Individuals with a migratory background can offer valuable insight to improve the treatment and prevention of gambling harms.

Migration is a risk factor for gambling-related harms. Little research has been conducted on gambling and gambling harms among migrant groups in Finland, but there are indications that gambling participation is high among migrants also in this context. Russian speakers constitute the largest migrant group in Finland. This study focuses on the experiences and views of Russian speakers in Finland on the Finnish gambling system and its relationship to gambling harms. The study is based on the results of qualitative data collected on gambling experiences among Russian-speaking residents of Finland. The data consist of an online survey directed at individuals who gamble (N = 26) and interviews conducted among family members of those gambling (N = 3). Russian speakers in Finland view gambling as highly normalised in the Finnish society. This normalisation reinforced by availability, accessibility, and state involvement. Russian speakers also have perspective on how to better prevent and treat gambling harms in Finland. Involving migrants with experience of different gambling systems can provide critical insight on established practices in gambling systems.

Availability restrictions and mandatory precommitment in land-based gambling: effects on online substitutes and total consumption in longitudinal sales data.

BACKGROUND: Gambling causes important harms in societies. According to the public health approach, the most effective policies to reduce harms target full populations. Availability restrictions and mandatory precommitment are among the most effective measures. However, restrictions on the availability of some gambling products or channels may also be offset by increased consumption in other products. Substitution effects can have negative public health impacts due to differing harm potential across different gambling products. This paper uses longitudinal sales data (2019-2022) from the Finnish gambling monopoly Veikkaus. During the observation period, the availability of gambling was restricted in Finland due to subsequent waves of Covid-19-related restrictions. In addition, the gambling monopoly introduced mandatory precommitment to land-based EGMs. We focus on how these restrictive policy changes impacted the total consumption of gambling and possible substitution effects. METHODS: The Finnish gambling monopoly provided weekly theoretical loss data per gambling product category and gambling channel (online, land-based) for the period of January 2019 - July 2022 based on a statutory obligation. We analysed the effects of availability restrictions and other public health measures on the consumption of different products using descriptive time series and regression analyses. We compared the sale of land-based products to online equivalents at product category level and included main policy change periods in the models. RESULTS: Total consumption of gambling declined during 2019-2022 mainly due to reduced land-based electronic gambling machine (EGM) consumption. Declines in land-based EGM sales were not offset by online alternatives or other close substitutes in the long term. However, during the first wave of Covid-19, there was an observable substitution of land-based table games by online alternatives and land-based horse betting and possibly sports betting by online horse betting. Overall, the results also show that Covid-19 functioned as a boost to an already existing trend of increasing digitalisation of gambling. CONCLUSIONS: The study provides empirical support for the effectiveness of public health-oriented policies in reducing the total consumption of gambling. Availability restrictions and mandatory precommitment are therefore likely to also reduce the burden of harms of gambling to individuals and societies.

Harmful types of gambling: changes and emerging trends in longitudinal helpline data.

BACKGROUND: Gambling products differ in terms of their harm potential. Products are also constantly developing and changing. However, little research has addressed changes and trends in the types of gambling that are associated with harms. The current study explores trends in the gambling product categories identified as harmful in longitudinal helpline data from three Nordic countries. METHODS: We use data collected by national helplines in Denmark (StopSpillet), Finland (Peluuri) and Sweden (Stödlinjen) in their daily operations (N = 46 646). The data consist of information collected on gamblers and concerned significant others who have contacted these helplines between January 2019 and December 2022. We analyse which gambling products are mentioned as harmful by clients. The analysis uses linear regression with the interaction term (country) times time regressed over the outcome variable (proportion per month). RESULTS: The results show that an increased share of contacts concern online gambling. Online casino products have become the most harmful category across contexts. The share of reported harms from online betting and new emerging online forms is also increasing. The share of land-based products as a reported source of harms has decreased across 2019-22. CONCLUSIONS: The results suggest that online gamlbing environments, and particularly online casino products, are associated with increasing harms to help-seekers. The harmfulness of different gambling products may not be stable, but change over time. Further harm prevention efforts are needed to address the online gambling field, including emerging formats.

Gambling among indebted individuals: an analysis of bank transaction data.

