gamble on online casino/bingo (19 vs. 14 percent, p < 0.01), but not in sports bettors. In logistic regression, the intervention was not associated with full week 1-4 abstinence. Conclusion A personalized motivational telephone intervention to people displaying high-risk gambling, delivered by a gambling operator, is promising, and effects were seen on the uptake of responsible gambling tools post-intervention. Effects may be more pronounced in users of chance-based, online games, than in sports bettors.
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Håkansson A, Franklin K, Dahlström M, Lyckberg A. Responsible gambling through a motivational telephone intervention to high-risk gamblers - An evaluation of user satisfaction and subjective intervention effects. Front Psychol 2022; 13:917216. [PMID: 36532977 PMCID: PMC9749855 DOI: 10.3389/fpsyg.2022.917216] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 11/03/2022] [Indexed: 07/17/2024] Open
Abstract
BACKGROUND AND AIMS Problem gambling causes major social and psychiatric consequences, and there is need to develop feasible harm-reducing or therapeutic interventions. It has been suggested that gambling operators with responsible gambling intentions can intervene in order to identify and help reduce the harm in problem gamblers. However, user satisfaction, and the risk of negative reactions and gamblers' transfer to other operators, rarely have been explored scientifically. METHODS This is a retrospective survey study of gamblers reached by a motivational, telephone intervention by the Swedish state-owned gambling operator (Svenska Spel), addressing gamblers with indicators of high-risk gambling practices (n = 197). Surveys were answered approximately 10 days after the intervention. RESULTS Thirty-seven percent perceived their gambling to have decreased due to the intervention, whereas 7% perceived their gambling instead had increased. A large majority (80%) reported a subjective favorable experience from the intervention. Forty percent reported gambling on other operators than Svenska Spel after the intervention, but only 7% gambled on a new operator following the intervention. CONCLUSION Survey data in gamblers reached with a motivational telephone intervention present mainly promising findings, and should be replicated in future studies in larger samples. The main findings display an overwhelmingly favorable subjective experience, and a limited risk of gamblers migrating to other operators.
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Affiliation(s)
- Anders Håkansson
- Department of Clinical Sciences Lund, Psychiatry, Faculty of Medicine, Lund University, Lund, Sweden
- Region Skåne, Gambling Disorder Unit, Malmö, Sweden
- Region Skåne, Competence Center Addiction, Malmö, Sweden
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Loyalty Program Rewards Increases Willingness to Use Responsible Gambling Tools and Attitudinal Loyalty. Int J Ment Health Addict 2022. [DOI: 10.1007/s11469-022-00905-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/15/2022] Open
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Forsström D, Rozental A, Wiklund E, Carlbring P, Lindner P. Gamblers' Perception of the Playscan Risk Assessment: A Mixed-Methods Study. J Gambl Stud 2022; 38:591-606. [PMID: 34091781 PMCID: PMC9119887 DOI: 10.1007/s10899-021-10043-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2021] [Indexed: 11/30/2022]
Abstract
Responsible gambling (RG) tools are globally widespread; they aim to prevent or decrease the harm caused by gambling. However, existing research suggests that several included features do not decrease gambling or significantly reduce the subsequent harm. Most of the previous studies have used gambling data to understand the changes in gambling behavior. However, the literature lacks research regarding gamblers' experience and perception of RG tools, which may provide insight into increasing the usage and effectiveness of RG tools. This mixed-methods study aimed to explore gamblers' perception of their risk assessment in the RG tool Playscan regarding developing harmful gambling problems. Overall, 757 participants rated the perceived accuracy of their risk assessment and their perception of the overall RG tool that conducted the assessment. Participants were also allowed to leave a comment providing feedback, which was analyzed using thematic analysis. Quantitative data was analyzed using logistic regression and structural equation modeling. Qualitative analyses revealed that most of the participants were pleased with the risk assessment and found it helpful. Moderated mediation analysis showed that participants' assessment agreement partially mediated the association between expressing a negative view and their general view of Playscan. These results highlight the need to decrease the level of disagreement for promoting a better general view of RG tools to potentially increase their usage and effectiveness.
