Predictors of gambling and problem gambling in Canada

Cluster analysis based on gambling variables and mental health in a clinical population of gamblers

BACKGROUND

Interest in characterizing individuals involved in addictive behaviors has been growing, which allows tailoring prevention and intervention strategies to the gambler's needs. The study aimed to 1) identify clusters of gamblers according to gambling-related characteristics and mental health; and 2) analyze differences in psychological variables between the clusters.

METHODS

A total of 83 participants undergoing treatment for gambling disorder (Mage = 45.52, 51.8 % female) completed a set of questionnaires. Hierarchical cluster analysis was performed to classify gambling based on gambling variables (i.e., gambling severity and gambling motives) and mental health (i.e., depression, anxiety, and hostility). Several ANOVAs were conducted to illustrate the distinguishing features of each cluster, encompassing both the variables included in the cluster analysis and other relevant psychological variables.

RESULTS

Findings suggest that gamblers can be classified into three clusters based on these variables: 1) "high gambling severity and good mental health," 2) "high gambling severity and poor mental health," and 3) "low gambling severity and good mental health." These clusters were differentiated as a function of psychological variables, such as emotional dependence, alexithymia, and stressful life events.

CONCLUSIONS

Classifying gamblers according to their profile provides a better understanding of their needs and problems, allowing for a more tailored approach in terms of prevention and intervention strategies.

Gambling in Older Adulthood: Longitudinal Associations Between Stressful Life Events, Individual, and Social Factors

Older adults are receiving increased attention in gambling research, in part because gambling and related problems appear to be increasing in this population. To date, little or no research has examined the complexities of gambling and later-life circumstances, including life events, and individual and social factors. This study utilized longitudinal data (5 waves) from older adults (60 + ; N = 670) in the Quinte Longitudinal Study (Williams et al., in: The Quinte longitudinal study of gambling and problem gambling 2006-2011, Bay of Quinte region, Ontario, 2014). Longitudinal multilevel models examined between- and within-person effects of stressful life events on gambling frequency and Problem Gambling Severity Index (PGSI) scores, and the possible moderating role of individual (age, gender, mental health, physical health) and social variables (marital status, social support) on this relationship. Results of the final model showed significant effects (p < .01) for linear time (PGSI scores declined across waves; β = - .06); gender (women's mean PGSI greater than men's; γ = .26); social support (less support associated with greater PGSI; γ = .05); and an interaction between age and stressful life events (effect of stressful events on PGSI is lesser with greater age; γ = - .02). Simple slopes (at mean age of 66 at wave 1, and ± 1SD) showed that at 61 (γ = .35) and 66 years (γ = .23), mean PGSI scores were greater with each additional stressful life event; there was no significant effect for stressful events at age 71. These findings suggest women, those with less social support, and greater stressful life events may be at greater risk of problem gambling, while greater age weakens the effect of stressful events and problem gambling.

What is known about population level programs designed to address gambling-related harm: rapid review of the evidence

BACKGROUND

Gambling and gambling-related harm attract significant researcher and policy attention. The liberalisation of gambling in most western countries is strongly associated with a marked rise in gambling activity and increases in gambling-related harm experienced at the population level. Programs to address gambling-related harm have traditionally focused on individuals who demonstrate problematic gambling behaviour, despite clear evidence of the effectiveness of a public health approach to high-risk activities like gambling. Little is known about the availability or efficacy of programs to address gambling-related harm at a population level.

METHODS

The Victorian Responsible Gambling Foundation commissioned a rapid evidence review of the available evidence on programs designed to reduce gambling-related harm at a population level. The review was conducted using a public health and harm reduction lens. MEDLINE, ProQuest Central and PsychInfo databases were searched systematically. Included studies were published in English between 2017 - 2023 from all countries with gambling policy contexts and public health systems comparable to Australia's; included primary data; and focused on primary and/or secondary prevention of gambling-related harm or problems.

RESULTS

One hundred and sixty-seven articles were eligible for inclusion. Themes identified in the literature included: risk and protective factors; primary prevention; secondary prevention; tertiary prevention; target population group; and public health approach. The evidence review revealed a gap in empirical evidence around effective interventions to reduce gambling-related harm at the population level, particularly from a public health perspective.

