Attitudes towards gambling, gambling participation, and gambling-related harm : cross-sectional Finnish population studies in 2011 and 2015

Background: Information about public gambling attitudes and gambling participation is crucial for the effective prevention of gambling-related harm. This study investigates female and male attitudes towards gambling, gambling participation, and gambling-related harm in the Finnish population aged 15-74. Methods: Cross-sectional random sample data were collected in 2011 (n = 4484) and 2015 (n = 4515). The data were weighted based on gender, age and region of residence. Attitudes were measured using the Attitudes Towards Gambling Scale (ATGS-8). Gambling-related harms were studied using the Problem Gambling Severity Index and the South Oaks Gambling Screen. Results: Attitudes towards gambling became more positive from 2011 to 2015. Female attitudes were generally negative, but nonetheless moved in a positive direction except in age groups under 25. Occasional gambling increased among women aged 18-24. Women aged 18-24 and 45-54 experienced more harms in 2015 than in 2011. Both land and online gambling increased among women aged 65-74. Male attitudes towards gambling were generally positive, and became more positive from 2011 to 2015 in all age groups except 15-17. Weekly gambling decreased among males aged 15-17. Gambling overall increased among males aged 18-24. Gambling several times a week decreased among men aged 35-44 and 45-54, and gambling 1-3 times a month increased in the latter age group. Online gambling increased only among men aged 55-64. Conclusions: Attitudes towards gambling became more positive in all except the youngest age groups. Under-age male gambling continued to decrease. We need to make decision-makers better aware of the continuing growth of online gambling among older people and women's increasing experiences of gambling-related harm. This is vital to ensure more effective prevention.Peer reviewe

The extent and type of gambling harms for concerned significant others : A cross-sectional population study in Finland

Aims: This study investigates the proportion of concerned significant others (CSOs) of problem gamblers at population level and describes the extent and type of gambling harms for CSOs. Methods: Cross-sectional random sample data (n = 4515) were collected in 2015. The data were weighted based on age, gender and residence. CSOs were identified using a question including seven options. Gambling harms were inquired using structured questions. Descriptive statistics and Chi-Squared and Fischer's exact tests were used. Results: Overall, the proportion of CSOs was 19.3%. Males had close friends with gambling problems more often than females, while females had family members with gambling problems more often than males. Of the CSOs, 59.5% had experienced one or more harms. Females experienced more harms than males. Typical harms were worry about health or well-being of close ones, emotional distress and problems in interpersonal relationships. CSOs with a problem gambler in the family, particularly a partner, child/children or mother, experienced harms more often than CSOs with a problem gambler as a close friend. Conclusions: Female gender was associated with a larger extent of harms. The extent of harms was greatest if the problem gambler was a family member; however, a substantial amount of harms were experienced when the problem gambler was a close friend. CSOs and their position in evaluating gambling harms in general should be acknowledged. Persons beyond the nuclear family and the harms they encounter should be better acknowledged in prevention and harm minimisation. Early identification and a clear referral path to tailored support in occupational, social and healthcare settings may be considered.Peer reviewe

Money used in gaming is associated with problem gambling : Results of the ESPAD 2019 Finland

Background and aims: The convergence of gaming and gambling may pose a risk for adolescents. Thus, it is important to find out how these behaviours are associated with other addictive behaviours in order to develop efficient preventive measures for youth. The aim of this study was to examine 1) whether problematic gaming and money used for gaming activities are risk factors for gambling, and 2) what kind of impact adolescents' substance use along with other factors related to friends and parents have on this association. Methods: The European School Survey Project on Alcohol and Other Drugs data, 2019 of Finnish adolescents aged 15 to 16 (N 5 4595). Cross-tabulations with Rao-Scott's chisquare tests were applied to study the associations of the background factors with gambling in the past 12 months. A multinomial logistic regression model was fitted for the outcome variable (gambling in the past 12 months) adjusted for all independent and background variables. Results: Problematic gaming alone was not associated with gambling participation, whereas using money for digital games increased the risk of gambling. Boys gamble more than girls. The use of alcohol and drugs increased the risk of gambling. Parental monitoring reduced the risk of gambling, whereas hanging around weekly with friends increased the risk. Discussion and conclusions: Using money on gaming sites may put some adolescents at risk of developing problems with either gaming or gambling. The link between using money in digital games and gambling participation calls for preventive measures, intervention and regulatory acts.Peer reviewe

How gambling motives are associated with socio-demographics and gambling behavior - A Finnish population study

