'Getting addicted to it and losing a lot of money it's just like a hole.' A grounded theory model of how social determinants shape adolescents' choices to not gamble.

BACKGROUND: Gambling abstinence when underage lowers the risk of harmful gambling in later life. However, little research has examined why many young people refrain from gambling, even though this knowledge can inform protective strategies and lower risk factors to reduce underage gambling and subsequent harm. This study draws on the lived experience of adolescent non-gamblers to explore how social determinants while growing up have shaped their reasons and choices to not gamble. METHODS: Fourteen Australian non-gamblers, aged 12-17 years, participated in an in-depth individual interview (4 girls, 3 boys) or online community (4 girls, 3 boys). Questions in each condition differed, but both explored participants' gambling-related experiences while growing up, including exposure, attitudes and behaviours of parents and peers, advertising, simulated gambling and motivations for not gambling. The analysis used adaptive grounded theory methods. RESULTS: The grounded theory model identifies several reasons for not gambling, including not being interested, being below the legal gambling age, discouragement from parent and peers, concern about gambling addiction and harm, not wanting to risk money on a low chance of winning, and moral objections. These reasons were underpinned by several social determinants, including individual, parental, peer and environmental factors that can interact to deter young people from underage gambling. Key protective factors were parental role modelling and guidance, friendship groups who avoided gambling, critical thinking, rational gambling beliefs, financial literacy and having other hobbies and interests. CONCLUSIONS: Choices to not gamble emanated from multiple layers of influence, implying that multi-layered interventions, aligned with a public health response, are needed to deter underage gambling. At the environmental level, better age-gating for monetary and simulated gambling, countering cultural pressures, and less exposure to promotional gambling messages, may assist young people to resist these influences. Interventions that support parents to provide appropriate role modelling and guidance for their children are also important. Youth education could include cautionary tales from people with lived experience of gambling harm, and education to increase young people's financial literacy, ability to recognise marketing tactics, awareness of the risks and harms of gambling, and how to resist peer and other normalising gambling influences.

Skill-Based Electronic Gaming Machines: Features that Mimic Video Gaming, Features that could Contribute to Harm, and Their Potential Attraction to Different Groups.

New gambling products have been developed over time as technology permits. For example, early mechanical slot machines were later replaced by electronic gaming machines (EGMs), which enabled a faster speed of play and more immersive experience. EGMs have in the decades since their invention become one of the main drivers of gambling expenditure worldwide and are one of the gambling products most strongly associated with harm. This literature review considers research relevant to a new subcategory of EGM, 'skill-based' EGMs, termed 'SGMs' here. SGMs can be highly varied in content, with some representing a minimal departure from EGMs, where the typical bonus round is replaced by some skill-based activity, such as a simple video game, which could increase the machine's appeal. Other SGMs feature more radical departures from conventional EGMs, such as multiplayer games using intellectual property from popular TV shows or video games. These skill-based elements could tap into common gambling fallacies such as the illusion of control, and therefore facilitate harmful engagement. SGMs could also be less harmful than current EGMs, if skill-based elements break the dissociative states associated with EGM gambling. The intellectual property used in SGMs may increase their appeal among people who generally do not gamble, and the skill-based elements could increase their interest among gamblers who predominately prefer skill-based gambling formats such as sports betting. The novelty and varied content of SGMs present many open questions, which research should aim to address in future.

Intimate partner violence linked to gambling: cohort and period effects on the past experiences of older women.