CONCLUSIONS

Addressing gambling-related harm requires a nuanced, multi-layered approach that acknowledges the complex social, environmental, and commercial nature of gambling and associated harms. Moreover, evidence demonstrates community programs to reduce gambling-related harm are more successful in reducing harm when based on sound theory of co-design and address the social aspects that contribute to harm.

Brief Report: The Rise of Online Betting in Ontario

In this paper we examine the nature of calls for the Ontario Problem Gambling Helpline from June 2021 to Jan 2023 to determine if the increased marketing of online and sports gambling has changed the nature of calls to the helpline. An interrupted time series model comparing the monthly calls before and after the expansion of online gambling and advertising (April 2023), found a significant effect. Calls related to the other games examined did not have a significant interrupted time series effect of from the expansion and advertising of online gambling. The results of this analysis clearly indicate an association between the expansion of legalized gambling and gambling advertising with the number of people who call the helpline for problem related to online gambling.

Are There Riskier Types of Gambling?

Gambling-related harm is a public health issue requiring market regulation and efforts aimed at prevention and treatment. An important consideration for the regulation of gambling is whether certain types of gambling are intrinsically more harmful than others. The present study was a comprehensive investigation of this issue in a nationwide sample of 10,199 Canadian adult gamblers that included 1346 individuals with problem gambling. We investigated (a) the univariate cross-sectional association between individual types of gambling and problem gambling; (b) the cross-sectional association between individual gambling types and problem gambling when controlling for breadth of gambling involvement; (c) the prospective/lagged relationship between participation in different gambling types and future problem gambling; and (d) the self-reports of people with gambling problems concerning the types and modalities they consider to be most problematic. Our collective results indicate that breadth of gambling involvement is a stronger predictor of gambling problems than involvement in any particular type, but that involvement in certain types (electronic gambling machines in particular, and casino table games and online gambling to a lesser extent) does confer additional risk.

Ethnicity as a risk factor for gambling disorder: a large-scale study linking data from the Norwegian patient registry with the Norwegian social insurance database

BACKGROUND

The study investigated ethnicity as a risk factor for gambling disorder (GD), controlling for demographics, citizenship, and years of residency in Norway.

METHODS

The sample comprised 65,771 individuals from a national patient registry (n = 35,607, age range 18-88 years) and a national social insurance database in Norway (n = 30,164, age rage 18-98 years). The data covered the period from 2008 to 2018.

RESULTS

The results showed that when controlling for age and sex, ethnic minorities were overall less likely than those born in Norway to be diagnosed with GD (odds ratio [OR] ranging from 0.293 to 0.698). After controlling for citizenship and years of residency in Norway, the results were reversed and indicated that ethnic minorities were overall more likely to be diagnosed with GD (OR ranging from 1.179 to 3.208).

CONCLUSION

The results suggest that citizenship and years of residency are important variables to account for when assessing the relationship between ethnicity and being diagnosed with GD. Our results may be explained by people from ethnic minority groups being more likely to experience gambling problems but less likely to seek contact with healthcare services for gambling problems.

Electronic gaming machine accessibility and gambling problems: A natural policy experiment

Background

Electronic gaming machines (EGMs) are one of the most harmful forms of gambling at an individual level. It is unclear whether restriction of EGM functions and accessibility results in meaningful reductions in population-level gambling harm.

Methods

A natural policy experiment using a large (N = 15,000) national dataset weighted to standard population variables was employed to compare estimates of gambling problems between Australian residents in Western Australia (WA), where EGMs are restricted to one venue and have different structural features, to residents in other Australian jurisdictions where EGMs are widely accessible in casinos, hotels and clubs. Accessibility of other gambling forms is similar across jurisdictions.

Results

Gambling participation was higher in WA, but EGM participation was approximately half that of the rest of Australia. Aggregate gambling problems and harm were about one-third lower in WA, and self-reported attribution of harm from EGMs by gamblers and affected others was 2.7× and 4× lower, respectively. Mediation analyses found that less frequent EGM use in WA accounted for the vast majority of the discrepancy in gambling problems (indirect path = -0.055, 95% CI -0.071; -0.038). Moderation analyses found that EGMs are the form most strongly associated with problems, and the strength of this relationship did not differ significantly across jurisdictions.

