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The current study assessed the effectiveness of delivering safer gambling messaging to regular sport bettors on social media. It also assessed whether the content of the message impacted message effectiveness. A 3 × 2 mixed factorial design was employed, with 281 participants randomly assigned to follow one of three Twitter accounts. The accounts either sent out informational messages, self-appraisal messages or emotional self-efficacy messages. Participants reported betting behaviour from the two weeks prior to following the accounts, in addition to during the two-week intervention period, using information from their online gambling accounts. Participants reported readiness to change gambling behaviour pre and post the two-week intervention period. A significant main effect of intervention stage highlighted reductions in betting behaviour and increased readiness to change behaviour. However, there was no significant main effect of condition and no significant interaction between intervention stage and condition upon betting behaviour or readiness to change. The findings suggest receiving safer gambling messages on social media may lead to a reduction in betting behaviour. However, similar reductions in behaviour were observed in the experimental and control conditions. Further research is needed to clarify whether changes in behaviour observed in the current study would extend over a longer period of time., (© 2024. The Author(s).)

Public concern around gambling advertising in the UK has been met not by government action but by industry self-regulations, such as a forthcoming voluntary ban on front-of-shirt gambling sponsorship in Premier League soccer. "Safer gambling" (harm prevention) adverts are one recent example, and are TV commercials which inform viewers about gambling-related harm. The present work is the first independent evaluation of safer gambling adverts by both gambling operators and a charity called GambleAware. In an online experiment, we observed the change in participants' (N = 2,741) Gambling Urge Scale (GUS) scores after viewing either: a conventional financial inducement gambling advert, a gambling operator's safer gambling advert, an advert from the GambleAware "bet regret" campaign, an advert from the GambleAware "stigma reduction" campaign, or a control advert that was not about gambling. Relative to a neutral control advert, GUS scores increased after viewing a financial inducement or an operator's safer gambling advert. In comparison to the neutral control condition, GUS score changes were similar after viewing a bet regret advert, but showed a significant decrease after viewing a stigma reduction advert. Those at higher risk of harm reported larger decreases in GUS after watching a bet regret or stigma reduction advert. Overall, this study introduced a novel experimental paradigm for evaluating safer gambling adverts, uncovered a potential downside from gambling operators' safer gambling adverts, and revealed variation in the potential effectiveness of charity-delivered safer gambling adverts., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

The transformation of gambling into a largely digital commodity has created a need for online payment technologies to facilitate online gambling, thereby also raising the question of what role these actors can play in the promotion of Responsible Gambling (RG). With the means and access they maintain, financial institutions are in a unique position to alleviate financial pitfalls, yet their role in the gambling context has thus far received little scrutiny. The objective of this study was to conduct an extant literature review to develop an initial set of financial indicators tailored for financial institutions, enabling them to engage in the RG initiatives. We conducted a two-step narrative literature review to identify both general Financial Well-Being (FWB) indicators across financial research disciplines, and one specific to gambling. A literature search over the past 20 years was performed across the following academic databases: Medline (Ovid), Sociological Abstracts (ProQuest), Web of Science (Clarivate), and PsycInfo (EBSCO). Manifest content analysis was used in step one to review general financial well-being, yielding a general FWB conceptual framework. In step two, we applied latent content analysis to the gambling-specific literature, linking essential concepts of gambling-related financial harms to the broader FWB literature. This resulted in a tentative taxonomy of indicators applicable to financial institutions with gambling customers. In tandem with the FWB conceptual framework, the preliminary taxonomy could provide a foundation for financial institutions catering to gambling customers to engage in the duty of care agenda, potentially broadening player protection beyond the current operator-focused RG measures., (© 2024. The Author(s).)

Background: Gambling and gambling-related harm attract significant researcher and policy attention. The liberalisation of gambling in most western countries is strongly associated with a marked rise in gambling activity and increases in gambling-related harm experienced at the population level. Programs to address gambling-related harm have traditionally focused on individuals who demonstrate problematic gambling behaviour, despite clear evidence of the effectiveness of a public health approach to high-risk activities like gambling. Little is known about the availability or efficacy of programs to address gambling-related harm at a population level., Methods: The Victorian Responsible Gambling Foundation commissioned a rapid evidence review of the available evidence on programs designed to reduce gambling-related harm at a population level. The review was conducted using a public health and harm reduction lens. MEDLINE, ProQuest Central and PsychInfo databases were searched systematically. Included studies were published in English between 2017 - 2023 from all countries with gambling policy contexts and public health systems comparable to Australia's; included primary data; and focused on primary and/or secondary prevention of gambling-related harm or problems., Results: One hundred and sixty-seven articles were eligible for inclusion. Themes identified in the literature included: risk and protective factors; primary prevention; secondary prevention; tertiary prevention; target population group; and public health approach. The evidence review revealed a gap in empirical evidence around effective interventions to reduce gambling-related harm at the population level, particularly from a public health perspective., Conclusions: Addressing gambling-related harm requires a nuanced, multi-layered approach that acknowledges the complex social, environmental, and commercial nature of gambling and associated harms. Moreover, evidence demonstrates community programs to reduce gambling-related harm are more successful in reducing harm when based on sound theory of co-design and address the social aspects that contribute to harm., (© 2024. The Author(s).)

Gambling risk behaviour is an emerging problem among adolescents. "Unplugged" is an effective Social Influence curriculum for preventing substance use among students. This study aims to develop and test a new component focused on gambling added to the Unplugged program. Schools of Piedmont region and Rome city were invited to participate in the study. A self-completed anonymous questionnaire including questions on socio-demographic characteristics, addictive behaviours, beliefs, attitudes and risk perceptions about gambling, normative perceptions, parental practices, school climate, refusal skills, impulsiveness, self-esteem, antisocial behaviours and sensation seeking was prepared for baseline and follow-up surveys. The protocol of the study was submitted and approved by the Novara Ethical Committee and registered in ClinicalTrials.gov (NCT05630157, Protocol ID: 080.742, 11/17/2022). Twenty-nine schools accepted to participate in the study. Sixty-three classes (1325 students) satisfied the eligibility criteria for intervention and were allocated to the intervention arm, and the other 61 (1269 students) were allocated to the control arm. Because of drop-out, absentees, refusals, and invalid questionnaires, data on 1874 students (998 in the intervention and 876 in the control arm), were available for the analysis at baseline. Data management of follow-up questionnaires is in progress. Results of the present study will be useful to clarify the effectiveness of prevention interventions in reducing gambling behaviours among adolescents. Moreover, this will be the first experience of evaluating a new component focused on a different risk behaviour, added to a curriculum previously shown as effective on other risk behaviours., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

The global gambling sector has grown significantly over recent years due to liberal deregulation and digital transformation. Likewise, concerns around gambling-related harms-experienced by individuals, their families, their local communities or societies-have also developed, with growing calls that they should be addressed by a public health approach. A public health approach towards gambling-related harms requires a multifaceted strategy, comprising initiatives promoting health protection, harm minimization and health surveillance across different strata of society. However, there is little research exploring how a public health approach to gambling-related harms can learn from similar approaches to other potentially harmful but legal sectors such as the alcohol sector, the tobacco sector, and the high in fat, salt and sugar product sector. Therefore, this paper presents a conceptual framework that was developed following a scoping review of public health approaches towards the above sectors. Specifically, we synthesize strategies from each sector to develop an overarching set of public health goals and strategies which-when interlinked and incorporated with a socio-ecological model-can be deployed by a range of stakeholders, including academics and treatment providers, to minimise gambling-related harms. We demonstrate the significance of the conceptual framework by highlighting its use in mapping initiatives as well as unifying stakeholders towards the minimization of gambling-related harms, and the protection of communities and societies alike., Competing Interests: All the co-authors (JW, BF, AN and SC) have received funding from GambleAware through their work at the Bristol Hub for Gambling Harms Research. The Bristol Hub for Gambling Harms Research (2022-2027) is funded by GambleAware which is funded by voluntary donations from the gambling industry to build capacity in interdisciplinary gambling harms research. Governance procedures and due diligence provide safeguards to ensure the Hub’s independence from GambleAware and the gambling industry. Neither GambleAware nor the gambling industry have any input to the strategic, operational or research activities of the Hub. SC has also received research funding from the Gambling Commission Regulatory Settlement funds. This does not alter our adherence to PLOS ONE policies on sharing data and materials., (Copyright: © 2024 Wheaton et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

