Gambling-related Harm Research Articles

Effectiveness of Public Messaging Within the Gambling Domain: A Systematic Review

AbstractGambling messaging is one potential component of a public health approach towards reducing gambling-related harm (GRH). This systematic review examined the effectiveness of existing public health gambling messaging interventions. Four databases were searched from inception to June 2023. Twenty-one papers met inclusion criteria. Studies were conducted in diverse settings, employed various designs, and evaluated messaging interventions that differed in their aims and reported outcomes. Interventions were categorised into three groups: general population-level messaging, gambling harm reduction messages, and product risk warnings. The evidence—currently limited—suggests that existing gambling messaging interventions are ineffective in changing behaviours but can raise awareness of GRH. Our findings underpinned recommendations for how the format and presentation of currently used ‘safer’ gambling messages and product warning labels may be improved. Research is required to develop and test messages that can help prevent and reduce GRH both for the general population and people who gamble.

Players’ perceptions of, and engagement with, the GameSense responsible gambling program in Massachusetts casinos

ABSTRACT Given the risk and prevalence of excessive gambling, stakeholders have developed educational resources and tools to promote responsible gambling (RG) and minimize gambling-related harms. However, the effectiveness of such programs relies on players’ awareness of, and their engagement with, such programming. This research investigated factors that influence player engagement with the GameSense RG program. We surveyed 1109 regular players across three casinos in Massachusetts where GameSense is used. We found that most players (73.1%) were aware of GameSense and that 17.6% had engaged with the program. In terms of reasons for visiting a Center, Latent Class Analysis revealed two distinct classes: ’Information Seekers’ and ”Curiosity and Swag Inspired’. As for those who had yet to visit a Center, three classes emerged: ‘Invitation Responsive’, ‘Self-Assured Non-Believers’, and ‘Self-Assured’. Although GameSense is for the broad spectrum of gamblers, we found that players who engaged in more RG behaviors were less likely to engage with the program. The results suggest encouraging all players to engage with GameSense may be a challenge. Efforts are needed to increase awareness and engagement of the program across the broad spectrum of gamblers.

Parent perspectives on sports betting and its effects on children

Abstract Background Gambling-related harm is a global challenge. Sports betting is a rapidly growing form of gambling, facilitated by access to online wagering platforms and increased advertising. Most public health initiatives target ‘problem’ gamblers, ignoring socio-cultural influences. Within this context, we examine what parents think about sports betting, the potential impacts on their children, and whether they participate in sports betting around their children. Methods Using a survey of 3,481 Australian adult sports fans with dependent children, we analyse parental attitudes to sports betting and their concerns about possible effects on children. ANOVA and regression methods are used to test for differences in attitudes to sports betting between parents who are gamblers (sports and non-sports) and non-gamblers. Results Compared to non-gambling parents, sports-betting parents are much more permissive (by up to 0.9 standard deviations) of sports betting around and by children, and less concerned (by up to 0.6 standard deviations) about any harmful effects of sports betting on children. Sports betting parents place less importance on discussing the risks of sports betting with their children, and the more often a parent bets on sports, the less confident they are about having these discussions. Parents who bet on sports are 5.8 percentage points less likely than non-gambling parents to have had such conversations. Conclusions The strong influence of parent modelling and normalisation, combined with policy initiatives that recommend parents discuss potential sports betting risks with their children, implies that having a better understanding of attitudes will facilitate improved educational and harm minimisation policy initiatives. The findings of our study are important for public health policy and should inform interventions aimed at gambling harm reduction. Targeting sports betting parents with better tailored educational campaigns is warranted. Key messages • Children of parents who bet on sports are less likely to receive messages about the risks of sports betting, in addition to being exposed to role modelling that reinforces sports betting. • Compared to non-gambling parents, those who bet on sports have more permissive attitudes towards sports betting, suggesting targeted messaging and interventions are warranted.

Trends in Lower-Risk Gambling by Age and Net Income among Finnish Men and Women in 2011, 2015, and 2019.

