Simulated Gambling: An Explorative Study Based on a Representative Survey.

Gambling usually involves wagering real money but can also be conducted with virtual money, chips, or coins. This phenomenon is sometimes referred to as simulated gambling, social gambling, or play money gambling. This study explores correlations and transitions between simulated gambling and real money gambling with an emphasis on gambling-related harms and public health concerns. The analysis is based on a national representative survey of 46,136 German Internet users which included 5,191 real money online gamblers (RMG), 54% of whom had also participated in simulated gambling (SG). The data set is divided into subsamples based on participation in SG to carve out significant differences in these groups in regard to various socio demographics, gambling patterns, and gambling problems. Regression models are used to predict RMG frequency, participation in SG, SG participation frequency, and problem gambling. The results show a clear proximity between SG and RMG with 17% of the total sample and 54% of problem gamblers reporting being "quite sure" or "certain" that simulated gambling had led them to gambling with real money. While 7% of individuals that engaged exclusively in RMG showed gambling problems, the rate is 33% for those that engaged in both RMG and SG. Regression results provide further evidence of a relationship between SG and problem gambling, although with differing effect sizes for different game forms. We argue that SG can be both a substitute and a primer for RMG, especially for problem gamblers.

Online Gambling Practices and Related Problems in Five European Countries: Findings from the Electronic Gam(bl)ing Multinational Empirical Survey (E-GAMES) Project.

Online gambling has demonstrated a significant and growing impact on overall gambling involvement. To examine online gambling practices and associated problems, we conducted surveys with national samples of Internet users in several European countries. The objective of this paper is to provide a portrait of online gambling practices and problems in five European countries (i.e., France, Italy, Germany, Switzerland, and Poland) with different online gambling regulatory systems. This paper is the first presenting national comparisons of online gambling practices. Participants reported on their gameplay patterns, demographic characteristics, gambling-related problems, gambling frequency, average spending on different online gambling activities, and offline gambling participation over the past 12 months. The Problem Gambling Severity Index was used to assess the severity of gambling problems in relation to online gambling (Ferris & Wynne, 2001 in The Canadian Problem Gambling Index: Final report, Canadian Centre on Substance Abuse, 2001). Pairwise logistic regressions examined the association between problem gambling and sociodemographic variables as well as gambling patterns and problem gambling. In all countries except Italy, the most popular online gambling activity was lotteries with nearly three quarters of participants reporting participation. The prevalence of at-risk and problem gambling was high in all countries with Poland reporting the highest prevalence and Switzerland the lowest. Gamblers who participated in gambling activities other than lottery were more likely to experience gambling-related problems. The rates in the present study are well above the levels usually found in surveys. High online gambling frequency, high spending, and participation in multiple online gambling activities were significantly associated with experiencing gambling-related problems.

Older adults' perceptions of the risks associated with contemporary gambling environments: Implications for public health policy and practice.

Introduction: Rapid changes in the Australian gambling environment have amplified the risks for gamblers and pose significant threats to public health. Technological advances, saturation of marketing, and the embedding of gambling in sport have all contributed to significant changes in the gambling risk environment. Older adults have witnessed the changes to the way gambling is provided and promoted in public spaces, but little is known about how these changes have shaped the way they conceptualize the risks associated with gambling. Method: Guided by critical qualitative inquiry, semi structured interviews were conducted with 40 Australian adults aged 55 years and older, who had gambled at least once in the last 12 months. Reflexive thematic analysis was used to interpret the data. Results: Participants discussed gambling environments in Australia and how they had changed through the proliferation of gambling products, environments, and opportunities; the risks posed through the embedding of gambling in community and media environments; the role of technology in gambling environments; and the role of marketing and promotions in the changing gambling environments. Participants recognized that these factors had contributed to gambling environments becoming increasingly risky over time. However, despite the perception of increased risk, many participants had engaged with new gambling technologies, products, and environments. Discussion: This research supports the adoption of public health responses that include consideration of the environmental, commercial, and political factors that may contribute to risky gambling environments.