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Affiliation(s)
- David Forsström
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden. .,Department of Psychology, Stockholm University, Stockholm, Sweden. .,The Centre for Psychotherapy, Education and Research, Liljeholmstorget 7, SE-117 63, Stockholm, Sweden.
| | - Alexander Rozental
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden ,UCL Great Ormond Street Institute of Child Health, London, UK
| | - Emma Wiklund
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Per Carlbring
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Philip Lindner
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden ,Centre for Dependency Disorders, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
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Håkansson A, Sundvall A, Lyckberg A. Effects of a national preventive intervention against potential COVID-19-related gambling problems. A self-report survey in online gamblers. JMIR Form Res 2021; 6:e33066. [PMID: 34678751 PMCID: PMC8916099 DOI: 10.2196/33066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 09/16/2021] [Accepted: 09/18/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has been suspected to increase gambling problems in the population. Several governments early introduced COVID-19-specific interventions aiming to prevent gambling problems, but their effects have not been evaluated. OBJECTIVE The present study aimed to evaluate a Swedish COVID-19-related temporary legislation imposing an automated weekly deposit limit for online casino gambling. METHODS The study was an anonymous survey sent by the state-owned gambling operator to online gamblers (N=619, among whom 54 percent moderate-risk/problem gamblers) who reached the weekly limit on online gambling during the summer of 2020. RESULTS Sixty percent were aware of having been limited by a COVID-19-related deposit limit, and a minority (23 percent) perceived the intervention as fairly bad or very bad. Among those aware of the intervention, 39 percent believed this intervention decreased their overall gambling, whereas eight percent believed it rather increased it. However, 83 percent reported having gambled on more than one operator after the limit, and the most common gambling type reported to have increased at another operator was online casino (42 percent in moderate-risk/problem gamblers and 19 percent in others, p<0.001). Having increased gambling following the intervention was associated with being a moderate-risk/problem gambler, and by negative attitudes towards the intervention. CONCLUSIONS A weekly deposit limit had relatively high acceptability, but the study highlights the limitations of a single-operator deposit limit, given the high number of gamblers also reporting to gamble on other operators, and the lower effect in clients with gambling problems. CLINICALTRIAL
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Mora-Salgueiro J, García-Estela A, Hogg B, Angarita-Osorio N, Amann BL, Carlbring P, Jiménez-Murcia S, Pérez-Sola V, Colom F. The Prevalence and Clinical and Sociodemographic Factors of Problem Online Gambling: A Systematic Review. J Gambl Stud 2021; 37:899-926. [DOI: 10.1007/s10899-021-09999-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2021] [Indexed: 12/14/2022]
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Håkansson A, Franklin K, Dahlström M, Lyckberg A. Responsible Gambling Telephone Intervention to High-Risk Gamblers by a State-Owned Gambling Operator in Sweden: Study Protocol for a Study on Effectiveness, User Satisfaction, and Acceptability. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17239069. [PMID: 33561040 PMCID: PMC7730336 DOI: 10.3390/ijerph17239069] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 11/30/2020] [Accepted: 12/02/2020] [Indexed: 02/08/2023]
Abstract
Gambling disorder is associated with severe financial, social, and psychological consequences, but treatment-seeking rates have been described to be low. Apart from formal treatment, motivational interventions in nontreatment-seeking high-risk gamblers have been shown to be promising. However, little is known about the effectiveness and acceptability of such motivational interventions carried out by a gambling operator as part of the company’s responsible gambling policies. Early experiences of such interventions are limited by the risk that gambling in individuals reached with the intervention may continue with a different gambling operator. The present study aims to evaluate effectiveness and user acceptability of a responsible gambling intervention continuously carried out by the Swedish state-owned gambling operator Svenska Spel Sport & Casino. This intervention for high-risk gamblers, identified either through substantial monetary losses or through a voluntary self-test by the gambler, includes a motivational telephone intervention aiming to encourage the gambler to set deposit limits, practice self-exclusion, or seek help. This protocol paper describes the two-tailed evaluation of this intervention: (1) A retrospective, register-based study of the effectiveness of the motivational intervention on gambling expenditures, deposit limits, and self-exclusions in comparison to control individuals not reached by the intervention, including all clients reached or attempted to be reached during September 2019–April 2020 (total n = 3626), as well as a one-to-one matched comparison of clients reached (n = 1404) and not reached; and (2) a prospective web survey study in individuals reached by the same ongoing telephone intervention practice from November 2020 (target n = 200), measuring clients’ attitudes to the intervention, perceived effects of the intervention on gambling, and their self-reported gambling on all operators after the intervention.
