Paying Attention to Women's Ageing Bodies in Recovery From Substance Use.

Background: Health-related research on women who use drugs (WWUD) tends to focus on reproductive and sexual health and treatment. Missing from the picture is an exploration of mid-life and older women's bodily experiences of transitioning from long-term substance use into recovery. While there are a growing number of studies that explore the intersection of drug use and ageing, the gaps in analysis lie in the intersections between drug use, recovery, ageing, gender, and the body. Methods: In-depth qualitative interviews were undertaken with 19 women in the UK who self-identified as "in recovery" from illicit drug use. The interviews were transcribed verbatim and analysed using Braun and Clarke's thematic analysis techniques. The study received ethical approval from the University of Glasgow. Results: Key findings from the interviews relate to the women's personal sense of power in relation to current and future health status, the challenges they endured in terms of ageing in recovery and transitioning through the reproductive life cycle, and the somatic effects of trauma on women's recovery. The findings demonstrate that health in recovery involves more than abstinence from drugs. Discussion: Moving from the body in active drug use to the body in recovery is not without its challenges for mid-life and older women. New sensations and feelings-physical and mental-must be re-interpreted in light of their ageing and drug-free bodies. This study reveals some of the substantive sex-based differences that older women in active drug use and recovery experience. This has important implications for healthcare and treatment for women in drug services and women with histories of drug use more generally.

Regulatory Resistance? Narratives and Uses of Evidence around "Black Market" Provision of Gambling during the British Gambling Act Review.

Commercial gambling is increasingly viewed as being part of the unhealthy commodities industries, in which products contribute to preventable ill-health globally. Britain has one of the world's most liberal gambling markets, meaning that the regulatory changes there have implications for developments elsewhere. A review of the British Gambling Act 2005 is underway. This has generated a range of actions by the industry, including mobilising arguments around the threat of the "black market". We critically explore industry's framing of these issues as part of their strategy to resist regulatory change during the Gambling Act review. We used a predefined review protocol to explore industry narratives about the "black market" in media reports published between 8 December 2020 and 26 May 2021. Fifty-five articles were identified and reviewed, and themes were narratively synthesised to examine industry framing of the "black market". The black market was framed in terms of economic threat and loss, and a direct connection was made between its growth and increased regulation. The articles mainly presented gambling industry perspectives uncritically, citing industry-generated evidence (n = 40). Industry narratives around the "black market" speak to economically and emotionally salient concerns: fear, safety, consumer freedom and economic growth. This dominant framing in political, mainstream and industry media may influence political and public opinion to support the current status quo: "protecting" the existing regulated market rather than "protecting" people. Debates should be reframed to consider all policy options, especially those designed to protect public health.

The impact of the initial Covid-19 lockdown upon regular sports bettors in Britain: Findings from a cross-sectional online study.

BACKGROUND: In Britain, unprecedented restrictions on daily life associated with the Covid-19 pandemic included the suspension of professional sports events during the initial 'lockdown'. This provides opportunities to observe changes in sports bettors' behaviour when their primary form of activity is removed and assess the impact of Covid-19 related circumstances upon gambling. METHODS: In July 2020, we conducted an online cross-sectional survey of people who bet regularly (at least monthly) on sports before Covid-19 (n = 3866). Bi-variate analyses compared changes in gambling behaviours before and during the initial lockdown. Multi-variate logistic regression models explored associations between problem gambling (men) and moderate risk or problem gambling (MRPG) (women) with changes in Covid-19 related circumstances and changing gambling behaviours during Britain's initial 'lockdown' (March-June 2020). RESULTS: 29.8% of male sports bettors and 33.4% of female sports bettors stopped gambling altogether during the initial Covid-19 lockdown, though 17.3% of men and 16.5% of women started a new form of gambling during lockdown. Among men, adjusted odds ratios of problem gambling were higher among those starting a new gambling activity during lockdown (OR = 2.50 [95% CI 1.38-4.53]). Among women, adjusted odds ratios of MRPG were higher among those whose frequency of gambling on any activity increased during lockdown (OR = 4.21 [1.99-8.92] and among those shielding for health reasons. Poorer wellbeing was associated with problem gambling for men and MRPG for women. CONCLUSIONS: Those changing gambling behaviours during the initial Covid-19 lockdown (e.g. increasing gambling frequency or starting a new gambling activity) are potentially vulnerable to gambling harms.