Using machine learning to retrospectively predict self-reported gambling problems in Quebec.

BACKGROUND AND AIMS: Participating in online gambling is associated with an increased risk for experiencing gambling-related harms, driving calls for more effective, personalized harm prevention initiatives. Such initiatives depend on the development of models capable of detecting at-risk online gamblers. We aimed to determine whether machine learning algorithms can use site data to detect retrospectively at-risk online gamblers indicated by the Problem Gambling Severity Index (PGSI). DESIGN: Exploratory comparison of six prominent supervised machine learning methods (decision trees, random forests, K-nearest neighbours, logistic regressions, artificial neural networks and support vector machines) to predict problem gambling risk levels reported on the PGSI. SETTING: Lotoquebec.com (formerly espacejeux.com), an online gambling platform operated by Loto-Québec (a provincial Crown Corporation) in Quebec, Canada. PARTICIPANTS: N = 9145 adults (18+) who completed the survey measure and placed at least one bet using real money on the site. MEASUREMENTS: Participants completed the PGSI, a self-report questionnaire with validated cut-offs denoting a moderate-to-high-risk (PGSI 5+) or high-risk (PGSI 8+) for experiencing past-year gambling-related problems. Participants agreed to release additional data about the preceding 12 months from their user accounts. Predictor variables (144) were derived from users' transactions, apparent betting behaviours, listed demographics and use of responsible gambling tools on the platform. FINDINGS: Our best classification models (random forests) for the PGSI 5+ and 8+ outcome variables accounted for 84.33% (95% CI = 82.24-86.41) and 82.52% (95% CI = 79.96-85.08) of the total area under their receiver operating characteristic curves, respectively. The most important factors in these models included the frequency and variability of participants' betting behaviour and repeat engagement on the site. CONCLUSIONS: Machine learning algorithms appear to be able to classify at-risk online gamblers using data generated from their use of online gambling platforms. They may enable personalized harm prevention initiatives, but are constrained by trade-offs between their sensitivity and precision.

Young women's engagement with gambling: A critical qualitative inquiry of risk conceptualisations and motivations to gamble.

BACKGROUND: Younger women's engagement with gambling has changed over recent decades due to a range of socio-cultural, environmental and commercial factors. However, younger women's distinct lived experiences with gambling have rarely been considered. The following critical qualitative inquiry explored factors that influenced younger women's engagement with gambling and their perceptions of gambling risks. METHODS: Semi-structured interviews were conducted with 41 Australian women aged 18-40 years. Participants were asked questions relating to their reasons for gambling, and the perceived risks associated with gambling. Reflexive thematic analysis was used to interpret the data. RESULTS: Five themes were constructed from the data. First, women reported that they gambled to escape their everyday lives, with some women reporting gambling within their own homes. Second, women reported gambling for financial reasons, particularly to change their life circumstances and outcomes. Third, gambling was used by women as a way to connect with social network members. Fourth, gambling was an incidental activity that was an extension of non-gambling leisure activities. Finally, lower risk perceptions of participants' own gambling risk contributed to their engagement and continuation of gambling. CONCLUSION: Public health and health promotion initiatives should recognise that young women's gambling practices are diverse, and address the full range of socio-cultural, environmental and commercial factors that may influence younger women's engagement with gambling.

Gamblers' Perceptions of the Impact of the COVID-19 Pandemic on Their Gambling Behaviours: Analysis of Free-Text Responses Collected through a Cross-Sectional Online Survey.