BACKGROUND: Problem gambling increases the risk of experiencing intimate partner violence (IPV). People impacted by gambling-related IPV face distinctive challenges, and these may be compounded by intersections with gender, generational influences and contextual factors. This study explored the past experiences of older women affected by male partner violence linked to gambling, and how these were shaped by cohort and period effects and problem gambling. Cohort effects are the generational characteristics of a group born at a particular time, while period effects relate to prevailing external conditions at the time of the abuse, including laws, services and practices. METHODS: A larger study exploring the nature of the relationship between problem gambling and IPV recruited 72 women through help services and advertising. The current study analysed a subset of interviews with 22 women aged 50 years or over. We analysed the data using adaptive grounded theory to explore the intersection between IPV, gambling, and cohort and period effects. RESULTS: Cohort effects on the women's experiences of IPV included gendered attitudes, traditional views of marriage, silence surrounding IPV, reticence to disclose the abuse, and little understanding of problem gambling. These influences deterred women from questioning their partner's gambling, and to instead keep the gambling and abuse hidden. Many women did not recognise abuse linked to gambling as IPV, since gambling was considered a normal, harmless pastime. Having a gambling problem exacerbated violence and coercive control by male partners as traditional gender norms supported male authority over their female partner. Women with a gambling problem sometimes felt they deserved the abuse. Period effects included a lack of IPV and gambling services, gendered service responses, failure to prioritise the women's safety, and no consideration by services of the role of gambling in the abuse. CONCLUSION: Reducing gender inequality is critical to reduce male partner violence towards women. Women impacted by gambling-related IPV, including the legacy of past abuse, need service responses that recognise all forms of abuse, understand the historical and contextual factors that exacerbate it, and recognise how gambling can amplify IPV. A reduction in problem gambling is needed to reduce gambling-related IPV.

Skin Gambling Contributes to Gambling Problems and Harm After Controlling for Other Forms of Traditional Gambling.

Esports betting and skin gambling involve betting on the outcomes of video game competitions and/or using virtual currencies for betting. The present study evaluated a conceptual model linking video game involvement, video-game related gambling, traditional gambling, and gambling problems and harm. Data were collected via a cross-sectional online survey with 737 participants aged 18 + who engaged in esports cash betting (n = 576), esports skin betting (n = 184), or skin gambling on games of chance (n = 330). The findings highlighted the distinctly different relationships esports cash betting versus skin gambling had with traditional gambling involvement and harmful gambling. Gambling with skins on games of chance was predictive of gambling problems and gambling harm after controlling for participation in traditional gambling (OR = 1.32 and 1.17 respectively). Whereas betting on esports with cash was associated with betting on a variety of other forms of gambling, and there was no unique contribution to problems and harm over and above participation on these other forms (e.g., EGMs, sports betting). Skin gambling is directly implicated in gambling problems and harm, whereas cash betting on esports is only indicative of interest in many forms of potentially harmful gambling. Greater research attention to skin gambling is warranted, and particularly with respect to its role as a virtual currency more easily accessible for gambling.

Motivations for Esports Betting and Skin Gambling and Their Association with Gambling Frequency, Problems, and Harm.

This study aimed to examine gambling motivations for esports betting and skin gambling and their association with gambling frequency, problems, and harm. Data were collected via a cross-sectional online survey with 736 participants aged 18 + who engaged in esports cash betting (n = 567), esports skin betting (n = 180), or skin gambling on games of chance (n = 325). Respondents were asked to rate their motivations for the three activities across seven domains: social, financial, positive feelings or enhancement, internal regulation, skill building, competition/challenge, and skin acquisition. The results highlight both similarities and differences in gambling motivations across products. Financial gain and enhancement (i.e., excitement) were the main motivations endorsed for all activities, whereas skin acquisition was an additional motivation for esports skin betting and skin gambling. Across all three products, gambling to escape or improve mood was associated with higher levels of problem gambling and harm. Financial gain motivation was associated with problem gambling only for esports skin betting and skin gambling on games of chance. These findings underscore the importance of considering motivational influences on engagement with emerging gambling activities, especially since some motivations may be a contributing factor in harmful gambling outcomes.

Seeking Solace in Gambling: The Cycle of Gambling and Intimate Partner Violence Against Women Who Gamble.

