Gambling-related Harm Research Articles

Isolating the impact of specific gambling activities and modes on problem gambling and psychological distress in internet gamblers

BackgroundGambling disorder is related to high overall gambling engagement; however specific activities and modalities are thought to have stronger relationships with gambling problems. This study aimed to isolate the relationship between specific gambling activities and modalities (Internet and venue/land-based) to gambling disorder and general psychological distress. Past-month Internet gamblers were the focus of this investigation because this modality may be associated with gambling disorders in a unique way that needs to be separated from overall gambling intensity.MethodsAustralians who had gambled online in the prior 30 days (N = 998, 57% male) were recruited through a market research company to complete an online survey measuring self-reported gambling participation, problem gambling severity, and psychological distress.ResultsWhen controlling for overall gambling frequency, problem gambling was significantly positively associated with the frequency of online and venue-based gambling using electronic gaming machines (EGMs) and venue-based sports betting. Psychological distress was uniquely associated with higher frequency of venue gambling using EGMs, sports betting, and casino card/table games.ConclusionsThis study advances our understanding of how specific gambling activities are associated with disordered gambling and psychological distress in users of Internet gambling services. Our results suggest that among Internet gamblers, online and land-based EGMs are strongly associated with gambling disorder severity. High overall gambling engagement is an important predictor of gambling-related harms, nonetheless, venue-based EGMs, sports betting and casinos warrant specific attention to address gambling-related harms and psychological distress among gamblers.

A Behaviour Sequence Analysis of Young People and Gambling-Related Harm

Gambling is a worldwide issue that requires continued, extensive investigation. Most people have gambled at some point in their lives, and many do so without incurring problems. However, a number of individuals do experience gambling-related harm, and understanding the pathways or life histories these individuals have experienced may elucidate how and why their gambling became harmful. The current research uses a novel method, Behaviour Sequence Analysis, to understand the temporal pathways that young people experience when first gambling. Behaviour Sequence Analysis takes multiple qualitative accounts, first-person interviews in the current study, and collates the data into statistical pathway models that show the chains between behaviours and events. A sample of 66 participants provided details of their life experiences regarding what led them to first gamble. Results indicated that parents and peers had a large influence and were facilitators in the first-time gambling episode, which was expected. However, the results also showed that many participants suggested that receiving scratch cards in their birthday cards was their first experience of gambling, and this seemingly innocuous act was the first step towards a pathway into gambling-related harm. The findings, therefore, support previous literature, while highlighting a novel method for future research, and various key intervention points for which strategies could be developed to reduce the potential for developing gambling-related harm behaviours.RésuméLes jeux de hasard constituent un problème mondial qui nécessite des études approfondies et continues. La plupart des gens ont joué à un moment de leur vie et beaucoup le font sans problème. Cependant, un certain nombre de personnes subissent des préjudices liés au jeu. Comprendre les parcours ou les histoires de vie de ces personnes peut expliquer comment et pourquoi leur jeu est devenu préjudiciable. Les recherches actuelles utilisent une méthode innovante, la Behaviour Sequence Analysis (analyse séquentielle de comportement) pour comprendre les parcours temporels qu’empruntent les jeunes lorsqu’ils commencent à jouer. Cette forme d’analyse séquentielle se fonde sur plusieurs analyses qualitatives et des entretiens à la première personne, et les données sont regroupées dans des modèles de parcours statistique qui mettent en évidence les liens entre les comportements et les événements. Soixante-six participants ont fourni des détails sur leur première expérience de jeu et sur ce qui les a amenés à jouer la première fois. Les résultats indiquent que les parents et les pairs ont une grande influence sur le premier épisode de jeu, ce à quoi l’on s’attendait. Cependant, les résultats montrent également que de nombreux participants ont indiqué que des cartes à gratter en guise de cadeau d’anniversaire étaient leur première expérience de jeu, et que cet acte apparemment anodin était le premier pas dans une voie menant à une dépendance au jeu. Les résultats corroborent donc la littérature antérieure, tout en soulignant une méthode innovante pour les recherches futures et divers points d’intervention clé pour lesquels des stratégies pourraient être élaborées afin de réduire le potentiel de développement de comportements préjudiciables liés au jeu.

