Gambling in Victoria: Changes in Participation, Problem Gambling and Gambling Environment Between 2008 and 2018.

Gambling and its impacts are an important public health issue. The relationship between gambling, problem gambling and gambling harm is complex and dynamic. Replicate prevalence studies are useful for surveillance and monitoring gambling impacts within jurisdictions. The purpose of this study was to compare changes in gambling and problem gambling in the Victorian adult population between 2008 and 2018 by investigating individual gambling activities and exploring their relationship with the Victorian gambling ecosystem. Gambling participation has decreased; problem gambling prevalence has not. Investigation beyond these summary measures reveals important details: (a) Electronic Gaming Machines (EGMs), casino table games, race and sports betting ('high-risk activities'), informal private betting, and Keno, and their associations with problem gambling endure. Further, the strength of this association is unaffected by changes in product technology, delivery, or the Victorian environment in which they reside, (b) participation in high-risk activities, excluding EGMs, increased while for other activities they decreased, (c) EGMs continue to pose the greatest risk for Victorians, (d) males and young adults continue having a higher problem gambling prevalence rate and preferring both online gambling and high-risk activities (excluding racing favoured by an ageing, older cohort, and Keno, by all ages), and (e) gambling access and exposure proliferated enabling single site multiple gambling opportunities on high-risk activities. Young adults represented a new vulnerable group as they reach the legal gambling age. The most effective interventions (based on major falls in real expenditure (losses) on EGMs, the highest risk activity) were the smoking bans, removal of ATMs from venues and decreases in bet size. There is great potential for prevention, intervention, and minimising harm in the gambling environment.

Charting a path towards a public health approach for gambling harm prevention.

Aim: Gambling harm is a serious public health issue affecting the health, financial security, and social well-being of millions of people and their close relations around the world. Despite its population health implications, gambling harm is not typically viewed and treated as a public health policy issue. This paper critically reviews the evolution of the public health perspective on gambling harm. It also considers how gambling harm can be operationalized within a public health model. Methods: A critical historical review of the emerging public health perspective on gambling harm was conducted. Key documents covering three decades of development were reviewed and appraised through a process of deliberation and debate over source impact in the fields of research, policy, and programming internationally. Results: The first decade mainly focused on identifying gambling harm and framing the public health issue. The second decade featured the expansion of health assessment and emerging areas of policy and program development. The third decade saw an increased focus on public health frameworks that advanced understanding of harm mechanics and impact. As reflected by the essential functions of a general public health model, gambling harm prevention efforts emphasize health promotion over other key functions like health assessment and surveillance. Conclusion: Gambling harm is a public health issue requiring greater attention to health assessment and surveillance data development.

Gambling and Problem Gambling in Victoria, Australia: Changes over 5 years.

Rates of gambling and gambling-related harm fluctuate over time, influenced by availability, adaptation and demographic change, among other things. Assessing change is compromised by methodological variation. The main aim of this paper is to assess change in gambling participation and problems in adult Victorians over a 5-year period. Data are from the Victorian Gambling Study (VGS) 2008-2012 (n = 15,000) and the 2003 Victorian Longitudinal Attitudes Survey (n = 8479). An additional aim was to determine the impact of methodological differences on prevalence estimates. Despite gambling availability increasing and more activities being included participation rates declined substantially. Decreases occurred across almost all demographic groups and gambling activities. When adjustments were made for methodological differences there were no significant changes in problem, moderate risk and low risk gambling. Males and people with lower education had higher rates in both surveys. In the latter survey, two groups that experienced large participation reductions, namely young adults and metropolitan residents, emerged as additional groups with higher rates of problem and moderate-risk gambling. Further research is required to discover why overall rates of harm may have plateaued when participation continues to fall and why some groups with reduced participation experience increased harm. The findings suggest that availability and total consumption models are over-simplistic. They further suggest that to be effective prevention programmes will need to extend beyond gambling availability to include interventions directed towards individuals at risk and wider environmental determinants of vulnerability and harm. Additionally this study found that restricting administration of the problem gambling measure to subsets of gamblers generate significantly lower prevalence estimates, implying that many previous surveys under-portray gambling-related harm and that without appropriate adjustment for methodological variation findings cannot be validly compared across studies.