Nov 3, 2023 | RESEARCH
Read the original article on The BASIS here.
By Kira Landauer, MPH
The prevalence of gambling problems is higher among U.S. military veterans when compared to the general civilian population. Aspects of military service — experiences of trauma, difficulty adjusting to life post-deployment, and low social support after returning from deployment — may contribute to the risk of problem gambling among veterans. This week, The WAGER reviews a study by Elina A. Stefanovics and colleagues that examined the associations between recreational gambling and at-risk/problem gambling, and homelessness and mental health/substance use disorders among low-income U.S. military veterans.
What were the research questions?
What is the prevalence of recreational gambling and at-risk/problem gambling among low-income U.S. military veterans? What are the associations between gambling status and physical health, mental health and substance use disorders, and homelessness?
What did the researchers do?
The researchers analyzed survey data from a subset of 781 veterans who completed the National Veteran Homeless and Other Poverty Experiences study. Eligible participants served on active duty in the U.S. Armed Forces and lived in a household under 300% of the federal poverty level in 2021. Study participants reported past-year gambling and were screened for at-risk/problem gambling (i.e., ARPG). They were then categorized into three groups: non-gambling; recreational gambling (i.e., past-year gambling with a negative gambling screen); and ARPG (i.e., past-year gambling with a positive gambling screen).
Participants were also asked about their experiences with homelessness, their income and other financial measures (e.g., debt), their physical health, and their history of mental health and substance use (including treatment). The researchers examined how these measures were associated with gambling group membership.
What did they find?
Nearly one-quarter of the low-income veterans surveyed gambled recreationally, and 6.7% screened positive for ARPG. Individuals in the ARPG group were more likely to be younger and less likely to be White. Compared to non-gambling, ARPG was associated with poorer physical health and current and lifetime mental health and substance use disorders (see Figure). Veterans in the recreational gambling group were more likely to have a current drug use disorder compared to the non-gambling group. ARPG group members were five times as likely to have ever received mental health or substance use treatment and three times as likely to report current psychiatric medication use relative to the non-gambling group. They were also more likely to report shame and perceived stigma as reasons for not seeking mental health treatment. Finally, members of the ARPG group were six times as likely to have a lifetime history of homelessness and five times as likely to report having student loans when compared to non-gambling participants.
Increased odds of lifetime mental health and substance use disorders among U.S military veterans experiencing at risk/problem gambling
Figure. Odds ratios of lifetime mental health and substance use disorders among low-income U.S. military veterans experiencing at-risk/problem gambling, compared to non-gambling veterans.
Why do these findings matter?
This study found that about one-third of low-income U.S. military veterans engage in recreational gambling or are experiencing ARPG, and that ARPG is associated with poor physical health, current and lifetime mental health and substance use disorders, and homelessness. Tailored approaches to identifying and addressing ARPG in this population are needed. Routine screening for gambling-related problems could be implemented across VA primary care and behavioral health centers. Further, VA providers should be equipped to provide problem gambling treatment. Given the high rates of ARPG among veterans with a history of homelessness, shelter staff should be trained to identify ARPG and make appropriate referrals. Finally, veterans might benefit from increased services to help address factors associated with ARPG, such as resources on adjusting to post-deployment life.
Every study has limitations. What are the limitations of this study?
This study utilized a cross-sectional design, so causality between variables cannot be determined. In other words, we cannot determine whether ARPG affected experiences of homelessness among veterans, or vice versa. The findings from this study might not be generalizable to all U.S. veterans (e.g., higher-income or reserve service veterans).
For more information:
Make the Connection is a resource for veterans looking to learn more about and change their gambling behavior. Do you think you or someone you know has a gambling problem? Visit the National Council on Problem Gambling for screening tools and resources. For additional resources, including gambling and self-help tools, visit our Addiction Resources page.
— Kira Landauer, MPH
Oct 12, 2023 | RESEARCH
By Annette Siu
See original article on The BASIS HERE.