Avoiding gambling harm: An evidence-based set of safe gambling practices for consumers.

Prior studies have identified self-regulatory strategies that are infrequently used by problem-gamblers, but which might be protective if used. However, guidelines with evidence-based safe gambling practices (SGPs) that prevent gambling-related harm are lacking. This study aimed to: 1) identify a parsimonious set of evidence-based SGPs that best predict non-harmful gambling amongst gamblers who are otherwise most susceptible to experiencing gambling harm; 2) examine how widely are they used; and 3) assess whether their use differs by gambler characteristics. A sample of 1,174 regular gamblers in Alberta Canada completed an online survey measuring uptake of 43 potential SGPs, gambling harms and numerous risk factors for harmful gambling. Elastic net regression identified a sub-sample of 577 gamblers most susceptible to gambling harm and therefore most likely to benefit from the uptake of SGPs. A second elastic net predicted gambling harm scores in the sub-sample, using the SGPs as candidate predictors. Nine SGPs best predicted non-harmful gambling amongst this sub-sample. The behaviour most strongly associated with increased harm was using credit to gamble. The behaviour most strongly associated with reduced harm was 'If I'm not having fun gambling, I stop'. These SGPs form the basis of evidence-based safe gambling guidelines which can be: 1) promoted to consumers, 2) form the basis of self-assessment tests, 3) used to measure safe gambling at a population level, and 4) inform supportive changes to policy and practice. The guidelines advise gamblers to: stop if they are not having fun, keep a household budget, keep a dedicated gambling budget, have a fixed amount they can spend, engage in other leisure activities, avoid gambling when upset or depressed, not use credit for gambling, avoid gambling to make money, and not think that strategies can help you win. These guidelines are a promising initiative to help reduce gambling-related harm.

What’s the Message? A Content Analysis of Emails and Texts Received from Wagering Operators During Sports and Racing Events

Previous research has established direct messages (such as emails and text messages) are a widely seen form of advertising and are highly influential on sports betting and race betting behaviour. Nevertheless, few studies have examined the specific content of these messages, and whether their content is related to account-holders' betting behaviour. The current study used an ecological momentary assessment design to examine direct messages received from wagering operators during the week around major Australian sports and racing events. Respondents completed a baseline survey followed by short daily surveys over a period of 1week during peak betting periods, and provided the research team with the emails and text messages they received from wagering operators during this time. A sample of 102 sports and 110 race bettors provided a total of 931 messages. These messages subsequently underwent a content analysis to extract key features that were promoted, including inducements, incentives, and bet type. The analysis found the messages were saturated with inducements to bet, however no relationships were identified between the content of messages and the gambling risk status or betting frequency of participants. The most common types of incentives offered included bonus bets, rewards points, better odds/winnings, and reduced risk. Frequently promoted inducements included bonus or better winnings, refund/stake back offers, and match your stake/deposit. Given the influences of inducements on increasing betting expenditure and impulsive betting identified through previous research, taken together with the findings of the current study, direct messages may contribute to experiencing gambling-related harm. These findings have important implications for consumer education and the regulation of direct messages.

