Publications by authors named "Alex M T Russell"

45 Publications

Structural characteristics of fixed-odds sports betting products.

J Behav Addict 2021 Apr 8. Epub 2021 Apr 8.

2Experimental Gambling Research Laboratory, School of Health, Medical and Applied Sciences, CQUniversity, Bundaberg, QLD, Australia.

Background And Aims: A literature exists on the structural characteristics of electronic gambling machines (EGMs), which are design innovations that can promote spending excessive time and money on these games. Fixed-odds sports betting products, where bettors place sports bets against a bookmaker, have also seen significant innovations in recent years. Despite some differences between these gambling products, similar structural characteristics could also be relevant to sports betting. The aim was to review previous research on contemporary fixed-odds sports betting products, and to identify whether structural characteristics from the EGM literature are also relevant to sports betting.

Methods: Structural characteristics uncovered by two influential reviews of EGMs were identified, and their relevance to fixed-odds sports betting products discussed via a narrative review.

Results: Structural characteristics of payout interval and potential betting frequency (in-play betting), multiplier potential (accumulators, complex bets, multis), win probability and payout ratio (all bets), bettor involvement (custom sports betting products, cash out), skill required (all bets), and near-misses (accumulators, complex bets, multis) were all identified in modern fixed-odds sports betting products.

Discussion And Conclusions: Fixed-odds sports betting products have increasingly incorporated structural characteristics previously found in EGMs. Future research could further assess the extent to which these structural characteristics contribute to fixed-odds sports bettors spending excessive amounts of time and money while betting. These findings can help guide further sports betting research, contribute to an improved understanding of the potential universality of gambling product design, and inform policy.
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http://dx.doi.org/10.1556/2006.2021.00008DOI Listing
April 2021

Young people who purchase loot boxes are more likely to have gambling problems: An online survey of adolescents and young adults living in NSW Australia.

J Behav Addict 2021 Feb 24. Epub 2021 Feb 24.

1Experimental Gambling Research Laboratory, School of Health, Medical and Applied Sciences, Central Queensland University, Bundaberg, QLD, Australia.

Background And Aims: Loot boxes are a common feature in video games where players win, buy or are gifted a virtual box or other container that is unwrapped to reveal virtual items of value, such as skins, weapons, in-game currency or special abilities. The current study aimed to relate the use of loot boxes to gambling problems and harm.

Methods: An online survey was conducted with 1,954 adolescents and young adults from NSW Australia, 59.9% female (aged 12-24), recruited by online panel aggregator, Qualtrics.

Results: Buying and selling loot boxes was associated with higher 12-month gambling frequency and gambling problems in young adults, aged 18-24 (Problem Gambling Severity Index). Young adults who bought loot boxes additionally had more gambling-related harms (Short Gambling Harms Screen). Young women, aged 18-24, who opened, bought and/or sold loot boxes spent more money in the last 12 months on gambling. In adolescents, aged 12-17, buying loot boxes was similarly associated with gambling problems (DSM-IV-MR-J). Furthermore, adolescent girls who bought and/or sold loot boxes viewed gambling more positively than other girls (Attitudes Towards Gambling Scale). There was no evidence, however, that longer-term experience in opening or purchasing loot boxes, a differentiating feature of the survey, is associated with current gambling problems.

Discussion And Conclusions: This study suggests that loot boxes may be attractive to people who are already predisposed to engage in other gambling, and females who use loot boxes may have unique vulnerabilities to gambling problems that could be explored in future research.
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http://dx.doi.org/10.1556/2006.2021.00007DOI Listing
February 2021

Recollected usage of legal youth gambling products: Comparisons between adult gamblers and non-gamblers in the UK and Australia.

Addict Behav 2021 03 2;114:106685. Epub 2020 Oct 2.

Department of Psychology, University of Warwick, Coventry CV4 7AL, United Kingdom. Electronic address:

The UK is rare in allowing a number of gambling forms to be used legally by children under the age of 18. Some previous research indicates that adult problem gamblers are more likely to recollect using these products as children. However, no research has as yet assessed recollected levels of use irrespective of adult gambling status, or investigated these issues in other countries. This is relevant given that at least two of the tested products, coin push machines and crane grab machines, exist in other countries. The present research involves cross-sectional surveys conducted amongst UK (N = 2010) and Australian adults (N = 640), associating recollected legal youth gambling usage with past 12-month gambling, and levels of problem gambling amongst adult gamblers. Adult gamblers recollected using more legal youth gambling products than non-gamblers. For example, 66.6% of UK gamblers reported legally buying National Lottery tickets aged 16-17, compared to 20.9% of UK non-gamblers; 60.8% of Australian gamblers reported using coin push machines as a child, compared to 48.6% of Australian non-gamblers. Overall, 18 of 19 tested associations were significant and in the hypothesized direction for the UK sample, compared to five of eight for the Australian sample. The legal provision of gambling to children is a topic for further international research and policy consideration.
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http://dx.doi.org/10.1016/j.addbeh.2020.106685DOI Listing
March 2021

Associations between recalled use of legal UK youth gambling products and adult disordered gambling.

J Behav Addict 2020 Oct 20;9(3):863-868. Epub 2020 Aug 20.

5Department of Psychology, University of Warwick, Coventry, CV4 7AL, UK.

Background And Aims: The UK allows a number of gambling products to be legally used by people under the age of 18. The aim of this study was to explore associations between recalled legal usage of five youth gambling products and adult disordered gambling.

Methods: A retrospective cross-sectional study of 1,057 adult UK gamblers, aged 18-40. Recalled legal use of five youth gambling products (category D fruit machines, coin push machines, crane grab machines, the National Lottery, and National Lottery scratchcards) was correlated with adult disordered gambling symptoms as measured by the Problem Gambling Severity Index (PGSI).