This study explored women's gambling in response to male intimate partner violence (IPV). Twenty-four women were recruited through service providers and online advertising. All women had been victimised by IPV and all experienced problems relating to the gambling on electronic gaming machines (EGMs). Thematic analysis of their in-depth interviews identified three major themes. The main pattern of gambling and IPV (Theme 1) was where ongoing coercive control preceded the woman's gambling. Situational violence in response to gambling was also observed. Regardless of temporal sequence, a self-perpetuating cycle of gambling and IPV victimisation was typically apparent, with both issues escalating over time. Reflecting severe traumatic violence, push factors from IPV that motivated the women's gambling (Theme 2) included physical escape, psychological escape, hope of regaining control over their lives, and gambling to cope with the legacy of abuse. Pull factors attracting these women to gambling venues (Theme 3) appeared to have heightened appeal to these victims of IPV. These included venues' social, geographic and temporal accessibility, allowance for uninterrupted play on EGMs, and the addictive nature of EGMs. These push and pull factors led to these women's prolonged and harmful gambling while exacerbating their partner's violence. Concerted efforts are needed to assist women in this cycle of IPV and gambling, prevent violence against women, and reduce harmful gambling products and environments.

Designing Improved Safer Gambling Messages for Race and Sports Betting: What can be Learned from Other Gambling Formats and the Broader Public Health Literature?

Safer gambling messages are one potential input to a public health approach toward reducing gambling-related harm, and yet there is no strong evidence supporting current messages such as "gamble responsibly" or "keep the fun in the game". Furthermore, sports betting is increasing in popularity in multiple jurisdictions, such as Australia and the US, increasing the need to design effective messaging campaigns for race and sports betting. Compared to other gambling formats, such as electronic gambling machines, the level of potential skill involved in race and sports betting may raise unique issues regarding the design of effective messages. This review first highlights research from the related public health domains of alcohol and tobacco. Then, five potential areas for further messaging-based research in race and sports betting are discussed: teaching safer gambling practices, correcting gambling misperceptions, boosting conscious decision making, norm-based messages, and emotional messages. A broad approach to message design is encouraged, given the potential for individual differences in message receptivity, and for frequently-repeated messages to be ignored or cause negative psychological reactance.

Strengthening the service experiences of women impacted by gambling-related intimate partner violence.

BACKGROUND: While problem gambling does not directly cause intimate partner violence (IPV), it exacerbates that violence significantly. Women experiencing both gambling harm and IPV often find themselves in challenging situations; furthermore, stigma and shame frequently act as barriers to seeking help from health and social service agencies. Despite the links between problem gambling and IPV, little is known about women's experiences of using support services for both IPV and gambling related issues. This paper explores positive experiences of help-seeking for gambling-related IPV in Australia by adopting a strengths-based research approach. METHODS: Qualitative, unstructured interviews were conducted for a larger study exploring the nature of the relationship between problem gambling and IPV. To gain new insights into the service experiences of women impacted by gambling related IPV, interviews with 48 women with lived experience of IPV relating to a male partner's gambling, and 24 women with lived experience of IPV relating to their own gambling were reanalysed using thematic analysis. RESULTS: Three themes emerged from the data signifying or demonstrating strength-based responses: 'Commitment to Integrated and Collaborative Responses'; 'Therapeutic Support'; and 'Instrumental Support'. The themes highlight the importance of recognising the intersectionality of gambling related IPV and supporting the person 'at the centre of the service'. Tangible and instrumental supports, such as emergency accommodation and financial assistance, were also central to the recovery process. CONCLUSION: Effective service responses are dependent on understanding how problem gambling and IPV intersect. Importantly, service providers must recognise and address the many facets of each woman's situation and the shame associated with resolving interdependent and complex issues. Responding to the needs of women impacted by gambling related IPV requires both individual-level awareness and organisational support; recommendations to strengthen service provision are provided.

Benchmarking gambling screens to health-state utility: the PGSI and the SGHS estimate similar levels of population gambling-harm.