Protocol for a Mixed-Method Investigation of the Impact of the COVID-19 Pandemic and Gambling Practices, Experiences and Marketing in the UK: The "Betting and Gaming COVID-19 Impact Study".

The COVID-19 pandemic led to unprecedented restrictions on people's movements and interactions, as well as the cancellation of major sports events and social activities, directly altering the gambling landscape. There is urgent need to provide regulators, policy makers and treatment providers with evidence on the patterns and context of gambling during COVID-19 and its aftermath. This protocol describes a study addressing the following three questions: (1) How has COVID-19 changed gambling practices and the risk factors for, and experience of, gambling harms? (2) What is the effect of COVID-19 on gambling marketing? (3) How has COVID-19 changed high risk groups' gambling experiences and practices? This mixed-method study focuses on two groups, namely young adults and sports bettors. In workpackage-1, we will extend an existing longitudinal survey of gambling in young adults (aged 16-24 years) (first wave conducted June-August 2019), adding COVID-19-related questions to the second wave (July-August 2020) and extending to a third wave in 2021; and undertake a survey of sports bettors in the UK (baseline n = 4000, ~July-August 2020), with follow-ups in ~October-November 2020 and ~February-March 2021. In workpackage-2, we will examine changes in expenditure on paid-for gambling advertising from January 2019 to July 2021 and undertake a mixed-method content analysis of a random sample of paid-for gambling advertising (n ~ 200) and social media marketing (n ~ 100) during the initial COVID-19 "lockdown". Workpackage-3 will involve qualitative interviews with a purposive sample of (a) young adults (aged 18-24 years) and (b) sports bettors.

Gambling as social practice: a complementary approach for reducing harm?

BACKGROUND: Gambling is now a well-recognised public health issue and forms the focus of extensive harm reduction initiatives. Recent developments in policy, practice and technology, such relaxation of regulations, the increasing influence of global gambling corporations, and the development of devices such as mobile phone apps and fixed odds betting terminals (FOBTs) mean that the landscape is a complex, dynamic, and fast moving one. Gambling is now practiced using new technologies, in various spaces and places, and features in a range of social surroundings. Therefore, research is needed to inform appropriate gambling harm reduction strategies that can respond to this complex domain. Yet, research and policy approaches to the reduction of gambling harm are predominantly framed through psychological and economic models of individual behaviour, addiction, and 'rational' action. This is beginning to change, with a growing corpus of socio-cultural approaches to gambling research now emerging. METHOD: In this article, we argue the case of recognising gambling as a social practice, the performance of which draws upon multiple elements such as technology and materials, spaces and places, language and discourse, and structures and agency. We call for a practice theory approach to gambling research that joins efforts to move beyond individual gamblers and their behaviour, to also acknowledge the interaction of multiple elements shaping gambling practices. To achieve this, we suggest that research methods such as visual ethnography can be helpful. CONCLUSION: We set out how a social practice perspective to gambling research can generate different insights and help inform more nuanced and appropriate gambling harm reduction initiatives.

Commercial determinants of health: advertising of alcohol and unhealthy foods during sporting events.

Tobacco, alcohol and foods that are high in fat, salt and sugar generate much of the global burden of noncommunicable diseases. We therefore need a better understanding of how these products are promoted.The promotion of tobacco products through sporting events has largely disappeared over the last two decades, but advertising and sponsorship continues bycompanies selling alcohol, unhealthy food and sugar-sweetened beverage. The sponsorship of sporting events such as the Olympic Games, the men's FIFA World Cup and the men's European Football Championships in 2016, has received some attention in recent years in the public health literature. Meanwhile, British football and the English Premier League have become global events with which transnational companies are keen to be associated, to promote their brands to international markets. Despite its reach, the English Premier League marketing and sponsorship portfolio has received very little scrutiny from public health advocates. We call for policy-makers and the public health community to formulate an approach to the sponsorship of sporting events, one that accounts for public health concerns.