Results: Recalled rates of legal engagement with each product ranged from 50.9% for Category D fruit machines to 96.6% for coin push machines. For category D fruit machines, the National Lottery, and National Lottery scratchcards, merely having legally engaged with these products as a child was associated with adult disordered gambling. Furthermore, higher levels of recalled legal youth usage with each of the five products was also associated with adult disordered gambling.

Discussion And Conclusions: These results relate to recent government proposals to increase the National Lottery scratchcard legal age to 18, and add to a wider literature on youth gambling and subsequent gambling-related harm.
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http://dx.doi.org/10.1556/2006.2020.00048DOI Listing
October 2020

Awareness and Attitudes of Gut Health, Probiotics and Prebiotics in Australian Adults.

J Diet Suppl 2020 Jun 26:1-15. Epub 2020 Jun 26.

Physical Activity Research Group, Appleton Institute & School of Health medical and Applied Sciences, Central Queensland University, Rockhampton, Australia.

The awareness of and attitudes toward gut health, probiotics, prebiotics and factors associated with probiotics use in Australian adults have been explored in a cross-sectional study using CQUniversity's National Social Survey ( = 1,265; 667 females). 58.9% of the participants were probiotics users, who were most commonly identified as female, younger, more educated ( < 0.05), with a higher awareness of gut health, and overall healthier lifestyle behaviors (fruits intake, activity, alcohol intake risk) compared to non-users. Maintaining health was the main reason for use. Many (59%) non-users reported a willingness to try probiotics, but only if recommended by a health professional. Probiotics use was associated with awareness of probiotic (odds ratio (OR): 2.02,  0.001) and prebiotic (OR:1.59,  = 0.003) terms, natural source of probiotics (OR:2.38,  0.001), recommended fruit serves (OR:1.32,  = 0.001), and alcohol score (OR:0.95,  = 0.036). Overall, those who had a healthier lifestyle and better understanding of gut health and probiotics were more likely to use probiotics. Education on gut health and probiotics from health professionals may improve probiotic use, especially in populations that are likely to benefit the most, including those with a specific condition or poor lifestyle.
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http://dx.doi.org/10.1080/19390211.2020.1783420DOI Listing
June 2020

Sleep hygiene in paramedics: What do they know and what do they do?

Sleep Health 2020 06 3;6(3):321-329. Epub 2020 Jun 3.

School of Health, Medical and Applied Sciences, Appleton Institute, Central Queensland University, 44 Greenhill Road, Rockhampton, Wayville, Queensland 5034, Australia.

Objectives: Shift workers routinely obtain inadequate sleep, which has major health and wellbeing consequences. Sleep hygiene describes a range of behaviours, lifestyle and environmental factors that can support optimal sleep. To date, limited research has examined sleep hygiene in shift workers. This study aimed to 1) assess the knowledge and understanding of sleep hygiene amongst shift working paramedics, as well as its perceived impact on sleep, and 2) investigate paramedics' engagement with sleep hygiene practices.

Study Design: Participants completed an online, cross-sectional survey.

Participants: Queensland Ambulance Service paramedics (n = 184) who engage in shift work.

Measures: The online survey included questions from the Standard Shiftwork Index and Sleep Hygiene Index.

Results: Most participants reported little or no understanding or knowledge of 'sleep hygiene' as a concept. Participants reported that sleep scheduling and bedroom environment (temperature, light, and noise) were the most impactful on sleep. Few participants reported nicotine and alcohol consumption, or daytime napping, whereas caffeine consumption and mentally-stimulating bedtime activities were more common. Participants who were young, single, and worked varying shift types (day, afternoon, and night) as part of their regular rosters demonstrated less knowledge regarding sleep hygiene, and were more likely to be exhibiting poor sleep hygiene engagement.

Conclusions: Paramedics demonstrated a limited level of understanding of sleep hygiene as a concept, and varied knowledge about the impacts of individual sleep hygiene factors. Further, paramedics demonstrated varied engagement with individual sleep hygiene practices. Future research should focus on the development of sleep hygiene interventions to optimise sleep in paramedics.
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http://dx.doi.org/10.1016/j.sleh.2020.04.001DOI Listing
June 2020

Impulsive Sports Betting: The Effects of Food or Substance Consumption.

J Gambl Stud 2020 Jun;36(2):539-554

Department of Entrepreneurship, Innovation and Marketing, La Trobe Business School, La Trobe University, Bundoora, VIC, Australia.

The present study aimed to explore how food or substance consumption (e.g., experiencing hunger, or having consumed alcohol or recreational drugs) could shape consumer impulsive spending on sports betting products. Based on a large online sample of Australian sports bettors, we found that participants with higher hunger level, or having consumed more alcohol or recreational drugs, tended to have increased impulsive bet size. These impulsiveness effects had both direct and indirect effect components. The significant direct effects confirmed that positive relationships directly existed between hunger, alcohol consumption, or recreational drug consumption and impulsive bet size, even when all potential mediators and covariates were statistically controlled. Moreover, results regarding specific indirect effects demonstrated that hunger, alcohol consumption, or recreational drug consumption was also indirectly linked with impulsive bet size, via their relationships with both promotional and financial influences, rather than social influences. Furthermore, participants' Problem Gambling Severity Index score was positively associated with their impulsive bet size. These findings support and complement the literature on impulsivity as well as the research on strategies for staying in control of gambling, and have implications for consumers, regulators, and treatment/help providers.
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http://dx.doi.org/10.1007/s10899-020-09938-1DOI Listing
June 2020

Fortnite microtransaction spending was associated with peers' purchasing behaviors but not gaming disorder symptoms.

Addict Behav 2020 05 11;104:106311. Epub 2020 Jan 11.

School of Psychology, The University of Adelaide, Australia.

