Birth cohort and sex differences in the age of gambling initiation in the United States: evidence from the National Comorbidity Survey Replication

Youth gambling has become a significant public health concern, and it appears that individuals are gambling at younger ages than they did in earlier generations. We tested this question by examining birth cohort differences in the age of onset of gambling in a national epidemiologic survey. Data were drawn from the United States National Comorbidity Survey Replication, a nationally representative general population survey of adults born 1904–84. Individuals were divided into four birth cohorts. The cohorts were compared on their lifetime gambling involvement and age of onset of gambling. Significant birth cohort and sex differences were found in the age of gambling initiation, with more recently born cohorts starting to gamble at progressively earlier ages, and men starting to gamble at younger ages than women. The mean age of onset of gambling for individuals born before 1942 was 32.9 years, and for those born between 1973 and 1984 it was 16.9 years. The overall mean ages of onset of gambling were 20.8 for men and 26.4 for women, but more recently born women appear to be ‘catching up’ with their male counterparts. This decreasing age of gambling initiation may help explain the increasing prevalence of disordered gambling in the United States.     

Stigma and problem gambling: current knowledge and future research directions

Stigma has been identified as a major barrier to help-seeking, treatment and recovery from gambling problems. However, little research has attempted to examine in any depth the causes, characteristics and consequences of stigma in relation to people experiencing gambling problems. The effects of stigma on people experiencing gambling problems, although not directly examined, are apparent through low rates of problem disclosure and treatment-seeking. In this paper, we aim to inform research into stigma associated with problem gambling by highlighting gaps in existing research and by providing direction for future research. The contribution of this paper is that for the first time stigma and problem gambling are drawn together and reviewed using broad constructs and literature from a range of seminal and new sources to present a synthesis of new and important information on stigma. In regard to problem gambling, the dimensions of stigma, except for origin, have yet to be investigated, as well as the processes of stigma creation, the characteristics of public and felt stigma, and coping strategies used to manage stigma. The practical implications of this review are summarized in a framework provided to inform future research into stigma related to problem gambling.     

Lottery marketing in Québec and social deprivation: excessive exposure,insufficient protection?

In 2008, the Institut national de santé publique du Québec (INSPQ) undertook a research programme on lotteries. The preliminary qualitative exploratory component enabled us to observe the diversity and ubiquity of lottery advertising to which the vast majority of the population is exposed, including minors and non-players. The aim of a second component was to better comprehend the relationships between exposure to lottery marketing, lottery purchasing habits, attitudes towards gambling, and socio-economic vulnerability indicators. The study's data was collected by a polling firm from a representative sample of adults in the Québec population (n = 2001). Our survey revealed significant links between exposure, gambling behaviour and certain socio-economic indicators: for example, individuals with lower levels of education more often play the lotteries and spend the most on them. In addition, a greater number of people who are less educated and from a low-income household considered that lottery advertising was very or excessively present in their daily lives and that the amount of advertising has increased in recent years. From the perspective of creating healthy environments and protecting vulnerable populations, legislative measures to control the quantity, location and contents of gambling marketing would be promising preventive measures.     

Determining optimal placement for pop-up messages: evaluation of a live trial of dynamic warning messages for electronic gaming machines

Dynamic warning messages are a harm minimization strategy aimed at preventing or reducing gambling-related problems by assisting individuals to make informed choices about their gambling. Laboratory studies have demonstrated the efficacy of dynamic warnings in facilitating responsible gambling. This article presents the results of a trial of the related effectiveness of dynamic warnings appearing either in the middle or on the periphery of electronic gaming machines (EGMs) screens in commercial gambling venues. Regular gamblers (n = 667) were surveyed to assess their recall of warning messages and the perceived impact of message placement on thoughts and behaviours. Messages appearing in the middle of screens were recalled to a greater extent, and respondents reported that these were more impactful and useful than messages on the periphery of screens. As one of the first trials of dynamic warning messages in operating EGM venues, the results provide important verification and validation of previous laboratory research. Results demonstrate that dynamic warning messages appearing in the middle of an EGM screen during play are likely to be a more effective harm minimization intervention than messages on the periphery of EGM screens.     

Aboriginal card gamblers and non-card gamblers: do they differ?

Many Indigenous populations engage in traditional gambling games, but little is known about their contemporary usage or the characteristics of people who participate. This paper presents the first quantitative study of traditional Indigenous Australian card gambling. The aim of this research was to compare Indigenous Australian card gamblers with non-card gamblers in terms of socio-demographic characteristics, gambling behaviour and motivations, gambling cognitions, gambling consequences, substance use while gambling and problem gambling severity. A gambling survey was conducted at Indigenous festivals, in several communities and online. Within a sample of 1001 gamblers, 414 people had gambled on traditional card games in the previous 12 months. Many card gamblers commenced gambling while young, were highly involved in both cards and commercial gambling and gambled because most of their family and friends also gamble. An important difference revealed here is that card gamblers gamble on more forms of commercial gambling than non-card gamblers. Gambling appears as a deep-seated habit in some participants' lives and although the proportion classified as problem gamblers is high in this sample the card gamblers held more realistic cognitions about chances of winning than did the non-card gamblers.     