The COVID-19 pandemic has brought drastic changes to the lives of a substantial portion of the world's population. Many stakeholders have expressed concern about the impact of the pandemic on gambling practices, which have historically increased during times of crisis. The purpose of this study was to provide a snapshot of the impact of the pandemic on gambling practices, focusing on the lived experiences of people who gamble. An online cross-sectional survey was conducted between 16 February and 15 March 2021. An open-ended question allowed the participants to describe in their own words the impact of the COVID-19 pandemic on their gambling practices. A qualitative analysis was conducted based on 724 responses to this question. Among the participants, 57% were problem gamblers, according to their Problem Gambling Severity Index score. Three themes were identified: (1) changes in gambling practices perceived by the respondents during the pandemic, (2) the impacts of these changes, and (3) the factors that influenced the changes in their gambling practices. A meaningful proportion of the sample of gamblers felt that their gambling practices had increased during the pandemic. Many of them did not report the deleterious effects of this increase, whereas others were devastated. Thus, variations in gambling practices during the pandemic must be interpreted with caution, as they may reflect a variety of realities.

Convenient consumption: a critical qualitative inquiry into the gambling practices of younger women in Australia.

There are a range of stereotypes and assumptions associated with women's gambling behaviours. While researchers have demonstrated that the practices associated with women's gambling are changing and becoming increasingly normalized, there is a limited understanding of how younger women ascribe meanings to these practices. This study explored the gambling practices of younger women. Forty-one women (20-40 years) participated in qualitative telephone interviews. Participants were asked open-ended questions about personal engagement in gambling, including experiences of gambling, gambling engagement, and experiences with different gambling products and environments. Data interpretation was guided by reflexive thematic analysis. Three themes were constructed from the data: (i) gambling infrastructures, including both products and the embedding of gambling in community environments, contributed to the convenient and regular consumption of gambling, with gambling easy to access and engage with; (ii) social networks and intergenerational gambling practices impacted the perceived social value and competencies related to gambling; and (iii) technology facilitated new gambling practices, routinizing gambling behaviours through automation and building perceived competencies with a range of gambling products. Gambling regulation and public health responses to gambling often focus on either individual behaviours or product characteristics. This study suggests that this focus is too narrow and excludes important influences on younger women's gambling practices, which include the infrastructure that supports the provision and consumption of gambling products. Public health research, policy and practice must consider the full range of determinants that may contribute to the initiation and continuation of gambling in younger women.

Younger women's engagement with gambling is changing. While there has been a significant focus on the gambling behaviours of men, very little research has investigated how women engage in different forms of gambling. We conducted in-depth telephone interviews with n = 41 women (20­40 years) in Australia about their personal engagement in gambling, their experiences of gambling, their motivations to gamble, and their engagement with different gambling products and environments. First, we found that the embedding of gambling in community environments (e.g. lotteries at shopping centres) meant that gambling was easy to access and engage with. This led to the convenient and regular consumption of some gambling products. Second, existing social practices among participants' social networks (including friends and family members) contributed to women feeling that gambling had social value, and that they had the skills to successfully participate in different forms of gambling. Finally, new technologies created routine gambling behaviours. For example, women automated the purchase of lottery tickets or used apps to help to build complex bets on activities such as sports. We conclude that public health and health promotion research, policy and practice must consider the unique factors that may influence the gambling behaviours of younger women.

Young people in Australia discuss strategies for preventing the normalisation of gambling and reducing gambling harm.

BACKGROUND: The normalisation of gambling for young people has received considerable recent attention in the public health literature, particularly given the proliferation of gambling marketing aligned with sport. A range of studies and reports into the health and wellbeing of young people have recommended that they should be consulted and engaged in developing public health policy and prevention strategies. There are, however, very few opportunities for young people to have a say about gambling issues, with little consideration of their voices in public health recommendations related to gambling. This study aimed to address this gap by documenting young people's perceptions about strategies that could be used to counter the normalisation of gambling and prevent gambling related harm. METHODS: This study took a critical qualitative inquiry approach, which acknowledges the role of power and social injustice in health issues. Qualitative interviews, using a constructivist approach, were conducted with 54 young people (11-17 years) in Australia. Reflexive thematic analysis was used to interpret the data. RESULTS: Five overall strategies were constructed from the data. 1) Reducing the accessibility and availability of gambling products; 2) Changing gambling infrastructure to help reduce the risks associated with gambling engagement; 3) Untangling the relationship between gambling and sport; 4) Restrictions on advertising; and 5) Counter-framing in commercial messages about gambling. CONCLUSIONS: This study demonstrates that young people have important insights and provide recommendations for addressing factors that may contribute to the normalisation of gambling, including strategies to prevent gambling related harm. Young people hold similar views to public health experts about strategies aimed at de-normalising gambling in their local communities and have strong opinions about the need for gambling to be removed from sport.