Monetized video games have received academic and regulatory scrutiny following concerns that these products may foster addiction-like behaviors, including compulsive spending. Previous studies have reported that individuals with markedly higher in-game financial expenditure are more likely to endorse symptoms of addictive behavior (i.e., gaming or gambling disorder). The present study recruited 428 adult Fortnite players from online forums and investigated gaming motivations and behaviors, as well as online social network influences, in relation to microtransaction spending and gaming disorder (GD) symptoms. The results showed that microtransaction spending was predicted by social influences (i.e., the frequency of spending by the participants' closest friend who spends money on Fortnite), greater accessibility to Fortnite across multiple devices, and having a higher in-game level. Spenders reported stronger motivation to acquire in-game rewards and were more likely to perceive game items as representing good value for money. Higher spenders were older and reported using more payment methods, having a close friend who pays for Fortnite more often, and spent more hours playing Fortnite. Problematic gaming was associated with trait impulsivity, weekly time spent playing the game, and the perception that reducing time spent playing would diminish one's sense of self-worth. Fortnite loot box spending was not associated with GD symptoms. These data suggest that different implementations of in-game monetization schemes may have different risk potential for consumers across games.
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http://dx.doi.org/10.1016/j.addbeh.2020.106311DOI Listing
May 2020

Interest in inducements: A psychophysiological study on sports betting advertising.

Int J Psychophysiol 2020 01 21;147:100-106. Epub 2019 Nov 21.

School of Health, Medical, and Applied Sciences, Central Queensland University, Australia.

Recent research has shown an association between the viewing of wagering advertising, which often presents inducements to gamble, and maladaptive sports-betting behaviours; however, the mechanism/s underlying the development of the intention to gamble remains relatively understudied. Eye-tracking and tonic electrodermal activity was recorded from 59 participants (including 49 regular gamblers and 10 non-gamblers), while they watched a series of advertisements. Following each advertisement, participants were asked to rate how likely they would be to take up the offer presented, therein. The number of fixations placed on each offer differed according to the type of inducement shown (p < .001), with reduced risk and cash back inducements being looked at more often than better odds and bonus bet inducements by all groups. Increased electrodermal activity while viewing the advertisements was associated with greater severity of gambling-related harm (p < .001), as well as greater ratings of desire for most advertisements. Rating of desire was, likewise, positively associated with gambling-related harm (p < .001). These results may suggest that, while the offers in gambling advertisements may be looked at by most viewers, unless there an attendant increase in arousal, it is quite unlikely that these inducements will elicit a desire to gamble. For individuals already at risk of gambling problems, exposure to these advertisements, especially those offering what is perceived to be safer betting options that minimise financial losses, may exacerbate existing harms. Such information may prove useful in guiding industry practice, government regulations, therapeutic interventions, and future research on this topic.
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http://dx.doi.org/10.1016/j.ijpsycho.2019.10.015DOI Listing
January 2020

The cost of hospitalisation for youth self-harm: differences across age groups, sex, Indigenous and non-Indigenous populations.

Soc Psychiatry Psychiatr Epidemiol 2020 Apr 15;55(4):425-434. Epub 2019 Nov 15.

Cairns and Hinterland Hospital and Health Service, Cairns, Australia.

Objective: To report the comparative rates, average length of stay and cost per episode of hospital management for self-harm in three age cohorts: 15-19 years, 20-24 years and 25-29 years; by sex and indigeneity.

Design, Setting, Participants: A secondary data analysis of the Australian Institute of Health and Welfare (AIHW) dataset between 1st January 2014 and 31st December 2014 inclusive.

Main Outcome Measures: Cost per episode of hospitalised self-harm and rates by age group, sex and Indigenous status.

Results: The rate of hospitalised self-harm among Australian youth was 254.0 per 100,000 population. This rate resulted in an annual cost to the healthcare system of AU$55 million or an average cost per episode of $4649 (95% CI $4488:$4810). Hospitalised self-harm was 21 times higher than the rate of suicide (11,820 episodes of hospitalised self-harm/564 suicides). Indigenous youth had on average a 1.4 times higher rate of hospitalised self-harm and 2.2 times higher rate of suicide than non-Indigenous counterparts. When controlling for age and sex, the average cost per episode was significantly lower for Indigenous youth compared to non-Indigenous youth, estimated marginal means $4538 and $4954, respectively (p < 0.001).

Conclusions: Hospitalised self-harm among Australian youth resulted in a substantial cost to the healthcare system. This cost is only part of the overall burden associated with self-harm. The rate of hospitalised self-harm was significantly higher in Indigenous youth, but the associated cost per episode was significantly lower.
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http://dx.doi.org/10.1007/s00127-019-01807-6DOI Listing
April 2020

Avoiding gambling harm: An evidence-based set of safe gambling practices for consumers.

PLoS One 2019 17;14(10):e0224083. Epub 2019 Oct 17.

University of Alberta, Edmonton, Canada.

Prior studies have identified self-regulatory strategies that are infrequently used by problem-gamblers, but which might be protective if used. However, guidelines with evidence-based safe gambling practices (SGPs) that prevent gambling-related harm are lacking. This study aimed to: 1) identify a parsimonious set of evidence-based SGPs that best predict non-harmful gambling amongst gamblers who are otherwise most susceptible to experiencing gambling harm; 2) examine how widely are they used; and 3) assess whether their use differs by gambler characteristics. A sample of 1,174 regular gamblers in Alberta Canada completed an online survey measuring uptake of 43 potential SGPs, gambling harms and numerous risk factors for harmful gambling. Elastic net regression identified a sub-sample of 577 gamblers most susceptible to gambling harm and therefore most likely to benefit from the uptake of SGPs. A second elastic net predicted gambling harm scores in the sub-sample, using the SGPs as candidate predictors. Nine SGPs best predicted non-harmful gambling amongst this sub-sample. The behaviour most strongly associated with increased harm was using credit to gamble. The behaviour most strongly associated with reduced harm was 'If I'm not having fun gambling, I stop'. These SGPs form the basis of evidence-based safe gambling guidelines which can be: 1) promoted to consumers, 2) form the basis of self-assessment tests, 3) used to measure safe gambling at a population level, and 4) inform supportive changes to policy and practice. The guidelines advise gamblers to: stop if they are not having fun, keep a household budget, keep a dedicated gambling budget, have a fixed amount they can spend, engage in other leisure activities, avoid gambling when upset or depressed, not use credit for gambling, avoid gambling to make money, and not think that strategies can help you win. These guidelines are a promising initiative to help reduce gambling-related harm.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0224083PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6797237PMC
March 2020

