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This article examines the effect of gambling location on the frequency, expenditure, and time spent on cash game poker in relation to individual characteristics of gamblers. Data were drawn from a 2012 Québec epidemiological gambling survey. The quantitative analysis used multilevel methods to model the dual-level hierarchical design of gambling location (level 1) and individual characteristics nested within poker cash game players (level 2). The sample was comprised of 270 individuals aged 18 years and above and living in private homes, who reported gambling on poker cash games in the past 12 months. Participants reported their gambling habits in up to three locations: private homes, the casino, and the Internet. Demographic data included age, gender, education level, and income. Significant variation was reported between the three locations and the gameplay patterns variables, i.e. betting frequency, time, and spending. The most frequently reported gambling locations were private dwellings (87.4%), followed by casinos (15.9%), and the Internet (13.7%). Some interactions between location and the demographic variables were observed. Moreover, the multilevel analysis revealed an important relationship between the location and poker cash gambling behavior. This study reveals the significance of contextual factors as a fundamental element in gambling behaviors and highlights the need for prevention strategies that target specific high-risk contexts rather than individually based interventions., (© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC part of Springer Nature.)

Background and Aims: Few meta-analyses have been conducted to pool the most constant risk factors for problem gambling. The present meta-analysis summarizes effect sizes of the most frequently assessed problem gambling risk factors, ranks them according to effect size strength and identifies any differences in effects across genders., Method: A random-effects meta-analysis was conducted on jurisdiction-wide gambling prevalence surveys on the general adult population published until March 2019. One hundred and four studies were eligible for meta-analysis. The number of participants varied depending on the risk factor analyzed, and ranged from 5327 to 273 946 (52% female). Weighted mean odds ratios were calculated for 57 risk factors (socio-demographic, psychosocial, gambling activity and substance use correlates), allowing them to be ranked from largest to smallest with regard to their association with problem gambling., Results: The highest odds ratio (OR) was for internet gambling [OR = 7.59, 95% confidence interval (CI) = 5.24, 10.99, P < 0.000] and the lowest was for employment status (OR = 1.03, 95% CI = 0.87, 1.22, P = 0.718). The largest effect sizes were generally in the gambling activity category and the smallest were in the socio-demographic category. No differences were found across genders for age-associated risk., Conclusions: A meta-analysis of 104 studies of gambling prevalence indicated that the most frequently assessed problem gambling risk factors with the highest effect sizes are associated with continuous-play format gambling products., (© 2021 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.)

There is limited research exploring the perceptions of people who gamble on the self-control strategies used to limit their gambling. This qualitative study examines self-control strategies used to limit money spent gambling, frequency of gambling, and time spent gambling. A total of 56 people who gamble (27 males and 29 females) participated in nine focus groups and five individual interviews in Montreal, Calgary, and Toronto (Canada). Self-control strategies used to limit their gambling expenditure were more common than frequency or time limiting strategies. Strategies to limit expenditure included: restricting access to money; keeping track of money allocated to gambling activities; and avoiding certain types of gambling activities. Various contextual factors were identified to influence those strategies, including social influences; winning or losing; using substances. Findings from this study emphasize the importance of communicating clear gambling limits to people who gamble, as well as the value of developing individual self-control strategies to limit frequency, time and money spent gambling.

An increasing number of clinical and empirical studies document the coping strategies used by partners of pathological gamblers (PGs). A postulate for this is that they may be useful for dealing with their partner's problematic gambling behaviors. Despite a widespread endorsement of this postulate, no study has yet documented their effectiveness: does the use of these coping strategies impact the gambler's behavior? To answer this question, semi-structured interviews were conducted with 19 participants (8 couples comprising one PG and his or her partner, one partner of a PG, and 2 PGs). Qualitative analysis of the interviews lead to a first main observation: via diverse coping strategies, partners of PGs can influence their spouse's gambling behaviors. The impact of these strategies may occur as initially expected by partners, that is by a reduction of gambling behaviors. However, the use of certain strategies can also increase the PG's gambling cravings, though this is not generally their partner's intention.