The public health community has called for governments to recognise the harms associated with gambling, and for gambling policies to include population-based harm prevention approaches. This Health Policy explores the translation of this call into global policy action by systematically reviewing legislation of jurisdictions that introduced major gambling legislation change (ie, restricting or extending gambling provision) between Jan 1, 2018, and Dec 31, 2021. We mapped the global availability of legal gambling and changes in its provision, and conducted critical frame analysis on a sample of 33 jurisdictions introducing major policy change to assess the extent to which the protection of health and wellbeing was embedded within legislation. More than 80% of countries worldwide now legally permit gambling. Harmful gambling was recognised as a health and wellbeing issue in most of the analysed jurisdictions, but near-exclusive focus was given to individual-level harms rather than to wider social and economic harms, or harms to others. Most of the proposed prevention measures focused on individual responsibility. Gambling policies worldwide are changing, but addressing gambling as a public health issue is not yet translating into comprehensive policy action across jurisdictions., Competing Interests: Declaration of interests DU has been funded as a member of staff at the University of Glasgow to work on this project by the Wellcome Trust through a Humanities and Social Sciences Fellowship to HW. VM has received funding from the Finnish Ministry of Social Affairs and Health (section 52 of the Finnish Lotteries Act), the Academy of Finland (project 349589 CODEG; Project 31834 POLEG), the Finnish Foundation for Alcohol Studies, and French Observatory for Drugs and Drug Addiction. VM has been paid for delivering a webinar by Bochum University and for peer reviews by Routledge. VM has received support for travel from the Finnish Foundation of Alcohol Studies. VM is a member of the Gambling Harms Evaluation committee of the Finnish Ministry of Social Affairs and Health and has provided expert advice and consultations to third sector and public sector actors in Finland. JN has been funded by the Finnish Ministry of Social Affairs and Health. This funding emanates from the gambling monopoly in Mainland Finland, based on section 52 in the Finnish Lotteries Act (1047/2001), which stipulates that gambling issues must be researched. JN has also received funding from the Academy of Finland (project 349589; Commercial Determinants of Harm in the Digital Environment). JN has received support for travel from the Finnish Foundation of Alcohol Studies. JN has obtained consultancy fees and travel support from governmental actors, private sector companies (including The Recycling Lottery, regulated under the Lotteries Act in Finland), and non-governmental organisations to provide insights on gambling-related harm. HW has received funding for gambling-related projects from the National Institute for Health Research, Economic and Social Research Council, Wellcome Trust, Office of Health Improvements and Disparities, Public Health England, Gambling Commission (including from regulatory settlements), Gambling Research Exchange Ontario, Greater London Authority, Greater Manchester Combined Authority, and the Department for Culture Media and Sport. HW has received funding from GambleAware for a project on gambling and suicide; consultancy fees from the Institute of Public Health, Ireland and the National Institute for Economic and Social Research; payment for her role as Deputy Chair of the Advisory Board for Safer Gambling, remunerated by the Gambling Commission; payment as an expert witness on gambling by Lambeth and Middlesborough Borough Councils; payment for delivery of a webinar by McGill University; has provided unpaid advice on research to GamCare; has received support for travel from the Turkish Green Crescent Society, Gambling Regulators European Forum, and Alberta Gambling Research Institute; is a member of the WHO Panel on gambling; and runs a research consultancy practice for public and third sector bodies. HW has not, and does not, provide services to the gambling industry., (Copyright © 2024 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.)

Gambling is a legitimate leisure activity in many countries that many people use. However, some of them suffer significant harm because of gambling. This may involve economic, social, physical or mental harm. These harms are not only suffered by the individual gambler, but affect the family, the community and society. The aim of this text is to propose a conceptual framework for understanding the determinants of gambling and its related harms and thus, contribute to the development of prevention policies to reduce its impact on health. The framework proposed in this manuscript places present evidence in the model of health inequalities, analyzing the effect of the socioeconomic and political context, the axes of inequalities, individual and social factors, and the health system in generating the health inequalities of gambling suffered by the most vulnerable groups. The evidence gathered in this framework suggests that health determinants lead to health inequality in relation to gambling and its associated harms.

