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Zusammenfassung Ziel der Studie Zahlreiche Studien weisen auf ein breites Spektrum häufig gleichzeitig auftretender psychischer Störungen wie jene der Generalisierten Angststörung bei der Behandlung von Personen mit Cannabiskonsumstörungen hin (GAD). Bisherige Internet-basierte Studien konnten zwar vereinzelt die Reduktion von Cannabiskonsum zeigen, berücksichtigten aber keine komorbide Störungen. Ziel des E-Coach gestützten Online-Selbsthilfeprogramm CANreduce 2.0 ist die Reduzierung des Cannabiskonsums und der gegebenenfalls vorhandenen GAD. Methodik Sekundäranalyse der in der Allgemeinbevölkerung rekrutierten Cannabiskonsumierenden der CANreduce 2.0 Studie der beiden aktiven Interventionsgruppen (N=367). Für die Analysen wurden diese Teilnehmende aufgrund ihres erreichten Symptomatik-Wertes der General Anxiety Disorder Scale (GAD-7) in 4 Gruppen eingeteilt: Minimale (GAD-7 Werte: 0–4; N=102), Milde (5–9; N=151), Moderate (10–14; N=78) und Schwere (15–21; N=36) Angststörung und anschliessend ihre Behandlungsverläufe mittels Intention-to-Treat Analysen bezüglich ihrer Cannabiskonsumtage und ihrer Werte auf dem Cannabis Use Disorder Identification Test (CUDIT), der Severity of Dependence Scale (SDS), der GAD-7, der Center of Epidemiologic Studies of Depression Scale (CES-D) sowie bezüglich ihrer Adhärenz verglichen. Ergebnisse Alle 4 Gruppen reduzierten unabhängig von ihrer GAD-Symptomatik die Anzahl ihrer Cannabiskonsumtage, ihren CUDIT und SDS Score sowohl 6 Wochen als auch 3 Monate nach der Baselineerhebung. Weiter haben mit Ausnahme von der minimalen GAD-7-Gruppe alle Gruppen eine Reduktion der Angstsymptomatik nach 3 Monaten aufgewiesen. Analog zeigten mit Ausnahme der minimalen GAD-7-Gruppe alle GAD-7-Gruppen eine deutliche Reduktion in der depressiven Symptomatik. Bezüglich der gemessenen Adhärenz zeigten sich keine Unterschiede zwischen den GAD-7-Gruppen. Schlussfolgerungen CANreduce 2.0 scheint sowohl den Cannabiskonsum, die Ausprägung der Cannabiskonsumstörung bzw. die Cannabisabhängigkeit wie auch eine gegebenenfalls vorhandene GAD-Symptomatik zu reduzieren.

Background: Adolescents and young adults are a crucial target group for preventing harm related to substance use. Recently, declining alcohol and tobacco consumption in young people has been observed in many countries. Based on survey data from 2004 to 2020, we describe time trends for several subgroups of adolescents and young adults (based on consumption levels and socioeconomic variables) and analyze associations between the level of alcohol per capita consumption or daily smoking and socioeconomic variables. Methods: Time trends for males and females are analyzed by a two-way ANOVA and predictors of use by using multivariate regression and logistic regression. Results: Alcohol per capita consumption decreased significantly for both sexes in the 16-year period, with male and female consumption levels converging. Daily smoking was equally prevalent for young males and females and decreased to a similar degree for both sexes. Being male and living in rural areas are associated with a higher level of alcohol consumption. Daily smoking is associated with a low level of education and is more prevalent among young adults who have already started to work. Conclusions: The decline in alcohol use and daily smoking among adolescents and young adults is taking place simultaneously. However, higher levels of alcohol consumption and daily smoking occur in different groups of adolescents and young adults, which should be considered in prevention strategies.

