Mapping the proportional distribution of gambling-related harms in a clinical and community sample

Assessing the Link Between General Causality Orientations and Problem Gambling, and the Mediational Role of Nonattachment, Greed, and Anhedonia

Gambling is common in the US, yet nearly one in three players experience gambling-related problems. Using Self-Determination Theory, this study explores how three causality orientations-autonomous, controlled, and impersonal-affect the severity of problem gambling. The study further investigates the mediating roles of nonattachment, dispositional greed, and anhedonia to illuminate how these orientations relate to problem gambling. The data from 675 participants (59% male; Mean age = 40.4 years, SD = 12.9) via Amazon's Mechanical Turk were collected following a screening procedure to identify at-risk players. Findings showed that dispositional greed mediated the impact of a controlled orientation on problem gambling severity, while anhedonia mediated the effect of impersonal orientation. Unexpectedly, nonattachment did not explain the effect of autonomous orientation on problem gambling, though a negative association was still observed. This research enhances understanding of how individual differences and causality orientations contribute to problem gambling behavior. The implications are discussed.

Gamified Problem Gambling and Psychological Distress: The Mediated-Moderated Roles of Cognitive and Economic Motives

Economic and non-economic motives for gambling may amplify anxiety and depression among young adults. On the grounds that online gambling is highly addictive, it is imperative to assess significant contributory factors in gambling that aggravate financial harm and psychological distress. The study examines gamified problem gambling and psychological distress among young adults in Ghanaian universities. The study further explores the mediating role of cognitive biases and heuristics as well as financial motive for gambling between gamified problem gambling and psychological distress. Through a cross-sectional design and convenience sampling technique, the study employed (n = 678) respondents who took part in different forms of gambling events in the last 2 years. Instruments for construct assessment include problem gambling severity, cognitive biases and heuristics, financial motive for gambling and psychological distress scales. Control variables include gender, age, income source and type of gambling patronized in the last 2 years. Using hierarchical regression, gamified problem gambling was found to have a positive effect on psychological distress. Also, cognitive biases & heuristics partially mediates between gamified problem gambling and psychological distress. Finally, financial motive for gambling moderates between gamified problem gambling and psychological distress. The outcomes bring to bear economic and non-economic motives that exacerbate psychological distress among young adults. Based on the vulnerability of problem gamblers in developing countries, the researchers recommend a need for stricter regulations to somewhat control online gambling frequency among young adults.

Validation of the 7-Item Domain-General Gambling Harm Scale (DGHS-7)

Introduction

Gambling can cause negative consequences affecting finances, work/study, physical and mental health, relationships, law abidingness, and the community. Although existing measures enable investigations of gambling harms, there is still a need for a brief measure covering the full range of gambling related harms.

Methods

We validated a 7-item domain-general harm scale (DGHS-7) using data from a cross-sectional survey of United Kingdom residents reporting gambling within the last 12 months (n = 2558, 62.4% women, mean age 40.1 years (SD = 12.5)). The DGHS-7 was investigated in terms of factor structure, measurement invariance, and convergent validity with a comprehensive 72-item checklist of gambling harm, the Short Gambling Harms Screen (SGHS), and the Problem Gambling Severity Index (PGSI). Discriminative validity was checked against the Personal Wellbeing Index (PWI). Internal consistency was also calculated.

Results

Confirmatory factor analysis supported a one-factor solution (χ² = 136.991, df = 14, χ²/df = 9.785, p <.001, CFI = 0.999, RMSEA = 0.059, 90% CI [0.050, 0.068]). Measurement invariance was supported for gender and binary categorization of age and income (ΔCFI = 0.001). The DGHS-7 correlated strongly with the 72-item checklist (r_s = 0.824), the SGHS (r_s = 0.793), the PGSI (r_s = 0.768), and moderately with the PWI (r_s = -0.303). Cronbach's alpha = 0.91 and ordinal alpha = 0.96 indicated good internal consistency.