Objective: Previous research suggests that a brief duty-of-care telephone call to high expenditure customers was associated with lower gambling over the subsequent year. The current aim was to assess effects on individual trajectories rather than overall group effects reported previously. The objective was to identify different patterns of individual change over the follow-up year and explore differential responses of subgroups of individuals., Method: A matched pair design contrasting the outcome for telephone intervention with a no-intervention control condition. Five hundred and ninety-six statistical pairs randomly drawn from the top 0.5% of customers based upon annual expenditure at Norsk Tipping, Norway. Primary outcome measure was gambling theoretical loss (TL), derived from the Norsk Tipping gambling data warehouse. Player trajectories across time were identified using growth mixture modeling to assess differential intervention effects on homogenous subgroups of individuals., Results: Relatively low, medium, and high TL subgroups were identified. The telephone intervention was associated with greater reductions than the control condition for all three subgroups but showed the strongest effect for the subgroup with the highest TL. The intervention was most effective for casino and sport gamblers, male, young, and middle-aged., Conclusions: A brief duty of care telephone contact with high expenditure customers showed sustained effects over 12 months, in particular for individuals showing the highest level of TL. Examining trajectories using advanced statistical models identified customer characteristics most strongly associated with reduced TL. These findings can guide prevention strategies with evidence-based knowledge about differential effects. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Background: Gambling regulated through a state monopoly is often justified for reasons of public health, that is, that monopolies are a more effective means of reducing potential harm. This focus on harm prevention has increased in recent years, particularly as a result of pressures arising from the growth of online gambling and of legislation designed to promote competition. While prior works have examined the role of stakeholders in influencing policy decisions and in public discussions of the monopoly systems, attention has been focused on those with direct financial interests; the opinions of the public have largely been absent from these discussions. In 2017 Finland restructured its monopoly order to improve efficacy of addressing gambling related harms; this restructuring offers a valuable insight into public perceptions of and attitudes toward the suitability of the Finnish system to address gambling-related harm., Methods: This work uses Structural Equation Modelling and compares attitudes toward the Finnish system between 2015 (pre-restructuring) and 2019 (post-restructuring)., Results: Overall public opinion of the Finnish system as being suitable for addressing gambling harms declined between 2015 and 2019, despite the restructuring. Several predictors of attitudes were identified, however, the majority had small effect sizes, while the model explained little variance., Conclusion: This work concludes that existing approaches to examining public opinions of gambling regulation should be amended to include additional predictors. Furthermore, it is likely that context-specific predictors should be included in models, in order to reflect the socio-cultural history of the population being investigated. Such predictors should be determined in respect to the population of interest but, for example, could include items measuring trust in authority, political orientation, cultural acceptance of gambling, or religious affiliation., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Objective: The objective of this study is to present a conceptual framework for the prevention of gambling disorder and try to corroborate some of its postulates. The assumption of gambling as if it were acting like a virus may have important considerations in terms of preventing gambling disorder in society and, therefore, it could be a relevant public health issue., Background: Like COVID-19, gambling disorder is a disease which is caused by the action of an external agent. The external agent was already in existence, but certain environmental conditions (absence of regulatory measures based on the prevention of gambling disorder) favored its propagation. Regarding immunization, for SARS-CoV-2, it is obtained through vaccination and prevention of exposure. However, it is unlikely that immunization can be developed for any gambling addiction prevention program to immunize everyone who is exposed to the "gambling virus". So, in the case of gambling disorder, preventive strategies should rather prevent gambling from affecting most people by limiting availability (supply) and accessibility (ease of access) to gambling., Study Design: This research is a quasi-experimental investigation aimed to evaluate the effects of anti-COVID measures on the frequency of gambling and evolution of gambling disorder. The present study analyzed gambling patterns and the problems caused by gambling in 2,903 people, including those who were at-risk gamblers or had a gambling disorder., Results: In general terms, restrictive measures to combat COVID-19 worked to prevent the consolidation of gambling habits and the appearance of gambling disorder, but they did not seem to be sufficient for people who already had this disorder. The most affected games were electronic games machines (EGMs) that took place in public places (gambling halls, bars and restaurants, etc.)., Conclusions: The findings of this work support the hypothesis that, just as the SAR-CoV-2 virus is responsible for the global pandemic of COVID-19, which can only be stopped with vaccines and social distancing, in the case of gambling, the absence of an effective vaccine for "gambling virus" can lead to an epidemic of gambling disorders in societies, if the environmental conditions that are favorable for the spread of such virus are not modified. Some preventive strategies that can be useful from a public health frame of reference are suggested., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Objective: Despite the widespread use of harm prevention messages on gambling advertising, it is unclear whether such messages achieve their goal of encouraging safer gambling behavior and preventing gambling harms. The current research therefore investigates whether and how existing harm prevention messages implemented on gambling advertisements in Belgium and the Netherlands affect consumers' gambling-related beliefs and intentions., Method: Two experimental studies (N experiment 1 = 169; N experiment 2 = 212) investigate (a) the influence of message prominence and (b) the impact of message framing by comparing the effectiveness of the message "Gamble in moderation" with different types of Flemish and Dutch harm prevention messages (that are currently used in Belgium and the Netherlands) on people's gambling-related beliefs and intentions., Results: The results of the first experiment show that although the size of a harm prevention message may increase message recognition, it does not affect the message's efficacy. In addition, the second experiment shows that the harm prevention message "Gamble in moderation" increases normative perceptions of gambling (vs. no message), and even enhances gambling intentions among at-risk gamblers compared to no message and other commonly used harm prevention messages. In contrast, exposure to the harm prevention message "What does gambling cost you? Stop in time" makes at-risk gamblers think most about the harms of gambling., Conclusions: Current harm prevention messages on gambling advertising often promote the concept of responsible gambling, but can have opposite effects than intended, especially among at-risk gamblers. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Background: Voluntary self-exclusion from gambling is a common harm reduction tool in individuals with a gambling disorder. Previous data have demonstrated that many gamblers breach their own self-exclusion, typically through other online services outside the jurisdiction in which they are self-excluded. The present study aimed to carry out a new follow-up measure-similar to previous studies in the same setting-of self-exclusion and its breaching in Sweden, in order to allow for the follow-up assessment of a nationwide, multi-operator self-exclusion system introduced in Sweden in 2019., Methods: A web survey to the web panel of a market survey company addressed 1505 past-year gamblers, who responded to a number of questions about gambling habits, including screening for gambling problems using the Problem Gambling Severity Index and self-exclusion-related items corresponding to previous studies., Results: Nine percent of past-year gamblers had self-excluded using the Spelpaus service. In logistic regression, self-exclusion was significantly associated with gambling problems, past-year online casino gambling, and absence of online poker gambling. Among self-excluders, 49 percent had ever gambled despite being self-excluded. Among those breaching their self-exclusion, the most common gambling types during self-exclusion were online casino (82 percent), sports betting (47 percent) and lotteries (43 percent)., Discussion: Self-exclusion remains a popular harm reduction tool against problem gambling, more common than in previous studies, mostly in individuals with recent gambling problems and in online casino gamblers. However, breaching self-exclusion is somewhat more common than in previous research. Online casino represents the most common means of self-exclusion breaching. Policy-making in the area needs to further address the risk of breaching one's self-exclusion and may further address the risk of overseas gambling., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Background and Aims: Participating in online gambling is associated with an increased risk for experiencing gambling-related harms, driving calls for more effective, personalized harm prevention initiatives. Such initiatives depend on the development of models capable of detecting at-risk online gamblers. We aimed to determine whether machine learning algorithms can use site data to detect retrospectively at-risk online gamblers indicated by the Problem Gambling Severity Index (PGSI)., Design: Exploratory comparison of six prominent supervised machine learning methods (decision trees, random forests, K-nearest neighbours, logistic regressions, artificial neural networks and support vector machines) to predict problem gambling risk levels reported on the PGSI., Setting: Lotoquebec.com (formerly espacejeux.com), an online gambling platform operated by Loto-Québec (a provincial Crown Corporation) in Quebec, Canada., Participants: N = 9145 adults (18+) who completed the survey measure and placed at least one bet using real money on the site., Measurements: Participants completed the PGSI, a self-report questionnaire with validated cut-offs denoting a moderate-to-high-risk (PGSI 5+) or high-risk (PGSI 8+) for experiencing past-year gambling-related problems. Participants agreed to release additional data about the preceding 12 months from their user accounts. Predictor variables (144) were derived from users' transactions, apparent betting behaviours, listed demographics and use of responsible gambling tools on the platform., Findings: Our best classification models (random forests) for the PGSI 5+ and 8+ outcome variables accounted for 84.33% (95% CI = 82.24-86.41) and 82.52% (95% CI = 79.96-85.08) of the total area under their receiver operating characteristic curves, respectively. The most important factors in these models included the frequency and variability of participants' betting behaviour and repeat engagement on the site., Conclusions: Machine learning algorithms appear to be able to classify at-risk online gamblers using data generated from their use of online gambling platforms. They may enable personalized harm prevention initiatives, but are constrained by trade-offs between their sensitivity and precision., (© 2023 Society for the Study of Addiction.)

Background: Gambling is increasingly offered and consumed in online and mobile environments. The digitalisation of the gambling industry poses new challenges on harm prevention and harm reduction. The digital environment differs from traditional, land-based gambling environments. It increases many risk-factors in gambling, including availability, ease-of-access, but also game characteristics such as speed and intensity. Furthermore, data collected on those gambling in digital environments makes gambling offer increasingly personalised and targeted., Main Results: This paper discusses how harm prevention and harm reduction efforts need to address gambling in online environments. We review existing literature on universal, selective, and indicated harm reduction and harm prevention efforts for online gambling and discuss ways forward. The discussion shows that there are several avenues forward for online gambling harm prevention and reduction at each of the universal, selective, and indicated levels. No measure is likely to be sufficient on its own and multi-modal as well as multi-level interventions are needed. Harm prevention and harm reduction measures online also differ from traditional land-based efforts. Online gambling providers utilise a variety of strategies to enable, market, and personalise their products using data and the wider online ecosystem., Conclusion: We argue that these same tools and channels should also be used for preventive work to better prevent and reduce the public health harms caused by online gambling., (© 2023. The Author(s).)