Adolescent Gambling, Gambling Expenditure and Gambling\u2013Related Harms in Finland, 2011\u20132017

Existing literature on recent trends in adolescent gambling is scarce. The rapidly changing landscape of gambling, together with the generally applied legal age limits, calls for the continuous monitoring of gambling also among the adolescent population. In Finland, the legal gambling age is 18. We examined changes in adolescents’ gambling, gambling expenditure and gambling–related harms from 2011 to 2017. Comparable cross-sectional biennial survey data were collected in 2011, 2013, 2015 and 2017 among 12–18-year-olds (N = 18,857). The main measures were self-reported six-month gambling, average weekly gambling expenditure (€) and harms due to gambling. Data were analyzed using cross-tabulations, χ2-tests and linear regression analysis. A significant decline in gambling among minors (aged 12–16-year-olds) was found (β = − 0.253), while no significant changes were observed among 18-year-olds (who are not targeted by the law). The mean gambling expenditure also declined from 2011 to 2017. Adolescent gamblers experienced significantly less (p = .003) gambling–related harms in 2017 (7.4%) compared to 2011 (13.5%). Adolescent gambling and its related negative consequences have become less prevalent in Finland between 2011 and 2017. Further monitoring is necessary to ascertain whether the positive direction will continue. Also, empirical analyses providing evidence of reasons for the observed trend are warranted.

Internet-delivered cognitive-behavioral therapy for significant others of treatment-refusing problem gamblers: A randomized wait-list controlled trial.

Problem gambling can cause severe harm to concerned significant others (CSOs) in the form of, for example, relationship problems, financial difficulties, and mental and physical illness. CSOs are important for their ability to support problem gamblers and motivate them to change. This study investigated the effect of an Internet-based intervention for CSOs of treatment-refusing problem gamblers on (a) gambling-related harm, (b) the gamblers' treatment-seeking rate, and (c) the relationship satisfaction and mental health of the CSOs. A total of 100 CSOs of problem gamblers were randomized into one of two conditions: Internet-delivered cognitive-behavioral therapy for CSOs or a wait-list control group. The intervention group was given Internet-based treatment consisting of nine modules with therapist support available via telephone and e-mail. Outcome measures were collected up 12 months posttreatment. The intervention improved the psychological well-being of the CSOs compared to the wait-list group at the posttest (CSO's emotional consequences: d = -0.90, 95% CI [-1.47, -0.33]; relationship satisfaction: d = 0.41, 95% CI [0.05, 0.76]; anxiety: d = -0.45, 95% CI [-0.81, -0.09]; depression: d = -0.49, 95% CI [-0.82, -0.16]). However, the effects on the gambling outcomes were small and inconclusive (gambling losses: multiplicative effect = 0.73, 95% CI [0.29, 1.85]; treatment-seeking: hazard ratio = 0.86, 95% CI [0.31, 2.38]). The results confirm earlier studies' findings that affecting the gambler via a CSO is challenging, but it is possible to increase the CSO's coping and well-being. The trial's outcome data and scripts are available for download (https://osf.io/awtg7/). (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Assessment and Treatment of Gambling Behavior

Although gambling is a common recreational activity, it results in harm for as many as 6% of individuals in the United States. The harm may be in the form of financial, social, or psychological. A variety of assessments are used to diagnose gambling-related harm and facilitate treatment. Cognitive-behavioral therapy (CBT) incorporating motivational enhancement techniques and goal setting are used to treat gambling harms. The components of CBT generally include identifying triggers and high-risk situations, coping with internal and external triggers, increasing other pleasurable activities, cognitive restructuring, and relapse prevention.

Understanding use of consumer protection tools among Internet gambling customers: Utility of the Theory of Planned Behavior and Theory of Reasoned Action

Consumer protection tools such as activity statements, deposit limits, and temporary self-exclusion are provided by most Internet gambling websites to minimise gambling related harms through the prevention of problems and enhancement of controls for those at risk of disordered gambling. However, customer engagement with these tools is very low. Developing a theoretical framework to understand the reasons individuals use consumer protection tools is important to design strategies to increase uptake. Customers of Australian online wagering sites (N = 564) completed an online survey with a follow-up (N = 193) to assess whether the Theory of Planned Behaviour explained intention to use tools and actual behaviour with additional consideration of past tool use. Results showed that past tool use, attitudes and subjective norms, but not perceived behavioural control, were positively correlated with intention to use consumer protection tools. Intention to use the tools prospectively predicted actual tool use. The study validates past behaviour as a predictor of intention, and intention representing a significant predictor of future behaviour. The Theory of Reasoned Action (without the inclusion of perceived behavioural control), rather than Theory of Planned Behaviour, appears to be a suitable conceptual model to understand consumer protection tool use for Internet wagering websites. Use and application of consumer protection tools on gambling websites is not perceived as effortful, but under volitional control and straightforward. Positively influencing individual attitudes, perceived views of others and past tool use could increase online wagering customers' use of consumer protection tools.