Do the Consequences Experienced by the People in the Life of a Problem Gambler Differ Based on the Nature of Their Relationship with the Gambler?

Consequences experienced by the partners of individuals with a gambling disorder are well documented. However, little is known about the deleterious effects experienced by other people than partners of gamblers. A better understanding of these consequences could help improve clinical practices. The goal of this paper is to compare the consequences experienced by partners of gamblers with those experienced by their close family members (parents, adult children, siblings) by using the categorization method proposed by Langham et al. (BMC Public Health, 2016). To achieve this goal, 46 semi-structured interviews were conducted. Results indicate that the extent and intensity of the consequences experienced vary widely based on their level of emotional and financial involvement with the gambler. Considering the specific elements involved for each type of person in a gambler's life, future research should distinguish participants based on the nature of their relationship with the gambler.

Gambling and the COVID-19 pandemic in the province of Quebec (Canada): protocol for a mixed-methods study.

INTRODUCTION: The COVID-19 pandemic has major collateral impacts on mental health. Gambling is among the major public health issues that seems to have been transformed by the pandemic. In the province of Quebec in Canada, gambling is an important leisure activity. About two out of three adults are in Quebec gamble. The objective of this study is to draw a portrait of the impacts of the COVID-19 pandemic on gamblers and to learn more about their experiences during the pandemic in the province of Quebec. METHOD AND ANALYSIS: This study has a sequential explanatory mixed-method design in two phases. The first phase is a cross-sectional online survey with Quebec residents who are 18 years of age or older and have gambled at least once in the previous 12 months. The second phase will be a qualitative study. Semistructured interviews will be conducted with gamblers, family members, addiction counsellors and state representatives selected through purposing sampling. ETHICS AND DISSEMINATION: This study is one of the first mixed-methods studies on the impacts of the COVID-19 pandemic on gambling. This study will generate new scientific knowledge on a worrisome public health issue, that is, gambling, and provide a better understanding of the experiences and gambling behaviours of gamblers during the pandemic. This study is funded by the Ministry of Health and Social Services of the Government of Quebec and was approved on 27 October 2020 by the Scientific and Research Ethics Committee of the CIUSSS de l'Estrie-CHUS. This is a 2-year study that will be completed in June 2022.

Gambling and the COVID-19 pandemic: A scoping review.

BACKGROUND: The impact of COVID-19 on mental health is tremendous. Since the beginning of the pandemic, several actors have raised concerns about the impact of the pandemic on gambling. Many actors fear a switch to online gambling in the context of the closure of many land-based gambling activities due to the restrictions imposed by public health authorities, such as physical distancing and lockdowns. This switch is worrisome because online gambling is considered a high-risk game. In that context, we need to know more about the impacts of the pandemic on gambling. This scoping review aims to summarize the literature that addresses the impacts of the COVID-19 pandemic on gambling. To our knowledge, this is the first review to focus on this subject. METHODS: An electronic literature search involving a strategy using keywords related to COVID-19 and gambling was conducted using MEDLINE, Academic Search Complete, CINAHL, PsychINFO, Social Works Abstract, and Socio Index databases on February 25th 2021. This search was combined with a manual search in Google Scholar. To be included, studies had to discuss gambling and COVID-19 as a primary theme, be written in English, and be published in a peer-reviewed journal. After collecting the information, we collated, summarized, and reported the results using narrative synthesis. RESULTS: The search identified 181 articles. After the removal of duplicates and screening, 24 full-text articles were reviewed and included in this study: 14 original articles, 8 commentaries or editorials, and 2 protocols. Contrary to expectations, preliminary evidence suggested that gambling behavior often either decreased or stayed the same for most gamblers during the pandemic. However, for the minority who showed increased gambling behavior, there was frequently an association with problem gambling. CONCLUSION: The available literature on COVID-19 and gambling is limited and the impact of the COVID-19 pandemic on gambling behavior and gambling problems is still unclear. Therefore, there is a need for more research on this topic, both qualitative and mixed methods studies, to better understand the impact of the pandemic on gambling. Considering the results, we need to be careful, particularly with problem gamblers and other subgroups of the population who seem to be more vulnerable to increased gambling habits during this pandemic period.