Conclusions

Psychometric support was found for a brief measure covering all recognized domains of gambling harm. The DGHS-7 is useful for researchers needing a generic and short measure for epidemiological and other studies calling for short scales.

Isolation and worry in relation to gambling and onset of gambling among psychiatry patients during the COVID-19 pandemic: A mediation study

When the COVID-19 pandemic started spreading globally, there was a fear that addictive behaviors would increase due to changes in everyday life caused by restrictions due to COVID-19. Studies were carried out to explore if this was true for gambling, typically revealing no overall increase in gambling behavior, although individuals who had previous experience with gambling problems were more likely to increase gambling during the pandemic. However, these studies only included individuals with previous gambling problems. It remains unknown whether other vulnerable groups, such as individuals with common mental disorders increased their gambling. This study aimed to explore the level of gambling problems among individuals with a history of mental disorders, namely, (i) pre-pandemic gamblers and (ii) pandemic-onset gamblers. Furthermore, we explored if worry and isolation mediate gambling and problem gambling. The data were analyzed using descriptive statistics and a structural equation model to investigate mediation. The results showed a high prevalence of at-risk and problem gambling in both groups. The pre-pandemic gamblers had a high level of at-risk and problem gambling. Furthermore, the individuals that started to gamble during the pandemic had an even higher degree of at-risk and problem gambling. The mediation showed that the onset of gambling was linked with the worry of COVID-infection and that worry predicted the level of gambling problems. This study highlights that vulnerability factors, isolation, and worry can be triggers for individuals with common mental disorders to engage in gambling as well as the importance of screening this population for gambling problems.

Legacy gambling harms: What are they and how long do they last?

BACKGROUND AND AIMS

Legacy gambling harms are negative consequences of gambling that extend past periods of low risk, moderate risk and problem gambling. Gambling harm is typically measured within a 12-month timeframe and is often restricted to examining harm amongst active gamblers. The present research aimed to explore whether people experienced gambling harms 12 months or more after the resolution of at-risk or problem gambling, and how long these legacy harms lasted.

METHODS

An online survey was conducted in New Zealand with past and current gamblers and concerned significant others (CSOs) of gamblers, N = 1,240 (50.8% female), that asked them about both past and current gambling harms.

RESULTS

A majority of both gamblers and CSOs of gamblers indicated that they still suffered from gambling harm even after most of their behavioural issues with gambling had been resolved, 12+ months ago. Legacy gambling harms reduced over time, with harms diminishing most quickly in the early years, and having an average half-life of 4 years. Harms involving community-relationships, church involvement, and domestic and other violence resolved more quickly than others.

DISCUSSION AND CONCLUSIONS

Legacy harms are common among ex-problem gamblers and should be considered in any full accounting of the impacts of gambling.

CONCLUSION

Understanding the time course and persistence of legacy harms from gambling can provide gamblers, treatment professionals and public health experts with insights into how to address gambling's long-term consequences.

Harm as reported by affected others: A population-based cross-sectional Finnish Gambling 2019 study

This study investigates the prevalence of being an affected other (AO) of a person with problem gambling; and the associations between being an AO and socio-demographics, gambling behaviour, health-related correlates and the amount and type of gambling-related harm (GRH) for the AOs. Furthermore, perspectives of the affected family members (AFMs) and close friends (ACFs) were acknowledged. Cross-sectional, random sample Finnish Gambling population-based survey data (n = 3,994) were collected in 2019. AOs were identified using a question with seven options. Information on GRH was sought using structured questions. One-fifth (21.2 %) of all respondents were AOs, men being typically ACFs and women being more often AFMs. Being an AO was associated with younger age, gambling participation, having a gambling problem of their own and health barriers such as psychological distress. AFMs experienced GRH more often and the amount of different GRHs was greater among the AFMs. The most common harm category experienced by the AOs was emotional harm. Both health-related issues and the amount of GRHs was largest among the AFMs. A substantial amount of GRH was also experienced by ACFs. The study suggests that support could be tailored for AFMs and ACFs, based on their AO status and individual needs. A public health approach for effective harm prevention in primary, secondary and tertiary levels are discussed.