BACKGROUND: Gambling is connected to important financial harms, including debt. Most existing research has investigated the relationship between gambling and debt using self-reported data. Only a few studies have used objective data. The current study focuses on the gambling of indebted individuals. It investigates the amounts and types of gambling consumed by indebted individuals, and the amounts of unsecured debt among heavy gamblers. METHODS: We use past-year banking data of Finnish individuals (N = 23 231) collected between 2018 and 2021 among applicants to a debt consolidation service. The transactions consist of deposits to, and winnings paid by gambling operators, distinguished by type of gambling (sports betting, casino, lottery) as well as active loans divided into secured and unsecured loans. RESULTS: Gambling is widespread among indebted individuals in Finland. In terms of gambling types, casino-type gambling is the most popular among indebted individuals. Gambling spending is highly concentrated. Nearly half (49.5%) of all gambling deposits are concentrated among the highest spending 5% of indebted individuals. Individuals with unsecured loans have higher median losses than those without unsecured loans. CONCLUSIONS: The results suggest that gambling and indebtedness are strongly linked. The connection is stronger for individuals with unsecured debt. This has implications for prevention and treatment. Easy access to unsecured credit is likely to worsen gambling harms. Debt counselling services routinely encounter gambling-related harms and need to be equipped to manage these issues.

Public health approaches to gambling: a global review of legislative trends.

The public health community has called for governments to recognise the harms associated with gambling, and for gambling policies to include population-based harm prevention approaches. This Health Policy explores the translation of this call into global policy action by systematically reviewing legislation of jurisdictions that introduced major gambling legislation change (ie, restricting or extending gambling provision) between Jan 1, 2018, and Dec 31, 2021. We mapped the global availability of legal gambling and changes in its provision, and conducted critical frame analysis on a sample of 33 jurisdictions introducing major policy change to assess the extent to which the protection of health and wellbeing was embedded within legislation. More than 80% of countries worldwide now legally permit gambling. Harmful gambling was recognised as a health and wellbeing issue in most of the analysed jurisdictions, but near-exclusive focus was given to individual-level harms rather than to wider social and economic harms, or harms to others. Most of the proposed prevention measures focused on individual responsibility. Gambling policies worldwide are changing, but addressing gambling as a public health issue is not yet translating into comprehensive policy action across jurisdictions.

Gambling harm prevention and harm reduction in online environments: a call for action.

BACKGROUND: Gambling is increasingly offered and consumed in online and mobile environments. The digitalisation of the gambling industry poses new challenges on harm prevention and harm reduction. The digital environment differs from traditional, land-based gambling environments. It increases many risk-factors in gambling, including availability, ease-of-access, but also game characteristics such as speed and intensity. Furthermore, data collected on those gambling in digital environments makes gambling offer increasingly personalised and targeted. MAIN RESULTS: This paper discusses how harm prevention and harm reduction efforts need to address gambling in online environments. We review existing literature on universal, selective, and indicated harm reduction and harm prevention efforts for online gambling and discuss ways forward. The discussion shows that there are several avenues forward for online gambling harm prevention and reduction at each of the universal, selective, and indicated levels. No measure is likely to be sufficient on its own and multi-modal as well as multi-level interventions are needed. Harm prevention and harm reduction measures online also differ from traditional land-based efforts. Online gambling providers utilise a variety of strategies to enable, market, and personalise their products using data and the wider online ecosystem. CONCLUSION: We argue that these same tools and channels should also be used for preventive work to better prevent and reduce the public health harms caused by online gambling.

Strengthening channeling policy: the Finnish approach to protecting domestic online gambling market.

Many jurisdictions struggle to curb offshore gambling as established approaches to gambling regulation no longer apply to online gambling. This study aimed to examine the arguments used by Finnish stakeholders who discussed channeling as a tool to curb offshore gambling and the monopolistic gambling regime as a sustainable framework to tackle the issue of offshore gambling. In total, 18 Finnish public servants employed in ministries in charge of gambling matters and representatives of Veikkaus, the state-owned gambling company, were interviewed for the purpose of this study. Channeling was described by the interviewees as an important policy tool but without a regulatory framework to block offshore operation, it would remain an ideal type of political strategy. Beside the monopolistic gambling regime, the pros and cons of a potential licensing regime were discussed. This study showed that legislative and regulatory changes form a lengthy political process; the decrease of the market share of online gambling marked the beginning of a new era in Finland's gambling policy.

Gambling-related suicides and suicidality: A systematic review of qualitative evidence.

The relationship between gambling and suicides or suicidality has received much research attention in recent years. Review studies have already mapped the quantitative occurrence of suicide attempts, suicides, and self-harm among gamblers, and found a positive association. Related comorbidities and conditions have also been charted in previous reviews. However, there is still a gap in knowledge regarding the actual processes that connect gambling and suicidal behavior. To understand these processes, the current paper conducts a systematic review of qualitative evidence on gambling-related suicides and suicidality. The aim was to identify the role of gambling as well as of confounding factors in suicidality, and what kind of support suicidal individuals have received or would need. We searched for relevant literature in seven scientific databases. We included all studies that presented empirical qualitative evidence on gambling-related suicide, suicidality and/or self-harm (N = 20). The results show two main processes that connect gambling and suicidal behavior: indebtedness and shame. At the same time, suicide is a multifactorial phenomenon, and related to other confounding factors. These include psychiatric conditions, personality traits, and life conditions. In many cases, these appear to emerge as a consequence of gambling. Treatment for suicidality has been effective in some cases, but indebtedness and shame may also function as barriers to help-seeking. We conclude that effective prevention is needed by adapting a more comprehensive public health approach and population-level interventions.