Multilevel Contextual Analysis of Poker Cash Game Gambling.

This article examines the effect of gambling location on the frequency, expenditure, and time spent on cash game poker in relation to individual characteristics of gamblers. Data were drawn from a 2012 Québec epidemiological gambling survey. The quantitative analysis used multilevel methods to model the dual-level hierarchical design of gambling location (level 1) and individual characteristics nested within poker cash game players (level 2). The sample was comprised of 270 individuals aged 18 years and above and living in private homes, who reported gambling on poker cash games in the past 12 months. Participants reported their gambling habits in up to three locations: private homes, the casino, and the Internet. Demographic data included age, gender, education level, and income. Significant variation was reported between the three locations and the gameplay patterns variables, i.e. betting frequency, time, and spending. The most frequently reported gambling locations were private dwellings (87.4%), followed by casinos (15.9%), and the Internet (13.7%). Some interactions between location and the demographic variables were observed. Moreover, the multilevel analysis revealed an important relationship between the location and poker cash gambling behavior. This study reveals the significance of contextual factors as a fundamental element in gambling behaviors and highlights the need for prevention strategies that target specific high-risk contexts rather than individually based interventions.

Once online poker, always online poker? Poker modality trajectories over two years.

Online poker is considered more at-risk than land-based poker in terms of intense gambling behaviors and gambling problems. The development of many online gambling sites has raised public health concerns about the potential increase in online poker players. Longitudinal studies are useful to better understand the evolution of gambling behaviors; however, very few consider online poker players. Using a prospective design, this study aims to identify online and land-based trajectories over a two-year period and the factors influencing those trajectories. Results are based on data collected at three time-points over the course of a prospective cohort study conducted in Quebec (n = 304). A latent class growth analysis was performed to determine trajectories based on the main poker modality played, either online or land-based poker. Multinomial multivariable logistic regression analyses were conducted to determine the correlates of poker playing trajectories. Over two years, three poker playing trajectories were identified, comprising two stable trajectories [stable land-based (51.5%) and stable online (36.3%)] and an unstable trajectory [unstable online land-based (12.1%)]. The second trajectory included online poker players at baseline who transitioned to land-based poker. Number of gambling activities increased the odds of being in the first trajectory as compared to the others. Severity of gambling problems was a significant predictor of the second "unstable" or the third "stable online" trajectories, but not for the first "stable land-based" poker trajectory. The majority of poker players remained in either the land-based or online trajectories over two years. No poker players transitioned from land-based to online poker.

"It did not apply to me": poker players' perspectives of prevention messages.

OBJECTIVE: Despite the risks associated with poker and its unique characteristics when compared with other forms of gambling, little knowledge exists of poker players' perceptions of prevention strategies. The aim of this study was to explore poker players' perceptions and understandings of existing problem gambling prevention strategies. METHODS: This exploratory qualitative study is a secondary data analysis of interviews conducted as a part of a sequential mixed-methods research project, with 12 poker players. RESULTS: Two main themes emerged from the thematic analysis highlighting a distinction between institutional and personal prevention strategies. When speaking about institutional prevention efforts, players were critical of existing formats, messages, and who these messages were being developed and disseminated by and for. Players believed existing messaging strategies demonstrate an overall lack of awareness concerning the reality of poker. Personal preventive strategies that players themselves put in place to reduce risks included money management, playing for free, maintaining a healthy play-life balance, and managing emotions, to be aware of their relationship with poker, as well as spotting paying opportunities. CONCLUSIONS: Given poker players' lack of receptivity to existing prevention messaging, it is essential to consider the unique nature of poker and its players. It is also imperative to explore the potential benefits of collaborating with players when it comes to targeted prevention strategies.

