Although Minnesota did not pass a bill legalizing sports gambling during the last session, many think it’s just a matter of time before it happens. With an eye toward the future – and an eye on the experiences of several other states who have legalized sports gambling – we talked to problem gambling leaders in New Jersey and Michigan for their observations and warnings. (The Summer 2023 issue of Northern Light highlighted the sports gambling experiences of Ohio and Pennsylvania.)
New Jersey
In New Jersey, where brick-and-mortar gambling has existed since 1978, online gambling was legalized in 2013. Sportsbooks became legal in 2018, leading to a dramatic increase in sports gambling.
Among other notable changes is the increase in gambling advertising, which has “bombarded the public,” according to Felicia Grondin, executive director of the Council on Compulsive Gambling of New Jersey (CCGNJ). She notes that the gambling industry’s advertising was $292 million in 2020 and $725 million a year later.
CCGNJ has worked with the state to regulate gambling advertising. The New Jersey Division of Gaming Enforcement (DGE) has begun a new responsible gambling initiative whereby operators must abide by certain requirements, including the frequency of advertising and font size (to ensure visibility of problem gambling helpline information). CCGNJ has also been advocating for a PSA-type ad that will inform the state’s residents of the potential for gambling harm.
Increase in Calls for Help
Calls to the state’s problem gambling helpline are up dramatically. Of the increase in helpline calls, 20 percent are related to sportsbooks and 27% are related to online play, a considerable portion of which is presumed to be related to sports gambling. There’s been a reduction in general calls from people asking where to find casinos, what winning numbers are for the lottery, etc., but calls have increased from those who need help with a gambling problem. “I think the public is starting to understand more about the purpose of our 800GAMBLER helpline and how it works,” says Felicia.
Effective Communications with State Legislature
CCGNJ has also put an emphasis on communications with the state legislature, which Felicia says has proven fruitful. They engage legislators on various problem gambling topics through visits to the statehouse and bi-monthly blogs. Thanks to these efforts, the state has been more deliberate in its approach to gambling. One example is reducing a ten-year extension for online gambling to five years. “Legislators are recognizing that people are developing gambling problems and the importance of monitoring its related impact,” says Felicia.
Educating School Students
Shortly before the state assembly introduced a bill to require schools to provide instruction on the risks of gambling, as they do with other public health issues, the CCGNJ created the Cognitive Perspective Restructuring program (CPR). The program educates kids about risky behavior, including gambling, and how to make wise choices for a bright future.
As it relates to Minnesota, Felicia cites several things that our state should think about as it considers legalizing sports gambling:
o Establish parameters around advertising — frequency, the content, where it’s aired, etc.
o Post warning labels at brick-and-mortar locations as well as online.
o Ensure that students are educated about the risks of gambling at an early age.
o Produce public service announcements to create greater awareness.
o Request an increase in problem gambling funding commensurate with expected growth in gambling.
Michigan
Michigan officially legalized sports betting in December 2019. The first retail sportsbooks in the state opened in March 2020 and the online launch took place in January 2021.
The growth in sports gambling echoes the growth occurring around the nation. In September 2023, Michigan sportsbooks tallied $457.7 million in bets for the month. This represents a 25.6% increase from September of 2022.
With the availability of online gambling, Michael Burke, executive director of the Michigan Association on Problem Gambling, says it’s as though Michigan has gone from 34 casinos to a state that has 10 million casinos in the pockets of each resident. “It used to take people five to ten years to get addicted, but with easier access now, it’s more like five to ten months,” he says. Michael also is concerned about the impact of easy access on youth gambling and says that educating kids about the risks is vital.
According to the Michigan Department of Health and Human Services, in the first year since the legalization of sports betting and online gambling in Michigan, more than 4,400 calls were made to the state’s problem gambling helpline in 2021. This was nearly triple the number of calls received in 2020, the year before online gambling was approved. Referrals for people to receive gambling treatment also grew significantly, from 295 referrals in 2020 to 420 referrals in 2021, a 42% increase.
As Michael looks to a state (such as Minnesota) that hasn’t yet legalized sports gambling, he has a warning. “If you’re going to bring in gambling, you have to know what the results are going to be as far as compulsive gambling is concerned,” he says. “Legislators need to take their responsibility seriously and ensure that there’s something in place for a person who suffers harm from gambling. That’s the least they can do.”
Gamblers Anonymous (GA) has unveiled an updated Blue Book, the first such revision in nearly 40 years. The purpose of the book is to better serve both new and current members in their search for recovery from gambling addiction.
Specifically, members wanted a book that would:
o Function as a how-to for GA
o Facilitate working with sponsees
o Help members quickly understand the process
o Be something that would help anyone understand what the program is
The existing Blue Book was dated and generally not being used by the fellowship, according to Tom S., a member of the committee charged with producing an updated book. Considerable changes have taken place in gambling since 1984, including online sports betting and the proliferation of casinos.
“Mostly gone are the days of cigar-smoking horse players and sports bettors dropping a dime in a payphone and calling a bookie,” says Tom. “The gamblers coming to our meetings today are more likely to be casino gamblers, gamblers caught up in state-sponsored gambling, female gamblers and younger gamblers. They didn’t find a connection to the Blue Book of 1984.”