Staff Perceptions of Responsible Gambling Training Programs: Qualitative Findings.

Staff training in responsible gambling forms an integral component of industry measures designed to respond to and minimize gambling-related harms. Research suggests that venue staff members have the capacity to identify behavioral indicators of problem gambling among patrons, but often are reluctant or fail to respond to patrons unless directly approached for assistance. Understanding the barriers preventing staff from proactively intervening with identified patrons is necessary if a positive shift toward greater levels of assistance for at-risk individuals is to be achieved. A series of focus groups were conducted with management and floor staff (N = 20) from a large New South Wales registered club venue to better understand their experiences and attitudes towards existing responsible gambling training programs. Qualitative phenomenological data were analyzed using inductive thematic analyses and resulted in the identification of three primary domains: ability to identify harmful gambling behaviors; perceived challenges and barriers to intervention; and potential improvements to current programs. Responses were consistent with the literature in demonstrating staff abilities to identify behavioral indicators, but importantly revealed a lack of certainty and understanding in relation to their specific roles, potential legal consequences and implications for employment by taking the initiative to proactively intervene. Recommended improvements to strengthen the effectiveness of programs included the implementation of well-defined protocols setting out role expectations and procedures for floor staff to follow, and importantly, a fundamental shift in middle and senior management culture to one that actively supports and positively acknowledges staff-customer interactions designed to assist problem gamblers.

Response to Commentary: the Future of Gaming Disorder Research and Player Protection: What Role Should the Video Gaming Industry and Researchers Play

In their commentary, Griffiths and Pontes (2019) argue that with the International Classification of Diseases (ICD-11) (2019) recognizing gaming disorder (GD) as a mental disorder there is an acute need for the gaming industry to develop and undertake responsible gaming initiatives. Rather than ‘reinventing the wheel’, they make a compelling argument that the gambling industry has incorporated a number of evidence-based initiatives to minimize gambling-related harms associated with disordered gambling which may be applicable to minimizing GD. Griffiths and Pontes, both renowned researchers in the field, present a call for collaboration between the gaming industry and academic researchers to gain a better understanding the phenomenon of GD and prevent its development and potential negative impact on society. They argue that preventing problematic video gaming cannot be overcome without all major stakeholders playing their part. Griffiths and Pontes elucidate five recommendations for the future of research on GD; all of which are designed as part of a commitment to social responsibility and duty of care for end users. We remain in full agreement with the authors that the gaming industry assume responsibility for undertaking responsible gaming initiatives and that collaboration and potential partnerships between the gaming industry and researchers can make important strides towards harm minimization. We have added some additional considerations with regard to potential issues with the collaborative process as well as commenting on some of the proposed recommendations for future areas of focus in gaming disorder research.

Paying for loot boxes is linked to problem gambling, regardless of specific features like cash-out and pay-to-win

Loot boxes are items in video games that may be bought with real-world money but contain randomised contents. Due to similarities between loot boxes and gambling, various countries are considering regulating them to reduce gambling-related harm. However, loot boxes are extremely diverse. A key problem facing regulators is determining whether specific types of loot boxes carry more potential for harm, and should be regulated accordingly.In this study, we specify seven key ways that loot boxes may differ from each other: They may involve paid or unpaid openings; give opportunities for cashing out; allow gamers to pay to win; involve the use of an in-game currency; feature crate and key mechanics; show near misses; and contain exclusive items.We then use a large-scale preregistered correlational analysis (n = 1200) to determine if any of these features strengthen the link between loot box spending and problem gambling. Our results indicate that being able to cash out, showing near-misses, and letting players use in-game currency to buy loot boxes may weakly strengthen the relationship between loot box spending and problem gambling. However, our main conclusion is that regardless of the presence or absence of specific features of loot boxes, if they are being sold to players for real-world money, then their purchase is linked to problem gambling.