Large-scale sports events have become a good opportunity for major enterprises to promote due to their high social attention; however, they also force enterprises to confront the risks of uncertainty and extreme loss. During the 2018 Russia World Cup, Vatti Co., Ltd.'s promotion activity "If France Wins, Get a Full Refund" suffered double losses economically and reputationally due to France's victory and the company's failure to fulfill its promise. This paper uses option hedging theory, and the risk management tools to construct a risk management model. Case analysis and program improvement were carried out. The research results show that using the winning odds can effectively control the risks. Companies should determine their promotion plan based on sale returns and the maximum implicit income generated by promotional activities. The research paper opens a new field using derivative financial instruments to control corporate promotion risks., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Chen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Numerous states in the USA have legalized sports betting due to recent legal decisions by the US Supreme Court. Here, sociodemographic correlates of current gambling and specific gambling activities associated with symptoms of gambling problems were identified., Methods: Cross-sectional data were obtained from the 2020 Rhode Island Young Adult Survey (RIYAS). RIYAS participants (n = 540) were a convenience sample of 18 to 25 year olds who lived in Rhode Island for at least part of 2020. Data were collected from May to October 2020. Four gambling activities were assessed (i.e. sports betting; betting on races; gaming tables at a casino; poker machines at a casino). Logistic regression models assessed main effects., Results: 22.4% engaged in one or more gambling activities. 11.5% of participants had any gambling problems. Odds of gambling activities were higher among men; Black, Indigenous, People of Color; older young adults; and essential workers. Odds of gambling problems were 2.4 times higher among participants who engaged with sports betting., Conclusions: Gambling activities are common among several population subgroups, and participation in sports betting may be a risk factor for the development of problem gambling. Comprehensive prevention policies are needed., (© The Author(s) 2022. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Objective: Online gambling has increased the accessibility and range of gambling products available to people all over the world. This trend has been particularly noticeable in the United Kingdom. Cryptocurrency-based gambling is a new, largely unregulated, way to gamble online, which uses mostly anonymous blockchain-based technologies, such as Bitcoin. The present research investigated consumer protection features of 40 frequently visited and U.K.-accessible cryptocurrency-based online gambling operators., Method: A content analysis was performed by visiting all 40 cryptocurrency-based online operators and recording their safer gambling and consumer protection practices. Coded features included aspects of the sign-up process, features of any safer gambling pages, customer support practices, and Identity verification., Results: Results revealed significant failings in the account registration process; none of the operators verified the identity of new users, and 35% required only an email or no personal information for sign-up. Overall, 37.5% of operators offered no safer gambling tools and a further 20% offered only one. Additionally, 64.7% of operators continued to email promotional material after being informed of a user's impaired control when gambling. Less than half of the analyzed operators held a valid license (47.5%), and none of the operators with an available deposit page required identity verification before enabling deposits., Conclusions: These results highlight the potential risks for young and vulnerable individuals, especially when a lack of identity verification is paired with the inherent anonymity of cryptocurrencies. Furthermore, it emphasizes the need for greater policy and research attention toward cryptocurrency-based online gambling. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Around the world, children are being exposed to intensive marketing for gambling products. This normalizes perceptions that gambling is essentially a harmless form of entertainment, despite mounting evidence of the harms it causes. Young people and their parents are supportive of strategies to protect children from being exposed to gambling marketing. Yet existing regulatory efforts are inconsistent and inadequate, and have not protected children from exposure to the many forms of marketing now being developed and exploited by the gambling industry. We outline existing knowledge about strategies used by the gambling industry to market its products, with a specific focus on the potential impact of gambling marketing on young people. We provide a definition of gambling marketing and outline the different forms of promotion that are currently used to market gambling, current regulatory responses, and the impact of marketing on children and young people. We then argue that a comprehensive public health approach to gambling is urgently required, which must include effective action to limit the influence of marketing for gambling products, while recognizing that it is never possible to insulate children entirely from their reach., (© The Author(s) 2023. Published by Oxford University Press.)

Issues Addressed: Research is needed to understand young people's perspectives about public health promotion strategies relevant for their health and wellbeing. This study provides suggestions from young male gamblers about sports betting harm prevention and reduction strategies., Methods: In-depth interviews were conducted with 16 young men aged 18 to 24 years, from Melbourne, Victoria, who regularly engaged in sports betting. A critical qualitative inquiry approach, using methods of constructivist grounded theory guided the study. Reflexive thematic analysis was used to interpret and construct themes from the data., Results: Participants indicated three main harm prevention strategies. These were online consumer protection and regulatory strategies, public education campaigns that highlighted sports betting risks and harms and the creation of formal and informal support networks to reduce stigma and encourage help seeking. They also supported being engaged in the development of harm prevention strategies and suggested ways to help reduce barriers to engagement., Conclusion: Young men recognise the need for regulatory, education and engagement responses to counter the risks posed by new gambling products. Young men may be difficult to engage in formal prevention activities, however, youth-led and informal interactive mechanisms may help to overcome this barrier, and contribute to a comprehensive public health approach to gambling harm prevention. SO WHAT?: Young men can draw upon their lived experiences of gambling to provide insights relevant for public health promotion. Mechanisms should be developed to engage young people in the co-production of strategies and policies aimed at gambling harm prevention and reduction., (© 2022 The Authors. Health Promotion Journal of Australia published by John Wiley & Sons Australia, Ltd on behalf of Australian Health Promotion Association.)

Gambling disorder in youth is an emerging public health problem, with adolescents and young adults constituting a vulnerable age group for the development of gambling-related problems. Although research has been conducted on the risk factors for gambling disorder, very few rigorous studies can be found on the efficacy of preventive interventions in young people. The aim of this study was to provide best practice recommendations for the prevention of disordered gambling in adolescents and young adults. We reviewed and synthesized the results of existing RCTs and quasi-experimental studies covering nonpharmacological prevention programs for gambling disorder in young adults and adolescents. We applied the PRISMA 2020 statement and guidelines to identify 1483 studies, of which 32 were included in the systematic review. All studies targeted the educational setting, i.e., high school and university students. Most studies followed a universal prevention strategy, that particularly targeted adolescents, and an indicated prevention strategy for university students. The reviewed gambling prevention programs generally showed good results in terms of reducing the frequency and severity of gambling, and also regarding cognitive variables, such as misconceptions, fallacies, knowledge, and attitudes towards gambling. Finally, we highlight the need to develop more comprehensive prevention programs that incorporate rigorous methodological and assessment procedures before they are widely implemented and disseminated.

Gambling is a global public health issue that can cause harm to individuals, families, and communities. Older adults are vulnerable to gambling harm due to life-stage experiences. This study aimed to examine current research relating to individual, socio-cultural, environmental, and commercial determinants of gambling among older adults. A scoping review was conducted (PubMed, PsycInfo, SocIndex, CINAHL Complete, Web of Science, Social Science and Sociology databases available in ProQuest, Google Scholar, citation searching), with peer reviewed studies included that were published between 1 December 1999 and 28 September 2022. Included studies were published in English in peer-reviewed journals that examined the determinants of gambling in adults aged 55 and over. Records were excluded if they were experimental studies, prevalence studies or had a population wider than the required age group. Methodological quality was assessed using JBI critical appraisal tools. Data was extracted using a determinants of health framework and common themes were identified. Forty-four were included. Most literature examined individual and socio-cultural determinants including reasons for gambling, risk management strategies, and social motivations for gambling. Few studies investigated environmental or commercial determinants, and those that did focused on accessibility of venues or promotions as pathways to gambling. Further research is needed to understand the impact of gambling environments and industry, and effective public health responses for older adults., (© 2023. The Author(s).)