A Cross-Cultural Study of Weekly Sports Bettors in Australia and Spain.

J Gambl Stud 2020 Sep;36(3):937-955

International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK.

Betting on sport is one of the fastest developing forms of gambling internationally. Sports betting is attracting considerable scholarly, media, and regulatory attention due to the cultural salience of sport, and the rising public health concerns about the rapid proliferation and penetration of betting products in everyday life. Despite its global expansion, little is known regarding the comparative impact sports betting is having in different territories. This study aims to examine a sample of Australian (n = 738) and Spanish (n = 361) weekly sports bettors to assess their similarities and differences concerning sociodemographic characteristics, channels (i.e., online vs. offline) and devices used, in-play betting, and problem gambling severity. The findings showed high problem gambling scores among sports bettors in both countries, and consistent similarities in the association between problem gambling, in-play betting, and offline betting. Also, clear trends were observed between problem gambling, higher educational level, and female sport betting, particularly in the Australian sample. These results suggest a common pattern of risk factors for problematic sports betting and can help to inform worldwide regulatory efforts to tackle harmful sports betting-specific features such as in-play betting.
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http://dx.doi.org/10.1007/s10899-019-09898-1DOI Listing
September 2020

What's the Message? A Content Analysis of Emails and Texts Received from Wagering Operators During Sports and Racing Events.

J Gambl Stud 2020 Dec;36(4):1107-1121

Experimental Gambling Research Laboratory, School of Health, Medical and Applied Sciences, CQUniversity, Sydney, NSW, Australia.

Previous research has established direct messages (such as emails and text messages) are a widely seen form of advertising and are highly influential on sports betting and race betting behaviour. Nevertheless, few studies have examined the specific content of these messages, and whether their content is related to account-holders' betting behaviour. The current study used an ecological momentary assessment design to examine direct messages received from wagering operators during the week around major Australian sports and racing events. Respondents completed a baseline survey followed by short daily surveys over a period of 1 week during peak betting periods, and provided the research team with the emails and text messages they received from wagering operators during this time. A sample of 102 sports and 110 race bettors provided a total of 931 messages. These messages subsequently underwent a content analysis to extract key features that were promoted, including inducements, incentives, and bet type. The analysis found the messages were saturated with inducements to bet, however no relationships were identified between the content of messages and the gambling risk status or betting frequency of participants. The most common types of incentives offered included bonus bets, rewards points, better odds/winnings, and reduced risk. Frequently promoted inducements included bonus or better winnings, refund/stake back offers, and match your stake/deposit. Given the influences of inducements on increasing betting expenditure and impulsive betting identified through previous research, taken together with the findings of the current study, direct messages may contribute to experiencing gambling-related harm. These findings have important implications for consumer education and the regulation of direct messages.
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http://dx.doi.org/10.1007/s10899-019-09896-3DOI Listing
December 2020

What Can be Done to Reduce the Public Stigma of Gambling Disorder? Lessons from Other Stigmatised Conditions.

J Gambl Stud 2020 Mar;36(1):23-38

Experimental Gambling Research Laboratory, School of Health, Medical and Applied Sciences, CQUniversity, Level 6, 400 Kent St, Sydney, NSW, 2000, Australia.

Gambling is embedded in Australian cultural history, and perceived as a normal, legitimate leisure activity. Despite this normalisation, people who experience gambling problems are heavily stigmatised which can lead to a variety of harms that extend beyond the individual. The stigma from the general public appears to be based on a stereotype of a typical "problem gambler"-selfish, greedy, impulsive and irresponsible. However, research suggests that people experiencing gambling problems have widely varying characteristics and do not conform to this stereotype. Regardless of whether the stigma is justified, it is both present and problematic. Gamblers experiencing problems delay help-seeking due to feelings of shame and, not unwarranted, expectations of negative judgement because of the heavy stigma associated with the stereotype. As stigma is a primary barrier to treatment and a reason why gambling problems can take longer to acknowledge, it is important to understand and address how stigma can be reduced to minimise the negative consequences of gambling on individuals, their families and friends and the wider community. There is little research on reducing gambling-related stigma, so there is a need to examine strategies used in other stigmatised conditions, such as mental health, to understand the general principles of effective stigma reduction measures. Because gambling disorder is unique, well-hidden and consequently not well understood, there is a need to recognise that techniques used in other domains may differ in their effectiveness within the context of gambling stigma.
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http://dx.doi.org/10.1007/s10899-019-09890-9DOI Listing
March 2020

Making EGMs Accountable: Can an Informative and Dynamic Interface Help Players Self-regulate?

J Gambl Stud 2020 Dec;36(4):1229-1251

Experimental Gambling Research Laboratory, School of Health, Medical and Applied Sciences, CQUniversity, Level 6, 400 Kent St, Sydney, NSW, 2000, Australia.