High Stakes: Children’s Exposure to Gambling and Gambling Marketing Using Wearable Cameras

Concerns continue to be raised about the ‘normalising’ influence of gambling and its marketing on children. This study sought to determine the nature and extent of children’s everyday exposure to gambling and its marketing. New Zealand children (11–13 years; n = 167) wore wearable cameras, capturing images of their day every seven seconds for four days, June 2014–July 2015. Images (n = 380,000) were assessed for their exposure to gambling and its marketing. On average, children were exposed to gambling products or activities 0.6 (95% CI 0.4, 1.0) times/day and marketing 6.9 (95% CI 4.6, 10.3) times/day. Marketing exposures occurred most frequently in book stores (1.7 (95% CI 0.7, 4.0)/day), convenience stores (1.5 (95% CI 0.7, 3.0)/day), and supermarkets (1.4 (95% CI 0.8, 2.5)/day), via a shop front signage (3.3 (95% CI 1.9, 5.5)/day) and in-store marketing (1.9 (95% CI 1.3, 2.7)/day). The national lottery (4.7 (95% CI 3.2, 7.0)/day) and scratch cards (0.6 (95% CI 0.4, 0.9)/day) were most frequently promoted. Children were frequently exposed to gambling and its marketing, in the everyday places they go. Regulation of gambling and its marketing could contribute to the reduction of gambling-related harm, improving children’s health, and well-being.

Use of Consumer Protection Tools on Internet Gambling Sites: Customer Perceptions, Motivators, and Barriers to Use.

Internet gambling has been widely legalised in recognition of its capacity to, and the importance of, providing consumer protection tools to prevent and minimise gambling-related harms. Most licensed Internet gambling sites are required to provide consumer protection tools, including activity statements, deposit limits, and time-outs (temporary self-exclusion). However, few Internet gambling customers engage with the tools. An online survey of 564 customers of Australian Internet gambling sites aimed to understand the extent to which consumer protection tools are used, characteristics of those using these tools, and the perceptions and attitudes towards tool use, including barriers to use. Most participants were aware of the tools and had accessed activity statements; few had used deposit limits (24.5%) or time-outs (8.1%) but use of these restrictive tools was higher among those at-risk of gambling problems. Satisfaction with tools was generally high among users and tools were mostly used as intended; however, only moderate changes in behaviour were reported. Participants predominately did not use the restrictive tools as they did not see these as relevant for them, and they were perceived to be intended for people with gambling problems. The findings are important to drive necessary improvements to consumer protection efforts including efforts to encourage perception that tools are relevant for all customers. Changes to current practice, including terminology and promotion of tools, are needed by Internet gambling operators and policy makers to improve the utilisation and effectiveness of consumer protection tools to enable sustainable gambling among the broader cohort of Internet gamblers.

Parent and child perceptions of gambling promotions in Australian sport.

Gambling is recognized as a significant public health problem. However, there is little research exploring community attitudes towards gambling and the development of advocacy initiatives. Engaging adults and young people in advocacy efforts is recognized as being beneficial to the successful implementation of harm prevention and reduction strategies. This study explored the attitudes of young people and their parents towards the alignment of gambling with sport, and the strategies they perceive could be used to prevent and reduce gambling related harm. Using a Constructivist Grounded Theory approach, 30 family groups from Melbourne, Australia participated in semi-structured interviews. Parents and young people were asked about gambling and its promotion, alignment with sporting codes, the potential impact on young people and strategies that may prevent or reduce gambling harm. Thematic analysis was undertaken to interpret the data. The sample comprised 29 parents, one grandparent and 48 young people. Themes emerging from the data related to the use of imagery and appeal strategies in advertisements, the normalization of betting in advertisements and the alignment of betting with sport. Parents and young people also identified a number of potential gambling harm prevention and reduction initiatives. Parents and young people were able to describe a range of strategies used by gambling companies to promote their products, understand the potential impact of these strategies, and recommend strategies to reduce harm. Given this level of understanding there is clearly an opportunity to engage young people and stakeholders in advocacy initiatives aimed at reducing and preventing gambling harm.