BACKGROUND: Both the Problem Gambling Severity Index (PGSI) and the Short Gambling Harms Screen (SGHS) purport to identify individuals harmed by gambling. However, there is dispute as to how much individuals are harmed, conditional on their scores from these instruments. We used an experienced utility framework to estimate the magnitude of implied impacts on health and wellbeing. METHODS: We measured health utility using the Short Form Six-Dimension (SF-6D), and used this as a benchmark. All 2603 cases were propensity score weighted, to balance the affected group (i.e., SGHS 1+ or PGSI 1+ vs 0) with a reference group of gamblers with respect to risk factors for gambling harm. Weighted regression models estimated decrements to health utility scores attributable to gambling, whilst controlling for key comorbidities. RESULTS: We found significant attributable decrements to health utility for all non-zero SGHS scores, as well as moderate-risk and problem gamblers, but not for PGSI low-risk gamblers. Applying these coefficients to population data, we find a similar total burden for both instruments, although the SGHS more specifically identified the subpopulation of harmed individuals. For both screens, outcomes on the SF-6D implies that about two-thirds of the 'burden of harm' is attributable to gamblers outside of the most severe categories. CONCLUSIONS: Gambling screens have hitherto provided nominal category membership, it has been unclear whether moderate or 'at-risk' scores imply meaningful impact, and accordingly, population surveys have typically focused on problem gambling prevalence. These results quantify the health utility decrement for each category, allowing for tracking of the aggregate population impact based on all affected gamblers.

How structural changes in online gambling are shaping the contemporary experiences and behaviours of online gamblers: an interview study.

BACKGROUND: Over the last decade, the provision of online gambling has intensified with increased access, enhanced betting markets, a broader product range, and prolific marketing. However, little research has explored how this intensification is influencing contemporary gambling experiences. This study focused on two research questions: 1) What changes in online gambling have online gamblers observed over the past decade? 2) How have these changes influenced the online gambling experiences and behaviours reported by treatment-seeking and non-treatment-seeking gamblers? METHODS: Two samples of Australian adults were interviewed: 1) 19 people who had been gambling online for at least a decade and with no history of treatment-seeking for online gambling, and 2) 10 people who had recently sought professional help for an online gambling problem. Telephone interviews were semi-structured, with questions that encouraged participants to consider how their online gambling, including any harmful gambling, had been influenced by changes in operator practices and online gambling environments. Data were analysed using thematic analysis. RESULTS: Both treatment- and non-treatment-seekers noted the increased speed and ease of online gambling, which now enables instant access from anywhere at any time and increased their gambling opportunities. Both groups highlighted the continued proliferation of advertising and inducements for online gambling, particularly during televised sports and racing events, in social media, and through targeted push marketing. Many treatment- and non-treatment-seekers were aware of the vast range of recently introduced bet types, particularly multi-bets. Treatment-seekers disproportionately reported negative effects from these changes, and described how and why they fostered their increased gambling, impulsive gambling, persistence and loss-chasing. They reported limited uptake and effectiveness of current harm minimisation tools. CONCLUSIONS: Counter to stated policy and practice objectives to minimise gambling harm, industry changes that have made online gambling easier, faster, and more heavily incentivised, and increased the array of complex bets with poorer odds, unduly affect addicted and harmed individuals - who are also the most profitable customers. Further consideration is needed to ensure gambling policy, industry practices and public health measures more effectively reduce gambling harm in contemporary settings. Inducements and the poor pricing of complex bets such as multi-bets, and their outsized attraction to players with problems, should be a key focus.

Stressful Life Events Precede Gambling Problems, and Continued Gambling Problems Exacerbate Stressful Life Events; A Life Course Calendar Study.