Adolescence is a developmental period during which risky behaviors—such as gambling and alcohol use—tend to emerge. In Finland, gambling and alcohol use among underage adolescents is common. Advising adolescents on the potential harms of risky behaviors is important because gambling at an early age is associated with a greater risk of developing addictive behaviors such as problem gambling and alcohol dependence later in life. This week, the WAGER reviews a study by Tiina Latvala and colleagues that examined trends in the relationship between adolescent gambling and alcohol use between genders over time.
What were the research questions?
(1) What trends are there in the relationships between gambling, alcohol use, and drunkenness among Finnish adolescents? and (2) How have these trends changed from 2009 to 2019?
What did the researchers do?
The researchers used data collected biannually from 2009 to 2019 from the School Health Promotion Study (SHPS). The SHPS is a national cross-sectional study that asks 14-16 year olds in Finland about their health behaviors and school experiences. The researchers measured the frequency of gambling and alcohol use by asking the questions, “How often do you gamble?” and, “How often do you use alcohol altogether, e.g., half a bottle of beer or more?” They measured the frequency of drunkenness by asking, “How often do you use alcohol until you are really drunk?”. Among those who used alcohol or got drunk at least once a month, the researchers classified respondents as regular gamblers (gambled at least once a week), occasional gamblers (gambled 2-3 times a week), or non-gamblers, and studied how many respondents fell into these categories each year.
What did they find?
Among boys who reported using alcohol at least once a month, regular gambling became less prevalent over time while occasional gambling and non-gambling became more prevalent. In the first year of data collection, 58.3% of boys who drank at least once a month were regular gamblers, but this number dropped to 20.6% by 2019 (see Figure). Girls who reported using alcohol at least once a month gambled less overall across the study period. Trends were similar for boys and girls who got drunk at least once a month (not shown). Overall, gambling, alcohol use, and drunkenness were more common among boys compared to girls. Gambling was also more common among adolescents who used alcohol or who had gotten drunk compared to those who were not using alcohol or had not gotten drunk.
Figure. This figure displays the proportions of regular gambling, occasional gambling, and no gambling among boys and girls in Finland who reported using alcohol at least once a month from 2009 to 2019.
Why do these findings matter?
Although the prevalence of adolescent gambling decreased over time between 2009 and 2019, there was still a significant proportion of underage adolescents who reported gambling. Additionally, those who used alcohol were also more likely to gamble, which suggests that there is a potential clustering of problems among adolescents. To decrease risky behaviors among adolescents, it is important to address social determinants of health through preventive interventions at the individual, community, and societal levels. Potential interventions include stricter enforcement of gambling policies, increasing education about potential harms resulting from risky behaviors among youth, and more.
Every study has limitations. What are the limitations in this study?
This study was conducted in Finland, so the findings about adolescent gambling and alcohol use might not be generalizable to other countries with different gambling regulations and attitudes. Additionally, because this study used self-report measures, the responses might be impacted by social desirability bias.
For more information:
Individuals who are concerned about their gambling behaviors or simply want to know more about problem gambling may benefit from visiting the National Council on Problem Gambling. The National Institute on Alcohol Abuse and Alcoholism has tips and resources for people struggling with problem drinking. Additional resources can be found at the BASIS Addiction Resources page.
Oct 10, 2023 | RESEARCH
By John Slabczynski
See original article on The BASIS HERE.
Many countries, such as the United Kingdom (UK), have created powerful regulatory bodies which are meant to protect consumers and mitigate risks that come with gambling. These regulatory bodies are not perfect, however. They can be slow to adapt to changes in the gambling landscape such as the rise of online gambling. Further complicating these issues is the presence of cryptocurrency-based1 online gambling operators. While online gambling carries its own risks, crypto gambling might be especially risky for consumers due to the lack of regulatory oversight. Research on the association between crypto-trading and gambling problems also suggests that individuals who engage crypto-gambling may be especially at-risk for gambling problems. This week, The WAGER reviews a study by Maira Andrade and colleagues that reviewed the responsible gambling (RG) features offered by crypto-based online gambling operators.
What was the research question?
What kinds of RG features do cryptocurrency-based online casinos employ?
What did the researchers do?