Electronic gaming machines (EGMs) are recognised as one of the most harmful gambling forms, because they promote high-speed repetitive gambling and automatically reinvest winnings. These features, amongst others, make it difficult for EGM gamblers to keep track of their play. Tools to assist gamblers exist, but have limited effectiveness because they require user registration and manual activation, leading to low uptake. The present study aimed to evaluate the effect of a more informative interface (including removal of automatic reinvestment of winnings) and pop-up messages on gambling behaviour, and on player experience. A total of 213 Australian participants, recruited through social media, played a simulated online EGM. The experiment was a two (standard vs. informative interface) × two (pop-ups absent vs. present) between-subjects design. The informative interface: promoted keeping track of spins played; increased accurate estimation of amount spent (as did pop-up messages) and time played; and provided game usage figures which acted as cues to quit play. Once the initial deposit (but not winnings) was expended, informative interface users could opt to reinvest their winnings, although many opted to exit at that point. No difference in total spending or dissociation was observed between experimental groups. Informative interface users reported no reduction in enjoyment. Pop-up messages reduced enjoyment with the standard interface, but increased enjoyment when paired with an informative interface. These findings indicate that a more informative interface and pop-up messages may be useful in reducing the harmful nature of EGMs.
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http://dx.doi.org/10.1007/s10899-019-09889-2DOI Listing
December 2020

Exploration of Intervention Strategies to Reduce Public Stigma Associated with Gambling Disorder.

J Gambl Stud 2020 Jun;36(2):713-733

Experimental Gambling Research Laboratory, School of Health, Medical and Applied Sciences, CQUniversity, Level 6, 400 Kent St, Sydney, NSW, 2000, Australia.

Stigma associated with gambling disorder is complex, and is a key obstacle that prevents sufferers from seeking early help for their condition. However, little research has addressed how best to reduce gambling stigma. This study explored the effectiveness of video intervention styles, that have been used to reduce public stigma for conditions such as mental illness and substance use disorders. This was done to determine which would be most suitable, considering the unique characteristics of gambling disorder. An online survey of 164 people living in Australia was conducted which examined attitudes toward gamblers experiencing problems before and after an intervention. Participants were randomly allocated to one of three interventions (contact, education, advocacy) or a control video. The study found that each intervention was associated with changes to different components of stigma. Importantly, the education intervention increased labelling, but reduced stereotype endorsement and anger. Advocacy also reduced anger, attributions of character flaws, and anticipated discrimination and recoverability. While these interventions were generally effective at reducing stigma, the contact intervention was mixed, effectively intervening for some aspects of stigma, but increasing stigma on others. No single intervention reduced all aspects of stigma, suggesting that a complementary approach utilising specific elements of each intervention style could be used to deliver relevant information and effectively reduce stigma. Taken together, this suggests that research should be conducted into comprehensive, combined interventions, that include aspects of all three intervention styles, in an attempt to reduce more aspects of stigma simultaneously.
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http://dx.doi.org/10.1007/s10899-019-09888-3DOI Listing
June 2020

Exploration of Intervention Strategies to Reduce Public Stigma Associated with Gambling Disorder.

J Gambl Stud 2020 Jun;36(2):713-733

Experimental Gambling Research Laboratory, School of Health, Medical and Applied Sciences, CQUniversity, Level 6, 400 Kent St, Sydney, NSW, 2000, Australia.

Stigma associated with gambling disorder is complex, and is a key obstacle that prevents sufferers from seeking early help for their condition. However, little research has addressed how best to reduce gambling stigma. This study explored the effectiveness of video intervention styles, that have been used to reduce public stigma for conditions such as mental illness and substance use disorders. This was done to determine which would be most suitable, considering the unique characteristics of gambling disorder. An online survey of 164 people living in Australia was conducted which examined attitudes toward gamblers experiencing problems before and after an intervention. Participants were randomly allocated to one of three interventions (contact, education, advocacy) or a control video. The study found that each intervention was associated with changes to different components of stigma. Importantly, the education intervention increased labelling, but reduced stereotype endorsement and anger. Advocacy also reduced anger, attributions of character flaws, and anticipated discrimination and recoverability. While these interventions were generally effective at reducing stigma, the contact intervention was mixed, effectively intervening for some aspects of stigma, but increasing stigma on others. No single intervention reduced all aspects of stigma, suggesting that a complementary approach utilising specific elements of each intervention style could be used to deliver relevant information and effectively reduce stigma. Taken together, this suggests that research should be conducted into comprehensive, combined interventions, that include aspects of all three intervention styles, in an attempt to reduce more aspects of stigma simultaneously.
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http://dx.doi.org/10.1007/s10899-019-09888-3DOI Listing
June 2020

Contrasting Effects of Gambling Consumption and Gambling Problems on Subjective Wellbeing.

J Gambl Stud 2019 Sep;35(3):773-792

School of Medical, Health, Medical and Applied Sciences, Central Queensland University, B8 G.47 University Drive, Bundaberg, QLD, 4670, Australia.

Most research on gambling focuses on the negative consequences associated with excessive consumption, which implicitly leads to a reduction in health and wellbeing. However, few studies have measured subjective wellbeing with respect to gambling involvement, and almost none has attempted to distinguish the separate effects of consumption and problems. We used the Personal Wellbeing Index (PWI) in two surveys with different recruitment criteria. Study 1 (N = 1524, 50.6% female) was designed to compare differences in personal wellbeing among gamblers, and Study 2 (N = 1586, 70.2% female) compared wellbeing between gamblers and non-gamblers. Participants provided demographic information, and answered questions allowing them to be grouped into high/low levels of consumption, and problem gambling risk categories. After accounting for gambling problems, higher consumption was associated with higher wellbeing. Study 2 showed consistent results; revealing that both high and low consumption non-problem gamblers (NPGs) had higher personal wellbeing than non-gamblers. Nevertheless, the deleterious effect of gambling problems on wellbeing was larger than the effect of consumption. After accounting for population prevalence (i.e., per capita), only 15.3% of the negative influence of gambling problems on PWI was attributable to problem gamblers; the remainder associated with lower risk categories. Although results were consistent when controlling for demographic covariates, the positive link between consumption and wellbeing may be due to unmeasured variables such as personality traits, health, and socioeconomic status. Nevertheless, the assessment of subjective wellbeing provides a unique perspective on both the positive and negative effects of gambling.
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http://dx.doi.org/10.1007/s10899-019-09862-zDOI Listing
September 2019

Sports betting incentives encourage gamblers to select the long odds: An experimental investigation using monetary rewards.