Do stressful life events cause gambling problems, or do gambling problems cause stressful life events? This study used a retrospective design to examine the temporal order of these associations. Specifically, the study employed a life course calendar in a self-directed online survey to minimise memory biases common in retrospective designs. A total of 1564 US respondents who had gambled at any point in their life (51.0% female, median age 46) were asked whether, for each year of their adult life, they had experienced each of eight stressful life events, and whether they had engaged in casual or heavy gambling, drinking or drug use, with heavy gambling defined in line with a problem gambling definition. We found that five stressful life events were associated with the onset of heavy gambling: work issues, financial issues, legal issues, relationship issues and the death of a loved one. The same five stressful life events predict the cessation of an episode of heavy gambling, indicating a possible tendency for gambling problems to self-resolve in the presence of stress. Insights are also gained into comorbidities with alcohol and drug use, and the course of stressful life events and gambling and substance use throughout the life course, albeit with a non-representative sample. The methodology allows tentative conclusions in terms of possible causation pathways, indicating that stressful life events may play a role both in the onset and the maintenance (or cessation) of gambling problems.

The Relationship Between Family Gambling Problems, Other Family Stressors, and Health Indicators in a Large Population-Representative Sample of Australian Adults.

PURPOSE: Harms due to excessive gambling can be experienced by gamblers and those close to them. Family gambling problems (FGPs) are currently under-researched, particularly in population-representative samples. This study aimed to identify prevalence, risk factors, and the complex of stressors and health-related consequences associated with FGPs, as well as isolating the impact of FGPs on physical and psychological health problems. METHODS: We analysed data from the National Health Survey 2011-13, a large (N = 15,475) nationally representative sample of Australian adults. Participants reported on the presence of 14 family stressors (including FGPs), self-assessed health status, and risky health behaviours. Psychological impact was measured by the Kessler Psychological Distress Scale-10, as well as several indicators of the presence of mental health problems. RESULTS: Overall, 1.7% of households reported a FGP. Interviewees in these households reported three times the number of other stressors than those without a FGP. In addition, they were around eight times more likely to be experiencing other addictions (drug and alcohol related problems) and stressors associated with socially deviant behaviours (trouble with police, abuse or violent crime, and witness to violence). Once age, gender, socioeconomic disadvantage, and other stressors were controlled for, FGPs significantly predicted lower self-assessed health and higher psychological distress. CONCLUSIONS: FGPs occur within a complex of other addictions and stressors, impacting the quality of life of people close to problem gambling. The findings are discussed in relation to their support for General Strain Theory (Agnew, Criminology 30:47-87, 1992).

A framework for indirect elicitation of the public health impact of gambling problems.

Gambling problems are increasingly understood as a health-related condition, with harms from excessive time and money expenditure contributing to significant population morbidity. In many countries, the prevalence of gambling problems is known with some precision. However, the true severity of gambling problems in terms of their impact on health and wellbeing is the subject of ongoing debate. We firstly review recent research that has attempted to estimate harm from gambling, including studies that estimate disability weights using direct elicitation. Limitations of prior approaches are discussed, most notably potential inflation due to non-independent comorbidity with other substance use and mental health conditions, and potential biases in the subjective attribution of morbidity to gambling. An alternative indirect elicitation approach is outlined, and a conceptual framework for its application to gambling is provided. Significant risk factors for propensity to develop gambling problems are enumerated, and relative risks for comorbidities are calculated from recent meta-analyses and reviews. Indirect elicitation provides a promising alternative framework for assessing the causal link between gambling problems and morbidity. This approach requires implementation of propensity score matching to estimate the counterfactual, and demands high quality information of risk factors and comorbid conditions, in order to estimate the unique contribution of gambling problems. Gambling harm is best understood as a decrement to health utility. However, achieving consensus on the severity of gambling problems requires triangulation of results from multiple methodologies. Indirect elicitation with propensity score matching and accounting for comorbidities would provide an important step towards full integration of gambling within a public health paradigm.

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

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.

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

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.

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

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.

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

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.

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

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.

Risk Factors for Gambling Problems Specifically Associated with Sports Betting.

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.

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

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.