Clustering Treatment Outcomes in Women with Gambling Disorder

The rising prevalence of gambling disorder (GD) among women has awakened considerable interest in the study of therapeutic outcomes in females. This study aimed to explore profiles of women seeking treatment for GD based on a set of indicators including sociodemographic features, personality traits, clinical state at baseline, and cognitive behavioral therapy (CBT) outcomes. Two-step clustering, an agglomerative hierarchical classification system, was applied to a sample of n = 163 women of ages ranging from 20 to 73 years-old, consecutively attended to by a clinical unit specialized in the treatment of G. Three mutually exclusive clusters were identified. Cluster C1 (n = 67, 41.1%) included the highest proportion of married, occupationally active patients within the highest social status index. This cluster was characterized by medium GD severity levels, the best psychopathological functioning, and the highest mean in the self-directedness trait. C1 registered 0% dropouts and only 14.9% relapse. Cluster C2 (n = 63; 38.7%) was characterized by the lowest GD severity, medium scores for psychopathological measures and a high risk of dropout during CBT. Cluster C3 (n = 33; 20.2%) registered the highest GD severity, the worst psychopathological state, the lowest self-directedness level and the highest harm-avoidance level, as well as the highest risk of relapse. These results provide new evidence regarding the heterogeneity of women diagnosed with GD and treated with CBT, based on the profile at pre- and post-treatment. Person-centered treatments should include specific strategies aimed at increasing self-esteem, emotional regulation capacities and self-control of GD women.

18-Item Version of the Short Gambling Harm Screen (SGHS-18): Validation of Screen for Assessing Gambling-Related Harm among Finnish Population

Background and aims: It is common for gambling research to focus on problem and disordered gambling. Less is known about the prevalence of gambling-related harms among people in the general population. This study aimed to develop and validate the 18-item version of the Short Gambling Harms Screen (SGHS-18). Methods: Population-representative web-based and postal surveys were conducted in the three geographical areas of Finland (n = 7186, aged 18 or older). Reliability and internal structure of SGHS-18 was assessed using coefficient omega and via confirmatory factor analysis (CFA). Four measurement models of SGHS-18 were compared: one-factor, six-factor, a second-ordered factor model and a bifactor model (M4). Results: The analysis revealed that only the bifactor model had adequate fit for SGHS-18 (CFI = 0.953, TLI = 0.930, GFI = 0.974, RMSEA = 0.047, SRMR = 0.027). The general factor explained most of the common variance compared to specific factors. Coefficient omega hierarchical value for global gambling harm factor (0.80) was high, which suggested that SGHS-18 assessed the combination of general harm constructs sufficiently. The correlation with the Problem and Pathological Gambling Measures (PPGM) was 0.44, potentially reflecting that gambling harms are closely—although not perfectly—aligned with the mental health issue of problem gambling. SGHS-18 scores were substantially higher for participants who gambled more often, who spent more money or who had gambling problems, demonstrating convergent validity for the screen. Discussion: The SGHS-18 comprehensively measures the domains of gambling harm, while demonstrating desirable properties of internal consistency, and criterion and convergent validity.