Illegal gambling by adolescent minors has become a major issue in many societies and lottery gambling is often considered a "gateway" to gambling more generally among this age group. The purpose of this study was to identify the influencing factors that affect retailer compliance concerning the selling of lottery products to minors. The research team received the original data (i) directly from the sales agents of the Austrian Lotteries after their responsible gambling training of the retailer in 2014/2015 (Round 1: n = 5032), (ii) directly from a third-party agency carrying out test purchases (i.e., "mystery shopping") in 2014 (Round 2: n = 1421), and (iii) retailers’ responses to their attitudes to youth protection issues (through direct interface with the research team) in 2015 (Round 3: n = 4516). The data from a total of 1036 participants who had taken part in all three rounds was analyzed in the present study. Results showed that in 13.1% of mystery shopping checks (n = 1421), lottery products were sold to a test purchaser under the age of 16 years. The analysis also showed that the older the test purchaser, the greater the likelihood that a lottery product was sold. Under-age lottery sales to girls were over three times more prevalent than sales to boys. Finally, the analysis showed that the higher the number of responsible gambling training sessions completed in the past and the more positive the attitude towards mystery shopping, the higher the compliance rate not to sell a lottery product to young mystery shoppers. Recommendations to increase compliance and raise the awareness among retailers are presented.

BACKGROUND Prevalence rates for lifetime cannabis use and cannabis use disorder are much higher in people with attention deficit/hyperactivity disorder than in those without. CANreduce 2.0 is an intervention that is generally effective at reducing cannabis use in cannabis misusers. This self-guided web-based intervention (6-week duration) consists of modules grounded in motivational interviewing and cognitive behavioral therapy. OBJECTIVE We aimed to evaluate whether the CANreduce 2.0 intervention affects cannabis use patterns and symptom severity in adults who screen positive for attention deficit/hyperactivity disorder more than in those who do not. METHODS We performed a secondary analysis of data from a previous study with the inclusion criterion of cannabis use at least once weekly over the last 30 days. Adults with and without attention deficit/hyperactivity disorder (based on the Adult Attention deficit/hyperactivity disorder Self-Report screener) who were enrolled to the active intervention arms of CANreduce 2.0 were compared regarding the number of days cannabis was used in the preceding 30 days, the cannabis use disorder identification test score (CUDIT) and the severity of dependence scale score (SDS) at baseline and the 3-month follow-up. Secondary outcomes were Generalized Anxiety Disorder score, Center for Epidemiological Studies Depression scale score, retention, intervention adherence, and safety. RESULTS Both adults with (n=94) and without (n=273) positive attention-deficit/hyperactivity disorder screening reported significantly reduced frequency (reduction in consumption days: with: mean 11.53, SD 9.28, PPPPPPPPPPP=.08), dependence (P=.95), use disorder (P=.85), attention deficit/hyperactivity disorder status (P=.84), depression (P=.84), or anxiety (P=.26) between baseline and final follow-up, dependent on positive attention-deficit/hyperactivity disorder screening. Attention deficit/hyperactivity disorder symptom severity at baseline was not associated with reduced cannabis use frequency or severity but was linked to greater reductions in depression (Spearman ρ=.33) and anxiety (Spearman ρ=.28). Individuals with positive attention deficit/hyperactivity disorder screening were significantly less likely to fill out the consumption diary (P=.02), but the association between continuous attention deficit/hyperactivity disorder symptom severity and retention (Spearman ρ=−0.10, P=.13) was nonsignificant. There also was no significant intergroup difference in the number of completed modules (with: mean 2.10, SD 2.33; without: mean 2.36, SD 2.36, P=.34), and there was no association with attention deficit/hyperactivity disorder symptom severity (Spearman ρ=−0.09; P=.43). The same was true for the rate of adverse effects (P=.33). CONCLUSIONS Cannabis users screening positive for attention deficit/hyperactivity disorder may benefit from CANreduce 2.0 to decrease the frequency and severity of cannabis dependence and attenuate symptoms of depression and attention deficit/hyperactivity disorder-related symptoms. This web-based program’s advantages include its accessibility for remote users and a personalized counselling option that may contribute to increased adherence and motivation to change among program users. CLINICALTRIAL International Standard Randomized Controlled Trial Number (ISRCTN) 11086185; http://www.isrctn.com/ISRCTN11086185