Lower-risk Gambling Guidelines (LRGGs) were developed in Canada to reduce the risk of gambling-related harm. The LRGGs, published in 2021, consist of three limits: gamble no more than 1% of household income per month; gamble no more than four days per month; and avoid regularly gambling at more than two types of games. All three limits should be followed at the same time. This study focuses on the situation in Finland before the LRGGs were published. The aim of this study is to investigate trends in lower-risk gambling by age and net income among men and women in the Finnish adult population in 2011, 2015, and 2019. Data were drawn from cross-sectional Finnish Gambling population surveys, including permanent residents in Mainland Finland aged 15-74 with Finnish, Swedish or Sámi as their mother tongue (2011; n = 4,484, 2015; n = 4,515, and 2019; n = 3,994). The results showed an increase in the prevalence of lower-risk gambling, rising from 29% in 2011 to 39% in 2019. This upward trend was observed among both men and women, with the prevalence among men increasing from 23 to 33%, and among women from 34 to 45%. The lowest prevalence of lower-risk gambling was found among individuals aged 60-74, especially regarding expenditure guidelines, as well as among women in the lowest income tertile. In conclusion, although the prevalence of lower-risk gambling has increased in Finland, there is still potential for further improvement to minimize harm.

Digitalisation of gambling harm? Gambling consumption, negative consequences, and clinical characteristics among Swedish help-seekers

Gambling is connected to a range of harms and negative consequences. Gambling is also evolving at a fast pace, particularly in digital environments. Understanding the effects of this on-going change and digitalisation of gambling markets requires systematic measuring of gambling consumption patterns, clinical characteristics, and gambling-related harms.The current study compares two cohorts of help-seekers for gambling in Sweden (2019; 2023), recruited via the Swedish national helpline. The aim is to assess harms and consumption across the two cohorts at a time of increased offer of digital gambling in Sweden. We used eight different screens to measure gambling-related behaviours and consequences, including the Gambling Disorder Identification Test (GDIT). Results were analysed using descriptive statistics, and differences across the two cohorts were tested for statistical significance.The results show that across 2019–2023, gambling consumption has intensified. Online EGMs are by far the most prevalent form of gambling among help-seekers. We also found that the experience of co-morbidities as well as most gambling-related harms were common in both cohorts, with some statistically significant increases in 2023. Harms were more commonly experienced amongst those who engaged in online EGM gambling in comparison to those who did not.The results suggest that the digitalisation of gambling and gambling products appears to be associated with a variety of harmful consequences. The results also show the importance of systematic and comprehensive measurement to capture different severity levels of harms and their wide range amongst those who gamble.

The lived experience of gambling-related harm in natural language.

Gambling-related harms can have a significant negative impact on disordered gamblers, lower risk gamblers, and affected others. Yet, most disordered and lower risk gamblers will never seek formal treatment, often due to the stigma and shame surrounding gambling. Online self-help forums are a popular alternative way for gamblers to anonymously seek help from others. Analysis of these interactions can provide a deeper understanding of gambling than more commonly used research methodologies. In the present study, we leverage recent developments in natural language processing to analyze posts on a U.K.-based online self-help gambling forum. Using correlated topic modeling, we canvass the various types of discussions among forum members. We also combine this approach with semantic similarity analysis based on sentence embeddings, to map first the posts, and then the 10 topics, onto six previously established gambling-related harm domains. The topic modeling revealed a cluster of discussions of many negative emotions, a topic regarding the positive emotions underlying the potential for change, a distinct topic regarding gambling's relationship harms, and numerous environmental factors that contributed to harm. Emotional/psychological and health harms were most strongly associated with users' posts, illustrating the multidimensionality of severe gambling-related harm. Our results reveal the co-occurrence of different harms, such as the frequent mentions of financial harms and concomitant emotional/psychological harms. The analysis of the lived experiences of gambling-related harm in natural language represents a useful tool for gambling research and can provide a different perspective to inform policy. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Not always as advertised: Different effects from viewing safer gambling (harm prevention) adverts on gambling urges