The researchers collected data from 40 cryptocurrency-based online casinos that were accessible from the UK. Of these, 22 were accessible directly from within the UK, while 18 required a VPN connection to access. The researchers then searched for the presence of seven features intended to promote RG on each of these sites. These included: (1) thorough account registration requirements, (2) a dedicated RG page, (3) separation of promotional material from the RG page, (4) availability of RG tools, such as deposit limits, (5) accessibility of gambling history, (6) RG material promoted via email, and (7) having RG-oriented customer service. (The researchers coded other crypto-based features, but we are not reviewing them here.)
What did they find?
The majority of operators required only minimal information to register. Fourteen sites required an email address (or less), and none required proof of age. The presence of responsible gambling material was also limited; though 31 out of the 40 sites offered an RG page, many contained either promotional material, suggested that gambling was a way to make money, or were otherwise insufficient in educating consumers about gambling-related harms. Slightly over half of the sample (62.5%) provided at least one RG tool, though these were also often limited or not user friendly. Notably, however, 39 of the websites offered gamblers access to their gambling history. Email communication was especially problematic among these sites. Only five sent emails containing RG information, and an additional five either didn’t respond or sent potentially harmful information after a hypothetical request for help from a consumer2 (see Figure).
Figure: Number of crypto-based online casinos with each of the seven RG features.
*One operator was not rated because they did not require an email at registration.
**Two operators were not rated on this criteria.
Why do these findings matter?
These findings could help regulators, researchers, and policymakers understand the current landscape of crypto-based gambling. For example, it’s possible that youth might be engaging with these sites, leading to potential current and future gambling-harm. Other findings suggest that these operators’ RG practices often involve harmful or incorrect information regarding gambling safety, which might increase gambling-related harm instead of reducing or preventing it.
Every study has limitations. What are the limitations in this study?
The researchers did not make deposits or otherwise gamble on any of the crypto-based gambling sites, so they did not get the full customer experience. As such, it is possible that the researchers missed some of the sites’ features or that their records of the sites’ features contain inaccuracies. For example, though the study found that 39 sites offered access to an accounts gambling history, it is unknown whether these were accurate reports or how frequently they were updated. Additionally, despite reviewing 40 sites, this sample is relatively small compared to the overall number of crypto-based gambling sites.
For more information:
Individuals who are concerned about their gambling may find support through the National Council on Problem Gambling or with Gamblers Anonymous. Additional resources can be found at the BASIS Addiction Resources page.
—John Slabczynski
1. Cryptocurrency refers to a digital asset that is worth money and can be used to buy goods and services. The most popular and well-known type of cryptocurrency is Bitcoin, which was released publicly in 2009.
2. To examine potential responses to someone experiencing gambling problems, the researchers sent requests to all 40 websites with the following text: “I want to control my gambling. Can you give me any information on how I can do that? I feel a bit addicted and sometimes I can’t control the money I’m spending.”
Aug 15, 2023 | RESEARCH, YOUTH GAMBLING
By Kira Landauer, MPH
See original article on The BASIS HERE.
Gambling is a common activity among adolescents. Most adolescents gamble without consequences but some experience gambling-related problems and associated harms, including disrupted social relationships, academic challenges, delinquency, and criminal behavior. Their gambling behavior might be influenced by the gambling attitudes and behaviors of their family and friends. This week, The WAGER reviews a study by Megan Freund and colleagues that investigated whether exposure to other people’s gambling is associated with the gambling behavior of Australian secondary students.
What was the research question?
Is exposure to other people’s gambling associated with past-month gambling, types of gambling activities, and at-risk or problem gambling among a sample of Australian adolescents?
What did the researchers do?
Students (n = 6,377) from 93 secondary schools in the Australian states of Victoria and Queensland participated in the Australian Secondary Students’ Alcohol and Drug Survey. Participants reported whether they had ever gambled and their past-month gambling behaviors, including the types of gambling activities they engaged in (i.e., hard or soft1). Students who reported ever gambling were screened for problem gambling. Participants were also asked whether their parent/caregiver, brother/sister, best friend, or other relative had gambled in the past month. The researchers assessed the associations between other people’s gambling and students’ past-month gambling, types of gambling activities, and at-risk or problem gambling.