There is little research on the control strategies used by the general public to self-manage gambling habits and avoid harmful consequences. The current study sought to identify the most common self-control strategies of people who gamble regularly, the characteristics of those who use them, and assess the effectiveness of limit-setting strategies in reducing gambling-related harm. We recruited a large sample (N = 10,054) of Canadian adults who reported gambling activity in the past 12 months. Participants completed a survey that assessed gambling habits, use of control strategies including quantitative limit setting, and gambling related harm. The most common control strategies were setting predetermined spending limits, tracking money spent, and limiting alcohol consumption. The number of self-control strategies used by gamblers was positively associated with gambling involvement, annual income, problem gambling severity and playing electronic gaming machines. Approximately 45% of respondents failed to adhere to self-determined quantitative limits for spending, frequency, and time spent gambling. People who stayed within their gambling limits were less likely to report harm even after controlling for other risk factors. However, the effectiveness of remaining within one's personal spending limit decreased for those whose limits exceed $200CAN monthly. The findings support public health interventions that promote lower-risk gambling guidelines aimed at helping gamblers stay within spending, frequency and duration limits.

For the last 20 years, poker has been one of the most popular forms of gambling for adults. Although various studies have demonstrated the specific characteristics of these players, few studies have focused on teenagers playing poker. However, a better understanding of this activity among this vulnerable group would help to develop more effective strategies for preventing gambling problems. Thus, this study aims to identify, through latent class analysis, subgroups in that population and to assess co-occurrence across various characteristics typically associated with gambling behavior. The sample was constituted of 759 adolescents (70.8% boys; M age = 15.44 years, range = 14-19) recruited in high schools and who had played poker in the last year. The statistical fit indices revealed a four-class solution. Class 1 almost exclusively played simulated poker. Class 2 played poker exclusively in the school context. Class 3 played poker almost exclusively at home. Class 4 showed a very diversified pattern regarding their modalities of poker playing. Results of the logistic regression suggested that gambling related variables (e.g., time spent playing, reading about gambling strategies and diversity of gambling funding) were significant predictors of class membership. This study shows that there is a variety of profiles among young poker players. Although one profile has few risk factors, others have more factors associated with adults' gambling problems. These profiles suggest that specific prevention strategies are probably appropriate to reach these different groups of young people. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Despite the popularity in poker-related activities in recent years, few studies have focused on the evolution of gambling habits of poker players over a long period of time. The aim of this study is to examine factors influencing trajectories of poker players. The results are based on data collected at a four-time measurement of a prospective cohort study conducted in Quebec (n = 304 poker players). A latent class growth analysis was performed to identify trajectories based on the Problem Gambling Severity Index score. Multinomial multivariable logistic regression analyses were conducted to determine the correlates of gambling trajectories. Over the 3 years of the study, three gambling problem trajectories were identified, comprising one decreasing trajectory (1st: non-problematic-diminishing), one stable trajectory (2nd: low risk-stable), and one increasing trajectory (3th: problem gamblers-increasing). Internet as the main poker form and number of game played were associated with at-risk trajectories. Depression symptoms were significant predictors of the third trajectory whereas impulsivity predicted the second trajectory. This study shows that the risk is remaining low over years for the vast majority of poker players. However, the vulnerable poker players at the beginning of the study remain on a problematic increasing trajectory. It is therefore important to prioritize individuals in the third trajectory for interventions.