Public concern around gambling advertising in the UK has been met not by government action but by industry self-regulations, such as a forthcoming voluntary ban on front-of-shirt gambling sponsorship in Premier League soccer. “Safer gambling” (harm prevention) adverts are one recent example, and are TV commercials which inform viewers about gambling-related harm. The present work is the first independent evaluation of safer gambling adverts by both gambling operators and a charity called GambleAware. In an online experiment, we observed the change in participants’ (N = 2,741) Gambling Urge Scale (GUS) scores after viewing either: a conventional financial inducement gambling advert, a gambling operator’s safer gambling advert, an advert from the GambleAware “bet regret” campaign, an advert from the GambleAware “stigma reduction” campaign, or a control advert that was not about gambling. Relative to a neutral control advert, GUS scores increased after viewing a financial inducement or an operator’s safer gambling advert. In comparison to the neutral control condition, GUS score changes were similar after viewing a bet regret advert, but showed a significant decrease after viewing a stigma reduction advert. Those at higher risk of harm reported larger decreases in GUS after watching a bet regret or stigma reduction advert. Overall, this study introduced a novel experimental paradigm for evaluating safer gambling adverts, uncovered a potential downside from gambling operators’ safer gambling adverts, and revealed variation in the potential effectiveness of charity-delivered safer gambling adverts.

Protocol for a pilot cluster randomised controlled trial of PRoGRAM-A (preventing gambling-related harm in adolescents): a secondary school-based social network intervention

BackgroundIn the UK, recent evidence of young people and gambling indicates a higher prevalence of gambling in comparison to other addictive behaviours. Engaging in gambling-related behaviour at a young age is associated with short and long-term consequences, including financial, emotional, academic, interpersonal, and physical and mental health detriments; otherwise known as gambling-related harms (GRH). Given the unique vulnerability of this younger group, early interventions aimed at delaying or preventing gambling are critical. PRoGRAM-A (Preventing Gambling-Related Harm in Adolescents) is a school-based, social network intervention to protect young people from future GRH, by delaying or preventing gambling experimentation.MethodsPilot cluster RCT with an embedded process evaluation and health economic scoping study.ParticipantsPRoGRAM-A will be delivered in four schools, with two control schools acting as a comparator. All are secondary schools in Scotland. Baseline surveys were conducted with students in S3 (ages 13–14). Follow-up surveys were conducted with the same cohort, six months post-baseline.InterventionPRoGRAM-A trainers will deliver a 2-day, out-of-school training workshop to Peer supporters. Peer supporters will be nominated by peers among their school year group (S3, age 13–14). Workshops will provide peer supporters with information on four gambling-related topics: (1) what is gambling? (2) gambling and gaming, (3) gambling marketing, (4) identifying harm and reducing risk. Peer supporters will disseminate the information (message diffusion) they have learned among their friends and family over a 10-week period. After the 2-day workshop, PRoGRAM-A trainers will conduct × 3 in-school follow-up sessions with peer supporters to offer support, encouragement, and advice to Peer Supporters as well as monitor and explore the extent of their message diffusion.Primary outcomeThe primary outcome of the pilot cluster RCT (cRCT) will be whether progression to a phase III RCT is justified.DiscussionThis will be the first pilot cluster RCT (cRCT) of an intervention to prevent gambling-related harms among young people within the UK. If findings indicate feasibility and acceptability, funding will be sought for a phase III RCT of effectiveness.Trial registrationResearchregistry8699. Registered 21st February 2023.

Online Gambling and At-Risk Gambling Behaviour in a Cross-Sectional Survey Among 13-19Year-Old Adolescents in Barcelona.