The revised book reflects changes that have already occurred in most GA meetings, including an effort to be more inclusive and an emphasis that meetings be solution-based — including recovery steps — rather than “war story” based.
The book was eight years in the making (partially delayed by the pandemic) and was produced by eight active Minnesota GA members with combined sobriety of approximately 120 years. The book is comprised of all original material, with no language borrowed from other twelve-step fellowships (although twelve-step principles and philosophy are woven throughout).
The book encapsulates the vast experience of its contributors and is a storehouse of ideas for recovering gamblers, covering issues such as how to deal with gambling urges, how to go to a meeting, how to get involved in GA, how to choose a sponsor, how to grow in recovery and how to repair relationships. The book also incorporates material from the GA Combo Book.
New chapters were added that address suicide, relapse, sponsorship, and hope and persistence.
“The chapter on suicide is extremely important and, until now, was completely missing from GA literature,” says Tom.
The new book does not include declaratives, such as “you must” or “you have to” statements. Different viewpoints are discussed and the suggestion is made for gamblers to discuss these perspectives with their sponsor or mentors.
The book is valuable for clients of counselors and therapists who choose to pursue their personal recovery journey in GA. Clients may also see themselves in the experiences depicted in the stories section of the book.
“I would encourage those who work with compulsive or problem gamblers to read this book from cover to cover, as it captures both the despair experienced by compulsive gamblers and the better way of life promised by GA,” says Jeannie B., who was also involved in producing the new book. “Professionals can also use the book to deepen their understanding of the GA program.”
To order a copy of the book, please visit gamblersanonymous.org.
Editor’s Note: Today’s review is part of our month-long Special Series on Addiction Myths and Misinformation. Throughout November, The BASIS is showcasing the dangers of myths and misinformation related to addiction.
People who experience gambling problems often hold irrational beliefs around gambling that encourage further involvement. For example, people who are on a losing streak may continue to gamble due to the belief that they are due for a win after so many losses (the gambler’s fallacy), while the hot hand fallacy can make someone think that wins will continue after a winning streak. Cognitive distortions like these can be rooted in misinterpretations of mathematics and are sometimes part of the constellation of factors that lead to gambling problems. Other factors related to the development of gambling problems, such as experiencing big wins and loss chasing, are closely related to these cognitive distortions. Therefore, understanding how these factors relate to one another is important for intervention and treatment efforts. This week, as part of our Special Series on Addiction Myths and Misinformation, The WAGER reviews a study by Róbert Krébesz and colleagues that examined how people experience cognitive distortions following a big win on a simulated slot machine.
What were the research questions?
(1) How do people experience cognitive distortions while gambling? (2) How do big wins influence the experience of cognitive distortions, and does this influence depend on when the big win occurs?
What did the researchers do?
Fourteen participants aged 18+ who reported that they did not gamble participated in a simulated slot machine experiment. The researchers preprogrammed the first 90 spins on the slot machine to award a big win in either the first 30 spins or between the 30th and 60th spins1. Participants who experienced a big win in their first 30 spins constituted the first group, early big winners, while participants who experienced a big win between their 30th and 60th spins made up the second group, late big winners. Throughout the experiment, participants continuously vocalized their thoughts and emotions out loud. These vocalizations were recorded and transcribed, and made up the primary data for the study. The research team coded these transcripts using a content analysis approach to indicate whether they contained cognitive distortions and if so, which ones.
What did they find?
This sample of non-gamblers displayed several cognitive distortions, including anthropomorphism, the gambler’s fallacy, illusion of control, over-interpretation of cues, illusory correlations, selective recall, near miss effect, and loss-chasing2. Of these, the most common were the gambler’s fallacy (57 occurrences), illusion of control (46 occurrences), and near miss effect (47 occurrences). Notably, cognitive distortions occurred most frequently in the phases where big wins occurred (i.e., the first 60 spins), yet were relatively rare in the final phase where no big win occurred (i.e., the last 30 spins). In terms of the timing of the big win, participants showed some differences in the types of cognitive distortions they experienced depending on when the win occurred (see Figure).
Cognitive distortions emerge following a big win on a simulated slot machine.
Figure. Displays the frequency of each type of cognitive distortion for both early and late big winners (N = 7 in each group). Three additional types of cognitive distortions were coded for, but these distortions (omnipotence, flexible attributes, and superstitious beliefs) were not present in either group. Click image to enlarge.
Why do these findings matter?
These findings are important for two reasons. First, they suggest that cognitive distortions may be an important focus of prevention efforts even for people who have not begun to experience gambling harm. For instance, responsible gambling messages, like pop-up messages that appear on slot machines, remind gamblers about the odds of winning games or suggest that players take frequent breaks. This study suggests a role for correcting cognitive distortions in these messages. Furthermore, the results suggest that pop-ups and other responsible gambling interventions focused on correcting gambling myths and misconceptions might be more effective if administered directly following a big win, such as after a player wins a slot machine jackpot.
Every study has limitations. What are the limitations in this study?
This study was a lab-based experiment and did not require participants to gamble with their own money, so the behavior of participants in this study might differ from the behavior of someone operating in an actual gambling environment. Additionally, the simulated slot machine in this experiment did not include features such as lights and sounds that are common to modern electronic gaming machines. Finally, this was a small study so results need to be replicated with a larger sample.
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. Click image to enlarge.
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.
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. Click image to enlarge.
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.