Prevalence rates for lifetime cannabis use and cannabis use disorder are much higher in people with attention deficit/hyperactivity disorder than in those without. CANreduce 2.0 is an intervention that is generally effective at reducing cannabis use in cannabis misusers. This self-guided web-based intervention (6-week duration) consists of modules grounded in motivational interviewing and cognitive behavioral therapy.We aimed to evaluate whether the CANreduce 2.0 intervention affects cannabis use patterns and symptom severity in adults who screen positive for attention deficit/hyperactivity disorder more than in those who do not.We performed a secondary analysis of data from a previous study with the inclusion criterion of cannabis use at least once weekly over the last 30 days. Adults with and without attention deficit/hyperactivity disorder (based on the Adult Attention deficit/hyperactivity disorder Self-Report screener) who were enrolled to the active intervention arms of CANreduce 2.0 were compared regarding the number of days cannabis was used in the preceding 30 days, the cannabis use disorder identification test score (CUDIT) and the severity of dependence scale score (SDS) at baseline and the 3-month follow-up. Secondary outcomes were Generalized Anxiety Disorder score, Center for Epidemiological Studies Depression scale score, retention, intervention adherence, and safety.Both adults with (n=94) and without (n=273) positive attention-deficit/hyperactivity disorder screening reported significantly reduced frequency (reduction in consumption days: with: mean 11.53, SD 9.28, P.001; without: mean 8.53, SD 9.4, P.001) and severity of cannabis use (SDS: with: mean 3.57, SD 3.65, P.001; without: mean 2.47, SD 3.39, P.001; CUDIT: with: mean 6.38, SD 5.96, P.001; without: mean 5.33, SD 6.05, P.001), as well as anxiety (with: mean 4.31, SD 4.71, P.001; without: mean 1.84, SD 4.22, P.001) and depression (with: mean 10.25, SD 10.54; without: mean 4.39, SD 10.22, P.001). Those who screened positive for attention deficit/hyperactivity disorder also reported significantly decreased attention deficit/hyperactivity disorder scores (mean 4.65, SD 4.44, P.001). There were no significant differences in change in use (P=.08), dependence (P=.95), use disorder (P=.85), attention deficit/hyperactivity disorder status (P=.84), depression (P=.84), or anxiety (P=.26) between baseline and final follow-up, dependent on positive attention-deficit/hyperactivity disorder screening. Attention deficit/hyperactivity disorder symptom severity at baseline was not associated with reduced cannabis use frequency or severity but was linked to greater reductions in depression (Spearman ρ=.33) and anxiety (Spearman ρ=.28). Individuals with positive attention deficit/hyperactivity disorder screening were significantly less likely to fill out the consumption diary (P=.02), but the association between continuous attention deficit/hyperactivity disorder symptom severity and retention (Spearman ρ=-0.10, P=.13) was nonsignificant. There also was no significant intergroup difference in the number of completed modules (with: mean 2.10, SD 2.33; without: mean 2.36, SD 2.36, P=.34), and there was no association with attention deficit/hyperactivity disorder symptom severity (Spearman ρ=-0.09; P=.43). The same was true for the rate of adverse effects (P=.33).Cannabis users screening positive for attention deficit/hyperactivity disorder may benefit from CANreduce 2.0 to decrease the frequency and severity of cannabis dependence and attenuate symptoms of depression and attention deficit/hyperactivity disorder-related symptoms. This web-based program's advantages include its accessibility for remote users and a personalized counselling option that may contribute to increased adherence and motivation to change among program users.International Standard Randomized Controlled Trial Number (ISRCTN) 11086185; http://www.isrctn.com/ISRCTN11086185.