Discussion

Lower harm from gambling in WA is attributable to restricted accessibility of EGMs, rather than different structural features. There appears to be little transfer of problems to other gambling forms. These results suggest that restricting the accessibility of EGMs substantially reduces gambling harm.

Clinical Correlates of Sports Betting: A Systematic Review

Sports betting is becoming increasingly widespread, and a growing number of individuals, both adolescents and adults, participate in this type of gambling. The main aim of this systematic review was to assess correlates of sports betting (sociodemographic features, gambling-related variables, co-occurring psychopathologies, and personality tendencies) through a systematic review conducted following the PRISMA guidelines. Relevant studies were identified via searches of NCBI/PubMed and APA PsycInfo databases. Individuals from the general population and/or with a clinical diagnosis of gambling disorder (GD) were included, irrespective of gender and age. In addition, the studies needed to have administered at least one clinical interview/psychometric instrument to assess the presence of problematic gambling/GD, contain at least one group of participants with sports betting, and directly analyze the association between sports betting and any of the following features: sociodemographics, gambling-related variables, co-occurring psychopathologies, and/or personality tendencies. Fifty-four articles were included. Multiple sociodemographic variables have been studied in relation to sports betting. In general, males with high impulsivity have greater tendencies for sports betting. The co-occurrence of certain pathologies, especially substance use or other addictive disorders, was also suggested. Most studies were cross-sectional, assessed participants using self-administered instruments, recruited samples using non-probability online panels, included small samples, had unbalanced samples, and included samples from only one country. Impulsive males may be particularly prone to sports gambling and related problems. Future research should examine prevention strategies that may help prevent the development of sport-betting-related GD and other addictive behaviors in vulnerable individuals.

Culturally and Linguistically Diverse Gamblers of East Asian Descent in Australia: A Comprehensive Review of Current Evidence

As a country with one of the highest per capita gambling losses per year in the world, and an evolving multicultural profile, Australia has become an important setting in which to examine the harms and benefits related to gambling. The Australian population includes people from East Asian cultural backgrounds who are a key demographic of interest for gambling operators planning to grow revenue. However, Australian gambling research has concentrated primarily on those belonging to the dominant cultural group. Most of the previous and limited number of studies to examine gambling among culturally and linguistically diverse (CALD) residents have focused on people of Chinese descent, and much of the literature is now becoming relatively old. This review examines the current evidence around cultural variations in gambling prevalence, motivations, beliefs, behaviours, and help service utilisation, focusing on gamblers with an East Asian cultural background. Numerous domains in which gambling motivations and behaviours vary across cultural groups are identified, and methodological considerations related to ethnographic gambling research are discussed. This review found that while barriers and predictors to help-seeking for CALD gamblers have been studied extensively, contemporary evidence of help service utilisation and effectiveness in Australia is lacking. Further research providing an accurate assessment of the impacts of gambling for CALD gamblers is needed to ensure that harm minimisation resources are effective for those most vulnerable to harm.

Developmental Patterns of Gambling Participation and Substance use Throughout Adolescence in a Population Birth Cohort

This study investigated adolescents' single and co-occurring developmental patterns of gambling participation and substance use and their association with gambling and substance use-related issues at age 17, controlling for confounders. Multiple assessments from age 12 to 17 were conducted in a population-based cohort (N=1594, 51.2% boys). Latent growth modeling was used to analyze developmental patterns and Generalized linear models to examine their association with age-17 gambling and substance use-related problems, types and variety of activities, and substance abuse. Results revealed six developmental patterns, including Low- or Non-substance Users or Gamblers (24.2% sample), two trajectory-classes of Later-Onset Increasing (to a moderate level) substance users, either with or without gambling participation (7.8% and 45.5%, respectively), two trajectory-classes of Early-Onset Increasing (to a higher level) substance users, either with or without gambling participation (6.2% and 12.7%, respectively), and a smaller trajectory-class of Slow-Increasing Substance Users and Early-Onset Gamblers, declining to non-gambling after age 13 (3.6%). Gambling participation and substance use did not appear to influence each other with regard to their onset and course throughout adolescence, and to age-17 types and variety of gambling activities or substances used, problems related to gambling participation or substance use, or substance abuse. These findings are consistent with the addictive syndrome model and with both common and individualized approaches to prevention and treatment for adolescent gamblers or substance users.

