Jun 16, 2025 | RESEARCH
Read the original article on the BASIS HERE.
By Nakita Sconsoni, MSW
Stigma occurs when someone is viewed negatively based on specific characteristics, like having an addiction. Stigma can lead to psychosocial impairments and may deter people from accessing treatment or recovery resources. Gambling disorder, in particular, is a highly stigmatized addiction that can perpetuate feelings of shame/embarrassment and lead to isolation. Despite these consequences, there is a lack of research on stigma related to gambling. Online support forums create spaces for gamblers to anonymously share their perspectives, which can help researchers and clinicians understand gamblers’ experiences with stigma. This week, The WAGER reviews a study by Katy Penfold and colleagues that investigated the experiences of stigma among gamblers who used online support forums.
What was the research question?
What experiences with stigma and discrimination do gamblers who have experienced gambling harm describe on online peer support forums?
What did the researchers do?
The researchers identified three UK-based public online support forums for gambling harm. Twenty-seven threads (389 posts) across these forums included content from someone with lived experience with gambling harm, discussing their experiences with stigma or discrimination, or obstacles to seeking help. The researchers used thematic analyses to identify themes relating to experiences of stigma. These interpretations were reviewed for accuracy by the research team and a gambling lived experience panel.
What did they find?
Participants’ discussions about stigma centered around five themes: (1) beliefs about gambling and how it can become an addiction, (2) self-stigma, (3) anticipating stigma from others, (4) stigmatizing others who experience gambling harm, and (5) experiencing stigma and discrimination (see Figure). Most participants viewed addiction as a disease and compared their experiences to drug dependence. Their perceptions of gambling appeared to influence how they viewed their own gambling behavior, often leading to self-stigma. Participants criticized themselves and often felt ashamed of their behavior. They anticipated that others would hold similar negative views and judge them for their addiction, discouraging help-seeking. Participants rarely stigmatized one another, but when they did, they seemed to make generalizations about all gamblers based on their own negative self-views. Some participants experienced discrimination by family/friends or others. These experiences ranged from non-hostile discrimination, like having a partner take control of the finances, to hostile discrimination, like being disrespected by casino employees.

Figure. Quotes from participants on their experiences with stigma, separated into five themes: (1) beliefs about gambling and how it can become an addiction, (2) self-stigma, (3) anticipating stigma from others, (4) stigmatizing others who experience gambling harm, and (5) experiencing stigma and discrimination. Click image to enlarge.
Why do these findings matter?
These findings can be used to inform stigma-reduction campaigns. Efforts to reduce stigma should challenge negative stereotypes and reframe gambling as a health-related issue—not a personal failing. There should also be efforts to educate families and communities on how to respond supportively when someone discloses their gambling. Although initiatives like these should be promoted year-round, there are high-risk times when public health organizations should increase outreach and other efforts (e.g., Problem Gambling Awareness Month, which occurs during March Madness and its sports betting season).
Every study has limitations. What are the limitations of this study?
While discussion forums allow for real-world insights into the experiences of people with gambling problems, participants might feel uncomfortable disclosing their true feelings, particularly their views on other gamblers’ behaviors. Although the researchers received feedback on their interpretation of the forum discussions, they are still subject to personal biases, which might have altered their understanding.
May 30, 2025 | RESEARCH
Read the original article on the BASIS HERE.
By Annette Siu
Lower-risk gambling guidelines are recommended limits on gambling behaviors to help minimize gambling-related harm. The guidelines include participating in no more than two types of gambling, gambling no more than four times a month, and gambling less than 1% of one’s household income. While gambling participation and problem gambling are linked, the extent to which low-risk gambling participation actually predicts future gambling-related harm is less clear, as both concepts are typically measured at the same time. This week, as part of our Special Series on Education to Promote Lower-risk Drinking, Gambling, and Substance Use, The WAGER reviews a study by Nolan Gooding and colleagues that examined this relationship longitudinally among Canadian adults.
What was the research question?
What levels of gambling participation are associated with an increased risk of future gambling-related harm?
What did the researchers do?
The researchers used data from the Alberta Gambling Research Institute’s National Project online panel survey. Participants were Canadian adults who had gambled at least once monthly during the past year. They completed a baseline and follow-up survey that assessed gambling participation (number of gambling types, number of gambling days per month, and percent of household income spent gambling) and gambling-related harm (e.g., financial and emotional harm). The researchers calculated the relative risk of gambling-related harm, collected at follow-up, based on levels of gambling participation collected at baseline.1
What did they find?
