In 2010, 0.7–0.9% of people aged 16 and over in Britain were reported to be ‘problem’ gamblers (NatCen 2010). Problem gambling can result in financial difficulties, relationship breakdown, emotional distress, poor health, reduced performance at work and criminal activity (Langham et al 2016). This digest summarises three recent studies relating to this issue.
Health behaviour and body mass index among problem gamblers
The aim of this study was to investigate whether problem gamblers differed from non-problem gamblers regarding health behaviour and body mass index (BMI) in people in Denmark aged 16 years or older.
Data was pooled from the Danish Health and Morbidity Survey of 2005 and 2010. Information on health behaviour, morbidity, social relations, and socio-demographic factors were collected from 19,673 adults. Multiple logistic regressions were used to investigate the association between problem gambling, health behaviour and BMI. Analyses were adjusted for sex, age, education, cohabiting status and other risk factors.
In total, 0.8% of the study population were identified as having a gambling problem in the past year. Problem gambling was significantly associated with unhealthy behaviours and obesity. Unhealthy behaviours included smoking, drinking alcohol, illicit drug use, sedentary leisure activity and an unhealthy diet. The findings suggest problem gambling is a serious public health issue that needs health promotion intervention.
Algren M, Ekholm O, Davidsen M et al (2015) Journal of Gambling Studies. www.ncbi.nlm.nih.gov/pubmed/24390713
Prevalence and determinants of gambling disorder among older adults
This systematic review examined the prevalence and determinants of gambling disorder in adults aged over 60 years. Studies that used community-based population sampling and were published up to May 2013 were identified using PubMed, Medline, CINAHL, EMBASE, PsycINFO and ProQuest.
In total, 25 studies met the inclusion criteria. Prevalence of lifetime gambling disorder ranged from 0.01% to 10.6% and past-year gambling disorder from 0% to 11%. Higher rates were reported among men and those aged 60–69 years.
Gambling status was significantly associated with poorer social and emotional well-being, suggesting some older people use gambling as a substitute for social support and to ameliorate negative emotions. Gambling disorder was also associated with comorbidity. The reasons for this association are complex and relate to the release of stress hormones during gambling, the sedentary nature of gambling that may attract people with limited mobility and discourage gamblers from participating in health enhancing activities, as well as genetic factors that may make gamblers susceptible to other risky behaviours.
The authors suggest older people are more likely to hide their gambling behaviour and they advise that prevalence rates could be higher than reported. They call for more well-designed research studies to better understand the phenomenon.
Subramaniam M, Wang P, Soh P et al (2015) Addictive Behaviors, 41, 199-209. doi: 10.1016/j.addbeh.2014.10.007.
What influences the types of help that problem gamblers choose?
People are not usually motivated to seek help until their gambling problem becomes severe. Interventions include counselling, self-exclusion, peer support groups, informal help and self-help. The aim of this study was to explore critical factors that influence the choice of help once people have decided to address their gambling problem. Interviews were conducted with 103 participants in Queensland, Australia. Data were analysed using grounded theory.
The study found three independent variables:
- Goals when taking up the intervention.
- The severity of the gambling problem.
- Independence and pride.
Those seeking abstinence were more likely to rate their gambling problem as severe and choose counselling, while those with a less severe problem wanted to control their gambling and were more likely to choose help from non-professionals. Those demonstrating high levels of pride were more likely to use only help from non-professionals. Six mediating variables were identified:
- Attitude to disclosure.
- Encouragement to take up the intervention.
- Assistance to take up and adhere to the intervention.
- Other support available.
- Confidence in and knowledge about the intervention.
- Ease and effectiveness of the intervention.
The authors argue that better understanding of the key influences on choice of help illuminates ways to encourage further uptake and better align interventions with gamblers’ preferences and therefore reduce the barriers that prevent people seeking help.
Hing N, Nuske E, Tolchard B et al (2015) International Journal of Mental Health and Addiction. tinyurl.com/IJMHA-study
Complied by Caroline McGraw, Lecturer, City University London
Langham E, Thorne H, Browne, et al (2016) Understanding gambling related harm: a proposed definition, conceptual framework and taxonomy of harms. BMC Public Health. 16, 1, 80. doi. 10.1186/s12889-016-2747-0.
NatCen (2010) British Gambling Prevalence Survey. tinyurl.com/z3rhey3