What did they find?
Thirty-one percent of students in the sample reported ever gambling and six percent had gambled in the past month. Ten percent of students who ever gambled were classified as either experiencing at-risk (8%) or problem gambling (2%). One in five students reported that someone in their household gambled in the past month. Most frequently, students reported past-month gambling among fathers (16%), followed by other relatives (14%). Students were more likely to have gambled in the past month, played any hard gambling activity, and be classified as an at-risk or problem gambler if they had a parent/caregiver, brother/sister, best friend, or other relative who had gambled in the past month. Past-month gambling and at-risk/problem gambling were most likely among students whose parent/caregiver or best friend had gambled (see Figure).
Figure. Odds ratios of the association between other people’s gambling (parent/caregiver, brother/sister, best friend, other relative/someone else) and past-month gambling and at-risk/problem gambling among a sample of Australian secondary students (n = 6,377).
Why do these findings matter?
These findings confirm the association between exposure to gambling in family and friends and gambling behaviors among adolescents. Young people with a parent/caregiver or close friend who gambled were most likely to have gambled recently, engaged in hard gambling activities, and to have experienced at-risk or problem gambling. These findings should inform future problem gambling prevention and education initiatives for young people, such as family-focused initiatives. Successful initiatives might also include skill development for young people, such as how to resist peer pressure to gamble.
Every study has limitations. What are the limitations of this study?
Data were self-reported, so the results might be subject to recall bias and social desirability bias. Because the study was based on a sample of adolescents and was conducted in Australia, the findings might not be generalizable to people in other places with different gambling landscapes.
For more information:
Do you think you or someone you know has a gambling problem? Visit the National Council on Problem Gambling for screening tools and resources. For additional resources, including gambling and self-help tools, visit our Addiction Resources page.
— Kira Landauer, MPH
1. Hard gambling activities are generally defined as having higher stakes or a more rapid pace of play (e.g., poker, casino games, sports betting) compared to soft gambling activities (e.g., lottery tickets, scratch cards).
Aug 14, 2023 | RECOVERY
The first time someone suggested I might have a gambling problem was in high school. Before I went on a casino trip that I won at an auction, my football coach pulled me aside. He told me to be careful with my gambling, to think about what I was going to do.
Looking back on it, I think it was really insightful for someone in the 1990s to realize that someone might have a gambling problem. Unfortunately, I ignored his advice.
I started gambling at a young age. By the time I was 10, I participated in church-related activities, including cake walks, nickel rolls and games of chance. I also played my share of Bingo.
I grew up at a time when casinos were just getting started in Minnesota, and I often went and gambled there although I was under age.
When I wanted to gamble, I would do whatever it took to get the high. This could be gambling in a casino, playing the lottery or playing cards. I bet on hockey games and would even bet with friends on how many times an elevator would stop at a floor. Everything in my life involved gambling and games of chance.
The first time I sought help for my gambling was around 2007, when I went to Project Turnabout. I didn’t finish treatment, but going there was an eye opener. They told me I was a compulsive gambler, an alcoholic and a drug addict. I didn’t want to hear any of it, so I left. But I did take something from it.
For the next 10 years, I still gambled, though I had bouts of being gambling-free. I was in and out of GA meetings.
I suppose if there were a turning point, it might have been in 2017 when a little old lady pulled me aside at a GA meeting. She was probably frustrated because I still gambled some. I remember she told me three things: 1. “You’re going to make it,” 2. “Whatever you do for the next 12 months, don’t gamble,” and 3. “Keep going to the meetings.”
I found that I took a natural bond to her and what she said. I built a trusting relationship with her. If someone else told me the same thing, it might not have stuck.
I now work as a treatment coordinator. At some point, I hope to work strictly with people who have gambling problems. I thought I would be a special education teacher but I became fascinated with the social services aspect. I feel I can help people in a different way and engage them in conversations about recovery.
My advice to people struggling with gambling is to go and check out many meetings. You will find one that feels right, and when you do, treasure it. Stay in the present moment as long and often as you can, get humble and be teachable.
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