Gambling forms part of social and leisure activities for adolescents but is not free of potential harms. Moreover, with the emergence of new technologies, gambling has become increasingly accessible and appealing to this population. The aim of this study was to determine the magnitude of gambling behaviour and its associated factors in adolescents aged 13-19years in the city of Barcelona in 2021. A cross-sectional study was conducted using data from the 2021 Survey of Risk Factors in Secondary Schools. A bivariate analysis was carried out and multiple logistic regression models were constructed to estimate adjusted odds ratios and their 95% confidence intervals for online, non-online, and at-risk gambling. The prevalence of gambling among adolescents in Barcelona was 18.6% in boys and 6.1% in girls. Gambling was associated with various sociodemographic, health, and lifestyle factors, with differences observed by sex and gambling modality (online vs. non-online). The prevalence of at-risk gambling was 6.2% in boys and 1% in girls. At-risk gambling was associated with male sex, engaging in online gambling, poor mental health, and participating in more than two different types of gambling. The results of this study show that gambling is a widespread activity among adolescents in Barcelona, with significant associated risks. Preventive programmes and regulations are needed to reduce gambling involvement and gambling-related harms.

Dataset of a national survey on online gambling activities among young people in Portugal.

Abstract* Background Recent advancements in online gambling have significantly increased the popularity and participation in gambling activities among the general population, specifically the young generations. These changes are reshaping gambling behaviors, attracting a growing number of enthusiasts. This paper describes a dataset that maps online gambling activities among young individuals in Portugal, providing insights into their gambling prevalence, habits, behaviors, preferences, and potential antecedents and consequences of these activities. Methods A survey was conducted with a representative sample of 1,993 young people in Portugal, aged between 18 and 34, to gather data on their activities. This methodology involved a quantitative telephone survey conducted in March and April 2023, utilizing quota sampling to ensure representation across various regions. The data collection process employed Computer Assisted Telephone Interviewing (CATI) and involved rigorous quality control measures to ensure accuracy and reliability. Conclusion The dataset generated from this survey provides valuable insights into the patterns of online gambling activities among young Portuguese individuals. It allows researchers to explore potential risk factors, including gambling-related harm, and to understand the sociodemographic factors influencing gambling behaviors. The findings can inform interventions and policies aimed at mitigating the negative consequences of online gambling among youth.

The feasibility and acceptability of an inoculative intervention video for gambling advertising: a focus group study of academics and experts-by-experience.

Gambling advertising employs a range of persuasive strategies. We therefore aimed to evaluate a counter-advertising intervention video to increase resilience to gambling advertising persuasion. Three in-depth focus groups were conducted, and each group contained a mixture of gambling-related academics (N=12) and experts with lived experience of gambling-related harm (N=10). Participants were given access to the intervention video and provided feedback during the focus groups. Qualitative data were audio recorded and thematically analysed by the research team. Three main themes were identified. First, participants recommended a shorter video that had a simplified and digestible structure. Second, frequent real-world examples of gambling advertisements within the video were discouraged, and the inclusion of a relatable human voiceover was considered imperative to the receptiveness of the video. Finally, participants deemed it important to deliver psychologically grounded yet jargon-free content via a conversational style. An overall narrative framed by consumer-protection was also preferred in order to increase acceptance of the video content, rather than a more didactic framing. Evaluating the acceptability of a counter advertising intervention video provided valuable insight from both an academic and lived-experience perspective. Such insight is instrumental to the meaningful co-design of counter-advertising interventions.

Effect of pachinko parlour openings and closings on neighbourhood income-generating crimes in Japan: 6.5 years of observations