Gambling Problem Trajectories and Associated Individuals Risk Factors: A Three-Year Follow-Up Study Among Poker Players.

Despite the popularity in poker-related activities in recent years, few studies have focused on the evolution of gambling habits of poker players over a long period of time. The aim of this study is to examine factors influencing trajectories of poker players. The results are based on data collected at a four-time measurement of a prospective cohort study conducted in Quebec (n = 304 poker players). A latent class growth analysis was performed to identify trajectories based on the Problem Gambling Severity Index score. Multinomial multivariable logistic regression analyses were conducted to determine the correlates of gambling trajectories. Over the 3 years of the study, three gambling problem trajectories were identified, comprising one decreasing trajectory (1st: non-problematic-diminishing), one stable trajectory (2nd: low risk-stable), and one increasing trajectory (3th: problem gamblers-increasing). Internet as the main poker form and number of game played were associated with at-risk trajectories. Depression symptoms were significant predictors of the third trajectory whereas impulsivity predicted the second trajectory. This study shows that the risk is remaining low over years for the vast majority of poker players. However, the vulnerable poker players at the beginning of the study remain on a problematic increasing trajectory. It is therefore important to prioritize individuals in the third trajectory for interventions.

Where Lies the Harm in Lottery Gambling? A Portrait of Gambling Practices and Associated Problems.

Lotteries are one of the most prevalent forms of gambling and generate substantial state revenues. They are also argued to be one of the least harmful forms of gambling. This paper is one of the first to examine exclusive lottery gamblers and compares their gambling patterns and problems as well other associated risky behaviours to those who are not exclusive lottery gamblers. Data were derived from two large surveys conducted with representative adult samples in France (n = 15,635) and Québec (n = 23,896). Participants were separated into two groups: exclusive lottery gamblers (ELGs) and non-exclusive lottery gamblers. Using multivariate analysis, study results reveal that ELGs, who represent two thirds of gamblers, generally exhibit less intensive gambling patterns and are less likely to report other risky behaviours. However, harms associated with moderate risk and problem gambling are found to be concentrated in specific subpopulations for both groups, primarily males, older individuals, and those who report lower income and education level. Given widespread participation in lotteries and concentration of harm within specific subgroups, these findings point to the need for prevention efforts despite the lower levels of harm associated with lottery gambling.

Life events and problem gambling severity: A prospective study of adult gamblers.

Several studies have shown that gambling problems are cyclical but few have empirically investigated factors that are associated with change. The purpose of this article is to prospectively examine associations between life events and problem gambling severity in a cohort of gamblers. Occurrence of life events and gambling problem severity were assessed 3 times over a period of 2 years in a cohort of nonproblem and problem gamblers (N = 179) drawn from a representative sample derived from a population survey. Cross-lagged analyses revealed that cumulative number of life events were associated with an increase in severity of problem gambling 12 months later. Regression analyses showed that significant life events in several domains, for example, "change in sleeping habits," "accidental injury or illness" or "retirement," are likely to be associated over time to the increase or the continuation of risky gambling habits. This study's findings on the potential negative influence of cumulative number of life events, or of specific ones, are informative for secondary prevention and treatment. (PsycINFO Database Record

Factors associated with high use of general practitioner and psychiatrist services among patients attending an addiction rehabilitation center.