J Behav Addict 2019 Jun 7;8(2):268-276. Epub 2019 Jun 7.

Experimental Gambling Research Laboratory, School of Health, Medical and Applied Sciences,CQUniversity, Melbourne, VIC,Australia.

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.

Methods: An online experiment was conducted with wagering customers ( = 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.

Results: 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.
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http://dx.doi.org/10.1556/2006.8.2019.30DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7044548PMC
June 2019

Proximal and Distal Risk Factors for Gambling Problems Specifically Associated with Electronic Gaming Machines.

J Gambl Stud 2020 Mar;36(1):277-295

Experimental Gambling Research Laboratory, School of Health, Medical and Applied Sciences, CQUniversity, 400 Kent St, Sydney, NSW, 2000, Australia.

Electronic gaming machines (EGMs) are widely used and the gambling product most commonly associated with harmful gambling. Understanding factors that increase the risk of problematic EGM play is therefore important. Previous studies into risk factors for EGM gambling have used measures of problem gambling based on an individual's total gambling activity, which therefore do not distinguish harmful gambling specifically associated with EGMs. This study used an EGM-specific measure (PGSI-EGM) to achieve its aim of identifying risk factors specifically associated with problematic EGM play. By removing nuisance effects from other gambling forms that higher-risk gamblers typically engage in, this approach provides a more accurate assessment of the determinants of EGM-related problems. An online survey was completed by 1932 at-least monthly EGM players in Australia. It measured demographics, EGM gambling behaviour, motivations, gambling urges, gambling fallacies, trait self-control, alcohol misuse, and the PGSI-EGM. A penalised regression model identified the most important proximal predictors of higher-risk EGM gambling as: higher gambling urges, higher levels of erroneous cognitions, playing EGMs more frequently, higher session expenditure, longer sessions, usually playing EGMs alone, and playing EGMs in more venues. Lower trait self control was the strongest distal determinant. Higher-risk EGM players tended to be younger, male, more educated, never married, to have higher (although still modest) incomes, and be more likely to have alcohol problems. These findings can inform interventions such as treatment, consumer education and venue interventions.
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http://dx.doi.org/10.1007/s10899-019-09867-8DOI Listing
March 2020

A Multivariate Evaluation of 25 Proximal and Distal Risk-Factors for Gambling-Related Harm.

J Clin Med 2019 Apr 13;8(4). Epub 2019 Apr 13.

Faculty of Extension, University of Alberta, Edmonton, AB T6G 2R3, Canada.

Individual differences in the risk of developing gambling-related harm play an important role in theoretical models and practical interventions. The present study attempted comprehensive measurement and evaluation of 25 known risk factors for gambling-related harm in order to determine which factors provided large and unique explanatory power. We surveyed 1650 regular gamblers from an online panel, screening in 1174 (466 male) who passed all checks of attention and response consistency. We evaluated each risk factor based on bivariate correlations with harms, then made separate multivariate evaluations of proximal (e.g., gambling motivations) and distal (e.g., religiosity) risk factors. Almost all bivariate correlations were significant, but most distal factors were not significant in multivariate models. Trait impulsivity was the most important risk factor by a large margin. Excessive consumption, less use of safe gambling practices, and more fallacies were key proximal risks of harm. Many well-known correlates of gambling harm (e.g., youth, lower educational attainment) do not show a direct role in the development of gambling harm when controlling for other factors. The results support theoretical models that emphasise early conditioning and biological vulnerability (manifested through impulsivity). Since maladaptive cognitive and behavioural schemas appear to be more important than motivations (e.g., escape, excitement, ego), interventions may benefit by targeting these proximal drivers of harm.
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http://dx.doi.org/10.3390/jcm8040509DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6518151PMC
April 2019

Risk Factors for Gambling Problems Specifically Associated with Sports Betting.

J Gambl Stud 2019 Dec;35(4):1211-1228

Experimental Gambling Research Laboratory, School of Health, Medical and Applied Sciences, CQUniversity, Bundaberg, QLD, Australia.

Studies examining risk factors for problem gambling amongst sports bettors have used screens that assess gambling problems in general. Because people experiencing gambling-related problems tend to gamble on multiple forms, it is unclear whether problems identified amongst sports bettors are due to sports betting itself. The present study examined a range of distal and proximal demographic, behavioural and psychological risk factors using a modified version of the Problem Gambling Severity Index which respondents answered only in relation to their sports betting. In general, those at risk were younger, spoke a language other than English, were more engaged sports bettors and gamblers, and tended not to watch the event they had bet on. They particularly endorsed money-oriented motivations, and had higher erroneous cognitions, gambling urges, and were more likely to experience alcohol issues. Higher-risk sports bettors were also more likely to apportion less responsibility for their gambling to themselves, and to have lower self control. A penalised model found that key predictors were money motivations, gambling urges and erroneous cognitions, alcohol issues and lower self-control, but not sports betting behaviour. These findings suggest that one's psychological relationship to sports betting is a primary driver of gambling-related problems, rather than just betting behaviour. As sports betting expands through new products and legalisation in additional jurisdictions, understanding who is most at risk from this form of gambling is important to inform legislation as well as harm reduction and treatment measures.
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http://dx.doi.org/10.1007/s10899-019-09848-xDOI Listing
December 2019

The impact of exposure to wagering advertisements and inducements on intended and actual betting expenditure: An ecological momentary assessment study.