BackgroundElectronic gambling machines (EGMs) in gambling venues cause gambling-related harm and are a public health concern. This study focused on pachinko parlours as gambling venues and income-generating crimes as gambling-related harm. We aimed to verify whether income-generating crime rates increase in proximity to pachinko parlours and during the opening and post-closing periods of pachinko parlours relative to the pre-opening periods.MethodsWe used crime records spanning 6.5 years, including data on the opening and closing days of pachinko parlours for 6.5 years. We also sampled the addresses of convenience stores, bowling alleys, and households with official land prices all over Japan. The dependent variable was the daily income-generating crime incidence rate. Areas within 0.5 km, 0.5–1 km, 1–5 km, and 5–10 km radii of the pachinko parlours were the independent variables. The pre-, opening-, and post-closing periods of the pachinko parlours were also independent variables. The covariates included the number of convenience stores and always open pachinko parlours near pachinko parlours. Data were analysed using an analysis of variance (ANOVA) and covariance (ANCOVA). We also used differences-in-differences analysis (DD) to reveal the increase in income-generating crime rates in neighbourhoods exposed to the opening or closing of pachinko parlours.ResultsThe daily income-generating crime incidence rate was significantly higher in areas within 0.5–1 km and 1–5 km radii of pachinko parlours than in those within 0.5 km and 5–10 km radii of them. The daily income-generating crime incidence rate was also significantly higher during the opening and post-closing periods than during the pre-opening period, even when controlling for the number of convenience stores and always open pachinko parlours. In particular, fraud crime rates increased with the opening and closing of pachinko parlours.ConclusionsThe highest income-generating crime incidence rate was observed within a 0.5–1 km and 1–5 km radius of pachinko parlours. The opening of pachinko parlours also increased income-generating crime incidence rates, which increased after closing. Pachinko parlours are considered to be creating public harm because the corporate activities of these parlours make the youth in their neighbourhood perpetrators of fraud and older adults its victims. Future research should examine the current findings using official crime records.

Digital geographies of home: parenting practices in the space between gaming and gambling

ABSTRACT This paper advances debates at the intersection of geographies of children, youth and families, digital geographies, and geographies of home. We argue that social, seasonal and limited time are vitally important for understanding the new landscape between gaming and gambling and have wider analytical purchase for geographers. This paper reveals parenting practices connected to the multi-billion-dollar industry of paid-for currency in digital games used to access gambling style systems and chance-based mechanisms such as loot boxes. We use this timely example to develop new digital geographies of home from original interviews with families based in England on their everyday lived experiences of gambling-style systems in digital games as well as data from video ethnographies with children and young people and interviews with international game designers. This paper challenges current understandings by examining how parents make sense of gambling-related harms and demonstrates the spatial and temporal dynamics of purchasing decisions, rules, and associated conflicts in domestic space. We argue these systems in digital games shape and are shaped by family geographies. This paper concludes by outlining its relevance for the social and health sciences at a time of intense legislative interest in the increasingly blurred space between gaming and gambling.

National burden of gambling in Japan: an estimation from an online-based cross-sectional investigation and national epidemiological survey

BackgroundGambling is a popular leisure activity in many countries, often expected to boost regional economies. Nevertheless, its negative impacts remain a significant concern. Gambling disorder is recognized as the most severe consequence; however, even non- or low-risk gamblers may also face negative impacts. This study aimed to estimate the number of Japanese gamblers experiencing gambling-related harm (GRH) and its distribution across six life domains, financial, relational, emotional, health, social and other aspects, based on the severity of their problem gambling risk.MethodsThis cross-sectional study relied on an online survey conducted between August 5 and 11, 2020. Participants aged 20 years and above, who engaged in gambling during 2019 were recruited via a market research company. The survey assessed the prevalence of GRH 72 items among four gambler risk groups (non-problem, low-, moderate-, and high-risk), as categorized by the Problem Gambling Severity Index. The data was adjusted for population weighting using representative national survey data: the 2017 Comprehensive Survey of Living Conditions and the 2017 Epidemiological Survey on Gambling Addictions.ResultsOut of the 28,016 individuals invited to the survey, 6,124 participated in the screening, 3,113 in the main survey, and 3,063 provided valid responses. After adjusting the survey data, it was estimated that 39.0 million (30.8%) of Japan’s 126.8 million citizens gambled in 2019. Among them, 4.44 million (11.4%) experienced financial harm, 2.70 million (6.9%) health harm, 2.54 million (6.5%) emotional harm, 1.31 million (3.4%) work/study harm, 1.28 million (3.3%) relationship harm, and 0.46 million (1.2%) other harm. Although high-risk gamblers experienced severe harm at the individual level, over 60% of gamblers who experienced GRHs were non- and low-risk gamblers, with the exception of other harm, at the population level.ConclusionsThe study highlighted the prevention paradox of gambling in Japan. While national gambling policies primarily focus on the prevention and intervention for high-risk gamblers, a more effective approach would involve minimizing GRH across the entire population.

