Electronic gaming machine accessibility and gambling problems: A natural policy experiment

Background: Electronic gaming machines (EGMs) are recognised as one of the most harmful forms of gambling at an individual level. However, it is unclear whether restriction of EGM functions and accessibility results in meaningful reductions in population-level gambling harm. Methods: This study employed a natural policy experiment to compare gambling problems between Australian residents in Western Australia (WA), where EGMs are restricted to a single venue and have different structural features, and residents in other Australian jurisdictions where EGMs are widely accessible in casinos, hotels and clubs. The accessibility of non-EGM forms of gambling is generally similar across all Australian jurisdictions. The study draws on a large (N = 15,000) nationally-representative dataset.Findings: Although gambling participation was slightly higher in WA, EGM participation was approximately half that found in the rest of Australia. Aggregate gambling problems and harm were about one-third lower in WA, and self-reported attribution of harm to EGMs by gamblers and affected others was 2·7x and 4x lower, respectively. Analyses using mediation and moderation determined that the attributable impact of EGMs in WA was 70% lower than elsewhere, and was responsible for the vast majority of the discrepancy in gambling problems (indirect path = -0·055, 95% CI -0·071; -0·038). Attributable problems to casino table games were slightly higher in WA, potentially due to redirection of demand, but this effect size was small relative to the reduction of problems due to EGMs. On an individual level, for a given level of participation in EGMs and other forms, the risk of problems were similar in WA and the rest of Australia. Interpretation: Reduced harm from gambling in WA is due to restricted accessibility of EGMs, and there is little transfer of problems to other gambling forms. These results suggest that restricting the accessibility of EGMs substantially reduces gambling harm.Funding: Gambling Research Australia (GRA) funded this research. GRA is a partnership between the Commonwealth, State and Territory Governments to initiate and manage a national program of gambling research.

What Influences how New Zealanders use Information Displays? An Analysis of Electronic Gaming Machine Records

<p>Electronic gaming machines (slot machines) contribute to problem gambling in New Zealand and worldwide. Information displays are one harm minimisation feature of New Zealand electronic gaming machines that has been investigated in recent years. New Zealand gamblers see two types of displays: interruptive pop-up displays after a set period of time has passed, and elective displays if a player presses an information button. These displays inform the gambler about their current session with the intention that they will facilitate informed decisions about continuing play or quitting. The current study used a week-long set of electronic gaming machine data from across New Zealand to run an exploratory investigation into the utility of these information displays. We first observed that fewer than 2% of pop-up displays resulted in people quitting. On this basis it is unlikely that interruptive pop-up displays are meaningfully reducing harm. Our analysis also revealed timing differences in how pop-up displays are scheduled on machines produced by different manufacturers. The likelihood of quitting on a pop-up was influenced by complex interactions of machine and session characteristics, however these effects were small. Secondly, our investigation of elective displays also identified a low rate of access, indicating they are also unlikely to be working effectively as a harm minimisation tool. Analysis revealed players’ likelihood of accessing an elective display was mostly influenced by the venue type they were in and the manufacturer of the machine. Possible recommendations to improve both types of displays include changes to message content, scheduled timing and visual features.</p>

What Influences how New Zealanders use Information Displays? An Analysis of Electronic Gaming Machine Records

<p>Electronic gaming machines (slot machines) contribute to problem gambling in New Zealand and worldwide. Information displays are one harm minimisation feature of New Zealand electronic gaming machines that has been investigated in recent years. New Zealand gamblers see two types of displays: interruptive pop-up displays after a set period of time has passed, and elective displays if a player presses an information button. These displays inform the gambler about their current session with the intention that they will facilitate informed decisions about continuing play or quitting. The current study used a week-long set of electronic gaming machine data from across New Zealand to run an exploratory investigation into the utility of these information displays. We first observed that fewer than 2% of pop-up displays resulted in people quitting. On this basis it is unlikely that interruptive pop-up displays are meaningfully reducing harm. Our analysis also revealed timing differences in how pop-up displays are scheduled on machines produced by different manufacturers. The likelihood of quitting on a pop-up was influenced by complex interactions of machine and session characteristics, however these effects were small. Secondly, our investigation of elective displays also identified a low rate of access, indicating they are also unlikely to be working effectively as a harm minimisation tool. Analysis revealed players’ likelihood of accessing an elective display was mostly influenced by the venue type they were in and the manufacturer of the machine. Possible recommendations to improve both types of displays include changes to message content, scheduled timing and visual features.</p>