Objective: To summarise the evidence on the impacts of gambling-related advertising that could lead to gambling-related harm, including impacts on vulnerable individuals and inequalities in the distribution of harms., Study Design: An umbrella review of studies investigating the impact of gambling advertising., Methods: A review was undertaken of systematic reviews of qualitative, quantitative and mixed method studies reporting outcomes associated with gambling advertising and marketing. The search strategy included database searches (Web of Science, PsycInfo) and website searches. The quality of the included reviews was determined using A MeaSurement Tool to Assess systematic Reviews 2., Results: 1024 papers were identified by database searches. Eight systematic reviews, including 74 unique studies, met inclusion criteria. Included studies, using quantitative and qualitative methods, consistently support the existence of a causal relationship between exposure to advertising of gambling products/brands and more positive attitudes to gambling, greater intentions to gamble and increased gambling activity at both individual and population level. There is evidence of a 'dose-response' effect; greater advertising exposure increases participation which leads to a greater risk of harm. There was more evidence for the impact on children and young people and for those already at risk from current gambling activity with those most vulnerable more likely to be influenced., Conclusion: Gambling advertising restrictions could reduce overall harm and mitigate the impact of advertising on gambling-related inequalities. Public health harm prevention strategies should include policies which limit exposure to advertising, particularly among children and vulnerable groups., (Copyright © 2022 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

In Canada, up to 3% of individuals have or are at risk of gambling disorder. Among these individuals, a lack of awareness of their problem gambling is a common barrier to treatment and negatively affects treatment adherence. A secondary analysis was conducted on data from 1346 individuals (mean age = 43.4, SD = 14.4; 54.3 % male) with problem gambling who did and did not perceive having a problem with their gambling as assessed by the fifth item of the Problem Gambling Severity Index, "In the past twelve months, how often have you felt that you might have a problem with gambling?" Additionally, we investigated predictors of increased general awareness at 12-month follow-up. At baseline, individuals who perceived a problem with their gambling experienced more gambling-related harms (OR = 1.714), had greater total gambling losses (OR = 1.067), were more likely to have a family history of problem gambling (OR = 2.143), experienced a greater loss of control (OR = 1.313) and more often gambled alone than with others (OR = 0.879), accounting for 26.6 % of the variance in general awareness. Baseline problem awareness was positively associated with attempts to cut down or control gambling at follow-up (χ 2 =11.350,p<.001), but negatively associated with remission (χ 2 =18.392,p<.001). Increases in awareness were related to an increase in the number of gambling-related harms, gambling involvement, impaired control, and lower educational attainment, explaining 35.5% of the variance in increased general awareness. The results indicate that experiencing more gambling-related harms increases the salience and awareness of problem gambling, and that awareness is also associated with an individual's gambling context, their loss of control, and their level of gambling involvement. The findings highlight the importance of gambling harms as they pertain to general awareness and suggest that improving the recognition of gambling harms could be beneficial for the prevention and intervention of gambling disorder., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Background: In New Zealand, Pacific people continue to be more at risk of gambling harm than the general population, despite increasing public health efforts and treatment service provisions introduced to address this social and health issue. In looking at why this is so, our first concern was to ask why the delivery of the prevailing gambling-focussed programmes was not influencing Pacific gambling behaviours. In seeking to answer this question, it was important to explore ethnic-Pacific-specific factors of gambling harm prevention and reduction., Methods: The research design was interpretivist/constructivist and phenomenological, applied through the lens of a Tongan worldview. Participants comprised Tongan male elders and youth. Recruitment of participants was through snowball sampling from churches and kava-drinking circles. A total of 28 elders and 18 youth participated through focus group talanoa and individual talanoa. This study employed descriptive thematic analysis., Results: Participants were not aware of any policy document or problem-gambling preventative programmes. Four key themes were raised, which include raising the awareness of existing gambling harm treatment providers, the church influence in addressing gambling harm, community-based strategies, and cultural-based approaches., Conclusions: This study proposes several recommendations such as more awareness of gambling harm providers in community, increasing cultural spaces and church engagements, and calls for further research in addressing the prevention and reduction of gambling harm amongst the Tongan community in New Zealand., (© 2022. The Author(s).)

Objective: Research has demonstrated that gambling is becoming increasingly normalised for women. As limited research has sought to understand women's perspectives on this issue, we sought women's opinions about the factors that may contribute to the normalisation of gambling for women, and the strategies that may counter this normalisation., Methods: Semi-structured interviews were conducted with 41 women in young and middle adulthood, aged 20-40 years., Results: Participants suggested that gambling was normal for women because gambling environments had been designed to appeal to women, newer technologies had removed the stigma of attending physical venues, and the growing equality and independence of women. To de-normalise gambling, women suggested addressing the influential role of marketing, designing new public education strategies, addressing the availability and accessibility of gambling, and restricting engagement with gambling products., Conclusion: This study highlighted women's perceptions of strategies to address the normalisation of gambling and the importance of providing risk information paired with broader policy reform and prevention initiatives to address the range of determinants that normalise gambling for women., Implications for Public Health: Involving women in advocacy and understanding their perspectives is important in developing relevant public health responses to the normalisation of gambling for women., (© 2022 The Authors.)

Gambling-related harms are increasingly recognised as public health concerns internationally. One response is to improve identification of and support for those affected by gambling-related harms, including individuals who gamble and those close to them, 'affected others'. Adult social care services have been identified as a setting in which screening for gambling-related harms is suitable and desirable. To achieve this, a tool is required which can identify gambling-related harms experienced by individuals and affected others. This scoping review aimed to identify whether any brief (i.e. three questions or less) screening tools are being used and, if so, how brief screening for gambling-related harm is being implemented in health and social care-related contexts. An international English language scoping review of research and grey literature was undertaken between April and July 2021. The search included single-item and brief screening tools which have been developed to identify gambling-related harms for individuals and affected others across a range of health and social care-related contexts. Findings show that screening tools for gambling-related harms have been developed for use in health settings rather than in social care contexts. For example within gambling, mental health or substance misuse support services. We found no evidence of a brief or single-item screening tool for identifying harms to individuals and affected others which is of adequate quality to strongly recommend for use in an adult social care setting. Development of a validated brief or single-item screening tool is recommended to assist adult social care practitioners to effectively screen, identify, support and signpost people affected by gambling-related harms., (© 2022 The Authors. Health and Social Care in the Community published by John Wiley & Sons Ltd.)

Background and Aims: Gambling disorder is characterized by problematic gambling behavior that causes significant problems and distress. This study aimed to develop and validate a predictive model for screening online problem gamblers based on players' account data., Methods: Two random samples of French online gamblers in skill-based (poker, horse race betting and sports betting, n = 8,172) and pure chance games (scratch games and lotteries, n = 5,404) answered an online survey and gambling tracking data were retrospectively collected for the participants. The survey included age and gender, gambling habits, and the Problem Gambling Severity Index (PGSI). We used machine learning algorithms to predict the PGSI categories with gambling tracking data. We internally validated the prediction models in a leave-out sample., Results: When predicting gambling problems binary based on each PGSI threshold (1 for low-risk gambling, 5 for moderate-risk gambling and 8 for problem gambling), the predictive performances were good for the model for skill-based games (AUROCs from 0.72 to 0.82), but moderate for the model for pure chance games (AUROCs from 0.63 to 0.76, with wide confidence intervals) due to the lower frequency of problem gambling in this sample. When predicting the four PGSI categories altogether, performances were good for identifying extreme categories (non-problem and problem gamblers) but poorer for intermediate categories (low-risk and moderate-risk gamblers), whatever the type of game., Conclusions: We developed an algorithm for screening online problem gamblers, excluding online casino gamblers, that could enable the setting of prevention measures for the most vulnerable gamblers.