Does the lived experience of gambling accord with quantitative self-report scores of gambling-related harm?

A broad quantitative literature has explored the extent and distribution of gambling-related harm. However, any quantitative measure involves a number of statistical decisions around item selection and weighting that may affect its ability to provide an accurate summary of a gambler’s lived experience. This may especially be an issue with a condition as varied and multifaceted as gambling-related harm. The present research therefore used qualitative methods to validate the categorization of gamblers into four levels of harm via the Gambling Harms Scale (10-items) (GHS-10) through an analysis of 30 semi-structured interviews with gamblers. Results showed that unharmed gamblers saw gambling as just another leisure activity, which relieved stress and brought them closer to other people. Low harm gamblers were similar but could experience emotional stresses over their level of gambling expenditure. Just under half of all moderate harm gamblers experienced occasional severe financial impacts and emotional stresses from their gambling. Finally, all high harm gamblers experienced chronic financial impacts and emotional stresses, which spilled over into relationship problems for three quarters of this group, and negative impacts on health or work/study for around half of this group. These results showed that the severity of participants’ lived experience of gambling increased with their GHS-10 score, providing a qualitative validation for this quantitative self-report measure. This qualitative validation for a quantitative scale is argued to be a promising avenue for future gambling research.

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

BackgroundGambling 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.MethodsThe 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.ResultsOne 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.ConclusionsAddressing 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.

The Dual Burden of Emerging Adulthood: Assessing Gambling Severity, Gambling-Related Harm, and Mental Health Challenges.

Growing concerns over gambling problems across age groups have sparked research in public health and psychology. During emerging adulthood, individuals are more susceptible to mental health problems and more likely to develop gambling problems than in other age groups. This study explored the potential differences between emerging adults and adults aged 30+ in terms of problem gambling severity (PGS), gambling-related harm (GRH), depression and anxiety, and the mediating role of depression and anxiety in the association between age, PGS, and GRH. A representative online sample of 3244 Israelis aged 18 and over was divided into two groups: 740 emerging adults aged 18-29 and 2504 adults aged 30+. Gambling behaviors, the Problem Gambling Severity Index, the Short Gambling Harm Screen, and the Patient Health Questionnaire-4 assessing depression and anxiety were administered. Emerging adults had significantly higher levels of GRH, PGS, and depression-anxiety than their older counterparts, above and beyond gender and education. Depression-anxiety fully mediated the associations between age and gambling-related outcomes. These findings underscore the importance of considering psychological well-being in efforts to address problem gambling and gambling-related harms, especially in emerging adults.

Too Young to Gamble: Long-term Risks from Underage Gambling

The increasing availability of gambling opportunities worldwide has the potential to impact youth gambling behavior and the prevalence of gambling-related harm. This paper studies whether starting gambling at an early age (i.e., below the minimum legal gambling age) increases an individual’s likelihood of suffering some kind of gambling-related harm in the future. Data taken from the Study on the Prevalence, Behavior and Characteristics of Gamblers in Spain provide information on respondents’ gambling starting age and assess gambling risk based on criteria established by the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Estimates from an ordered probit model suggest that starting to gamble while under the minimum legal age is associated with a higher likelihood of problem gambling.

The relationship between gambling behaviour and gambling-related harm: A data fusion approach using open banking data.

