In their critical review of the prevention paradox (PP) applied to gambling-related harm, Delfabbro and King (2017) raise a number of concerns regarding specific assumptions, methods, and findings as well as the general conceptual approach. Besides discussing the PP, the review also considers the merits of considering a “continuum of harm,” as opposed to the more traditional categorical approach to classifying problem gamblers. Their critique is carefully modulated and balanced, and starts a useful dialogue in the context of a public health approach to gambling. Unfortunately, some of Delfabbro and King’s (2017) arguments rest on the treatment of gambling harm as a binary state and conflates gambling-related harm with disordered gambling. In this reply, we argue that the application of PP logic to gambling harm has not yet been addressed by us, and is only indirectly related to the more important objective of understanding how gambling can reduce ones’ quality of life.
The prevention paradox (PP) describes a situation in which a greater number of cases of a disease-state come from low-risk members of a population, because they are more prevalent than high-risk members. Past research has provided only tangential and disputed evidence to support the application of the PP to gambling-related harm.
To assess whether the PP applies to gambling, the prevalence of a large set (72) of diverse harmful consequences from gambling was examined across four risk categories for problem gambling, including no-risk, low-risk, moderate-risk, and problem-gambling.
Respondents who had gambled on non-lottery forms in the past 6 months completed an online survey (N = 1,524, 49.4% male). The data were weighted to the known prevalence of gambling problems in the Victorian community.
The prevalence of gambling harms, including severe harms, was generally higher in the combined categories of lower risk categories compared to the high-risk problem-gambling category. There were some notable exceptions, however, for some severe and rare harms. Nevertheless, the majority of harms in the 72-item list, including serious harms such as needing temporary accommodation, emergency welfare assistance, experiencing separation or end of a relationship, loss of a job, needing to sell personal items, and experiencing domestic violence from gambling, were more commonly associated with lower risk gamblers.
Many significant harms are concentrated outside the ranks of gamblers with a severe mental health condition, which supports a public-health approach to ameliorating gambling-related harm.
Authors:Belinda C. Goodwin, Matthew Browne, Matthew Rockloff and Phillip Donaldson
A diverse class of stimuli, including certain foods, substances, media, and economic behaviours, may be described as ‘reward-oriented’ in that they provide immediate reinforcement with little initial investment. Neurophysiological and personality concepts, including dopaminergic dysfunction, reward sensitivity and rash impulsivity, each predict the existence of a latent behavioural trait that leads to increased consumption of all stimuli in this class. Whilst bivariate relationships (co-morbidities) are often reported in the literature, to our knowledge, a multivariate investigation of this possible trait has not been done. We surveyed 1,194 participants (550 male) on their typical weekly consumption of 11 types of reward-oriented stimuli, including fast food, salt, caffeine, television, gambling products, and illicit drugs. Confirmatory factor analysis was used to compare models in a 3×3 structure, based on the definition of a single latent factor (none, fixed loadings, or estimated loadings), and assumed residual covariance structure (none, a-priori / literature based, or post-hoc / data-driven). The inclusion of a single latent behavioural ‘consumption’ factor significantly improved model fit in all cases. Also confirming theoretical predictions, estimated factor loadings on reward-oriented indicators were uniformly positive, regardless of assumptions regarding residual covariances. Additionally, the latent trait was found to be negatively correlated with the non-reward-oriented indicators of fruit and vegetable consumption. The findings support the notion of a single behavioural trait leading to increased consumption of reward-oriented stimuli across multiple modalities. We discuss implications regarding the concentration of negative lifestyle-related health behaviours.
Authors:Matthew Browne, Rachel Volberg, Matthew Rockloff and Anne H. Salonen
Background and aims
The Prevention Paradox (PP) suggests that a large proportion of aggregate harm from gambling occurs to people who do not have a gambling disorder. However, it has not yet been tested using a population-representative sample. We aimed to test whether the PP applies to gambling in Finland. The prevalence rates of diverse harmful consequences from gambling were surveyed amongst a population-representative sample of past-year gamblers.
The study used first wave data (N = 7,186) of Finnish Gambling Harms survey, collected via online and postal surveys in 2017. A subset of 3,795 adults (≥18 years), who had gambled at least monthly in 2016, were selected for analysis.
Gambling-related harms were evaluated with the 72-item Harms Checklist. Problem and Pathological Gambling Measure (PPGM) measured respondents’ probable disordered gambling from the subset of items for impaired control (4 questions) and other issues (3 questions).
Consistent with previous findings, the majority of harms were reported by those in the less severe PPGM categories (i.e. scoring <5). However, considering each domain separately, this was true only for financial, emotional/psychological, and work/study harms. The PP was not supported for health, relationship, or social deviance harms.
The population prevalence of the most serious harms (e.g. unsafe living conditions) is concentrated among those with severe impaired control issues. However, even excluding the ∼15% of harms occurring to occasional gamblers, most financial, emotional and work/study impacts occur to those with lower levels of control issues. Efforts at harm reduction should focus on the entire spectrum of issues that people experience from their gambling.
Authors:Alex M. T. Russell, Nerilee Hing, Matthew Browne and Vijay Rawat
Background and aims
Direct messaging via text messages (texts) and emails is a widely used method to advertise sports and race-betting offers. However, they have attracted little research, as this advertising is not in the public domain. This study aimed to determine whether betting expenditure is related to receiving direct wagering messages, and the specific inducements they promote. We hypothesized that receiving direct messages, particularly texts, would be related to betting expenditure within 24 hr.