Skin Gambling Contributes to Gambling Problems and Harm After Controlling for Other Forms of Traditional Gambling

Esports betting and skin gambling involve betting on the outcomes of video game competitions and/or using virtual currencies for betting. The present study evaluated a conceptual model linking video game involvement, video-game related gambling, traditional gambling, and gambling problems and harm. Data were collected via a cross-sectional online survey with 737 participants aged 18 + who engaged in esports cash betting (n = 576), esports skin betting (n = 184), or skin gambling on games of chance (n = 330). The findings highlighted the distinctly different relationships esports cash betting versus skin gambling had with traditional gambling involvement and harmful gambling. Gambling with skins on games of chance was predictive of gambling problems and gambling harm after controlling for participation in traditional gambling (OR = 1.32 and 1.17 respectively). Whereas betting on esports with cash was associated with betting on a variety of other forms of gambling, and there was no unique contribution to problems and harm over and above participation on these other forms (e.g., EGMs, sports betting). Skin gambling is directly implicated in gambling problems and harm, whereas cash betting on esports is only indicative of interest in many forms of potentially harmful gambling. Greater research attention to skin gambling is warranted, and particularly with respect to its role as a virtual currency more easily accessible for gambling.

The relationship between problematic gambling severity and engagement with gambling products: Longitudinal analysis of the Emerging Adults Gambling Survey

AIMS

To measure the association between problem gambling severity and 19 different gambling activities among emerging adults (aged 16-26).

DESIGN

An online non-probability longitudinal survey collecting data in two waves: wave 1, July/August 2019; wave 2, July/October 2020.

SETTING

Great Britain PARTICIPANTS: A total of 2080 young adults participating in both waves.

MEASUREMENTS

Problem gambling scores were collected using the Problem Gambling Severity Index (PGSI). Binary variables recorded past year participation in 19 different gambling forms, ranging from lotteries to online casino and gambling-like practices within digital games (e.g. loot box purchase, skin betting). Controls included socio-demographic/economic characteristics, the Eysenck Impulsivity Scale and the number of gambling activities undertaken.

FINDINGS

Zero inflated negative binomial model lacked evidence of an effect between past year participation in any individual activities and subsequent PGSI scores. However, negative binomial random effects models for current gamblers (n = 497) showed that skin betting (incidence-rate ratio [IRR] = 2.32; 95% CI = 1.69-3.19), fixed odd betting terminals (IRR = 2.21, 95% CI = 1.61-3.05), slot/fruit machines (IRR = 1.43, 95% CI = 1.07-1.91), online betting on horse/dog races (IRR = 1.53, 95% CI = 1.17-2.00) and online betting on non-sports events (IRR = 1.44, 95% CI = 1.11-1.89) were associated with increased PGSI scores. Online casino gambling had a significant interaction by wave; the impact of online casino betting in wave 2 on PGSI scores increased by a factor of 1.61.

CONCLUSIONS

Past year participation of young adults (aged 16-26) in certain forms of gambling does not appear to be associated with future Problem Gambling Severity Index scores. Among young adults who are current gamblers, past year participation in certain land-based (e.g. electronic gaming machines) and online forms (e.g. skin betting) of gambling appears to be strongly associated with elevated Problem Gambling Severity Index scores.

18 Years of Changing Trends: Swiss Data on the Clinical Characteristics and Game Types Associated with Problem Gambling

Recent changes in the Swiss gambling context include the introduction of a new gambling policy (Swiss Federal Act on Gambling; GA), and the associated opening of the online gambling market. Within this context it is important to observe evolving trends in gambling behavior. This study therefore aims to identify the gambling behavior and clinical characteristics of a treatment-seeking population over an 18-year period (2001 to 2018). Specifically, the proportion of referrals relating to the three most popular game-types; VLT play, slot machines and online gambling, and associated socio-demographic characteristics, gambling-related spending and clinical features. The results indicate the high addictive potential for VLT and slot-machine use, over the 18-year period with an increasing use of online gambling from 2012 to 2018 (even before the official opening of the market). Problem-gambling vulnerability factors such as low income, unemployment and debts as well as self-reported suicidal ideation, were also over-represented in the sample. This longitudinal overview provides a detailed picture of treatment-seeking referrals, for future comparisons and can be used to tailor clinical interventions.