Measuring Behavioural Dependence in Gambling: A Case for Removing Harmful Consequences from the Assessment of Problem Gambling Pathology

Behavioural dependence (BD) for gambling has traditionally been subsumed under the concept of 'problems': a hybrid construct that includes both indicators of BD, and adverse consequences (harm) arising from excessive time and money expenditure. Although progress has been made towards specific measurement of harm, dedicated measures of BD do not exist. Theory led us to expect that (1) dependence and harm are measurably distinct constructs, (2) harm mediates the relationship between dependence and wellbeing, and finally, that (3) separate measures should be more effective than a unidimensional problems measure in predicting wellbeing. Candidate BD items from six existing measures of gambling problems were extracted and evaluated with respect to DSM-5 criteria and content overlap, leading to 17 candidate items. This was further reduced to 8 items based on both item content and psychometric criteria, using data from an online panel of 1524 regular gamblers, with demographic characteristics similar to Australian population norms. Participants also completed measures of harm, problems, and subjective wellbeing. All three hypotheses were confirmed. BD was shown to be highly reliable and unidimensional, and measurably distinct from gambling harms. Harm mediated the negative relationship between BD and wellbeing. The harm + BD model yielded better predictions of personal wellbeing that a unidimensional, continuous problems measure-and explained about twice the variance of a simple contrast between problem and non-problem gamblers. We conclude that is psychometrically justified to specifically measure gambling BD, and this may be of particular use in theoretically-driven applications.

The Evolution of Gambling-Related Harm Measurement: Lessons from the Last Decade

Jurisdictions around the world have a self-declared mandate to reduce gambling-related harm. However, historically, this concept has suffered from poor conceptualisation and operationalisation. However, recent years have seen swift advances in measuring gambling harm, based on the principle of it being a quantifiable decrement to the health and wellbeing of the gambler and those connected to them. This review takes stock of the background and recent developments in harm assessment and summarises recent research that has validated and applied the Short Gambling Harms Screen and related instruments. We recommend that future work builds upon the considerable psychometric evidence accumulated for the feasibility of direct elicitation of harmful consequences. We also advocate for grounding harms measures with respect to scalar changes to public health utility metrics. Such an approach will avoid misleading pseudo-clinical categorisations, provide accurate population-level summaries of where the burden of harm is carried, and serve to integrate gambling research with the broader field of public health.

The identification of Australian low-risk gambling limits: A comparison of gambling-related harm measures

BACKGROUND AND AIMS

Problem gambling severity and gambling-related harm are closely coupled, but conceptually distinct, constructs. The primary aim was to compare low-risk gambling limits when gambling-related harm was defined using the negative consequence items of the Problem Gambling Severity Index (PGSI-Harm) and the Short Gambling Harms Scale items (SGHS-Harm). A secondary aim was compare low-risk limits derived using a definition of harm in which at least two harms across different domains (e.g. financial and relationship) were endorsed with a definition of harm in which at least two harms from any domain were endorsed.

METHODS

Data were collected from dual-frame computer-assisted telephone interviews of 5,000 respondents in the fourth Social and Economic Impact Study (SEIS) of Gambling in Tasmania. Receiver operating characteristic (ROC) curve analyse were conducted to identify low-risk gambling limits.

RESULTS

PGSI-Harm and SGHS-Harm definitions produced similar overall limits: 30-37 times per year; AUD$510-$544 per year; expenditure comprising no more than 10.2-10.3% of gross personal income; 400-454 minutes per year; and 2 types of gambling activities per year. Acceptable limits (AUC ≥0.70) were identified for horse/dog racing, keno, and sports/other betting using the PGSI definition; and electronic gaming machines, keno, and bingo using the SGHS definition. The requirement that gamblers endorse two or more harms across different domains had a relatively negligible effect.

DISCUSSION AND CONCLUSIONS

Although replications using alternative measures of harm are required, previous PGSI-based limits appear to be robust thresholds that have considerable potential utility in the prevention of gambling-related harm.

Is there a health inequality in gambling related harms? A systematic review

Background

Here we present a systematic review of the existing research into gambling harms, in order to determine whether there are differences in the presentation of these across demographic groups such as age, gender, culture, and socioeconomic status, or gambling behaviour categories such as risk severity and participation frequency.