UK-based gambling policymakers have proposed affordability checks starting at monthly losses of £125. The present study combines open banking data with self-reports of the Problem Gambling Severity Index (PGSI) and other relevant information to explore the harm profiles of people who gamble at different levels of electronic gambling behaviour. This was a data fusion study in which participants consented to share their bank data via an open banking application programming interface (API) and who also completed relevant self-report items. Hierarchical hurdle models were used to predict being an at-risk gambler (PGSI > 0) and being a 'higher-risk' gambler (higher PGSI scores among those with non-zero scores) using four specifications of electronic gambling behaviour (net-spend, outgoing expenditure, incoming withdrawals, interaction model combining expenditure and withdrawals), and by adding self-reported data across two additional steps. The study took place in the United Kingdom. Participants were past-year people who gamble (n = 424), recruited via Prolific. Self-report measures were used of gambling-related harm (PGSI), depression [Patient Health Questionnaire 9 (PHQ-9)], age and gender; bank-recorded measures of income and electronic gambling behaviour. Unharmed gamblers had an average monthly gambling net-spend of £16.41, compared with £208.91 among highest-risk gamblers (PGSI ≥ 5). Being an at-risk gambler (PGSI > 0) was predicted significantly by all four types of gambling behaviour throughout all three steps [1.08 ≤ odds ratios (ORs) ≤ 2.92; Ps < 0.001), with only outgoing expenditure being significant in the interaction model (2.26 ≤ ORs ≤ 2.81; Ps < 0.001). Higher PHQ-9 scores also predicted at-risk gambling in steps 2-3 (1.09 ≤ ORs ≤ 1.10; Ps < 0.001), as did lower age (0.95 ≤ ORs ≤ 0.96; Ps < 0.001) and male gender identity in step 3 (2.51 ≤ ORs ≤ 2.95; Ps < 0.001). Being a higher-risk gambler was predicted significantly by gambling behaviour only in the expenditure-only (1.16 ≤ ORs ≤ 1.17; Ps ≤ 0.048) and withdrawal-only (1.08 ≤ ORs ≤ 1.09; Ps ≤ 0.004) models, and was not predicted by income (0.98 ≤ ORs ≤ 1.14; Ps ≥ 0.601), age (0.98 ≤ ORs ≤ 0.99; Ps ≥ 0.143) or male gender identity (1.07 ≤ ORs ≤ 1.15; Ps ≥ 0.472). The UK government's proposed affordability checks for gamblers should rarely affect people who are not experiencing gambling-related harm. At-risk gambling is predicted well by different types of gambling behaviour. Novel insights about gambling can be generated by fusing self-reported and objective data.

Towards an Active Role of Financial Institutions in Preventing Problem Gambling: A Proposed Conceptual Framework and Taxonomy of Financial Wellbeing Indicators.

The transformation of gambling into a largely digital commodity has created a need for online payment technologies to facilitate online gambling, thereby also raising the question of what role these actors can play in the promotion of Responsible Gambling (RG). With the means and access they maintain, financial institutions are in a unique position to alleviate financial pitfalls, yet their role in the gambling context has thus far received little scrutiny. The objective of this study was to conduct an extant literature review to develop an initial set of financial indicators tailored for financial institutions, enabling them to engage in the RG initiatives. We conducted a two-step narrative literature review to identify both general Financial Well-Being (FWB) indicators across financial research disciplines, and one specific to gambling. A literature search over the past 20 years was performed across the following academic databases: Medline (Ovid), Sociological Abstracts (ProQuest), Web of Science (Clarivate), and PsycInfo (EBSCO). Manifest content analysis was used in step one to review general financial well-being, yielding a general FWB conceptual framework. In step two, we applied latent content analysis to the gambling-specific literature, linking essential concepts of gambling-related financial harms to the broader FWB literature. This resulted in a tentative taxonomy of indicators applicable to financial institutions with gambling customers. In tandem with the FWB conceptual framework, the preliminary taxonomy could provide a foundation for financial institutions catering to gambling customers to engage in the duty of care agenda, potentially broadening player protection beyond the current operator-focused RG measures.