Background and Aims: Lower-risk recommendations for avoiding gambling harm have been developed as a primary prevention measure, using self-reported prevalence survey data. The aim of this study was to conduct similar analyses using gambling company player data., Methods: The sample (N = 35,753) were Norsk Tipping website customers. Gambling indicators were frequency, expenditure, duration, number of gambling formats and wager. Harm indicators (financial. social, emotional, harms in two or more areas) were derived from the GamTest self-assessment instrument. Receiver operating characteristics (ROC) curves were performed separately for each of the five gambling indicators for each of the four harm indicators., Results: ROC areas under the curve were between 0.55 and 0.68. Suggested monthly lower-risk limits were less than 8.7 days, expenditure less than 54 €, duration less than 72-83 min, number of gambling formats less than 3 and wager less than 118-140€. Most risk curves showed a rather stable harm level up to a certain point, from which the increase in harm was fairly linear., Discussion: The suggested lower-risk limits in the present study are higher than limits based on prevalence studies. There was a significant number of gamblers (5-10%) experiencing harm at gambling levels well below the suggested cut-offs and the risk increase at certain consumption levels., Conclusions: Risk of harm occurs at all levels of gambling involvement within the specific gambling commercial environment assessed in an increasingly available gambling market where most people gamble in multiple commercial environments, minimizing harm is important for all customers.

There is increasing public health concern about harmful gambling, but no consensus on effective policies and interventions to reduce risk and prevent harm has been reached. Focusing on policies and interventions (ie, measures), the aim of this study was to determine if expert consensus could be reached on measures perceived to be effective that could be implemented successfully. Our work involved a pre-registered, three-round, independent Delphi panel consensus study and an implementation rating exercise. A starting set of 103 universal and targeted measures, which were sourced from several key resources and inputs from public health stakeholders, were grouped into seven domains: price and taxation; availability; accessibility; marketing, advertising, promotion, and sponsorship; environment and technology; information and education; and treatment and support. Across three rounds, an independent panel of 35 experts individually completed online questionnaires to rank each measure for known or potential effectiveness. A consensus was reached if at least 70% of the panel judged a measure to be either not effective, moderately effective, or highly effective. Then, each measure that reached a consensus for effectiveness was evaluated on four implementation dimensions: practicability, affordability, side-effects, and equity. A summative threshold criterion was used to select a final optimal set of measures for England. The panel reached consensus on 83 (81%) of 103 measures. Two measures were judged as ineffective by the panel. The remaining 81 effective measures were drawn from all domains (14 of 15 measures in the the marketing, advertising, promotion, and sponsorship domain were judged as effective, whereas five of ten measures in the information and education domain were judged as effective). During the evaluation exercise, the 81 measures were assessed for likelihood of implementation success. This assessment considered the practicality, affordability, ability to generate unanticipated side-effects, and ability to decrease differences between advantaged and disadvantaged groups in society of each measure. We identified 40 universal and targeted measures to tackle harmful gambling (three measures from the price and taxation domain; ten from the availability domain; five from the accessibility domain; six from the marketing, advertising, promotion, and sponsorship domain; eight from the environment and technology domain; three from the information and education domain; and five from the treatment and support domain). Implementation of these measures in England could substantially strengthen regulatory controls while providing new resources. The findings of our work offer a blueprint for a public health approach to preventing harms related to gambling., Competing Interests: Declaration of interests We declare no competing interests., (Copyright © 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license. Published by Elsevier Ltd.. All rights reserved.)

Background: Studies published on gender-related differences in the gambling behavior of adolescents have focused mainly on psychological and social factors. The aim of this study was to develop separate risk factor models for male and female adolescents, considering the environmental, psychological, behavioral and socio-economic factors related to their gambling., Methods: A survey was conducted through a questionnaire developed on a dedicated web site in 2014 on a representative sample of the Italian 15-19-years-old population, including 34,922 students attending 438 secondary schools. The SOGS-RA questionnaire was used to measure gambling behavior. To verify the risk factors associated with gambling a logistic regression stratified by gender was performed., Results: In our representative sample of Italian adolescents nationwide, the prevalence of each level of gambling was higher in males than in females. The logistic regression stratified by gender found that for both genders, gambling was positively associated with internet surfing, playing sports, getting into a fight, having unprotected sex, pulling stunts, drinking alcohol at least once in the previous month, having not a satisfactory relationship with teachers, receiving pocket money from parents, spending each week much money and having someone in the family (father, sister/brother, other relatives) who gambles. On the other hand, having poor or average school marks, going to ED in the previous year, smoking at least once in the previous month, having dissatisfied with relationships with father and having a lower family income than their friends was only associated with gambling in boys. Having an accident or injury in the previous year and having a mother who gambled was associated only in girls with higher odd of at risk or problem gambling behavior. A low psychological distress is protective only in girls for risk of gambling., Conclusions: Understanding the gender-related differences, and how they emerge in younger people at the start of their gambling careers, can suggest how best to educate individuals, families and the community on the topic of gambling. Programs to prevent substance use and abuse should be multifaceted, and include efforts to prevent gambling with a gender perspective approach., (© 2022. The Author(s).)