In this ecological momentary assessment study, regular sports (n = 98) and race (n = 104) bettors from Australia completed short daily surveys over 1 week that captured exposure to direct messages, betting behavior in the previous 24 hr, and betting intention for the next 24 hr. Respondents were asked to forward any texts and emails received to the researchers, who coded them for inducement content.
Longitudinal analyses found that receiving emails was positively associated with betting intention, whereas texts were positively associated with higher likelihood of betting and betting expenditure. These effects persisted when controlling for problem gambling status and signature betting events. Refund stake and bonus odds inducements were positively associated with likelihood of race betting (although not in multivariate models), as were bonus winnings inducements for sports betting.
Discussion and conclusions
Direct messages, particularly texts, are powerful marketing tools, encouraging a nearly immediate, and arguably impulsive, betting response, which may increase gambling-related problems. Overseeing this private form of advertising presents challenges to regulators, and to public health efforts that aim to reduce gambling harm.
Authors:Matthew J. Rockloff, Matthew Browne, Alex M. T. Russell, Nerilee Hing and Nancy Greer
Background and aims
Incentives for wagering products can provide extra value to gamblers. However, there is no financial reason why this added value should lead people to take greater gambling risks. This study aimed to experimentally test if wagering incentives cause gamblers to choose higher-risk (long odds) bets than un-incentivized bets.
An online experiment was conducted with wagering customers (N = 299, female = 12). Participants bet $4 on each of six video game simulations of a sport that they had wagered on in the past 12 months (Australian Football League, Cricket, or Soccer). Each game offered different common wagering incentives: Bonus bet, Better odds/winnings, Reduced risk, Cash rebate, Player’s choice of inducement, or No-inducement. For each game, participants could bet on long, medium, or short odds, and subsequently viewed a highlight reel of the simulated game outcome and bet outcome.
Participants selected significantly longer odds (i.e., riskier) bets on games when an incentive was offered compared to the No-inducement condition. Better odds/winnings was the most attractive incentive, followed by Bonus bet, Cash rebate, Reduced risk, and No-incentive, respectively. No significant differences were observed based on demographics or problem gambling severity.
Discussion and conclusions
The choice of long odds with incentivized bets increases the volatility of player returns. Increased volatility results in more gamblers in a losing position and fewer gamblers with larger wins. Moreover, if long odds bets are priced to provide poorer value to bettors compared to short odds, they would increase gamblers’ losses and equivalently increase operators’ profits.
Authors:Belinda C. Goodwin, Matthew Browne, Matthew Rockloff and Natalie Loxton
Background and aims
Impulsivity has consistently been associated with over-consumption and addiction. Recent research has reconceptualized impulsivity as a two-dimensional construct (). This study explores the relationship of the two components of impulsivity, reward drive (RD) and rash impulsivity (RI), on a broad group of 23 hedonic consumption behaviors (e.g., gambling, substance use, eating, and media use). We tentatively grouped the behaviors into three descriptive classes: entertainment, foodstuffs, and illicit activities and substances.
RD and RI positively predicted elevated levels of consumption in a community sample (N=5,391; 51% female), for the vast majority of the behaviors considered. However, the effect sizes for RD and RI varied significantly depending on the behavior; a pattern that appeared to be at least partially attributable to the class of consumption. Results support the view that RD is related more strongly to the consumption of products that provide social engagement or a sense of increased status; whereas RI better reflects an approach toward illicit or restricted products that are intensely rewarding with clear negative consequences.
Discussion and conclusion
Results support the utility of the two-factor model of impulsivity in explaining individual differences in patterns of hedonic consumption in the general population. We discuss findings in terms of strengthening current conceptualizations of RI and RD as having distinct implications with respect to health-related behaviors.
Authors:Matthew Browne, Nerilee Hing, Alex M. T. Russell, Anna Thomas and Rebecca Jenkinson
Background and aims
Research suggests that a large proportion of regular sports and race bettors experience harm related to their gambling. In Australia, people who bet regularly are targeted by a proliferation of different forms of inducements and advertising – many of which are believed to encourage excessive betting and erroneous perceptions of risk. However, scant research has examined the impact of marketing messaging to this group, which is also limited to cross-sectional or qualitative designs. We aimed to determine whether exposure to wagering advertisements and inducements influenced intended betting expenditure, actual betting expenditure, and spending more than intended.
We report on an ecological momentary assessment study, measuring regular exposure to 20 different forms of marketing, as well as wagering spend from 318 race bettors and 279 sports bettors. Up to 15 assessments per participant were conducted over 3 weeks (mean = 11.46, median = 14), yielding 6,843 observations for analysis.
Exposure to advertising and inducements was reliably linked to a greater likelihood of betting, higher intended and actual betting expenditure, and spending more than intended. “Push” messaging and inducements that convey the impression of reduced risk (stake-back inducements and multibet offers) were particularly influential, as well as brands promoted during events and advertisements on betting websites/apps.
Discussion and conclusions
Given that a large proportion of regular sports and race bettors experience problems, restrictions on these forms of marketing are advisable. These findings suggest that this is particularly important for marketing that is “pushed” to gamblers or that suggests reduced risk.