Background and aims: The aims were to examine how socio-demographics and gambling behavior relate to both primary and additional gambling motives, and whether the gambling motives change during a one-year-period. Methods: The Finnish Gambling Harms Survey data was used. Gambling motives were measured with a categorical question. Gambling severity was measured using the Problem and Pathological Gambling Measure (PPGM). Using the first-wave data including only past-year gamblers (n = 5,684), five logistic regression models were utilized to explore the associations of gambling motives with socio-demographics and gambling behavior. The stability of gambling motives was assessed with McNemar's test using longitudinal data (n = 2,078). Results: Gambling for positive feeling was associated with younger age, high income, high gambling involvement and at-risk gambling. Monetary motive was associated with female gender, high gambling involvement, online or mixed-mode and at-risk gambling. Supporting worthy causes was associated with older age, monthly and weekly gambling, and land-based gambling. Socializing was associated with younger age and gambling occasionally on land-based venues with multiple game types. Finally, the motive to escape was intensified among 25-34-year-olds, homemakers, and those with high gambling involvement and at-risk or problem gambling. Gambling motives remained relatively stable for one year. Discussion and conclusions: Gender and age profiles varied in different motives. Positive feeling, socializing and escape motive was heightened among younger respondents while supporting worthy causes was heightened among the oldest. Women gambled for money more often than men. Escape motive was associated with problem gambling. Longer follow-up is needed to confirm the longitudinal results.Peer reviewe

Treatment for the concerned significant others of gamblers : A systematic review

Background and aims: Research recognizes the extent of harm experienced by concerned significant others (CSOs) of gamblers. This systematic review's aims are to examine the interventions for CSOs, evaluate potential benefits, and thematically describe treatment processes. The Stress-Strain-Coping-Support model (SSCS) served as the theoretical framework. Methods: Database searches were conducted in: MEDLINE, CINAHL Complete, Web of Science Core Collection, Social Services Abstracts, Applied Social Science Index and Abstracts, Cochrane Central Register of Controlled Trials, and APA Psyclnfo (between 01/Jan 2011-10/Jun 2021). Other search methods were also utilized. Inclusion criteria: interventions for CSOs with CSO specific outcomes. The Evidence Project Risk of Bias Tool was used for assessment. Results: 19/768 records were included. Nine interventions were utilized: 3 CSO directed, 4 for couples, and 2 low threshold online interventions. A quantitative synthesis (N = 7 studies) of effect size estimates for depression and anxiety measures didn't indicate any intervention to have better outcomes than others. Core themes in the treatment process identified in the qualitative synthesis (N = 7) included: information and understanding, social support, coping skills, communication, and strain. Limitations in the evidence related to sampling, control-conditions and outcome measurements. Discussion and conclusion: Several interventions were identified, yet no specific interventions appeared more beneficial than others. Using the SSCS model, commonalities and differences in intervention content were identified, along with themes that influence treatment processes. The need for tailored interventions is discussed. Future treatment efficacy research should carefully select study designs and outcome measurements.Peer reviewe

Gambling participation, gambling habits, gambling-related harm, and opinions on gambling advertising in Finland in 2016

Background: This report is an overview of results from the 2016 Finnish Gambling Harms Survey covering the population and clinical perspectives. It summarises the main findings on gambling participation, gambling habits, gambling-related harm, and opinions on gambling advertising. Methods: The population sample (n = 7186) was collected from three regions and the clinical sample (n = 119) in a gambling help clinic. Results: Frequency of gambling in the population sample was characteristically once a week, while in the clinical sample it was daily. Men gambled more often than women only in the population sample. The most common gambling environments were kiosks, grocery stores or supermarkets, and home. The most typical gambling-related harms were financial or emotional/psychological harms; the amount of experienced harm was considerable among the clinical sample. The clinical sample also perceived gambling advertising as obtrusive and as a driving force for gambling. Conclusions: The results of the clinical sample imply that when gambling gets out of hand, the distinctions between gamblers' habits diminish and become more streamlined, focusing on gambling per se - doing it often, and in greater varieties (different game types). There is a heightened need to monitor gambling and gambling-related harm at the population level, especially amongst heavy consumers, in order to understand what type of external factors pertaining to policy and governance may contribute to the shift from recreational to problem gambling.Peer reviewe

The relationship between gambling expenditure, socio-demographics, health-related correlates and gambling behavioura cross-sectional population-based survey in Finland