Primary and secondary outcome measures

Inclusion criteria were: 1) focus on gambling harms; 2) focus on harms to the gambler rather than affected others; 3) discussion of specific listed harms and not just harms in general terms. Exclusion criteria were: 1) research of non-human subjects; 2) not written in English; 3) not an empirical study; 4) not available as a full article.

Methods

We conducted a systematic search using the Web of Science and Scopus databases in August 2020. Assessment of quality took place using Standard Quality Assessment Criteria.

Results

A total of 59 studies published between 1994 and 2020 met the inclusion criteria. These were categorised into thematic groups for comparison and discussion. There were replicated differences found in groups defined by age, socioeconomic status, education level, ethnicity and culture, risk severity, and gambling behaviours.

Conclusion

Harms appear to be dependent on specific social, demographic and environmental conditions that suggests there is a health inequality in gambling related harms. Further investigation is required to develop standardised measurement tools and to understand confounding variables and co-morbidities. With a robust understanding of harms distribution in the population, Primary Care Workers will be better equipped to identify those who are at risk, or who are showing signs of Gambling Disorder, and to target prevention and intervention programmes appropriately.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-10337-3.

Opportunity Costs or Not? Validating the Short Gambling Harm Screen against a Set of "Unimpeachable" Negative Impacts

Assessing the harmful consequences of gambling is an area of active investigation. One measure intended to capture gambling-related harm is the 10-item short gambling harm screen (SGHS). Although good psychometric properties have been reported, it has been suggested that the screen's less severe probes may not represent genuinely harmful consequences, but rather may reflect rational opportunity costs. Consequently, it has been argued that the screen may lead to overestimation of the extent of gambling-related harm in the population. The current study sought to examine the psychometric performance of three less severe suspect items in the SGHS. Associations between each of these items and a specially constructed scale of relatively severe "unimpeachable" gambling harms were calculated from archival data from 5551 Australian and New Zealand gamblers. All three suspect items, both individually and upon aggregation, predicted greater endorsement of "unimpeachable" harms, and indicated the presence of gambling problems. Moreover, the SGHS as a whole is highly correlated with "unimpeachable" gambling harms. Including suspect items in the SGHS was found to improve predictions of low- and moderate-risk gambling status, but slightly decreased predictions of severe gambling problems. The results are inconsistent with the notion that SGHS harm probes capture either inconsequential consequences or opportunity costs. They confirm prior findings that harm symptomatology is unidimensional, and that the report of multiple more prevalent, but less severe, harms serves as an effective indicator of the spectrum of experienced harm.

Gambling-Specific Cognitions Are Not Associated With Either Abstract or Probabilistic Reasoning: A Dual Frequentist-Bayesian Analysis of Individuals With and Without Gambling Disorder

BACKGROUND

Distorted gambling-related cognitions are tightly related to gambling problems, and are one of the main targets of treatment for disordered gambling, but their etiology remains uncertain. Although folk wisdom and some theoretical approaches have linked them to lower domain-general reasoning abilities, evidence regarding that relationship remains unconvincing.

METHOD

In the present cross-sectional study, the relationship between probabilistic/abstract reasoning, as measured by the Berlin Numeracy Test (BNT), and the Matrices Test, respectively, and the five dimensions of the Gambling-Related Cognitions Scale (GRCS), was tested in a sample of 77 patients with gambling disorder and 58 individuals without gambling problems.

RESULTS AND INTERPRETATION

Neither BNT nor matrices scores were significantly related to gambling-related cognitions, according to frequentist (MANCOVA/ANCOVA) analyses, performed both considering and disregarding group (patients, non-patients) in the models. Correlation Bayesian analyses (bidirectional BF10) largely supported the null hypothesis, i.e., the absence of relationships between the measures of interest. This pattern or results reinforces the idea that distorted cognitions do not originate in a general lack of understanding of probability or low fluid intelligence, but probably result from motivated reasoning.