BACKGROUND Despite increasing demand for treatment among cannabis users in many countries, most users are not in treatment. Internet-based self-help offers an alternative for those hesitant to seek face-to-face therapy, though low effectiveness and adherence issues often arise. OBJECTIVE Through adherence-focused guidance enhancement, we aimed to increase adherence to and the effectiveness of internet-based self-help among cannabis users. METHODS From July 2016 to May 2019, cannabis users (n=775; male: 406/575, 70.6%, female: 169/575, 29.4%; age: mean 28.3 years) not in treatment were recruited from the general population and were randomly assigned to (1) an adherence-focused guidance enhancement internet-based self-help intervention with social presence, (2) a similar intervention with an impersonal service team, and (3) access to internet as usual. Controls who were placed on a waiting list for the full intervention after 3 months underwent an assessment and had access to internet as usual. The primary outcome measurement was cannabis-use days over the preceding 30 days. Secondary outcomes included cannabis-dependence severity, changes in common mental disorder symptoms, and intervention adherence. Differences between the study arms in primary and secondary continuous outcome variables at baseline, posttreatment, and follow-up were tested using pooled linear models. RESULTS All groups exhibited reduced cannabis-use days after 3 months (social presence: –8.2 days; service team: –9.8 days; internet as usual: –4.2 days). The participants in the service team group (P=.01, d=.60) reported significantly fewer cannabis-use days than those in the internet as usual group; the reduction of cannabis use in the social presence group was not significant (P=.07, d=.40). There was no significant difference between the 2 intervention groups regarding cannabis-use reduction. The service team group also exhibited superior improvements in cannabis-use disorder, cannabis-dependence severity, and general anxiety symptoms after 3 months to those in the internet as usual group. CONCLUSIONS The adherence-focused guidance enhancement internet-based self-help intervention with an impersonal service team significantly reduced cannabis use, cannabis-use disorder, dependence severity, and general anxiety symptoms. CLINICALTRIAL ISRCTN Registry ISRCTN11086185; http://www.isrctn.com/ISRCTN11086185

The novel coronavirus-2019 (COVID-19) pandemic has had major impacts on most societies worldwide including the cancelation and postponement of sports events. This has had a major impact on the sports betting industry. The present study is first to investigate the behavior of a sample of online sports bettors before and after COVID-19 measures were put in place by European governments. The authors were given access to the player data by a large European online gambling operator comprising players from Sweden, Germany, Finland, and Norway. The behavioral change of the sports bettors before March 7 and after March 7 (2020) was computed. All sports bettors who placed at least one wager in at least 5 calendar weeks out of the 10 possible calendar weeks between January 1 and March 7 (n = 5396) were included in the analysis. Results showed statistically significant reductions among sports bettors wagering in online casinos. This indicates that there was no conversion of money spent from sports betting to online casino games, at least for this particular online gambling operator. The findings suggest that there was a significant decrease in the amount of money wagered by sports bettors during the COVID-19 pandemic (compared with before it) and that sports bettors did not switch to playing more online casino games and that there was also a significant reduction in playing online casino games among sports bettors.

Background Depression and harmful alcohol use are two of the top five leading causes of years of life lost to disability in high-income countries. Integrated treatment targeting both at the same time is often considered more complicated and difficult and, therefore, more expensive. Consequently, integrated internet-based interventions could be a valuable addition to traditional care. Methods A three-arm randomized controlled trial was conducted comparing the effectiveness of (1) an integrated, minimal-guidance, adherence-focused self-help intervention designed to reduce both alcohol use and depression symptoms (AFGE-AD); (2) a similar intervention designed to reduce alcohol use only (AFGE-AO), and (3) internet access as usual (IAU) as a control condition, in at least moderately depressed alcohol misusers from February 2016—March 2020. We recruited 689 alcohol misusers (51.6 % males, mean age = 42.8 years) with at least moderate depression symptoms not otherwise in treatment from the general population. Six months after baseline, 288 subjects (41.8 %) were reachable for the final assessment. Results All interventions yielded reduced alcohol-use after six months (AFGE-AD: -16.6; AFGE-AO: -19.8; IAU: -13.2). Those who undertook active-interventions reported significantly fewer standard drinks than controls (AFGE-AD: p = .048, d=0.10; AFGE-AO: p = .004, d=0.20). The two active-intervention groups also reported significantly less severe depression symptoms than controls (AFGE-AD: p = .006, d=0.41; AFGE-AO: p = .008, d=0.43). Testing revealed noninferiority between the two interventions. Conclusions This study documented sustained effectiveness of the first integrated, fully internet-based self-help intervention developed for the reduction of both alcohol use and depression symptoms in at least moderately depressed adult alcohol misusers recruited from the general population.