Cost-of-play information is one public health intervention recommended to help reduce gambling-related harm. In the UK, this information is given on electronic gambling machines in a format known as the "return-to-player", e.g., "This game has an average percentage payout of 90%." However, previous evidence suggests that this information could be improved by equivalently restating it in terms of the "house-edge", e.g., "This game keeps 10% of all money bet on average." A "volatility warning," stating that this information applies only in the statistical long-run, has also been recommended to help gamblers understand cost-of-play information. However, there is no evidence comparing these information provisions' effect on gamblers' behavior. An experiment tested US gamblers'(N = 2433) incentivized behavior in an online slot machine, where this information was manipulated between-participants along with a counter showing the total amount bet. Preregistered analyses showed that participants gambled significantly less when house-edge information or a volatility warning were shown compared to standard return-to-player information, with no effect of the total amount bet counter, and no significant interaction effects. However, these significant findings had small effect sizes, suggesting that a public health approach to gambling should not rely on informational provisions only. Subject to supportive evidence from more ecologically-valid designs such as field studies, these results suggest that improved cost-of-play information could lead to reduced rates of gambling expenditure and therefore benefit a public health approach to gambling., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Children's exposure to the marketing of harmful products in public outdoor spaces may influence their consumption of those products and affect health into adulthood. This study aimed to: i) examine the spatial distribution of children's exposure to three types of marketing-related 'harms' (alcohol, unhealthy food, and gambling) in outdoor spaces in the Wellington region, New Zealand/Aotearoa; ii) compare differences in the distribution of harms by socioeconomic deprivation; and iii) estimate the effectiveness of different policies that ban such marketing. Data were from 122 children aged 11-13y who wore wearable cameras and GPS devices for four consecutive days from July 2014 to June 2015. Images were analysed to identify harmful product marketing exposures in public outdoor spaces. Eight policy scenarios were examined to identify the effectiveness of marketing bans, for all children and by socioeconomic deprivation. Children's ratio of harmful marketing was higher for children from high deprivation households and was also found to cluster, with hots spots observed around city centers. The effectiveness of marketing bans depended on the target setting and ban area, with banning 400 m around bus stops leading to the largest reduction. Effectiveness varied also by type of harm and socioeconomic deprivation. For example, banning alcohol marketing in residential areas was estimated to have a larger effect on exposure reduction for children from high deprivation households. Our findings suggest that alcohol, unhealthy food and gambling marketing often cluster outdoors and that targeted bans of such marketing would likely improve child health and, for some banning scenarios, promote equity., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Objective: Academics, gambling regulators, and the gambling industry increasingly espouse a shared responsibility view of preventing gambling harm, considering individual gamblers and external stakeholders (e.g., gambling industry employees, government regulators, and public health workers) to be jointly responsible for this task. This study is the third in a series exploring gamblers' beliefs about responsibility for preventing gambling harm. Method: A sample of 4,336 subscribers to MGM Resorts International (MGM)'s loyalty card program as of January 2020 completed a web-based survey. Results: We observed that 58.1% of participants only held individual gamblers responsible for helping prevent gambling harm. However, two factors increased the likelihood of holding a shared responsibility viewpoint and assigning responsibility to casinos for reducing gambling harm: (a) scoring positive on the Brief Biosocial Gambling Screen (BBGS) or an Expanded Problem Gambling Screen (EPGS) and (b) being aware of GameSense, an onsite responsible gambling education program. Those who screened positive on the BBGS or EPGS also were more likely than their counterparts to deny personal responsibility for minimizing gambling harm to individual gamblers; that is, they were more likely to hold a purely external responsibility viewpoint. A meta-analytic year-over-year comparison revealed that compared to being aware of GameSense, screening positive for problem gambling was more strongly associated with assigning responsibility to casinos for minimizing gambling harm. Conclusions: We discuss these findings in the context of self-determination theory and suggest implications for health promotion and best practices for message design in responsible gambling programs. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Objective: Some gambling product messages are designed to inform gamblers about the long-run cost of gambling, for example, "this game has an average percentage payout of 90%." This message is in the "return-to-player" format and is meant to convey that for every £100 bet about £90 will be paid out in prizes. Some previous research has found that restating this information in the "house-edge" format, for example, "this game keeps 10% of all money bet on average," is better understood by gamblers and reduces gamblers' perceived chances of winning. Here we additionally test another potential risk communication improvement: A "volatility statement" highlighting that return-to-player and house-edge percentages are long-run statistical averages, which may not be experienced in any short period of gambling., Method: Gambling information format and volatility statement presence were manipulated in an online experiment involving 2,025 U.K. gamblers., Results: The house-edge format and the presence of volatility statements both additively reduced gamblers' perceived chances of winning. In terms of gamblers' understanding, house-edge messages were understood the best, but no consistent effect of volatility statements was observed., Conclusions: The return-to-player gambling messages in current widespread use can be improved by switching to the house-edge format and via the addition of a volatility statement. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Background: Electronic gambling machines (EGMs) are amongst the most harmful forms of gambling. The high availability of EGMs is also linked to increased consumption. To reduce the burden of EGMs on public health, policies to reduce their numbers have recently been introduced in Italy and Finland. This study compares the aims and justifications of these legislative changes, as well as their overall impacts on total consumption., Methods: The objectives and justifications of policies to reduce the number of EGMs were based on qualitative media analysis. The impacts on total consumption were measured using financial figures provided by gambling providers in Italy and Finland., Results: Results show that the reductions in EGM numbers were justified in terms of public health concerns in both countries, but the amplitude of policies varied. In Italy, the reductions were more ambitious than in Finland, and included reductions in the number of gambling locations. The financial data nevertheless indicated that the reductions may not have been significant enough., Conclusions: Public health concerns were initially highlighted in the media discussions, but eventually in both countries reduction policies were less ambitious due to industry lobbying and state revenue interests. The reductions therefore do not appear to have been effective in reducing total consumption and the burden on public health., (© 2022. The Author(s).)

The desire to escape from pressures/anxiety represents an important motivation for problematic engagement with short-term rewarding behaviors that could contribute to the development of recognized and candidate behavioral addictions, including problematic shopping, a prevalent condition among youth in the U.S.A. characterized by excessive shopping cognitions/behaviors that lead to distress/impairment. However, to date, the specific correlates of shopping to relieve anxiety or tension have yet to be evaluated. We aimed at addressing this gap by analyzing data (N = 2556) from a high-school survey from Connecticut in an exploratory fashion. Adolescents who acknowledged experiencing a growing tension or anxiety that could only be relieved by shopping were classified as having negative-reinforcement shopping and compared to the remaining students. Data were analyzed in chi-square and logistic regression models to examine negative-reinforcement shopping in relation to socio-demographics, health correlates, gambling-related perceptions/attitudes, and problem-gambling severity/gambling behaviors. Negative-reinforcement shopping was more frequent in female and Hispanic students, was linked to more permissive gambling attitudes and at-risk/problematic gambling, and was associated with the use of alcohol, tobacco, marijuana, and other drugs, dysphoria/depression, and weapon-carrying and physical fighting. Taken together, these findings highlight adverse measures of health and functioning linked to negative-reinforcement shopping that may be particularly relevant to girls and Hispanic youth. Additional efforts to prevent negative outcomes are warranted.

In the field of adolescent gambling prevention, there is a lack of intervention studies reporting and assessing training courses for the intervention providers. The present work fills this gap by realizing a dissemination study inside the PRIZE program aimed at modifying a set of cognitive protective factors and affective risk factors. The purpose of this work was twofold: To develop and evaluate a training course with the intervention providers (Study 1), and to assess the short- and long-term effects of the intervention itself (Study 2). The training course was delivered to 44 health professionals (32 females, Mage = 39.34 years). Results showed a significant increase of correct knowledge about gambling and a significant reduction of their susceptibility to probabilistic reasoning biases. Participants also actually learnt the main competencies to conduct the educational activities, they were satisfied for the training course received, and they felt high levels of self-efficacy. The intervention was implemented with 1894 high school students (61% males; Mage = 15.68 years). In the short term, we found a significant increase of adolescents' correct gambling knowledge, random events knowledge, and probabilistic reasoning ability, and a significant decrease of superstitious thinking, monetary positive outcome expectation, and gambling-related erroneous thoughts and fallacious behavioral choices. In the long-term, a significant decrease of gambling frequency, gambling versatility, and gambling problem severity was obtained. Overall, this work highlights the importance to train prevention program providers in order to optimize the effectiveness of large-scale gambling intervention programs towards adolescents., Competing Interests: The authors have declared that no competing interests exist

Background: The normalisation of gambling for young people has received considerable recent attention in the public health literature, particularly given the proliferation of gambling marketing aligned with sport. A range of studies and reports into the health and wellbeing of young people have recommended that they should be consulted and engaged in developing public health policy and prevention strategies. There are, however, very few opportunities for young people to have a say about gambling issues, with little consideration of their voices in public health recommendations related to gambling. This study aimed to address this gap by documenting young people's perceptions about strategies that could be used to counter the normalisation of gambling and prevent gambling related harm., Methods: This study took a critical qualitative inquiry approach, which acknowledges the role of power and social injustice in health issues. Qualitative interviews, using a constructivist approach, were conducted with 54 young people (11-17 years) in Australia. Reflexive thematic analysis was used to interpret the data., Results: Five overall strategies were constructed from the data. 1) Reducing the accessibility and availability of gambling products; 2) Changing gambling infrastructure to help reduce the risks associated with gambling engagement; 3) Untangling the relationship between gambling and sport; 4) Restrictions on advertising; and 5) Counter-framing in commercial messages about gambling., Conclusions: This study demonstrates that young people have important insights and provide recommendations for addressing factors that may contribute to the normalisation of gambling, including strategies to prevent gambling related harm. Young people hold similar views to public health experts about strategies aimed at de-normalising gambling in their local communities and have strong opinions about the need for gambling to be removed from sport., (© 2022. The Author(s).)