Addressing gambling harms by reducing the supply of electronic gambling machines: a comparative study of Italy and Finland.

BACKGROUND: Electronic gambling machines (EGMs) are amongst the most harmful forms of gambling. The high availability of EGMs is also linked to increased consumption. To reduce the burden of EGMs on public health, policies to reduce their numbers have recently been introduced in Italy and Finland. This study compares the aims and justifications of these legislative changes, as well as their overall impacts on total consumption. METHODS: The objectives and justifications of policies to reduce the number of EGMs were based on qualitative media analysis. The impacts on total consumption were measured using financial figures provided by gambling providers in Italy and Finland. RESULTS: Results show that the reductions in EGM numbers were justified in terms of public health concerns in both countries, but the amplitude of policies varied. In Italy, the reductions were more ambitious than in Finland, and included reductions in the number of gambling locations. The financial data nevertheless indicated that the reductions may not have been significant enough. CONCLUSIONS: Public health concerns were initially highlighted in the media discussions, but eventually in both countries reduction policies were less ambitious due to industry lobbying and state revenue interests. The reductions therefore do not appear to have been effective in reducing total consumption and the burden on public health.

Treatment and help services for gambling during COVID-19: Experiences of gamblers and their concerned significant others.

Aims: During the COVID-19 pandemic, many treatment or help services for gambling were closed or moved online. At the same time, closures of gambling opportunities impacted gambling availability and practices. This study investigates gamblers' and their concerned significant others' (CSOs) experiences and views on treatment and help services during this exceptional time and perceptions on how to develop services further after the pandemic. Design: Three online questionnaires to elicit gambler and CSO experiences were conducted during the spring 2020 in Finland. In total, 847 respondents answered and shared experiences on how the situation had impacted their gambling behaviour and service needs, how service closures or the moving of services online had impacted them, and how they thought the prevention and treatment of gambling harms should be organised during and after COVID-19. Results: Changed gambling practices reduced overall service needs. Service closures had negative impacts, but online services were considered positively, as these provided a low-threshold option. Respondents also shared insights into how the service provision for gamblers should further be developed during and after COVID-19.

Socio-Demographics, Gambling Participation, Gambling Settings, and Addictive Behaviors Associated with Gambling Modes: A Population-Based Study.

Online and land-based gambling differ in terms of participation and harms. Multimode gambling has also been distinguished as a separate mode. The current study uses the Finnish Gambling 2019 population study sample of 18-74-year-old past-year gamblers (N = 3,077) to evaluate how these gambling modes differ in terms of socio-demographics, gambling participation, gambling settings, and addictive behaviors. We used land-based gambling as the reference group in a multinomial regression model. Male gender (OR 1.48), age between 18 and 54 (OR 1.88), and high income (OR 1.87) were associated with online gambling. The odds of online gambling were higher among those who gambled at least monthly (OR 1.34) and among those with the highest gambling spending (OR 3.62). Younger age (OR 2.31), high income (OR 1.51), gambling at least four game types (OR 2.96), spending the most money on gambling (OR 4.56), and gambling in at least three gambling settings were associated with multimode gambling. Socio-demographics and gambling participation were indicators of gambling modes. Online gambling was more intensive while multimode gambling was more frequent and versatile than land-based gambling. However, this was not reflected as increased addictive behaviors, probably due to the harmful nature of Finnish land-based gambling.

Gambling harms caused by electronic gambling machines should be prevented with state control.

Unlike in other Nordic countries, most of the electronic gambling machines (EGMs) are placed outside the Casino Helsinki and the gambling arcades in Finland. The placement of EGMs in non-casino locations, such as supermarkets, kiosks, and petrol stations, is matter of serious concern. We argue that availability and accessibility of EGMs has led to normalisation and banalisation of gambling in Finland. Exposure to EGMs also put at risk vulnerable populations and problem gamblers, who already suffer from the negative consequences of gambling harms. Gambling companies' self-regulation initiatives and corporate social responsibility programmes are not enough to prevent and limit EGM related gambling harms. We suggest that Finland should follow Norway's example and limit the availability of EGMs and transfer them from non-casino locations to gambling arcades. Finnish EGM policy should be a question of public policy guided by public health concerns.

On the efficiency of Nordic state-controlled gambling companies.