The Development of Empirically Derived Australian Low-Risk Gambling Limits

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

A framework for indirect elicitation of the public health impact of gambling problems

Gambling problems are increasingly understood as a health-related condition, with harms from excessive time and money expenditure contributing to significant population morbidity. In many countries, the prevalence of gambling problems is known with some precision. However, the true severity of gambling problems in terms of their impact on health and wellbeing is the subject of ongoing debate. We firstly review recent research that has attempted to estimate harm from gambling, including studies that estimate disability weights using direct elicitation. Limitations of prior approaches are discussed, most notably potential inflation due to non-independent comorbidity with other substance use and mental health conditions, and potential biases in the subjective attribution of morbidity to gambling. An alternative indirect elicitation approach is outlined, and a conceptual framework for its application to gambling is provided. Significant risk factors for propensity to develop gambling problems are enumerated, and relative risks for comorbidities are calculated from recent meta-analyses and reviews. Indirect elicitation provides a promising alternative framework for assessing the causal link between gambling problems and morbidity. This approach requires implementation of propensity score matching to estimate the counterfactual, and demands high quality information of risk factors and comorbid conditions, in order to estimate the unique contribution of gambling problems. Gambling harm is best understood as a decrement to health utility. However, achieving consensus on the severity of gambling problems requires triangulation of results from multiple methodologies. Indirect elicitation with propensity score matching and accounting for comorbidities would provide an important step towards full integration of gambling within a public health paradigm.

Debt stress partly explains the relationship between problem gambling and comorbid mental health problems

RATIONALE

Easy access to consumer credit products, such as credit cards, overdrafts, and personal loans, may facilitate gambling beyond affordable levels, which can result in debt problems. Debt and mental health problems are both potential motivators and core consequences of problem gambling. Debt stress (i.e., worry regarding ability to repay debts) is one potential psychological mechanism underlying the relationship between debt and mental health problems. Few previous studies have investigated debt stress among gamblers.

OBJECTIVE

This cross-sectional study aimed to investigate the mediating effect of debt stress between gambling frequency and mental health and wellbeing.

METHODS & RESULTS

A sample of 309 Australian past-month gamblers (83.8% male; mean age 41.5 years) completed an online survey. There was no evidence for the preregistered association between gambling frequency and debt stress, ruling out a predicted mediating effect for debt stress between gambling frequency and mental health and wellbeing. However, exploratory path analysis showed debt stress has statistically significant mediating effects between problem gambling and psychological distress, depression, wellbeing, and gambling-related family impacts, after controlling for sociodemographic factors and psychiatric history.

CONCLUSIONS & IMPLICATIONS

Debt stress is a robust indicator of financial problems and may indicate underlying problem gambling and mental health issues, making debt stress a useful risk indicator. Clinical services should conduct screening for debt stress and address subjective worry about debts as a standard part of treatment plans as this may help to mitigate some of the impact of gambling and/or financial problems on poor mental health. Health practitioners should develop strong referral networks with gambling and financial counselling services. Government investment in making gambling and financial counselling services freely available and easily accessible is recommended to ensure appropriate support is received via effective care pathways.

The prevention paradox applies to some but not all gambling harms: Results from a Finnish population-representative survey

BACKGROUND AND AIMS

The Prevention Paradox (PP) suggests that a large proportion of aggregate harm from gambling occurs to people who do not have a gambling disorder. However, it has not yet been tested using a population-representative sample. We aimed to test whether the PP applies to gambling in Finland. The prevalence rates of diverse harmful consequences from gambling were surveyed amongst a population-representative sample of past-year gamblers.

METHODS

The study used first wave data (N = 7,186) of Finnish Gambling Harms survey, collected via online and postal surveys in 2017. A subset of 3,795 adults (≥18 years), who had gambled at least monthly in 2016, were selected for analysis.

MEASUREMENTS

Gambling-related harms were evaluated with the 72-item Harms Checklist. Problem and Pathological Gambling Measure (PPGM) measured respondents' probable disordered gambling from the subset of items for impaired control (4 questions) and other issues (3 questions).