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Affiliation(s)
- Anders Håkansson
- Division of Psychiatry, Department of Clinical Sciences Lund, Faculty of Medicine, Lund University, 221 00 Lund, Sweden
- Region Skåne, Malmö Addiction Center, 205 02 Malmö, Sweden
- Correspondence: ; Tel.: +46-46-175-596
| | - Katja Franklin
- AB Svenska Spel, 621 80 Visby, Sweden; (K.F.); (M.D.); (A.L.)
| | - Maria Dahlström
- AB Svenska Spel, 621 80 Visby, Sweden; (K.F.); (M.D.); (A.L.)
| | - Axel Lyckberg
- AB Svenska Spel, 621 80 Visby, Sweden; (K.F.); (M.D.); (A.L.)
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Gainsbury SM, Angus DJ, Procter L, Blaszczynski A. Use of Consumer Protection Tools on Internet Gambling Sites: Customer Perceptions, Motivators, and Barriers to Use. J Gambl Stud 2020; 36:259-276. [PMID: 31119509 DOI: 10.1007/s10899-019-09859-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Internet gambling has been widely legalised in recognition of its capacity to, and the importance of, providing consumer protection tools to prevent and minimise gambling-related harms. Most licensed Internet gambling sites are required to provide consumer protection tools, including activity statements, deposit limits, and time-outs (temporary self-exclusion). However, few Internet gambling customers engage with the tools. An online survey of 564 customers of Australian Internet gambling sites aimed to understand the extent to which consumer protection tools are used, characteristics of those using these tools, and the perceptions and attitudes towards tool use, including barriers to use. Most participants were aware of the tools and had accessed activity statements; few had used deposit limits (24.5%) or time-outs (8.1%) but use of these restrictive tools was higher among those at-risk of gambling problems. Satisfaction with tools was generally high among users and tools were mostly used as intended; however, only moderate changes in behaviour were reported. Participants predominately did not use the restrictive tools as they did not see these as relevant for them, and they were perceived to be intended for people with gambling problems. The findings are important to drive necessary improvements to consumer protection efforts including efforts to encourage perception that tools are relevant for all customers. Changes to current practice, including terminology and promotion of tools, are needed by Internet gambling operators and policy makers to improve the utilisation and effectiveness of consumer protection tools to enable sustainable gambling among the broader cohort of Internet gamblers.
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Affiliation(s)
- Sally M Gainsbury
- Gambling Treatment and Research Clinic, Science Faculty, Brain and Mind Centre, School of Psychology, University of Sydney, 94 Mallett St, Camperdown, NSW, 2050, Australia.
| | - Douglas J Angus
- Gambling Treatment and Research Clinic, Science Faculty, Brain and Mind Centre, School of Psychology, University of Sydney, 94 Mallett St, Camperdown, NSW, 2050, Australia
| | - Lindsey Procter
- Gambling Treatment and Research Clinic, Science Faculty, Brain and Mind Centre, School of Psychology, University of Sydney, 94 Mallett St, Camperdown, NSW, 2050, Australia
| | - Alex Blaszczynski
- Gambling Treatment and Research Clinic, Science Faculty, Brain and Mind Centre, School of Psychology, University of Sydney, 94 Mallett St, Camperdown, NSW, 2050, Australia
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Jonsson J, Hodgins DC, Munck I, Carlbring P. Reaching out to big losers leads to sustained reductions in gambling over 1 year: a randomized controlled trial of brief motivational contact. Addiction 2020; 115:1522-1531. [PMID: 31977104 DOI: 10.1111/add.14982] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Revised: 10/14/2019] [Accepted: 01/21/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIMS A previous randomized controlled trial demonstrated that telephone- and letter-based motivational interventions with high-expenditure gamblers had significant short-term positive effects on gambling and use of responsible gambling tools. This post-trial follow-up examined outcomes in gambling expenditure over 12 months. DESIGN Observational study following a three-arm randomized controlled trial. SETTING Customers of Norsk Tipping (NT) gambling platforms, Norway. PARTICIPANTS A total of 1003 statistical triplets from the top 0.5% of customers based upon annual expenditure, matched on sex, age and net losses. Mean age was 53.4 years; 19% were women, mean yearly loss for 2016 was 88 197 NoK. Interventions and comparator Feedback intervention by telephone, letter or a no-contact control condition. MEASUREMENTS Primary outcome measure was gambling theoretical loss, derived from the NT customer database. Secondary outcomes were responsible gambling customer actions and whether or not the participant was retained as an NT customer. FINDINGS Per-protocol analyses of triplets who received the telephone call or letter as randomly assigned (n = 596) showed a positive and sustained effect over 12 months: the telephone group showed a 30% reduction in theoretical loss (d = 0.44) and the letter group 13% (d = 0.18), both outperforming the control group with a 7% reduction (d = 0.11). The telephone condition was superior to both the letter and control conditions in per-protocol (P < 0.001) and to control condition in intention-to-treat analyses (ITT) (P < 0.001). Individuals in the telephone condition took more responsible gambling actions. The letter condition had better outcomes than the control in the ITT-only analysis (P < 0.001). More than 93% were still customers a year after the intervention. CONCLUSIONS Personal contact with high-expenditure gambling customers in Norway that provided individualized feedback on expenditures was associated with reduced theoretical losses and greater use of responsible gambling tools over a 12-month period, compared with no contact. Telephone intervention with customers had a larger impact than a mailed letter.