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.

Is there a need for personal gambling licences?

Licensing is currently the most popular option among regulators for controlling gambling operations. However, approximately 20% of operators are still public monopolies. Many forms of gambling (especially lotteries) are government operated even in countries with a licensing system. This creates an inherent conflict of interest, given that government is supposed to protect the well-being of its citizenry and to reap the benefits of gambling at the same time. At least in the gambling monopoly, however, addressing the unavoidable harm that results from gambling should be a priority. Industry self-regulation and reliance on “responsible gambling” rely too much on individuals to control their own gambling. It is suggested in this contribution that it is possible to provide more comprehensive consumer protection, recognising both the duty of governments to take care of their own citizens and the fact that industry self-regulation is not enough. Pre-commitment cards have been tested in various contexts, and have shown promise in terms of providing tools for individuals to restrict their own gambling. However, given the known shortcomings such as allowing the use of other cards that are not one’s own, and other venues, it is clear that in themselves they do not guarantee effective prevention. Personal licensing is therefore explored as a move forward in this literature-based discussion. Although the system may be applicable to other contexts, the focus is on the Nordic countries. Given that the underlying justification for gambling monopolies is to control gambling-related harm, in the cases of Finland and Norway licensing could be combined with loyalty cards introduced by monopoly operators. This would provide a feasible alternative to current practices of responsible gambling.

Challenges in the Conceptualisation and Measurement of Gambling-Related Harm.

This paper examines the significance of recent developments in research relating to gambling-related harm. Previous research, it is argued, has failed to capture gambling-harm in a way that is useful to inform public policy and regulation. This is because most standardised psychometric measures and the DSM classifications have conflated gambling behaviour and harm and mostly focused on serious harms. As a result, little has generally been known about the prevalence of harm in lower risk gambling groups. Here we summarise the findings from recent harm research, the methodologies used and their conceptual implications. It is argued that strong progress has been made in the categorization and measurement of gambling harm, but that caution must be applied when applying these measures to estimate the 'burden of disease' associated with gambling in the community. Particular issues discussed include: the differentiation of opportunity cost and harm; the validity of additive methods involving different severities of measured harm; using comparisons with unfamiliar disorders; and the validity of prevention paradox arguments in this area of research.

Women and gambling-related harm: a narrative literature review and implications for research, policy, and practice

BackgroundWhile the prevalence of women’s participation in gambling is steadily increasing, there is a well-recognised male bias in gambling research and policy. Few papers have sought to synthesise the literature relating to women and gambling-related harm and provide practical suggestions to guide future research, policy, and practice which take into account the specific nuances associated with women’s gambling.MethodsA narrative literature review was conducted to review the evidence base on women’s gambling behaviours and experiences of harm. Drawing from strategies used effectively in other areas of public health, key elements for a gendered approach to harm prevention were identified and adapted into practical public health research, policy and practice strategies.ResultsResults indicated a lack of research that explores women’s gambling. Few studies have examined the impact of gambling on the lives of women, with limited understanding of the factors that influence women’s engagement with gambling products, and the impact of industry tactics. A gendered approach was identified as a strategy used successfully in other areas of public health to shift the focus onto women and to ensure they are considered in research. In tobacco control, increasing trends in women’s smoking behaviour were combatted with targeted research, policy and practical initiatives. These key elements were adapted to create a conceptual framework for reducing and preventing gambling harm in women. The framework provides regulatory direction and a research agenda to minimise gambling-related harm for women both in Australia and internationally. Evidence-based policies should be implemented to focus on the influence of gender and associated factors to address gambling-related harm. Practical interventions must take into account how women conceptualise and respond to gambling risk in order to develop specific harm prevention programs which respond to their needs.ConclusionA gendered approach to gambling harm prevention shifts the focus onto the unique factors associated with women’s gambling and specific ways to prevent harm. As seen in other areas of public health, such a framework enables harm measures, policies, and interventions to be developed that are salient to girls and women’s lives, experiences and circumstances.