FINDINGS

Consistent with previous findings, the majority of harms were reported by those in the less severe PPGM categories (i.e. scoring <5). However, considering each domain separately, this was true only for financial, emotional/psychological, and work/study harms. The PP was not supported for health, relationship, or social deviance harms.

CONCLUSIONS

The population prevalence of the most serious harms (e.g. unsafe living conditions) is concentrated among those with severe impaired control issues. However, even excluding the ∼15% of harms occurring to occasional gamblers, most financial, emotional and work/study impacts occur to those with lower levels of control issues. Efforts at harm reduction should focus on the entire spectrum of issues that people experience from their gambling.

The Winners and the Losers: Tax Incidence of Gambling in Finland

Gambling markets have grown rapidly for the last few decades. As a result, gambling is also a very important and common source of tax income for many governments these days. This raises a question about the overall fairness of the gambling taxation systems. In this paper, we aim to study the tax incidence of gambling in Finland. First, we analyse who are the expected payers of the gambling taxes and second, who are expected to be the receivers of the gambling-tax based contributions. In the first part of the study, we analyse the demographic incidence of gambling taxation by using the Finnish gambling 2015 population survey combined with registry based variables. Our data contains 3776 individuals. In the second part of the study, we use data of county level gambling-taxation based contributions to different organisations to analyse how the gambling expenditures are distributed back to citizens in a form of public spending. This study shows that different socio-demographic factors have diverse association with the decisions whether or how much to gamble. The results also suggest that more disadvantaged, i.e. lower income, less educated and rural area living, individuals are expected to be the “losers” of the Finnish gambling taxation system. In other words, the Finnish gambling system is found to be regressive by nature.

Public health effects of gambling - debate on a conceptual model

BACKGROUND

Gambling for money is a popular leisure time activity in most countries, which has major social and economic impacts not only affecting the gambler, but his/her significant others, and the society. Gambling impact studies can help researchers and policymakers compare the health and social costs and benefits of different gambling policies and can be used when considering which gambling policies will reduce or increase costs or benefits the most. In a public health approach, the impacts of gambling, negative and positive, are assessed across the entire severity spectrum of the activity. Although some studies have created basic principles for conducting impact studies, a theoretical model is currently lacking. The aim of this debate is to review complementing and contrasting views on the effects of gambling to create a conceptual model, where a public health perspective is applied.

MAIN TEXT

The effects of gambling can be structuralized using a conceptual model, where impacts are divided into negative and positive; costs and benefits. Costs and benefits are categorized into three classes: financial, labor and health, and well-being. These classes manifest in personal, interpersonal, and societal levels. Individual impacts cause effects on a personal level to gamblers themselves. External impacts influence the interpersonal and society/community levels and concern other people. The temporal level refers to the development, severity and scope of the gambling impact. These include general impacts, impacts of problem gambling and long-term impacts of gambling.

CONCLUSIONS

The conceptual model offers a base on which to start building common methodology for assessing the impact of gambling on the society. While measuring monetary impacts is not always straightforward, the main issue is how to measure the social impacts, which are typically ignored in calculations, as are personal and interpersonal impacts. The reviewed empirical work largely concentrated on the costs of gambling, especially costs on the community level. The Model can be used to identify areas where research is scarce. Filling the gaps in knowledge is essential in forming a balanced evidence base on the impacts of gambling. Ideally, this evidence could be the starting point in formulating public policies on gambling.