Le tabac, l'alcool et les aliments riches en graisse, en sel et en sucre génèrent la plus large partie de la charge mondiale des maladies non transmissibles. Il est donc nécessaire de mieux comprendre la manière dont ces produits sont promus. La promotion des produits du tabac dans le cadre d'événements sportifs a largement disparu au cours des vingt dernières années, mais la publicité et le sponsoring par des entreprises qui vendent de l'alcool, des produits alimentaires peu sains et des boissons sucrées sont encore d'actualité. Depuis quelques années, la littérature sur la santé publique commence à porter son attention sur le sponsoring d'événements sportifs, tels que les Jeux olympiques, la Coupe du monde masculine de la FIFA ou encore le Championnat d'Europe de football masculin de 2016. Mais dans le même temps, le football britannique et la Premier League anglaise sont devenus des événements mondiaux auxquels les multinationales aiment être associées pour promouvoir leurs marques auprès de marchés internationaux. Malgré leur portée, le marketing et le sponsoring de la Premier League anglaise semblent négligés par les défenseurs de la santé publique. Nous appelons les décideurs politiques et la communauté de santé publique à élaborer une approche pour le sponsoring d'événements sportifs qui réponde aux enjeux de santé publique.

El tabaco, el alcohol y los alimentos que son ricos en grasa, como la sal y el azúcar, generan gran parte de la carga mundial de enfermedades no contagiosas. Por tanto, necesitamos una mejor comprensión de la forma en que se promueven estos productos. La promoción de los productos del tabaco a través de eventos deportivos ha desaparecido en gran medida en las últimas dos décadas, pero la publicidad y el patrocinio continúan por parte de las empresas que venden alcohol, alimentos poco saludables y bebidas azucaradas. El patrocinio de eventos deportivos como los Juegos Olímpicos, la Copa Mundial de la FIFA masculina y el Campeonato de Fútbol Europeo del 2016 ha recibido cierta atención en los últimos años en la bibliografía sobre salud pública. Mientras tanto, el fútbol británico y la Premier League inglesa se han convertido en eventos globales con los que las empresas transnacionales están dispuestas a asociarse, para promocionar sus marcas ante los mercados internacionales. A pesar de su alcance, la cartera de comercialización y patrocinio de la Premier League inglesa apenas han sido objeto de escrutinio por parte de los defensores de la salud pública. Pedimos a los responsables de la formulación de políticas y a la comunidad de la salud pública que formulen un enfoque para el patrocinio de eventos deportivos, que tenga en cuenta estas preocupaciones sobre la salud pública.

Gambling Harm and Crime Careers.

Incarcerated populations across the world have been found to be consistently and significantly more vulnerable to problem gambling than general populations in the same countries. In an effort to gain a more specific understanding of this vulnerability the present study applied latent class analysis and criminal career theory to gambling data collected from a sample of English and Scottish, male and female prisoners (N = 1057). Theoretical links between gambling and crime were tested through three hypotheses: (1) that prisoners in the UK would have higher rates of problem gambling behaviour than the national population; (2) that if the link between gambling and crime is coincidental, gambling behaviour would be highly prevalent in an offending population, and (3) if connections between gambling behaviour and offending are co-symptomatic a mediating factor would show a strong association. The first of these was supported, the second was not supported and the third was partially supported. Latent class analysis found six gambling behaviour clusters measured by responses to the Problem Gambling Severity Index, primarily distinguished by loss chasing behaviour. Longitudinal offending data drawn from the Police National Computer database found four criminal career types, distinguished by frequency and persistence over time. A significant association was found between higher level loss chasing and high rate offending in criminal careers suggesting that impulse control may be a mediating factor for both gambling harm and criminal careers.

The Online Bingo Boom in the UK: A Qualitative Examination of Its Appeal.

