Motivational telephone intervention to risk gamblers by a state-owned gambling operator in Sweden.

Background and aims: Few studies have tested the effect of a motivational telephone intervention from a gambling operator to clients with high-risk gambling practices. This study aimed to study subsequent limit setting, self-exclusions and gambling post-intervention, compared to controls. Methods: The study assessed a motivational, personalized telephone intervention by the state-owned Swedish gambling operator AB Svenska Spel within its subsection of sports, poker, online casino and bingo gambling. Clients successfully reached with the telephone intervention (n = 1,420) were compared to clients who could not be reached (n = 1,504). Gambling practices during 8 weeks pre-intervention were assessed, and outcome measures limit setting, self-exclusion, and gambling 4 weeks post-intervention. Results: The telephone intervention was associated with increased limit settings (10 vs. 5 percent, p < 0.001), self-exclusions (11 vs. 8 percent, p < 0.01), lowered theoretical losses (p < 0.001), but not significantly associated with gambling abstinence (18 vs. 15 percent, p = 0.07). In unadjusted analyses of sub-groups, significant associations of the intervention with full gambling abstinence were seen in people who gamble on online casino/bingo (19 vs. 14 percent, p < 0.01), but not in sports bettors. In logistic regression, the intervention was not associated with full week 1-4 abstinence. Conclusion: A personalized motivational telephone intervention to people displaying high-risk gambling, delivered by a gambling operator, is promising, and effects were seen on the uptake of responsible gambling tools post-intervention. Effects may be more pronounced in users of chance-based, online games, than in sports bettors.

Responsible gambling through a motivational telephone intervention to high-risk gamblers - An evaluation of user satisfaction and subjective intervention effects.

Background and aims: Problem gambling causes major social and psychiatric consequences, and there is need to develop feasible harm-reducing or therapeutic interventions. It has been suggested that gambling operators with responsible gambling intentions can intervene in order to identify and help reduce the harm in problem gamblers. However, user satisfaction, and the risk of negative reactions and gamblers' transfer to other operators, rarely have been explored scientifically. Methods: This is a retrospective survey study of gamblers reached by a motivational, telephone intervention by the Swedish state-owned gambling operator (Svenska Spel), addressing gamblers with indicators of high-risk gambling practices (n = 197). Surveys were answered approximately 10 days after the intervention. Results: Thirty-seven percent perceived their gambling to have decreased due to the intervention, whereas 7% perceived their gambling instead had increased. A large majority (80%) reported a subjective favorable experience from the intervention. Forty percent reported gambling on other operators than Svenska Spel after the intervention, but only 7% gambled on a new operator following the intervention. Conclusion: Survey data in gamblers reached with a motivational telephone intervention present mainly promising findings, and should be replicated in future studies in larger samples. The main findings display an overwhelmingly favorable subjective experience, and a limited risk of gamblers migrating to other operators.

In search of lower risk gambling levels using behavioral data from a gambling monopolist.

Background and aims: Lower-risk recommendations for avoiding gambling harm have been developed as a primary prevention measure, using self-reported prevalence survey data. The aim of this study was to conduct similar analyses using gambling company player data. Methods: The sample (N = 35,753) were Norsk Tipping website customers. Gambling indicators were frequency, expenditure, duration, number of gambling formats and wager. Harm indicators (financial. social, emotional, harms in two or more areas) were derived from the GamTest self-assessment instrument. Receiver operating characteristics (ROC) curves were performed separately for each of the five gambling indicators for each of the four harm indicators. Results: ROC areas under the curve were between 0.55 and 0.68. Suggested monthly lower-risk limits were less than 8.7 days, expenditure less than 54 €, duration less than 72-83 min, number of gambling formats less than 3 and wager less than 118-140€. Most risk curves showed a rather stable harm level up to a certain point, from which the increase in harm was fairly linear. Discussion: The suggested lower-risk limits in the present study are higher than limits based on prevalence studies. There was a significant number of gamblers (5-10%) experiencing harm at gambling levels well below the suggested cut-offs and the risk increase at certain consumption levels. Conclusions: Risk of harm occurs at all levels of gambling involvement within the specific gambling commercial environment assessed in an increasingly available gambling market where most people gamble in multiple commercial environments, minimizing harm is important for all customers.

A Normative Feedback Intervention on Gambling Behavior-A Longitudinal Study of Post-Intervention Gambling Practices in At-Risk Gamblers.