AimsTo investigate gambling expenditure and its relationship with socio-demographics, health-related correlates and past-year gambling behaviour. DesignCross-sectional population survey. SettingPopulation-based survey in Finland. ParticipantsFinnish people aged 15-74years drawn randomly from the Population Information System. The participants in this study were past-year gamblers with gambling expenditure data available (n = 3251, 1418 women and 1833 men). MeasurementsExpenditure shares, means of weekly gambling expenditure (WGE, Euro) and monthly gambling expenditure as a percentage of net income (MGE/NI, %) were calculated. The correlates used were perceived health, smoking, mental health [Mental Health Inventory (MHI)-5], alcohol use [Alcohol Use Disorders Identification Test (AUDIT)-C], game types, gambling frequency, gambling mode and gambling severity [South Oaks Gambling Screen (SOGS)]. FindingsGender (men versus women) was found to be associated significantly with gambling expenditure, with exp = 1.40, 95% confidence interval (CI) = 1.29, 1.52 and P ConclusionsIn Finland, male gender is associated significantly with both weekly gambling expenditure and monthly gambling expenditure related to net income. People in Finland with lower incomes contribute proportionally more of their income to gambling compared with middle- and high-income groups.Peer reviewe

How can the potential harms of loot boxes be minimised? : Proposals for understanding and addressing issues at a national level

Background and aims: Loot boxes are in-game items which distribute rewards to players via random -number generation; many games require players to make in-game payments to access their contents. The combination of financial outlay and random rewards has raised concern about similarities to gambling. This debate paper presents a series of themes identified by an inter-institutional working group in Finland, alongside suggested actions, and are presented with the intention of stimulating debate among stakeholders. Methods: This work uses an exploratory research approach to gather data from a range of sources, including state-of-the-art reports from several fields and qualitative content analysis of invited presentations from a range of stakeholders, including affected individuals, practi-tioners, and field-specific experts. Results and Discussion: Several significant themes emerged from the work and are presented alongside a series of proposed action points. Based on this preliminary exploration we propose a series of, non-exhaustive, actions for both primary and secondary prevention. Furthermore, the group identified the potential for responsible gaming practices to be adopted which would help to minimize the harm from overspending in gaming activities. Finally, we identified the need for further research in the field, for example the use of player data and both longitudinal and qualitative studies. Conclusions: The emergent themes are discussed in relation to both the views of the presenters and existing research in the field and are intended to promote discussion concerning the viability of context-specific approaches to an issue of global reach and significance.Peer reviewe

At-risk and problem gambling among adolescents : a convenience sample of first-year junior high school students in Finland

Background: Adolescent gambling and substance use are viewed as a public health concern internationally. The early onset age of gambling is a known risk factor for developing gambling problems later in life. The aims of this study are: to evaluate the internal consistency reliability, factorial validity and classification accuracy of the Finnish version of DSM-IV-Multiple Response-Juvenile (DSM-IV-MR-J) criteria measuring at-risk/problem gambling (ARPG); to examine gender differences in gambling participation, ARPG and substance use among first-year junior high school students; and to investigate the association of gambling and gaming (video game playing) participation, substance use and social variables with ARPG. Methods: This study examined 988 adolescents (mean age 13.4 years) at 11 public schools in Finland between October-December 2013. The response rate was 91.6%. Chi-squared test and binary logistic regression analysis were used. Results: 'Illegal acts' was the most endorsed and sensitive, but the least specific criteria identifying ARPG. During the past year, 51.6% of the respondents had gambled, 7.9% were identified as at-risk/problem gamblers (DSM-IV-MR-J score >= 2), 8.0% had smoked and 8.9% had been drinking for intoxication, and the first three were significantly more common among boys than girls. The odds ratio of being a male past-year at-risk/problem gambler was 2.27, 5.78 for gambling often or sometimes, 2.42 for video game playing weekly or more often and 6.23 for having peer gamblers. Conclusions: Overall, the Finnish version of the DSM-IV-MR-J had acceptable internal consistency reliability and factorial validity. None of the DSM-IV-MR-J criteria were accurate enough to screen ARPG per se. ARPG past-year prevalence was relatively high with males gambling more than females. ARPG was as common as drinking alcohol for intoxication and smoking. Peer gambling was strongly associated with ARPG. Efficient strategies to minimise the risks of gambling problems, tools for prevention and identification of ARPG among the underage are needed.Peer reviewe

Past-year gambling behaviour among patients receiving opioid substitution treatment

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