Online bingo has seen significant growth in recent years. This study sought to increase understanding of this growth by exploring the appeal of online bingo. Our aim was to examine the content of ten online bingo websites in the UK and analyse a qualitative secondary dataset of 12 female bingo players to investigate the appeal of online bingo. Using two distinct data sources allowed us to assess how the key messages online websites are trying to convey compare with actual players' motivation to play bingo. Our analysis of bingo websites found a common theme where websites were easy to navigate and structured to present a light-hearted, fun, reassuring, social image of gambling. In addition, the design decisions reflected in the bingo sites had the effect of positioning online bingo as a benign, child-like, homely, women-friendly, social activity. Comparison of the website content with our participants' reasons to play bingo showed congruence between the strategies used by the bingo websites and the motivations of bingo players themselves and the benefits which they seek; suggesting that bingo websites strive to replicate and update the sociability of traditional bingo halls. Online bingo differs from traditional forms of bingo in its ability to be played anywhere and at any time, and its capacity to offer a deeply immersive experience. The potential for this type of online immersion in gambling to lead to harm is only just being investigated and further research is required to understand how the industry is regulated, as well as the effects of online bingo on individual gambling 'careers.'

'Risky places?': mapping gambling machine density and socio-economic deprivation.

The aims of this project were to map the location and density of gambling machines in Britain; to explore whether geographic areas with higher densities of machines exist and to examine the socio-economic characteristics of these areas relative to others. Using geospatial analysis of premises records, we identified 8861 Machine Zones which were areas with a 400 meter radius around gambling machine venue and 384 High Density Machine Zones (HDMZ) with 1 or more gambling machine per hectare. There was a significant correlation between machine density and socio-economic deprivation. HDMZs had greater levels of income deprivation, more economically inactive people and a younger age profile than other areas; 37 % of those living in HDMZs were economically inactive compared with 33 % of those in non-machine areas. HDMZs were in seaside locations but also New Towns or satellite towns to major urban areas. Area affluence explains some of this pattern; of the New Towns with HDMZs, 78 % were in New Towns with a high proportion of low income areas. We therefore concluded that the distribution of gambling machines in Great Britain, in line with other international jurisdictions, displays a significant association with areas of socio-economic deprivation. The profile of the resident population living in HDMZs mirrors the profile of those most at-risk of experiencing harm from gambling. This spatial pattern has important implications for assessing the relationship between gambling availability and gambling-related harm, and for the future development of policy, harm-prevention and treatment strategies.

Techno economic systems and excessive consumption: a political economy of 'pathological' gambling.

This article argues that gambling is a paradigmatic form of consumption that captures the intensified logic at the heart of late modern capitalist societies. As well as a site of intensified consumption, it claims that gambling has also become the location of what has been described as a new form of 'social pathology' related to excess play. Drawing on Castells' (1996) notion of techno-economic systems, it explores the ways that intersections between technology, capital and states have generated the conditions for this situation, and critiques the unequal distribution of gambling environments that result. It argues that, while the products of these systems are consumed on a global scale, the risks associated with them tend to be articulated in bio-psychological discourses of 'pathology' which are typical of certain types of knowledge that have salience in neo-liberal societies, and which work to conceal wider structural relationships. We argue that a deeper understanding of the political and cultural economy of gambling environments is necessary, and provide a synoptic overview of the conditions upon which gambling expansion is based. This perspective highlights parallels with the wider global economy of finance capital, as well as the significance of intensified consumption, of which gambling is an exemplary instance. It also reveals the existence of a geo-political dispersal of 'harms', conceived as deteriorations of financial, temporal and social relationships, which disproportionately affect vulnerable social groups. From this, we urge an understanding of commercial gambling based on a critique of the wider social body of gambling environments within techno economic systems, rather than the (flawed) individual bodies within them.

Consumption and its discontents: addiction, identity and the problems of freedom.

The focus of this paper is on the notion of 'addictive consumption', conceived as a set of discourses that are embedded within wider socio-historical processes of governance and control. It examines the discursive convergences and conflicts between practices of consumption and notions of addiction, which it notes are consistently represented in terms of the oppositional categories of self-control vs. compulsion and freedom vs. determinism. These interrelations are explored with reference to the development of notions of addiction, and their relation to shifting configurations of identity, subjectivity and governance. Finally, it suggests that the notion of 'addiction' has particular valence in advanced liberal societies, where an unprecedented emphasis on the values of freedom, autonomy and choice not only encourage the conditions for its proliferation into ever wider areas of social life, but also reveal deep tensions within the ideology of consumerism itself.