Online poker is considered more at-risk than land-based poker in terms of intense gambling behaviors and gambling problems. The development of many online gambling sites has raised public health concerns about the potential increase in online poker players. Longitudinal studies are useful to better understand the evolution of gambling behaviors; however, very few consider online poker players. Using a prospective design, this study aims to identify online and land-based trajectories over a two-year period and the factors influencing those trajectories. Results are based on data collected at three time-points over the course of a prospective cohort study conducted in Quebec (n = 304). A latent class growth analysis was performed to determine trajectories based on the main poker modality played, either online or land-based poker. Multinomial multivariable logistic regression analyses were conducted to determine the correlates of poker playing trajectories. Over two years, three poker playing trajectories were identified, comprising two stable trajectories [stable land-based (51.5%) and stable online (36.3%)] and an unstable trajectory [unstable online land-based (12.1%)]. The second trajectory included online poker players at baseline who transitioned to land-based poker. Number of gambling activities increased the odds of being in the first trajectory as compared to the others. Severity of gambling problems was a significant predictor of the second "unstable" or the third "stable online" trajectories, but not for the first "stable land-based" poker trajectory. The majority of poker players remained in either the land-based or online trajectories over two years. No poker players transitioned from land-based to online poker., Competing Interests: None., (© 2020 The Authors.)

Studies suggest that youth who are exposed to their first gambling experience at an earlier age are at increased risk of developing problems. However, studies reporting age of onset of gambling exposure as a risk factor for gambling problems are cross-sectional by design and the relationship between both variables are sometimes inferred over extending periods of time. Methodologically speaking, it could induce a recall bias, a fact already documented in numerous areas of research related to high-risk conducts in adolescence. Thus, the goal of this study was twofold: to longitudinally describe, among adolescents, the level of discrepancy between reports of age of initiation to gambling activities, and to assess if the discrepancies could be associated with a certain number of known predictors of gambling participation. Additionally, recall period effect (e.g. time passed between answering the same question) was also assessed. Data were collected from a large longitudinal study on gambling among youth and four measurement times at 1-year interval were used, with only young people who have been introduced to gambling retained in the analyses (n =297; 63.3% boys; mean age = 15.25 years). Results revealed significant inconsistencies about age of initiation to gambling activity between measurement times. Moreover, results also revealed that age (e.g. being older) and time passed are significantly associated to the level of inconsistencies of self-reported age of initiation of gambling activity. Theoretical and practical implications of these findings are discussed.

A railway accident which occurred in Lac-Megantic in Quebec, Canada, caused disruption for an entire community. This study examines the psychosocial difficulties in a group of exposed adolescents aged between 11 to 17, nine months after the tragedy. The analyses were conducted on a sample of 515 adolescents, attending high school, and living near the impact area. Post-traumatic stress disorder (PTSD), mental health problems (depression, anxiety), and problem use of alcohol or drugs prevalence were estimated. Multiple logistic regression was used to identify risk factors for PTSD clinical threshold. Almost half (43.4%) of adolescents reported being severely exposed to the railway accident and one third (31.3%) have reported a PTSD. Serious injuries, depression and anxiety (p < .05) were associated with greater risks for adolescents with a PTSD. However, sex, victimization, and emerging problems or problem use of alcohol or drugs are not associated with the PTSD. The results of the study highlight the relationship between a traumatic event such as the railway accident and the presence of PTSD nine months after, as well as risk factors for PTSD in adolescents. Paying close attention to mental health problems in adolescents when a traumatic event occurs and provide adequate aid is essential.

The concept of passion is relevant to understanding gambling behaviours and gambling problems. Longitudinal studies are useful to better understand the absence and development of gambling problems; however, only one study has specifically considered poker players. Using a longitudinal design, this study aims to determine the influence, 1 year later, of two forms of passion-harmonious and obsessive-on gambling problems in poker players. A total of 116 poker players was recruited from across Quebec, Canada. The outcome variable of interest was participants' category on the Canadian Pathological Gambling Index, and the predictive variable was the Gambling Passion Scale. Multiple logistic regression analyses were conducted to identify independent risk factors of at-risk poker players 1 year later. Obsessive passion at baseline doubled the risk of gambling problems 1 year later (p < 0.01); for harmonious passion, there was no association. Number of gambling activities, drug problems, and impulsivity were also associated with at-risk gambling. This study highlights the links between obsessive passion and at-risk behaviours among poker players. It is therefore important to prevent the development of obsessive passion among poker players.