A mapping review of research on gambling harm in three regulatory environments

BackgroundHarmful gambling is a complex issue with diverse antecedents and resulting harms that have been studied from multiple disciplinary perspectives. Although previous bibliometric reviews of gambling studies have found a dominance of judgement and decision-making research, no bibliometric review has examined the concept of “harm” in the gambling literature, and little work has quantitatively assessed how gambling research priorities differ between countries.MethodsGuided by the Conceptual Framework of Harmful Gambling (CFHG), an internationally relevant framework of antecedents to harmful gambling, we conducted a bibliometric analysis focusing on research outputs from three countries with different gambling regulatory environments: Canada, Australia, and New Zealand. Using a Web of Science database search, 1424 articles published from 2008 to 2017 were retrieved that could be mapped to the eight CFHG factors. A subsample of articles (n = 171) containing the word “harm” in the title, abstract, or keywords was then drawn. Descriptive statistics were used to examine differences between countries and trends over time with regard to CFHG factor and harm focus.ResultsPsychological and biological factors dominate gambling research in Canada whereas resources and treatment have received more attention in New Zealand. A greater percentage of Australia and New Zealand publications address the gambling environment and exposure to gambling than in Canada. The subset of articles focused on harm showed a stronger harms focus among New Zealand and Australian researchers compared to Canadian-authored publications.ConclusionsThe findings provide preliminary bibliometric evidence that gambling research foci may be shaped by jurisdictional regulation of gambling. Countries with privately operated gambling focused on harm factors that are the operators’ responsibility, whereas jurisdictions with a public health model focused on treatment and harm reduction resources. In the absence of a legislated requirement for public health or harm minimisation focus, researchers in jurisdictions with government-operated gambling tend to focus research on factors that are the individual’s responsibility and less on the harms they experience. Given increased international attention to gambling-related harm, regulatory and research environments could promote and support more diverse research in this area.

"It was terrible. I didn't set a limit": Proximal and Distal Prevention Strategies for Reducing the Risk of a Bust in Gambling Venues.

Although most gamblers set limits on their gambling and stick to them most of the time, there are times when limits are breached (a 'bust'). Little is known about the prevalence, reasons for and strategies to address busts despite associated harms with a single bust. This mixed methods study used an online survey with a sample of electronic gaming machine gamblers. A total of 104 gamblers were recruited from 11 Australian gambling venues and almost half (45%) reported a bust in the past 12months. The amount of money spent on the bust ranged from $20 to $1500 AUD (M = $446, SD = $402). The presence of a bust was positively associated with the amount of money spent in the past 30days, and self-reported greater gambling related harms and greater gambling severity. Reasons for busts included both distal (pre-venue) factors (i.e., negative affect, lapse in intentions to set a limit, needing to win money) and proximal (inside venue) factors (i.e., chasing losses, wins or spins, social facilitation and losing money too quickly). Bust-prevention strategies identified by participants were both distal (e.g., avoid gambling altogether, leave cards or cash at home, set a time or money limit) and proximal (e.g., walk away when losing and change the manner of gambling). As busts are relative to a priori limits, gamblers at any level of gambling severity can experience a bust. Repeated busts may be an indicator of loss of control and a progression towards problem gambling. Interventions need to focus on factors that mitigate the risk of a bust (e.g., pre-commitment) and that assist gamblers to stick to their limits all of the time.