Participating in more types of gambling at baseline was associated with an increased relative risk of experiencing financial and emotional harm at follow-up (see Figure). For example, people who participated in at least five types of gambling were 8.54 times more likely to experience emotional harm compared to those who participated in one type of gambling. Similarly, as the number of days per month spent gambling increased, the relative risk of experiencing harm also increased. Finally, a higher percent of household income spent on gambling was associated with a greater relative risk of experiencing gambling-related harm.

Figure. Relative risk of financial and emotional harm based on gambling participation levels. Click image to enlarge.
Why do these findings matter?
Participating in more types of gambling, gambling more frequently, and spending more on gambling are associated with a greater risk of experiencing harm. These findings are mostly consistent with the quantitative limits established through the lower-risk gambling guidelines, which suggests that following the guidelines can help reduce the risk of gambling-related harm. To further support harm reduction, gambling interventions should focus on responsible gambling strategies, such as using lower-risk gambling guidelines to set time and money limits.
Every study has limitations. What are the limitations in this study?
This study used self-report measures, which are subject to social desirability and recall bias. The sample only included Canadian adults, so the results might not generalize to other geographic areas with different gambling environments. Additionally, there was attrition: around half of the baseline respondents completed the follow-up survey. This contributed to non-random missing data and likely affected the results.
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 or Gamblers Anonymous. Additional resources can be found at the BASIS Addiction Resources page.
— Annette Siu
1. The researchers also conducted receiver operating characteristic analyses to determine optimal low-risk limits for each measure of gambling participation. However, we are not covering those analyses in this review.
Apr 17, 2025 | RESEARCH
Read the original article on the BASIS HERE.
By Timothy Edson, Ph.D.
Growing evidence suggests that gambling and gaming are closely intertwined. Many gambling products are becoming increasingly gamified, while gambling and gambling-adjacent features and mechanics within modern video games have received increased attention. Escapism, or using entertainment to escape from everyday life, is a common motivation for problematic gambling and gaming. This week, The WAGER reviews a study by Hannu Jouhki and colleagues that assessed how basic psychological needs affect the relationship between escapism and problematic gambling and gaming.
What were the research questions?
Which psychological needs are associated with motivations to gamble or play video games to escape daily life? To what extent do psychological needs influence the relationship between escapism and experiencing problems with video games or gambling?
What did the researchers do?
The researchers analyzed longitudinal survey data from 1,095 Finnish adults. Participants were assessed for problem gambling, problem gaming, and escapism (e.g., how often they gamed or gambled to avoid real-life social encounters or situations). They also reported their levels of frustration in achieving the psychological needs of autonomy (control of their decisions), competence (ability to complete tasks) and relatedness (meaningful relationships with others) in their daily life. Accounting for demographics (e.g., gender, income) and personality (e.g., impulsivity, openness), the researchers used random effects count modeling to understand: (1) the effects of psychological needs on escapism, and (2) the effects of escapism and psychological needs on problem gambling and gaming, including moderation effects.
What did they find?
Participants who felt greater frustration with autonomy and competence (but not relatedness) were more likely to report increased levels of gambling or gaming to escape. Other predictors of escapism included younger age, impulsivity, and having a significant other experiencing gambling problems (see Figure). Those who indicated increased levels of escapism were more likely to also report increased levels of problematic gambling and/or gaming. The relationship between escapism and problem gambling was stronger for those reporting increased competence frustration, while the relationship between escapism and problem gaming was stronger for those with increased competence and autonomy frustration.

Figure. Variables that significantly predict gambling and/or gaming to escape daily life among Finnish adults (N = 1095). The numbers at the end of each bar are standardized coefficients from a random effects negative binomial regression model. Positive numbers (in blue) represent variables associated with increased gambling and/or gaming to escape (e.g., competence frustration) while negative numbers (in green) represent variables associated with decreased escapism (e.g., older age). The larger the number, the larger the effect the variable has on escapism.
Why do the findings matter?
People who have trouble living life on their own terms (autonomy frustration) or handling life’s challenges (competence frustration) might be more likely to gamble or play video games to escape. Those experiencing competence frustration, in particular, could be at greater risk of this escapism translating into problematic gambling and gaming. Cognitive behavioral therapy (CBT) may help individuals reduce competence frustrations by helping them understand and evaluate these feelings. Broader society changes, like universal basic income, might also reduce competence frustrations by relieving the pressure to continually perform and be productive to just get by. By reducing competence frustration in diverse ways, we can perhaps begin to thrive in the real world and feel less need to escape from it.