One approach to minimizing the negative consequences of excessive gambling is staff training to reduce the rate of the development of new cases of harm or disorder within their customers. The primary goal of the present study was to assess suitable benchmark criteria for the training of gambling employees at casinos and lottery retailers. The study utilised the Delphi Method, a survey with one qualitative and two quantitative phases. A total of 21 invited international experts in the responsible gambling field participated in all three phases. A total of 75 performance indicators were outlined and assigned to six categories: (1) criteria of content, (2) modelling, (3) qualification of trainer, (4) framework conditions, (5) sustainability and (6) statistical indicators. Nine of the 75 indicators were rated as very important by 90 % or more of the experts. Unanimous support for importance was given to indicators such as (1) comprehensibility and (2) concrete action-guidance for handling with problem gamblers, Additionally, the study examined the implementation of benchmarking, when it should be conducted, and who should be responsible. Results indicated that benchmarking should be conducted every 1–2 years regularly and that one institution should be clearly defined and primarily responsible for benchmarking. The results of the present study provide the basis for developing a benchmarking for staff training in responsible gambling.

Online gaming is more and more common and increasingly accessible. Due to a lack of social control the participation could be a potential risk for certain customers. The given article focuses on prevention measures that are provided by the Austrian online gaming operator, the Austrian Lotteries, provider of the online gaming platform win2day, in the light of the specifics of Internet gaming in order to avoid problems with gaming., Glücksspielangebote im Internet werden immer stärker genutzt und sind auf einfache Weise zugänglich. Durch die fehlende soziale Kontrolle kann die Teilnahme für manche Personen ein Risiko bedeuten. Welche Präventionsmaßnahmender österreichische Anbieter von Online Glücksspielen, die Casinos Austria-Österreichische Lotterien Unternehmensgruppe, Betreiber der Online-Plattform win2day.ateinsetzt, um problematisches Glücksspiel zu verhindern, wird vor dem Hintergrund der Besonderheiten des Internetglücksspiels in diesem Artikel vorgestellt.

Certain gambling operators now provide social responsibility tools to help players gamble more responsibly. One such innovation is the use of pop-up messages that aim to give feedback to the players about the time and money they have thus far spent gambling. Most studies of this innovation have been conducted in laboratory settings, and although controlled studies are indeed more reliable than real-world studies, the non-ecological validity of laboratory studies is still an issue. This study investigated the effects of a slot machine pop-up message in a real gambling environment by comparing the behavioural tracking data of two representative random samples of 400,000 gambling sessions before and after the pop-up message was introduced. The study comprised approximately 200,000 gamblers. The results indicated that, following the viewing of a pop-up message after 1000 consecutive gambles on an online slot machine game, nine times more gamblers ceased their gambling session than did those gamblers who had not viewed the message. The data suggest that pop-up messages can influence a small number of gamblers to cease their playing session, and that pop-ups appear to be another potentially helpful social responsibility tool in reducing excessive play within session.

Online gaming is more and more common and increasingly accessible. Due to a lack of social control the participation could be a potential risk for certain customers. The given article focuses on prevention measures that are provided by the Austrian online gaming operator, the Austrian Lotteries, provider of the online gaming platform win2day, in the light of the specifics of Internet gaming in order to avoid problems with gaming.