Striving Towards National Lower-Risk Gambling Guidelines: An Empirical Investigation Among a Sample of Swedish Gamblers.

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Several countries, including Canada and Australia, have developed public health-based lower-risk gambling limits to differentiate lower-risk from higher-risk gambling. This study aimed to identify a preliminary set of lower-risk gambling limits (gambling frequency, duration, expenditure, expenditure as a proportion of personal net income, and diversity), and investigate if gambling types are linked to additional harms, in a Swedish context. The study involved secondary analyses of two online survey studies using the Gambling Disorder Identification Test (GDIT). Receiver operating curve analyses were conducted in relation to both + 1 and + 2 gambling-related harms in a sample of 705 past-year gamblers. Potential lower-risk limits ranges identified were: gambling frequency of "2-3 times a week" to "4 or more times a week" (8-16 times monthly); gambling duration of 6 to 15h per month; gambling expenditure of 2,000 SEK (approximately $USD190) per month; gambling expenditure as a proportion of personal net income of 5%; and gambling diversity of only one problematic gambling type. Gambling on slots and sports betting were associated with gambling-related harms. The lower-risk limits in the current study were higher than in previous studies, which may be explained by the large proportion of support- or treatment-seeking gamblers with high rates of problem gambling and problematic online gambling in the study sample. An international consensus-based framework on gambling consumption is warranted, with lower-risk limits validated in future empirical studies using larger datasets collected from the Swedish general population.