Every study has limitations. What are the limitations in this study?
This study took place in a single country, Finland. It is unclear if we would see the same findings were this study to be replicated in other countries. The study also excluded youth, a sizable demographic in the video game community for whom gamblified gaming can often lead to problems.
— Timothy Edson, Ph.D.
Mar 21, 2025 | CONCERNED OTHERS, RESEARCH
Read the original article on the BASIS HERE.
By John Slabczynski
Editor’s note: Today’s review is part of our month-long Special Series on Addiction and Social Support. Throughout March, the BASIS is highlighting the role of social support in addiction-related experiences.
Though it is a popular recreational activity, gambling can be harmful in a number of ways. Gambling-related harms include financial, physical, and mental harms to both the gambler as well as gamblers’ friends and family. Despite the fact that gambling-related harms can extend beyond the gambler, relatively little research has explored the experiences of those affected by others’ gambling behavior. Of particular note are methods to attenuate these harms such as through positive coping strategies and finding increased social support. This week, as part of our Special Series on Addiction and Social Support, The WAGER reviews a study by Catherine Tulloch and colleagues that explored how coping styles and social support influence the experiences of people affected by others’ gambling.
What was the research question?
How do social support, coping style, problem gambling severity, and closeness to individuals experiencing problem gambling influence distress and harms to close loved ones?
What did the researchers do?
The researchers used a survey panel platform to recruit 1,131 Australians who were close to someone with a gambling problem. Participants completed a modified version of the Problem Gambling Severity Index that allows for second-hand responses (e.g., “Did [the gambler in your life] borrow money or sell anything to get money to gamble?”). Participants also reported on their closeness to the individual with a gambling problem, the harms they’ve experienced as a result of their loved one’s gambling (financial or otherwise), their distress, how often they engaged in certain ways of coping with their relative’s gambling, and social support. The researchers then used a series of regression analyses to examine the predictive role of problem gambling severity, closeness, social support, and coping styles on distress and harm.
What did they find?
Participants reported more harm and more distress when (1) their loved ones had more severe gambling problems, (2) they were closer to their loved one, and (3) they frequently coped with their loved one’s gambling in a maladaptive way. In comparison, increased social support was related to lower levels of harm and distress (see Figure). Interestingly, though the researchers did not identify any interactions among variables predicting harm, they did find that problem gambling severity interacted with closeness, maladaptive coping, and withdrawal coping. Specifically, the effect of the gambler’s problem gambling severity on the participant’s distress was stronger for participants who were closer to the gambler or who engaged in either withdrawal or maladaptive coping strategies. Notably, however, the interaction effects and influence of withdrawal coping disappeared when the researchers examined the predictors of harm and distress simultaneously, which suggests the interactions might not be especially stable

Figure. Displays the 𝛃 (Beta) for each variable included in the full multivariate regression model predicting gambling-related harm (top) or distress (bottom). 𝛃 can be interpreted as the estimated change in the dependent variable (e.g., distress) for a one-unit change in the independent variable (e.g., social support). PGSI = Problem Gambling Severity Index. Only predictors that reached statistical significance in at least one model are included. Adapted from Tulloch et al. (2025). Click image to enlarge.
Why do these findings matter?
These findings provide insight into risk factors for vicarious harm among affected others. Social support seems to buffer the painful effects on affected others, so groups like Gam-Anon may be especially important for loved ones affected by problem gambling. Furthermore, interventions that target coping styles and social support among those affected by another’s gambling, such as the 5-step treatment model, may be especially beneficial as has been suggested by previous research.
Every study has limitations. What are the limitations in this study?
This study used a proxy measure for problem gambling severity. While proxy measures are commonly used, their validity is often not established, as is the case with the measure used in this study. Additionally, this study measured social support via perceived informal support and thus does not include professional support or other for formalized systems.
Mar 14, 2025 | PROBLEM GAMBLING, RESEARCH
Read the original article on the BASIS HERE.
By Kira Landauer, MPH
Adolescent gambling is common, with many young people gambling before reaching a legal gambling age. This is concerning because underage gambling increases the risk of experiencing gambling problems later in life. Parental attitudes and behaviors are crucial to positive youth development, and gambling behaviors are no exception. This week, The WAGER reviews a study by Cassandra K. Dittman and colleagues that examined adolescent gambling from the perspective of parents in New South Wales, Australia.
What were the research questions?