An empirical analysis of the use of the Herfindahl-Hirschman Index in assessing the distribution of electronic gaming machines and its socio-economic implications

Sargent and Holmes (2014) proposed the use of the Herfindahl-Hirschman Index in assessing the effects of the distribution of electronic gaming machines (EGMs) on expenditure and tax outcomes for local areas. This paper reports empirical analysis on the use of the Herfindahl Hirschman Index (HHI) in this application. Comparative testing of HHI and population-based measures, such as EGM density, was conducted using EGM data from the New South Wales State Government (Australia) for the period 1995 to 2005. The analysis also compares the use of the commonly used Australian Bureau of Statistics’ (ABS) Socio-Economic Indexes for Areas (SEIFA) Index of Relative Socio-Economic Disadvantage, with the Index of Education and Occupation. The socio-economic elements comprising the latter index are acknowledged as being relevant to the assessment of gambling impacts. The results indicate that the use of a concentration measure such as the HHI may augment the use of existing measures in policy development and localized decision-making on distribution of gambling facilities.     

Compliance check of gambler and youth protection in German amusement arcades: a pilot study

German gambling operators are required to identify problem gamblers at an early stage and exclude them from gambling on their premises. The main aim of this pilot study was to investigate the compliance of staff in Bremen’s amusement arcades. While visiting 29 of 111 amusement arcades, covert gamblers simulated signs of problematic gambling behaviour, arranged self-exclusions, monitored observance of the exclusion list and made fieldnotes about the staff’s reactions. The application of age checks was also tested. The findings showed that only in six cases (5%) did the staff adequately respond to evident signs of problematic gambling behaviour. Although 18 of 29 cases (62%) eventually resulted in self-exclusions or ban-like agreements, in some instances it was necessary to overcome major obstacles that emanated from the staff’s behaviour. During 15 subsequent follow-up visits, 13 banned mystery gamblers (87%) had no problems gambling on amusement-with-prizes (AWP) machines. Finally, just 26% of the 20- to 25-year-old mystery gamblers had their ID checked. The results indicate the necessity of regular external evaluations regarding the implementation of gambling harm-minimization measures in order to identify any shortcomings. In addition, the level of staff compliance may be increased by amending current legislation (e.g. by introducing a nationwide self-exclusion programme).     

Reduced inhibitory control predicts persistence in laboratory slot machine gambling

Impairments in inhibitory control characterize a range of addictive behaviours including gambling disorder. This study investigated the relationship between a neuropsychological measure of inhibitory control and behaviour on a simulated slot machine that included a measure of gambling persistence, in a non-clinical sample of regular gamblers. Regular gamblers (n = 75) performed a laboratory slot machine task for 30 trials where they could win real money, followed by a persistence phase under extinction (i.e. without wins). Participants also completed a stop-signal task, along with measures of gambling-related cognitions, social desirability, and symptoms of disordered gambling. In hierarchical regression models, reduced inhibitory control was found to predict greater persistence and a higher subjective desire to play again after both wins and near-misses (i.e. unsuccessful outcomes close to the jackpot). These data illustrate the impact of low inhibitory control on relevant behavioural tendencies in a group of regular gamblers. Our results help elucidate a cognitive process that may contribute to problem gambling, with implications for screening and treatment.     

Gambling problems seldom come alone: prevalence and temporal relationships of mental health problems in casino excluders

ABSTRACT

To estimate the effectiveness of gambling exclusion programmes, previous research focused on changes in gambling behaviour post-exclusion. Although other mental health problems, especially co-morbid mental disorders, may be crucial for relapse and recovery of gambling-related problems, these factors have rarely been studied in excluders. Therefore, this study aimed to assess a comprehensive mental health status of excluders using well-validated diagnostic instruments. Fifty-eight casino excluders participated in face-to-face diagnostic interviews and completed several validated questionnaires (e.g. Stinchfield Questionnaire, Brief Symptom Inventory). Retrospective temporal sequences of diagnosed mental disorders, help-seeking behaviour and exclusion were examined. The majority of excluders reported impairments in mental health aspects. About three-quarters met criteria of lifetime gambling disorder, more than half in the last 12 months whereby screening and diagnostic measures correlated moderately. Other mental disorders were frequent, especially affective and substance-related disorders and typically preceded the onset of gambling disorder. Six years passed between self-awareness of gambling problems and help-seeking. Two more years passed until exclusion. Frequent mental health problems suggest the need for individually tailored support beyond exclusion programmes (e.g. psychotherapy, pharmacotherapy, counselling services). Late help-seeking and exclusion entry claim for improved early detection and intervention concepts that consider underlying mental disorders.