A Multivariate Evaluation of 25 Proximal and Distal Risk-Factors for Gambling-Related Harm

Individual differences in the risk of developing gambling-related harm play an important role in theoretical models and practical interventions. The present study attempted comprehensive measurement and evaluation of 25 known risk factors for gambling-related harm in order to determine which factors provided large and unique explanatory power. We surveyed 1650 regular gamblers from an online panel, screening in 1174 (466 male) who passed all checks of attention and response consistency. We evaluated each risk factor based on bivariate correlations with harms, then made separate multivariate evaluations of proximal (e.g., gambling motivations) and distal (e.g., religiosity) risk factors. Almost all bivariate correlations were significant, but most distal factors were not significant in multivariate models. Trait impulsivity was the most important risk factor by a large margin. Excessive consumption, less use of safe gambling practices, and more fallacies were key proximal risks of harm. Many well-known correlates of gambling harm (e.g., youth, lower educational attainment) do not show a direct role in the development of gambling harm when controlling for other factors. The results support theoretical models that emphasise early conditioning and biological vulnerability (manifested through impulsivity). Since maladaptive cognitive and behavioural schemas appear to be more important than motivations (e.g., escape, excitement, ego), interventions may benefit by targeting these proximal drivers of harm.

Gambling expenditure by game type among weekly gamblers in Finland

BACKGROUND

Excessive expenditure and financial harms are core features of problem gambling. There are various forms of gambling and their nature varies. The aim was to measure gambling expenditure by game type while controlling for demographics and other gambling participation factors. A further aim was to find out how each game type was associated with gambling expenditure when the number of game types played is adjusted for.

METHODS

Using data from the 2015 Finnish Gambling survey on adult gamblers (n = 3555), multiple log-linear regression was used to examine the effects of demographics, gambling participation, and engaging in different game types on weekly gambling expenditure (WGE) and relative gambling expenditure (RGE).

RESULTS

Male gender, lower education level, higher gambling frequency and higher number of game types increased both WGE and RGE, while younger age decreased WGE but increased RGE. Furthermore, seven specific game types increased both WGE and RGE. Weekly horse race betting and non-monopoly gambling had the strongest increasing effect on expenditure. Betting games and online poker were associated with higher expenditure even when they were played less often than weekly. Among weekly gamblers the highest mean WGE was recorded for those who played non-monopoly games (146.84 €/week), online poker (59.61 €/week), scratch games (51.77 €/week) and horse race betting (48.67 €/week). Those who played only 1-2 game types a week had the highest mean WGE and RGE on horse race betting and other betting games.

CONCLUSIONS

It seems that overall gambling frequency is the strongest indicator of high gambling expenditure. Our results showed that different game types had different effect sizes on gambling expenditure. Weekly gambling on horse races and non-monopoly games had the greatest increasing effect on expenditure. However, different game types also varied based on their popularity. The extent of potential harms caused by high expenditure therefore also varies on the population level. Based on our results, future prevention and harm minimization efforts should be tailored to different game types for greater effectiveness.

Gambling participation, gambling habits, gambling-related harm, and opinions on gambling advertising in Finland in 2016

Background:

This report is an overview of results from the 2016 Finnish Gambling Harms Survey covering the population and clinical perspectives. It summarises the main findings on gambling participation, gambling habits, gambling-related harm, and opinions on gambling advertising.

Methods:

The population sample (n = 7186) was collected from three regions and the clinical sample (n = 119) in a gambling help clinic.

Results:

Frequency of gambling in the population sample was characteristically once a week, while in the clinical sample it was daily. Men gambled more often than women only in the population sample. The most common gambling environments were kiosks, grocery stores or supermarkets, and home. The most typical gambling-related harms were financial or emotional/psychological harms; the amount of experienced harm was considerable among the clinical sample. The clinical sample also perceived gambling advertising as obtrusive and as a driving force for gambling.

Conclusions:

The results of the clinical sample imply that when gambling gets out of hand, the distinctions between gamblers’ habits diminish and become more streamlined, focusing on gambling per se – doing it often, and in greater varieties (different game types). There is a heightened need to monitor gambling and gambling-related harm at the population level, especially amongst heavy consumers, in order to understand what type of external factors pertaining to policy and governance may contribute to the shift from recreational to problem gambling.