Pictograms to aid laypeople in identifying the addictiveness of gambling products (PictoGRRed study)

The structural addictive characteristics of gambling products are important targets for prevention, but can be unintuitive to laypeople. In the PictoGRRed (Pictograms for Gambling Risk Reduction) study, we aimed to develop pictograms that illustrate the main addictive characteristics of gambling products and to assess their impact on identifying the addictiveness of gambling products by laypeople. We conducted a three-step study: (1) use of a Delphi consensus method among 56 experts from 13 countries to reach a consensus on the 10 structural addictive characteristics of gambling products to be illustrated by pictograms and their associated definitions, (2) development of 10 pictograms and their definitions, and (3) study in the general population to assess the impact of exposure to the pictograms and their definitions (n = 900). French-speaking experts from the panel assessed the addictiveness of gambling products (n = 25), in which the mean of expert's ratings was considered as the true value. Participants were randomly provided with the pictograms and their definitions, or with a standard slogan, or with neither (control group). We considered the control group as representing the baseline ability of laypeople to assess the addictiveness of gambling products. Each group and the French-speaking experts rated the addictiveness of 14 gambling products. The judgment criterion was the intraclass coefficients (ICCs) between the mean ratings of each group and the experts, reflecting the level of agreement between each group and the experts. Exposure to the pictograms and their definition doubled the ability of laypeople to assess the addictiveness of gambling products compared with that of the group that read a slogan or the control group (ICC = 0.28 vs. 0.14 (Slogan) and 0.14 (Control)). Laypeople have limited awareness of the addictive characteristics of gambling products. The pictograms developed herein represent an innovative tool for universally empowering prevention and for selective prevention.

Exploring the association between loot boxes and problem gambling: Are video gamers referring to loot boxes when they complete gambling screening tools?

Concerns regarding the similarities between video game 'loot boxes' and gambling have been supported by correlations in survey studies between loot box engagement and problem gambling scores. It is generally noted that this correlation could reflect loot box users migrating to conventional gambling, and/or people with gambling problems being attracted to loot boxes when they play video games. We describe a third possibility, that when gamers complete problem gambling screens they may be referring to harms incurred from their loot box use. Using three secondary datasets from cross-sectional online surveys, we explore this account in two ways. First, in participants who do not endorse any participation in conventional forms of gambling, we compare rates of positive (i.e. non-zero) scores on the Problem Gambling Severity Index (PGSI) in participants with and without loot box use. Second, noting that some PGSI items have less relevance to loot box use versus gambling, we compare endorsement rates of individual PGSI items, in gamers versus gamblers, and loot box users vs non-loot box users (focusing on item 3 "going back another day to win back the money you lost"). In analysis 1, positive PGSI scorers among non-gamblers were significantly elevated in loot box users vs non-loot box users, although absolute numbers were low overall. In analysis 2, there were no reliable differences (gamers vs gamblers, loot box users vs non-loot box users) in PGSI item 3 endorsement rates. We conclude that these results provide partial support for this third option, and highlight a need for future studies to consider this possibility more directly.

Addressing gambling harms by reducing the supply of electronic gambling machines: a comparative study of Italy and Finland

Background

Electronic gambling machines (EGMs) are amongst the most harmful forms of gambling. The high availability of EGMs is also linked to increased consumption. To reduce the burden of EGMs on public health, policies to reduce their numbers have recently been introduced in Italy and Finland. This study compares the aims and justifications of these legislative changes, as well as their overall impacts on total consumption.

Methods

The objectives and justifications of policies to reduce the number of EGMs were based on qualitative media analysis. The impacts on total consumption were measured using financial figures provided by gambling providers in Italy and Finland.