Aims: This article assesses the efficiency of six Nordic state-controlled gambling companies in raising revenue for their host societies, and the terms under which they operate. Finland, Sweden, Denmark and Norway have established gambling monopolies on the grounds that they help to prevent fraud and money laundering, and channel proceeds to their host societies. Within the last decade, Denmark (2012) and Sweden (2019) have opened substantial parts of their gambling markets to competition, whereas Finland and Norway continue to uphold monopolies. Design: The analysis is based on publicly disclosed income statements and financial reporting concerning Nordic gambling operators for the year 2017. We calculated how much they contribute to societies, what are the costs, and how these figures compare among the companies. Results: We found that Veikkaus raises the highest amounts of surplus to society both in absolute terms and in relative numbers, and that, overall, the companies vary in efficiency. We discuss the reasons for these differences, focusing on their respective product portfolios, institutional frameworks and competitive market positions. Conclusions: The results problematise the measurement of efficiency in gambling companies in monetary terms. Efficiency depends on high total consumption with little regard to the principles of responsible gambling and the prevention of gambling problems. Nordic countries have a strong commitment to the protection of health, but in the case of gambling, protecting the monopoly seems to outweigh harm prevention.

From Habit-Forming to Habit-Breaking Availability: Experiences on Electronic Gambling Machine Closures During COVID-19.

Electronic gambling machines (EGMs) are among the most harmful forms of gambling. The structural characteristics of EGMs prolong and reinforce gambling similarly to other habit-forming technologies. In Finland, the wide availability of EGMs in non-casino locations is likely to further reinforce the habit-creating nature of gambling offer by incorporating EGMs into everyday practices. The COVID-19 pandemic changed the landscape of gambling in Finland. The most visible change was the closure of land-based EGMs in non-casino environments, arcades, and the casino in March 2020. Since then, the status of EGMs has varied depending on the pandemic situation. The current qualitative study focuses on how Finnish past-year gamblers experience prolonged EGM closures and occasional re-openings 1 year into the pandemic. The data consist of responses to an online questionnaire eliciting experiences (N = 187) as well as interviews (N = 27, conducted in groups or alone). To aid our analysis, we employ the sociological pragmatist theory of the concept of "habit." The analysis focuses on gambler experiences on EGM shutdowns and re-openings, and views on whether closures have contributed to abstaining from gambling or to shifting to other gambling products. Policy implications of the results are discussed.

Setting Limits: Gambling, Science and Public Policy-summary of results.

The gambling industry has grown into a global business in the 21st century. This has created the need for a new emphasis on problem prevention. This article highlights the core themes of the book Setting Limits: Gambling, Science and Public Policy, taking a broad view of the consequences of gambling for society as a burden on health, well-being and equality. The book covers the extent of gambling and gambling-related problems in different societies and presents a critical review of research on industry practices, policy objectives and preventive approaches, including services to people suffering from gambling and its consequences. It discusses the developments in game characteristics and gambling environments and provides evidence on how regulation can affect those. Effective measures to minimize gambling harm exist and many are well supported by scientific evidence. They include restrictions on general availability as well as selective measures to prevent gamblers from overspending. The revenue generated from gambling for the industry, governments, and providers of public services funded from gambling returns presents an obstacle to developing policies to implement harm-reduction measures. A public interest approach must weigh these interests against the suffering and losses of the victims of gambling.

Cultures and spaces of convenience gambling.

BACKGROUND: In many countries, the bulk of gambling takes place in convenience spaces in relatively confined, local markets. Nevertheless, research on gambling locations has so far concentrated on destination gambling in casinos. AIM: This article studies convenience gambling and distinguishes special (e.g., gambling arcades) from everyday convenience gambling spaces (e.g., electronic gambling machines in supermarkets). Rather than geographically or functionally analysing the harm potential of convenience gambling, we approach the issue through cultural theory. METHOD: We conducted reception analytical group interviews with Finnish and French gamblers. This method is based on focus-group discussions stimulated by six short film clips. Our data consisted of 14 Finnish and 14 French groups, altogether 110 participants. The interviews were analysed thematically on the basis of the types of discourses the participants evoked. RESULTS: The Finnish respondents discussed how their gambling culture was embedded in their everyday lives. They saw it as a harmless pastime if the sums used were small and otherwise unbudgeted. The French informants instead strongly connected gambling with the casino and were suspicious of the easy, cheap availability of convenience gambling. They also differentiated between exceptional and mundane spaces of convenience gambling, which the interviewed Finnish gamblers did not. CONCLUSIONS: Social or cultural availability is not only a matter of access; it also influences gamblers after they have entered the gambling venue. Structural characteristics interact with the gambler and the setting, but they are also mediated by the cultural context.