Overconfidence in Understanding of How Electronic Gaming Machines Work Is Related to Positive Attitudes

Previous research has demonstrated that attitudes are a primary determinant of intention to gamble on electronic gaming machines (EGMs) consistent with the Theory of Reasoned Action. This paper aims to address how biases in judgment can contribute to attitudes and subsequently behavior, including maladaptive problematic gambling behavior. We take a novel approach by viewing overconfidence in one’s understanding of how outcomes are determined on EGMs as an indication of cognitive distortions. The novelty of this paper is further increased as we compare attitudes to existing EGMs with novel EGMs which include a skill component, referred to as skill-based gaming machines (SGMs), which enables a better controlled comparison between actual and perceived skill. In Study 1, 232 US-based participants were recruited online who were shown various slot machines and SGMs and asked a series of questions about perceived skill and chance in determining outcomes to assess their understanding, then were asked their confidence in their understanding, attitudes toward the machines and they completed the Problem Gambling Severity Index. In Study 2, 246 Australian participants were recruited through community and university student samples; they attended a laboratory where they were randomly allocated to play a real EGM or SGM without money and completed the same measures as in Study 1. In Study 2, participants were randomly told that the outcomes on the machine they would play were determined entirely by chance, skill, or a mixture of both. In both studies, our findings suggest that there are more extreme values in overconfidence in how EGMs work, whereas individuals are more similar in their confidence in understanding SGMs. We also find a relationship between overconfidence in EGM understanding and positive attitudes toward EGMs, but no such relationship with SGMs. There was no impact from controlling for demographics, problem gambling severity, or labeling of machines on these relationships.

Predicting future harm from gambling over a five-year period in a general population sample: a survival analysis

Background There is little longitudinal evidence on the cumulative risk of harm from gambling associated with excess spending and frequency of play. The present study sought to assess the risk of gambling problems over a five-year period in adults who exceed previously derived low-risk gambling limits compared to those who remain within the limits after controlling for other modifiable risk factors. Methods Participants were adults (N = 4212) drawn from two independent Canadian longitudinal cohort studies who reported gambling in the past year and were free of problem gambling at time 1. Multivariate Cox regression was employed to assess the impact over time of gambling above low-risk gambling thresholds (frequency ≥ 8 times per month; expenditure ≥75CAD per month; percent of household income spent on gambling ≥1.7%) on developing moderate harm and problem gambling. Covariates included presence of a DSM5 addiction or mental health disorder at time 1, irrational gambling beliefs, number of stressful life events in past 12 months, number of game types played each year, and playing electronic gaming machines or casino games. Results In both samples, exceeding the low-risk gambling limits at time 1 significantly increased the risk of moderate harm (defined as ≥2 consequences on the Problem Gambling Severity Index [PGSI]) within 5 years after controlling for other modifiable risk factors. Other significant predictors of harm were presence of a mental disorder at time 1, cognitive distortions about gambling, stressful life events, and playing electronic gaming machines or casino games. In one sample, the five-year cumulative survival rate for moderate harm among individuals who stayed below all the low-risk limits was 95% compared to 83% among gamblers who exceeded all limits. Each additional low-risk limit exceeded increased the cumulative probability of harm by 30%. Similar results were found in models when the outcome was problem gambling. Conclusions Level of gambling involvement represents a highly modifiable risk factor for later harm. Staying below empirically derived safe gambling thresholds reduces the risk of harm over time.

Predicting Future Harm from Gambling over a Five-Year period in a General Population Sample: A Survival Analysis

Background. There is little longitudinal evidence on the cumulative risk of harm from gambling associated with excess spending and frequency of play. The present study sought to assess the risk of gambling problems over a five-year period in adults who exceed previously derived low-risk gambling limits compared to those who remain within the limits after controlling for other modifiable risk factors. Methods. Participants were adults (N = 4212) drawn from two independent Canadian longitudinal cohort studies who reported gambling in the past year and were free of problem gambling at time 1. Multivariate Cox regression was employed to assess the impact over time of gambling above low-risk gambling thresholds (frequency ≥ 8 times per month; expenditure ≥ 75CAD per month; percent of household income spent on gambling ≥ 1.7%) on developing moderate harm and problem gambling. Covariates included presence of a DSM5 addiction or mental health disorder at time 1, irrational gambling beliefs, number of stressful life events in past 12 months, number of game types played each year, and playing electronic gaming machines or casino games. Results. In both samples, exceeding the low-risk gambling limits at time 1 significantly increased the risk of moderate harm (defined as ≥ 2 consequences on the Problem Gambling Severity Index [PGSI]) within five years after controlling for other modifiable risk factors. Other significant predictors of harm were presence of a mental disorder at time 1, cognitive distortions about gambling, stressful life events, and playing electronic gaming machines or casino games. In one sample, the five-year cumulative survival rate for moderate harm among individuals who stayed below all the low-risk limits was 95% compared to 83% among gamblers who exceeded all limits. Each additional low-risk limit exceeded increased the cumulative probability of harm by 30%. Similar results were found in models when the outcome was problem gambling.Conclusions. Level of gambling involvement represents a highly modifiable risk factor for later harm. Staying below empirically derived safe gambling thresholds reduces the risk of harm over time.