BACKGROUND: This study aimed to 1) identify the characteristics of individuals with substance use disorders (SUDs) who make high use of services provided by general practitioners (GP) and psychiatrists while receiving services concurrently from an addiction rehabilitation center (ARC), and 2) to compare high service users to moderate and low service users. METHODS: Data were compiled for 4,407 individuals with SUDs who were receiving services from an ARC in 2004. The data came from the merging of four databases: the ARC data registry (January 1(st), 2004-December 31, 2004), the Quebec Health Insurance Board database (March 31, 2003-April 1st, 2005), the Quebec provincial database for hospitalizations (March 31, 2003-April 1st, 2005), and the Quebec National Institute of Public Health database (2004). Independent variables were grouped according to the Andersen Behavioral Model of Health Services Use: predisposing, enabling and need factors. Generalized estimating equations analyses were performed to assess the influence of individual and neighborhood-level characteristics on high use of services outside the ARC provided by GPs and psychiatrists. Benjamini-Hochberg's procedure was applied to correct for multiple comparisons. RESULTS: About 97 % of individuals attending the ARC consulted a GP or a psychiatrist during the two-year study period, for a mean of 1.5 consultations per month. Findings revealed that 5 % of the sample made 26 % of all consultations over the two years, and they were defined as high users. No single predisposing factor was associated with high use. One enabling factor significantly increased the risk of being a high user of services from general practitioners and psychiatrists: receiving services at the ARC for three years prior to 2004. Four needs factors, all related to mental health diagnoses (schizophrenia, mood disorder, anxiety disorder, personality disorder), predicted high use of general practitioner and psychiatrist services. CONCLUSIONS: This study found that nearly all individuals with SUDs receiving services from an ARC were users of health services from GPs and psychiatrists outside the ARC. High users most probably accessed them in inpatient settings. No previous study has compared high service users with low and moderate users among individuals with SUDs. Considering that ARCs are treating individuals with complex needs, some of whom make high use of medical professionals, both ARCs and their clients could benefit from increased collaboration and integration between the addictions and mental healthcare sectors.

A cross-cultural comparison of population gambling patterns and regulatory frameworks: France and Québec.

Few empirical studies have examined the relationships between differing regulatory approaches and patterns of gambling behaviors. This article reports on a correlational cross-cultural comparison of differences in the regulatory approaches and gambling behavior among general adult populations in France and Québec, Canada. We drew data from two large population surveys conducted in France and Québec (N=27 653 and N=11 888, respectively). We found diverging and converging aspects of government regulatory policies. Statistical analyses demonstrated significantly higher participation rates and prevalence of 'assiduous gamblers' in Québec. In France, among assiduous gamblers, the proportion of moderate-risk and probable pathological gamblers is significantly higher. Future research should examine environmental conditions and varying gambling offerings, as well as gambling regulation, to determine their potential influence on gambling behaviors.

Gambling Patterns and Problems of Gamblers on Licensed and Unlicensed Sites in France.

In 2010 France enacted a law to regulate supply and consumption of online gambling. Its primary aim was to protect citizens from gambling-related harm. This study aims to assess differences in gambling patterns and related harm between online gamblers who use licensed versus unlicensed sites. Participants (N = 3860) completed a self-administered online survey on gambling practices. Pairwise logistic regressions examined the association between the legal statuses of gambling sites people patronized and demographic variables and gambling types. Multivariate logistic regression models explored associations between gambling patterns and related problems according to the legal status of sites people have gambled on. Overall, 53.7 % of online gamblers report gambling exclusively on licensed sites. Those who bet on regulated activities on unlicensed sites, versus licensed sites, are more likely to be female, younger, less educated, inactive in the labor market and are more likely to perceive their financial situation to be difficult. Gambling on unlicensed sites is associated with more intense gambling patterns and more gambling-related problems compared to licensed sites. Findings demonstrate that gambling activities carried out on state licensed sites are associated with less overall harm to gamblers. Implications of these findings on future policy are discussed and prospective research directions are outlined.