Background: Safer gambling messages are a common freedom-preserving method of protecting individuals from gambling-related harm. Yet, there is little independent and rigorous evidence assessing the effectiveness of safer gambling messages. In our study, we aimed to test the effect of the historically most commonly-used UK safer gambling message on concurrent gambling behaviour of people who gamble in the UK., Methods: In this study, three preregistered, incentivised, and randomised online experiments, testing the UK's "when the fun stops, stop" message, were carried out via the crowdsourcing platform Prolific. Adults based in the UK who had previously participated in the gambling activities relevant to each experiment were eligible to participate. Experiments 1 and 3 involved bets on real soccer events, and experiment 2 used a commercially available online roulette game. Safer gambling message presence was varied between participants in each experiment. In experiment 2, exposed participants could be shown either a yellow or a black-and-white version of the safer gambling message. Participants were provided with a monetary endowment with which they were allowed to bet. Any of this money not bet was afterwards paid to participants as a bonus, in addition to the payouts from any winning bets. In experiment 2 participants had the opportunity to re-wager any winnings from the roulette game. The primary outcome in experiment 1 was participants' decisions to accept (or reject) a series of football bets, which varied in their specificity (and payoffs), and the primary outcomes of experiments 2 and 3 were the proportion of available funds bet, which were defined as the total amount of money bet by a participant out of the total that could have been bet., Findings: Participants for all three experiments were recruited between May 17, 2019, and Oct 17, 2020. Of the 506 participants in experiment 1, 41·3% of available bets were made by the 254 participants in the gambling message condition, which was not significantly different (p=0·15, odds ratio 1·22 [95% CI 0·93 to 1·61]) to the 37·8% of available bets made by the 252 participants in the control condition. In experiment 2, the only credible difference between conditions was that the 501 participants in the condition with the yellow version of the gambling message bet 3·64% (95% Bayesian credibility interval 0·00% to 7·27%) more of available funds left over than the 499 participants in the control condition. There were no credible differences between the bets made by the 500 participants in the black-and-white gambling message condition and the other conditions. In experiment 3, there were no credible differences between the 502 participants in the gambling message condition and the 501 participants in the control condition, with the largest effect being a 5·87% (95% Bayesian credibility interval -1·44% to 13·20%) increase in the probability of betting everything in the gambling message condition., Interpretation: In our study, no evidence was found for a protective effect of the most common UK safer gambling message. Alternative interventions should be considered as part of an evidence-based public health approach to reducing gambling-related harm., Funding: University of Warwick, British Academy and Leverhume, Swiss National Science Foundation., Competing Interests: Declaration of interests PWSN is a member of the Advisory Board for Safer Gambling—an advisory group of the Gambling Commission in the UK. In 2020, PWSN was a special advisor to the House of Lords Select Committee Enquiry on the Social and Economic Impact of the Gambling Industry. In the past 3 years, PWSN has received research funding from Clean Up Gambling, and has contributed to research projects funded by GambleAware, Gambling Research Australia, NSW Responsible Gambling Fund, and the Victorian Responsible Gambling Foundation. In 2019, PWSN received travel and accommodation funding from the Spanish Federation of Rehabilitated Gamblers and, in 2020, received an open access fee grant from Gambling Research Exchange Ontario. EAL was a co-investigator on a grant funded by the Alberta Gambling Research Institute, which ended in February, 2019. All other authors declare no competing interests., (Copyright © 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.)

Competing Interests: AR has received research funding from Federation University, the Victorian Responsible Gambling Foundation, Australia's National Research Organisation for Women's Safety, and the Australian Commonwealth Department of Social Services. She has been employed on grants funded by the Australian Research Council and Deakin University, and has received travel funding from the Turkish Green Crescent Society, Monash University, and the Winston Churchill Memorial Trust, all outside of the submitted work.

Objectives: The aim of this paper is to identify possible regulatory, policy and program measures to address gambling harm to bingo players and their communities, and in doing so extend existing public health approaches to gambling to better include bingo., Study Design: This was a qualitative case study of three populations in Victoria, Australia where bingo was popular and structural disadvantage common: Indigenous people in the state's east, Pacific people in the north and older people on low or fixed incomes in the capital, Melbourne., Methods: Our study investigated experiences of bingo, including gambling harm and recommendations for change. Data were generated through interviews with 53 bingo players and 13 stakeholders as well as 12 participant observations of bingo sessions., Results: Five broad drivers of and influences on harm to bingo players are identified: technological, regulatory and commercial changes eroding bingo's protective factors; bingo being used to bolster other forms of gambling; promotion of gambling interests over people's wellbeing; not recognising experiences of different communities and; external structural influences such as racialised poverty. We identify recommendations from bingo players and stakeholders to address harm arising from bingo involving wagering. Based on these recommendations and available evidence, we propose five sets of measures to mitigate against gambling harm to bingo players and their communities, and so extend existing public health approaches to gambling to better encompass bingo. These sets of measures are: safeguarding bingo's protective features; delinking bingo from the gambling eco-system; dismantling political protection of the gambling industry; tailoring strategies for sub-populations and preventing oppression and abuse., Conclusions: In the face of significant regulatory, commercial and technological changes to bingo that risk increasing and intensifying harm, a public health approach to bingo could help mitigate gambling harm., (Copyright © 2022. Published by Elsevier Ltd.)

To explore how Experts by Experience (EbyE) conceptualize key priorities for preventing and reducing gambling-related harm in the United Kingdom (UK). To identify barriers and facilitators to EbyE engagement in decisions for gambling research, education, treatment (RET) and policy development. Qualitative study utilizing semi-structured interviews with 20 participants from the UK between March and July 2020. Gamblers aged 29-60 years who self-reported that they had experienced gambling-related harm, and who actively used their experiences to inform strategies to prevent and reduce gambling-related harm in the UK. Participants were motivated to: advocate for gambling reform, and raise awareness of their experiences of gambling addiction or disorder. Gambling regulation was described as not adequately keeping pace with gambling industry practices, with initiatives needed to prevent the harms associated with product design, how individuals engaged with products and marketing practices. The reliance on voluntary contributions by the gambling industry for RET was perceived as a potential barrier to reform. Participants recommended new independent structures which engaged EbyE in meaningful ways in contributing to decision-making. An independent body run by and for EbyE was one mechanism that participants perceived could represent the voices of those impacted by gambling-related harm. Individuals with a lived experience of gambling-related harm, including affected social network members, bring a range of unique experiences and perspectives, and should be seen as valuable stakeholders in co-producing strategies to prevent and reduce gambling-related harm., (© The Author(s) 2021. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Often portrayed as a harmless leisure activity in the UK, gambling is being increasingly recognised as a public health concern. However, a gambling policy system that explicitly tackles public health concerns and confronts the dependencies and conflicts of interest that undermine the public good is absent in the UK. Although there is a window of opportunity to change the gambling policy system, with the UK Government's launch of a review of the Gambling Act 2005, the adoption of a comprehensive and meaningful public health approach is not guaranteed. Too often, government policy has employed discourses that align more closely with those of the gambling industry than with those of the individuals, families, and communities affected by the harms of gambling. In view of the well described commercial determinants of health and corporate behaviour, an immense effort will be needed to shift the gambling discourse to protect public health. In this Viewpoint, we seek to advance this agenda by identifying elements that need challenging and stimulating debate., Competing Interests: Declaration of interests RC reports personal fees from the House of Lords, WHO, and the Turkish Green Crescent Society; and travel and accommodation support from the Alberta Gaming Research Institute, outside the submitted work. MP reports being a coinvestigator in the SPECTRUM consortium, funded by the UK Prevention Research Partnership, a consortium of UK funders (UKRI Research Councils [Medical Research Council, Engineering and Physical Sciences Research Council, Economic and Social Research Council, and Natural Environment Research Council], charities [British Heart Foundation, Cancer Research UK, Wellcome Trust, and The Health Foundation], and government bodies [Scottish Government Chief Scientist Office, Health and Care Research Wales, National Institute of Health Research, and Public Health Agency]). All other authors declare no competing interests., (Copyright © 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licence. Published by Elsevier Ltd.. All rights reserved.)