Predicting Future Harm from Gambling over a Five-Year period in a General Population Sample: A Survival Analysis

Background. There is little longitudinal evidence on the cumulative risk of harm from gambling associated with excess spending and frequency of play. The present study sought to assess the risk of gambling problems over a five-year period in adults who exceed previously derived low-risk gambling limits compared to those who remain within the limits after controlling for other modifiable risk factors. Methods. Participants were adults (N = 4212) drawn from two independent Canadian longitudinal cohort studies who reported gambling in the past year and were free of problem gambling at time 1. Multivariate Cox regression was employed to assess the impact over time of gambling above low-risk gambling thresholds (frequency ≥ 8 times per month; expenditure ≥ $75CAN per month; percent of household income spent on gambling ≥ 1.7%) on developing moderate harm and problem gambling. Covariates included presence of a DSM5 addiction or mental health disorder at time 1, irrational gambling beliefs, number of stressful life events in past 12 months, number of game types played each year, and playing electronic gaming machines or casino games. Results. In both samples, exceeding the low-risk gambling limits at time 1 significantly increased the risk of moderate harm (defined as ≥ 2 consequences on the Problem Gambling Severity Index [PGSI]) within five years after controlling for other modifiable risk factors. Other significant predictors of harm were presence of a mental disorder at time 1, cognitive distortions about gambling, stressful life events, and playing electronic gaming machines or casino games. In one sample, the five-year cumulative survival rate for moderate harm among individuals who stayed below all the low-risk limits was 95% compared to 83% among gamblers who exceeded all limits. Each additional low-risk limit exceeded increased the cumulative probability of harm by 30%. Similar results were found in models when the outcome was problem gambling.Conclusions. Level of gambling involvement represents a highly modifiable risk factor for later harm. Staying below empirically derived safe gambling thresholds reduces the risk of harm over time.

Predicting Future Harm from Gambling over a Five-Year period in a General Population Sample: A Survival Analysis

Background There is little longitudinal evidence on the cumulative risk of harm from gambling associated with excess spending and frequency of play. The present study sought to assess over a five-year period the risk of gambling problems in adults who exceed previously derived low-risk gambling limits compared to those who remain within the limits after controlling for other modifiable psychosocial risk factors. Methods Participants were adults (N = 4212) drawn from two independent Canadian longitudinal cohort studies (Quinte Longitudinal Study and Leisure, Lifestyle, and Lifecycle Project) who reported gambling in the past year and were free of problem gambling at time 1. Multivariate Cox regression was employed to assess the impact of gambling above low-risk gambling thresholds (frequency ≥ 8 times per month; expenditure ≥ $75CAN per month; percent of household income spent on gambling ≥ 1.7%) on developing gambling problems over time. Covariates included presence of a DSM 5 addiction or mental health disorder at time 1, irrational gambling beliefs, number of stressful life events in past 12 months, number of game types played each year, and playing electronic gaming machines or casino games. Results In both samples, exceeding the low-risk gambling limits at time 1 significantly increased the risk of moderate harm within five years after controlling for other modifiable risk factors. Other significant predictors of harm were presence of a mental disorder at time 1, cognitive distortions about gambling, stressful life events, and playing electronic gaming machines or casino games. In the QLS sample, the five-year cumulative survival rate among individuals who stayed below all the low-risk limits was 95% compared to 83% among gamblers who exceeded all limits. Each additional low-risk limit exceeded increased the cumulative probability of harm by 30%. Conclusions Level of gambling involvement represents a highly modifiable risk factor for later harm. Staying below empirically derived safe gambling thresholds reduces the risk of harm over time.