(1) What are parents’ knowledge of and attitudes towards their adolescent child’s gambling? (2) Are adolescents exposed to gambling via their parents’ gambling?
What did the researchers do?
The researchers recruited 1,185 parents (31% fathers, 69% mothers) of adolescents in New South Wales, Australia. Participants completed an online survey. They were asked about their attitudes towards adolescent gambling and ranked their concern with gambling alongside other adolescent issues (e.g., bullying, alcohol use). Parents reported both their adolescent child’s and their own gambling behavior over the past 12 months and whether they had gambled with their adolescent present. The researchers used descriptive statistics to explore parental attitudes towards gambling and adolescent gambling exposure and gambling behavior. They used comparison tests such as ANOVA to examine differences across these facets by parent and adolescent gender.
What did they find?
Most parents disapproved of adolescent exposure to gambling. However, parents were less concerned with gambling compared to other adolescent issues like bullying and drug use. Twenty-seven percent of parents reported that their adolescent had gambled in the past year. Of the 947 parents who reported past-year gambling themselves, two-thirds had gambled with their adolescent present. Skin betting and fantasy sports betting were the most common parent-adolescent gambling activities (see Figure). Compared to mothers, fathers engaged in more gambling in the presence of their adolescent. Fathers also gambled more with their adolescent sons compared to daughters.

Figure. Frequency of adolescent exposure to their parent’s gambling in the past year, by gambling activity and among parents who participated in that gambling activity. Please note: Figure does not depict the percent of parents from the sample who participated in each activity. For example, 12.0% of parents participated in skin betting in the past 12 months. Of them, 74.6% did so in the presence of their adolescent child at least once. Click image to enlarge.
Why do these findings matter?
Adolescents often gamble with the knowledge of their parents, and that some parents–particularly fathers–actively facilitate their child’s gambling by involving them in their personal gambling activities. Parents may underestimate the risks associated with adolescent gambling. This could be because gambling is generally perceived as socially acceptable and often portrayed positively (e.g., through advertisements). Parents, and fathers in particular, could benefit from increased awareness and education about the risks associated with youth gambling, through initiatives like the GambleAware Parents Campaign.
Every study has limitations. What are the limitations of this study?
Participants might not have been fully representative of the Australian parent population and their responses may be subject to self-report biases such as recall bias. This study examined parental knowledge of their adolescent child’s gambling. It is possible that adolescents gamble more than their parents realize, so the frequency of adolescent gambling reported by parents may be an underestimate.
For more information:
The Massachusetts Department of Public Health provides information for parents about the risks of teen gambling and a guide for talking about gambling. Do you think that you or someone you know might have 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
Mar 4, 2025 | ADVOCACY, PROBLEM GAMBLING, RESEARCH
Last fall, a lengthy report on the state of gambling was published in The Lancet Public Health, a British monthly journal that focuses on public health. The report (The Lancet Public Health Commission on gambling Wardle, Heather et al. The Lancet Public Health, Volume 9, Issue 11, e950 – e994) provides a comprehensive view of the development of gambling in the last two centuries.
The Lancet Public Health Commission’s report on gambling highlights the escalating global public health crisis posed by the gambling industry, particularly due to its rapid digital expansion. The commission estimates that approximately 450 million individuals worldwide experience harmful effects from gambling, with at least 80 million suffering from gambling disorder—a condition characterized by compulsive gambling behavior despite negative consequences.
The report states that the proliferation of mobile and online gambling platforms has made access easier than ever, contributing to the rise in gambling-related harms. Sophisticated marketing strategies, including targeted digital advertising and sports sponsorships, have increased exposure, especially among adolescents and children. This exposure is concerning, as early interaction with gambling increases the risk of developing gambling disorders later in life.
The commission identifies several severe consequences associated with gambling, including financial losses, mental health issues, family breakdowns, heightened risk of suicide, and increased crime rates. These harms are not evenly distributed; vulnerable groups such as adolescents and individuals from lower socioeconomic backgrounds are disproportionately affected.
To address these challenges, the commission advocates for stronger global regulatory controls, similar to those applied to alcohol and tobacco industries. Recommended measures include restricting access to gambling, limiting advertising and implementing public health campaigns to raise awareness about the risks associated with gambling. The commission emphasizes the need for policymakers to treat gambling as a critical public health issue to mitigate its widespread and profound impact.
In summary, the report calls for comprehensive action to curb the growing public health threat posed by the gambling industry’s expansion, particularly in the digital realm.
Page 1 of 1012345...10...»Last »