J Behav Addict 2019 Mar 28;8(1):146-156. Epub 2019 Mar 28.

Australian Gambling Research Centre,Australian Institute of Family Studies, Melbourne, VIC,Australia.

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.

Methods: 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.

Results: 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.
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http://dx.doi.org/10.1556/2006.8.2019.10DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7044597PMC
March 2019

Psychiatric inpatient cost of care before and after admission at a residential subacute step-up/step-down mental health facility.

J Med Econ 2019 May 15;22(5):491-498. Epub 2019 Mar 15.

a Centre for Indigenous Health Equity Research and School of Health, Medical and Applied Sciences, Psychology and Public Health Department , CQUniversity , Brisbane , Australia.

Background: Residential step-up/step-down services provide transitional care and reintegration into the community for individuals experiencing episodes of subacute mental illness. This study aims to examine psychiatric inpatient admissions, length of stay, and per capita cost of care following the establishment of a step-up/step-down Prevention And Recovery Care (PARC) facility in regional Australia.

Methods: This was a pragmatic before and after study set within a participatory action research methodology. The target sample comprised patients at a PARC facility over 15 months. Six-month individual level data prior to study entry, during, and over 6-months from study exit were examined using patient activity records. Costs were expressed in 2015-2016AU$.

Results: An audit included 192 people experiencing 243 episodes of care represented by males (58%), mean age = 39.3 years (SD = 12.7), primarily diagnosed with schizophrenia (48%) or mood disorders (30%). The cost of 1 day in a psychiatric inpatient unit was found to be comparable to an average of 5 treatment days in PARC; the mean cost difference per-bed day (AU$1,167) was associated with fewer and shorter inpatient stays. Reduced use of inpatient facility translated into an opportunity cost of improved patient flow equivalent to AU$12,555 per resident (bootstrapped 95% CI = $5,680-$19,280). More noticeable outcomes were observed among those who stayed in PARC for longer during index admission (r = 0.16, p = 0.024), who have had more and lengthy inpatient stays (r = 0.52, p < 0.001 and r = 0.69, p < 0.001), and those who stepped-down from the hospital (p < 0.001). This information could be proactively used within step-up/step-down services to target care to patients most likely to benefit. Despite early evidence of positive association, the results warrant further investigation using an experimental study design with alongside economic evaluation.

Conclusion: Efforts should be directed toward the adoption of cost-effective alternatives to psychiatric inpatient facilities that provide comparable or improved patient outcomes.
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http://dx.doi.org/10.1080/13696998.2019.1588126DOI Listing
May 2019

Wagering Advertisements and Inducements: Exposure and Perceived Influence on Betting Behaviour.

J Gambl Stud 2019 Sep;35(3):793-811

Australian Gambling Research Centre, Australian Institute of Family Studies, Melbourne, VIC, Australia.

A proliferation of wagering advertising has raised concerns about its effects, especially on vulnerable gamblers. This study examined exposure to wagering advertisements and inducements, and their reported influence on the size, frequency and riskiness of bets placed-amongst regular bettors and by gambler risk group. An Ecological Momentary Assessment design minimised recall bias. After completing a baseline survey, 722 regular bettors completed up to 15 surveys administered on 5 days per week over three non-consecutive weeks. Data were analysed for the 316 race bettors and 279 sports bettors completing at least one survey. The results indicate that regular bettors have almost daily exposure to wagering advertising, including for inducements. The most frequently seen and influential advertisement types were direct messages (emails, texts and/or phone calls from wagering operators, which, in Australia, bettors are automatically opted-into when opening a betting account) and advertisements on betting websites or apps. Participants reported the most influential inducements to be: stake-back offers, multi-bet offers, match your stake or deposit offers, better odds/winnings inducements, happy hours, rewards programs, and cash out early offers. The findings indicate that wagering advertisements, including for inducements, are likely to be having powerful effects on regular bettors. On each day that respondents saw these advertisements (most days for most advertisement types), substantial minorities reported increased size and frequency of betting. Results did not vary by gambler risk group. Understanding which types of wagering advertising are associated with most gambling-related harm can inform advertising regulations, targeted public health interventions, and future research.
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http://dx.doi.org/10.1007/s10899-018-09823-yDOI Listing
September 2019

Social influences normalize gambling-related harm among higher risk gamblers.

J Behav Addict 2018 Dec;7(4):1100-1111

3 Experimental Gambling Research Laboratory, School of Health, Medical and Applied Sciences, CQUniversity , Bundaberg, QLD, Australia.

Background And Aims: Social influences are key drivers of gambling, and can begin in youth through parental modeling and facilitation. Over time, social influence from friends and colleagues also becomes important. Social network analysis provides a method to measure the combined nature of these social influences. This study aimed to compare social influences across gambling risk groups, by examining key characteristics of the social networks, among Australian adults.

Methods: A total of 784 respondents (egos) reported their demographics, gambling behavior and gambling risk, as well as those of the 20 most influential people in their lives (alters). Egos also reported the strength of the connection between themselves and each of their alters, and between each pair of alters. Data were analyzed using egocentric social network analysis approaches.

Results: Egos in higher risk groups reported more alters who gamble, including a higher proportion experiencing gambling-related harm. Relationship strength indicated that egos in higher risk groups tended to feel closer to their alters, regardless of whether the alter gambles or not. Network density (interconnectedness between alters) was greater for egos in higher risk groups.