Background: In problem gambling, normative personalized feedback interventions have demonstrated promising effects. Given the widespread increase in online gambling in recent years, internet-delivered normative feedback may serve as a promising intervention. This study aimed to examine whether such an intervention, delivered by a gambling operator and aiming to help problem gamblers decrease their gambling, may in fact be associated with lower gambling practices post-intervention. Methods: Online questions on norms and beliefs about one's own and peers' gambling habits, derived from the Gambling Quantity and Perceived Norms Scale, were followed by personalized feedback, delivered online by the Swedish state-owned gambling operator. A total of 1,453 gamblers consented to participate in a pre-post measure of wagering levels. Results: Wagering decreased significantly post-intervention (28 days) compared to pre-intervention (28 days prior). The decrease was significantly more pronounced in younger and online casino gamblers. In an 84-day follow-up, the decrease remained significant, although less pronounced. Conclusions: An online normative intervention delivered by a state-owned gambling operator, addressing norms and beliefs about gambling levels, may lower risky gambling in the short term. Implications and further research needs are discussed.

Effects of a National Preventive Intervention Against Potential COVID-19-Related Gambling Problems in Online Gamblers: Self-Report Survey Study.

BACKGROUND: The COVID-19 pandemic has been suspected to increase gambling problems in the population. Several governments introduced COVID-19-specific interventions early with the aim to prevent gambling problems, but their effects have not been evaluated. OBJECTIVE: This study aimed to evaluate a Swedish COVID-19-related temporary legislation imposing an automated weekly deposit limit for online casino gambling. METHODS: The study was an anonymous survey sent by a state-owned gambling operator to online gamblers (N=619), among whom 54.0% (n=334) were moderate-risk/problem gamblers who reached the weekly limit on online gambling during the summer of 2020. RESULTS: Overall, 60.1% (372/619) were aware of having been limited by the COVID-19-related deposit limit, and a minority (145/619, 23.4%) perceived the intervention as fairly bad or very bad. Among those aware of the intervention, 38.7% (144/372) believed the intervention decreased their overall gambling, whereas 7.8% (29/372) believed it rather increased it. However, 82.5% (307/372) reported having gambled at more than one operator after the limit, and the most common gambling type reported to have increased at another operator was online casino (42% among moderate-risk/problem gamblers and 19% among others; P<.001). An increase in gambling following the intervention was associated with being a moderate-risk/problem gambler and having negative attitudes toward the intervention. CONCLUSIONS: The weekly deposit limit had relatively high acceptability, but the study highlights the limitations of a single-operator deposit limit, given the high number of gamblers also reporting gambling at other operators and the lower effect in clients with gambling problems.

Responsible Gambling Telephone Intervention to High-Risk Gamblers by a State-Owned Gambling Operator in Sweden: Study Protocol for a Study on Effectiveness, User Satisfaction, and Acceptability.

Gambling disorder is associated with severe financial, social, and psychological consequences, but treatment-seeking rates have been described to be low. Apart from formal treatment, motivational interventions in nontreatment-seeking high-risk gamblers have been shown to be promising. However, little is known about the effectiveness and acceptability of such motivational interventions carried out by a gambling operator as part of the company's responsible gambling policies. Early experiences of such interventions are limited by the risk that gambling in individuals reached with the intervention may continue with a different gambling operator. The present study aims to evaluate effectiveness and user acceptability of a responsible gambling intervention continuously carried out by the Swedish state-owned gambling operator Svenska Spel Sport & Casino. This intervention for high-risk gamblers, identified either through substantial monetary losses or through a voluntary self-test by the gambler, includes a motivational telephone intervention aiming to encourage the gambler to set deposit limits, practice self-exclusion, or seek help. This protocol paper describes the two-tailed evaluation of this intervention: (1) A retrospective, register-based study of the effectiveness of the motivational intervention on gambling expenditures, deposit limits, and self-exclusions in comparison to control individuals not reached by the intervention, including all clients reached or attempted to be reached during September 2019-April 2020 (total n = 3626), as well as a one-to-one matched comparison of clients reached (n = 1404) and not reached; and (2) a prospective web survey study in individuals reached by the same ongoing telephone intervention practice from November 2020 (target n = 200), measuring clients' attitudes to the intervention, perceived effects of the intervention on gambling, and their self-reported gambling on all operators after the intervention.