Substance addiction in young adults is particularly problematic. Yet, much remain at stake in understanding the specifics of this population's access to services. The objective of this study is to explore young adults' initiation of substance misuse treatment. Our study sample was composed of 35 individuals aged 18 to 30 with problematic psychoactive substance use who have been identified in criminal courts, hospital emergency departments, and Health and Social Services Centers in Québec (Canada). A thematic analysis was performed on the 62 semi-structured interviews conducted with participants. Three components emerged. First, personal elements-expectations, individual motivations, perceptions of use, and capacity to control it-influence initiation of substance misuse treatment. Second, family and peers have noticeable influences. Finally, system characteristics and prior care experiences also shape the process. Consideration should be given to tailor interventions that can reach young adults and encourage them to initiate appropriate care.

Background: In preparation for an autologous stem cell transplantation, patients undergo chemomobilization; however, a dearth of standardized, evidence-based patient education on chemomobilization exists in the literature and in practice.
., Objectives: The purpose of this quality improvement educational initiative is to identify an 
evidence-based approach to appraise the educational needs of patients and their caregivers and to enhance chemomobilization education. 
., Methods: A review of the literature related to chemomobilization was conducted, as well as an informal survey of educational practices at five 
National Cancer Institute-designated comprehensive cancer centers. A 14-item survey was administered to 50 patients who underwent chemomobilization to assess their educational needs, experiences, and preferences. 
., Findings: Patients prefer written information to review. Receiving verbal education from reliable healthcare providers in a structured format may enhance effective comprehension and retention. Patients identified timing, process, side effects, and expectations about chemomobilization as the most important topics to include in education.

Objectives: There are presently no data available concerning Internet addiction (IA) problems among adolescents in Canada and the province of Quebec. The goal of this study is thus to document and compare the influence of gender on Internet use and addiction., Method: The study data were collected from a larger research project on gambling among adolescents. Activities conducted online (applications used and time spent) as well as answers to the Internet Addiction Test (IAT) were collected from 3938 adolescents from grades 9 to 11. The two most often employed cut-off points for the IAT in the literature were documented: (40-69 and 70+) and (50+)., Results: Boys spent significantly more time on the Internet than did girls. A greater proportion of the girls made intense use of social networks, whereas a greater proportion of the boys made intense use of massively multiplayer online role-playing games, online games, and adult sites. The proportion of adolescents with a potential IA problem varied according to the cut-off employed. When the cut-off was set at 70+, 1.3% of the adolescents were considered to have an IA, while 41.7% were seen to be at risk. At a 50+ cut-off, 18% of the adolescents were considered to have a problem. There was no significant difference between the genders concerning the proportion of adolescents considered to be at risk or presenting IA problems. Finally, analysis of the percentile ranks would seem to show that a cut-off of 50+ better describes the category of young people at risk., Conclusions: The results of this study make it possible to document Internet use and IA in a large number of Quebec adolescents., (© The Author(s) 2016.)

Poker is the gambling game that is currently gaining the most in popularity. However, there is little information on poker players' characteristics and risk factors. Furthermore, the first studies described poker players, often recruited in universities, as an homogeneous group who played in only one of the modes (land based or on the Internet). This study aims to identify, through latent class analyses, poker player subgroups. A convenience sample of 258 adult poker players was recruited across Quebec during special events or through advertising in various media. Participants filled out a series of questionnaires (Canadian Problem Gambling Index, Beck Depression, Beck Anxiety, erroneous belief and alcohol/drug consumption). The latent class analysis suggests that there are three classes of poker players. Class I (recreational poker players) includes those who have the lowest probability of engaging intensively in different game modes. Participants in class II (Internet poker players) all play poker on the Internet. This class includes the highest proportion of players who consider themselves experts or professionals. They make a living in part or in whole from poker. Class III (multiform players) includes participants with the broadest variety of poker patterns. This group is complex: these players are positioned halfway between professional and recreational players. Results indicate that poker players are not an homogeneous group identified simply on the basis of the form of poker played. The specific characteristics associated with each subgroup points to vulnerabilities that could potentially be targeted for preventive interventions.