Discussion And Conclusions: The findings indicate that both gambling behavior and gambling-related harm are normalized through social connections. Greater interconnectedness in the networks of higher risk gamblers indicates difficulties in reducing or removing these influences. The findings indicate limitations of individualised interventions, and instead highlight the important role of changing norms within society, which can be transmitted throughout these networks.
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http://dx.doi.org/10.1556/2006.7.2018.139DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6376388PMC
December 2018

Who Bets on Micro Events (Microbets) in Sports?

J Gambl Stud 2019 Mar;35(1):205-223

Department of Entrepreneurship, Innovation and Marketing, La Trobe Business School, La Trobe University, Bundoora, VIC, Australia.

Sports betting is expanding globally through introduction into new markets and growth in existing markets. Traditionally, bets were placed on the outcome of a match before match commencement, with the outcome not determined for hours or even days. The advent of in-play betting has reduced the delay between bet and outcome. A controversial form of in-play betting is betting on micro events (micro-betting), where consumers bet on outcomes such as the next ball in cricket, or the next point in tennis, with the outcome determined almost immediately. This enables rapid, impulsive and continuous betting and may heighten the risk of problem gambling. We surveyed 1813 Australian sports bettors to determine demographic, behavioural and psychological characteristics of micro event bettors, and of those who place a higher proportion of their bets on micro events. Our two hypotheses were supported: that more highly engaged bettors, including those with gambling problems, are more likely to (1) bet on micro events, and (2) place more of their bets on micro events. Of those who bet on micro events, 78% met criteria for problem gambling, and only 5% non-problem gambling (vs 29% and 28% respectively for non micro event bettors). Placing a higher proportion of bets on micro events was also related to problem gambling. Micro event bettors were likely to: be younger, well educated and single; engaged in a wider variety of gambling activities; and to have high trait impulsivity. Micro event betting appears to appeal almost exclusively to bettors with gambling problems, so a ban would represent a highly targeted intervention to reduce gambling-related harm.
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http://dx.doi.org/10.1007/s10899-018-9810-yDOI Listing
March 2019

Are direct messages (texts and emails) from wagering operators associated with betting intention and behavior? An ecological momentary assessment study.

J Behav Addict 2018 Dec 24;7(4):1079-1090. Epub 2018 Oct 24.

3 Experimental Gambling Research Laboratory, School of Health, Medical and Applied Sciences, CQUniversity , Melbourne, VIC, Australia.

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.

Methods: 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.

Results: 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.
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http://dx.doi.org/10.1556/2006.7.2018.99DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6376386PMC
December 2018

Where's the Bonus in Bonus Bets? Assessing Sports Bettors' Comprehension of their True Cost.

J Gambl Stud 2019 Jun;35(2):587-599

Experimental Gambling Research Laboratory, School of Health, Medical and Applied Sciences, CQUniversity, University Drive, Bundaberg, QLD, 4670, Australia.

Wagering inducements with bonus bets are prominently marketed and often have play-through conditions requiring further expenditure. However, these conditions are not usually presented in the inducement advertisement and may be difficult to locate. The play-through conditions themselves are complex and may lead bettors to miscalculate the inducement's true cost. Therefore, in relation to inducements with bonus bets, this study aimed to assess: (1) whether their perceived attractiveness varies with the amount and type of information provided about their play-through conditions; (2) bettors' comprehension of their true cost; and (3) whether bettors' comprehension of their true cost varies with problem gambling severity. A sample of 299 Australian sports bettors completed an online survey and rated the attractiveness of three variations of an inducement. Promo1 simply noted that "terms and conditions apply"; promo2 included the terms and conditions immediately below the offer; and promo3 revealed the true cost of the offer. Respondents were asked to calculate the true cost before this was revealed. The study found that detailing key terms and conditions for an offer directly below the advertisement impacts negatively on its perceived attractiveness. Moreover, nearly three in five bettors underestimated the additional amount they would need to bet to access any winnings from the bonus bet. No significant differences were found amongst gambler risk groups. The results imply that current approaches to marketing these inducements are likely to lead consumers to overestimate their attractiveness and underestimate their cost. To enhance responsible gambling practice, these promotional offers should be presented in ways that enable informed decision-making.
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http://dx.doi.org/10.1007/s10899-018-9800-0DOI Listing
June 2019

Gambling Risk Groups are Not All the Same: Risk Factors Amongst Sports Bettors.

J Gambl Stud 2019 Mar;35(1):225-246

Department of Entrepreneurship, Innovation and Marketing, La Trobe Business School, La Trobe University, Bundoora, VIC, Australia.

Sports betting is increasing worldwide, with an associated increase in sports betting-related problems. Previous studies have examined risk factors for problem gambling amongst sports bettors and have identified demographic, behavioural, marketing, normative and impulsiveness factors. These studies have generally compared those in problem gambling, or a combination of moderate risk and problem gambling, groups to non-problem gamblers, often due to statistical power issues. However, recent evidence suggests that, at a population level, the bulk of gambling-related harm stems from low risk and moderate risk gamblers, rather than problem gamblers. Thus it is essential to understand the risk factors for each level of gambling-related problems (low risk, moderate risk, problem) separately. The present study used a large sample (N = 1813) to compare each gambling risk group to non-problem gamblers, first using bivariate and then multivariate statistical techniques. A range of demographic, behavioural, marketing, normative and impulsiveness variables were included as possible risk factors. The results indicated that some variables, such as gambling expenditure, number of accounts with different operators, number of different types of promotions used and impulsiveness were significantly higher for all risk groups, while others such as some normative factors, age, gender and particular sports betting variables only applied to those with the highest level of gambling-related problems. The results generally supported findings from previous literature for problem gamblers, and extended these findings to low risk and moderate risk groups. In the future, where statistical power allows, risk factors should be assessed separately for all levels of gambling problems.
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http://dx.doi.org/10.1007/s10899-018-9765-zDOI Listing
March 2019