Results

Results show that the reductions in EGM numbers were justified in terms of public health concerns in both countries, but the amplitude of policies varied. In Italy, the reductions were more ambitious than in Finland, and included reductions in the number of gambling locations. The financial data nevertheless indicated that the reductions may not have been significant enough.

Conclusions

Public health concerns were initially highlighted in the media discussions, but eventually in both countries reduction policies were less ambitious due to industry lobbying and state revenue interests. The reductions therefore do not appear to have been effective in reducing total consumption and the burden on public health.

Sports-betting-related gambling disorder: Clinical features and correlates of cognitive behavioral therapy outcomes

BACKGROUND AND AIMS

The number of patients with gambling disorder (GD) whose gambling preference is sports betting is increasing. However, their clinical profile and their responses to psychological treatments -compared to patients with other forms of gambling- have not been thoroughly studied. Therefore, the aims of this study were: (1) to compare the clinical characteristics of GD patients whose primary gambling activity was sports betting (SB+; n = 113) with GD patients with other primary gambling activities (SB-; n = 1,135); (2) to compare treatment outcomes (dropout and relapses) between SB + and SB- patients; and (3) to explore relationships between specific variables (GD severity, psychological distress and personality features) and treatment outcome in SB + and SB- GD patients, through correlation models and path-analysis.

METHODS

The cognitive behavioral treatment consisted of 16 weekly sessions. Personality features, psychopathology, and sociodemographic and clinical factors were assessed.

RESULTS

The SB + group included higher proportions of younger patients who were single and had higher educational levels, older ages of GD onset, and greater GD severities. Regarding treatment outcomes, the dropout rate was lower in the SB + group, and no between-group differences were found regarding relapse. Dropout within the SB + group was related to being unemployed, and relapse was related to being unmarried and experiencing more psychological distress.

DISCUSSION AND CONCLUSION

The differences between SB + and SB- GD patients suggest that GD patients with sports-betting problems may benefit from tailored therapeutic approaches.

The Gamblification of Investing: How a New Generation of Investors Is Being Born to Lose

Investing and gambling share key features, in that both involve risk, the coming together of two or more people, and both are voluntary activities. However, investing is generally a much better way than gambling for the average person to make long-run profits. This paper reviews evidence on two types of “gamblified” investment products where this advantage does not hold for investing: high-frequency stock trading and high-risk derivatives. This review defines a gamblified investment product as one that leads most investors to lose, that attracts people at risk of experiencing gambling-related harm, and that utilizes product design principles from gambling (either by encouraging a high frequency of use or by providing the allure of big lottery-like wins). The gamblification of investing produces novel challenges for the regulation of both financial markets and gambling.

The stock market as a casino: Associations between stock market trading frequency and problem gambling

BACKGROUND AND AIMS

Personal investors decrease their stock market investment returns by trading frequently, which the behavioral finance literature has primarily explained via investors' overconfidence and low levels of financial literacy. This study investigates whether problem gambling can help account for frequent trading in a sample of active gambler/investors, as suggestive of frequent trading being in part driven by a behavioral addiction to gambling-like activities.

METHODS

A retrospective cross-sectional study of 795 US-based participants, who reported both being active gamblers and holding stock market investments. Recollected stock trading activity (typical portfolio size, purchases and sales of stocks) was compared with scores on the Problem Gambling Severity Index, a financial literacy scale, and a measure of overconfidence.

RESULTS

Self-reported relative stock portfolio turnover was positively associated with problem gambling scores. This association was robust to controls for financial literacy, overconfidence, and demographics, and occurred equally among investors of all self-reported portfolio sizes.

DISCUSSION AND CONCLUSIONS

This study provides support for the hypothesis that behavioral addiction to gambling-like activities is associated with frequent stock market trading. New investment products that increase the ease of trading may therefore be detrimental to some investors.

The impact of the initial Covid-19 lockdown upon regular sports bettors in Britain: Findings from a cross-sectional online study

BACKGROUND

In Britain, unprecedented restrictions on daily life associated with the Covid-19 pandemic included the suspension of professional sports events during the initial 'lockdown'. This provides opportunities to observe changes in sports bettors' behaviour when their primary form of activity is removed and assess the impact of Covid-19 related circumstances upon gambling.