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Affiliation(s)
- Jakob Jonsson
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | - David C Hodgins
- Department of Psychology, University of Calgary, Calgary, Canada
| | - Ingrid Munck
- Department of Education and Special Education, University of Gothenburg, Gothenburg, Sweden
| | - Per Carlbring
- Department of Psychology, Stockholm University, Stockholm, Sweden
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Forsström D, Rafi J, Carlbring P. Dropouts’ usage of a responsible gambling tool and subsequent gambling patterns. COGENT PSYCHOLOGY 2020. [DOI: 10.1080/23311908.2020.1715535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Affiliation(s)
- David Forsström
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
| | - Jonas Rafi
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Per Carlbring
- Department of Psychology, Stockholm University, Stockholm, Sweden
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Procter L, Angus DJ, Blaszczynski A, Gainsbury SM. Understanding use of consumer protection tools among Internet gambling customers: Utility of the Theory of Planned Behavior and Theory of Reasoned Action. Addict Behav 2019; 99:106050. [PMID: 31522130 DOI: 10.1016/j.addbeh.2019.106050] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 06/19/2019] [Accepted: 07/13/2019] [Indexed: 11/16/2022]
Abstract
Consumer protection tools such as activity statements, deposit limits, and temporary self-exclusion are provided by most Internet gambling websites to minimise gambling related harms through the prevention of problems and enhancement of controls for those at risk of disordered gambling. However, customer engagement with these tools is very low. Developing a theoretical framework to understand the reasons individuals use consumer protection tools is important to design strategies to increase uptake. Customers of Australian online wagering sites (N = 564) completed an online survey with a follow-up (N = 193) to assess whether the Theory of Planned Behaviour explained intention to use tools and actual behaviour with additional consideration of past tool use. Results showed that past tool use, attitudes and subjective norms, but not perceived behavioural control, were positively correlated with intention to use consumer protection tools. Intention to use the tools prospectively predicted actual tool use. The study validates past behaviour as a predictor of intention, and intention representing a significant predictor of future behaviour. The Theory of Reasoned Action (without the inclusion of perceived behavioural control), rather than Theory of Planned Behaviour, appears to be a suitable conceptual model to understand consumer protection tool use for Internet wagering websites. Use and application of consumer protection tools on gambling websites is not perceived as effortful, but under volitional control and straightforward. Positively influencing individual attitudes, perceived views of others and past tool use could increase online wagering customers' use of consumer protection tools.
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Affiliation(s)
- Lindsey Procter
- University of Sydney, Science Faculty, Brain and Mind Centre, School of Psychology, Gambling Treatment and Research Clinic, 94 Mallet St, Camperdown, NSW 2050, Australia.
| | - Douglas J Angus
- University of Sydney, Science Faculty, Brain and Mind Centre, School of Psychology, Gambling Treatment and Research Clinic, 94 Mallet St, Camperdown, NSW 2050, Australia.
| | - Alex Blaszczynski
- University of Sydney, Science Faculty, Brain and Mind Centre, School of Psychology, Gambling Treatment and Research Clinic, 94 Mallet St, Camperdown, NSW 2050, Australia.
| | - Sally M Gainsbury
- University of Sydney, Science Faculty, Brain and Mind Centre, School of Psychology, Gambling Treatment and Research Clinic, 94 Mallet St, Camperdown, NSW 2050, Australia.
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