METHODS

In July 2020, we conducted an online cross-sectional survey of people who bet regularly (at least monthly) on sports before Covid-19 (n = 3866). Bi-variate analyses compared changes in gambling behaviours before and during the initial lockdown. Multi-variate logistic regression models explored associations between problem gambling (men) and moderate risk or problem gambling (MRPG) (women) with changes in Covid-19 related circumstances and changing gambling behaviours during Britain's initial 'lockdown' (March-June 2020).

RESULTS

29.8% of male sports bettors and 33.4% of female sports bettors stopped gambling altogether during the initial Covid-19 lockdown, though 17.3% of men and 16.5% of women started a new form of gambling during lockdown. Among men, adjusted odds ratios of problem gambling were higher among those starting a new gambling activity during lockdown (OR = 2.50 [95% CI 1.38-4.53]). Among women, adjusted odds ratios of MRPG were higher among those whose frequency of gambling on any activity increased during lockdown (OR = 4.21 [1.99-8.92] and among those shielding for health reasons. Poorer wellbeing was associated with problem gambling for men and MRPG for women.

CONCLUSIONS

Those changing gambling behaviours during the initial Covid-19 lockdown (e.g. increasing gambling frequency or starting a new gambling activity) are potentially vulnerable to gambling harms.

Gambling and Problem Gambling in Canada in 2018: Prevalence and Changes Since 2002

OBJECTIVE

The purpose of this study was to provide an updated profile of gambling and problem gambling in Canada and to examine how the rates and pattern of participation compare to 2002.

METHOD

An assessment of gambling and problem gambling was included in the 2018 Canadian Community Health Survey and administered to 24,982 individuals aged 15 and older. The present analyses selected for adults (18+).

RESULTS

A total of 66.2% of people reported engaging in some type of gambling in 2018, primarily lottery and/or raffle tickets, the only type in which the majority of Canadians participate. There are some significant interprovincial differences, with perhaps the most important one being the higher rate of electronic gambling machine (EGM) participation in Manitoba and Saskatchewan. The overall pattern of gambling in 2018 is very similar to 2002, although participation is generally much lower in 2018, particularly for EGMs and bingo. Only 0.6% of the population were identified as problem gamblers in 2018, with an additional 2.7% being at-risk gamblers. There is no significant interprovincial variation in problem gambling rates. The interprovincial pattern of problem gambling in 2018 is also very similar to what was found in 2002 with the main difference being a 45% decrease in the overall prevalence of problem gambling.

CONCLUSIONS

Gambling and problem gambling have both decreased in Canada from 2002 to 2018 although the provincial patterns are quite similar between the 2 time periods. Several mechanisms have likely collectively contributed to these declines. Decreases have also been reported in several other Western countries in recent years and have occurred despite the expansion of legal gambling opportunities, suggesting a degree of inoculation or adaptation in large parts of the population.

Indigenous Gambling and Problem Gambling in Canada

The present study provides a profile of Canadian Indigenous gambling and problem gambling using the 2018 Canadian Community Health Survey (CCHS) (n = 23,952 adults; 1,324 Indigenous) and an online panel survey of 10,199 gamblers (n = 589 Indigenous). The relative popularity of different types of gambling was similar between Indigenous and non-Indigenous samples. However, there was higher Indigenous participation in electronic gambling machines (EGMs), bingo, instant lotteries, overall gambling and a higher rate of problem gambling (2.0% versus 0.5%). Variables predictive of Indigenous problem gambling were EGM participation, gambling fallacies, having a mental or substance use disorder, sports betting, and male gender. Compared to non-Indigenous problem gamblers, Indigenous problem gamblers had higher substance use and lower impulsivity. In general, variables predictive of Indigenous problem gambling were the same ones predictive of problem gambling in all populations, with elevated Indigenous problem gambling rates primarily being due to elevated rates of these generic risk factors. Many of these risk factors are modifiable. Particular consideration should be given to reducing the disproportionate concentration of EGMs in geographic areas having the highest concentration of Indigenous people and ameliorating the disadvantageous social conditions in this population that are conducive to mental health and substance use problems.