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Apcg 2013
1. 11/06/2014 Syaron Basnet 1
" Problem gambling in Finnish Adult
Population
“With reference to AVTK 2010 results“
APCG 2013
Syaron Basnet
MSC health, PhD Researcher
National Institute for Health and Welfare
syaron.basnet@thl.fi
3. Gambling Disorder
• From impulse control disorder to gambling disorder
• Over past three decades many changes in terminology
– problem gambling, compulsive gambling, pathological
gambling….
• DSM-5
- gambling disorder now is categorized as Substance-
Related and Addictive Disorder
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5. Defining the term "Gambling"
• A game of chance and uncertainty
• It is wagering of any type of item of value mostly money upon
a game or event of uncertain outcome (Walker, 2006)
• The Finnish Criminal Code (39/1889), defines gambling as
follows:
– “pools, bingo, tote and betting games, money and goods
lotteries, casino operations and other similar games and
activities where
• “winning is completely or partially dependent on chance or
events beyond the control of the participants in the game or
activity and
• where the possible loss is clearly disproportionate to the
solvency of at least one of the participants.”
11/06/2014
Source: Esityksen nimi / Tekijä
5
7. What we have witnessed in past decade
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Availability Accessibility
Prevalence Comobidity
+++
Legal gambling
opportunities
Increase in per
capita
gambling
expenditure
Significant
increase in
overall rate of
gambling
participation
8. Developmental Overview of gambling market
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Structure of gambling development
Prohibition modelRisk model Alibi model
SinEntertainment Vice
Liberalization
Expansion of market
Expressive and active games-
High risks
Instrumental and passive
games-low risk
Source: Kingma , International Gambling Studies, Vol. 4, No. 1, June 2004
10. Gambling in Finland
70% of Finns aged between 15-74 had gambled during the
past 12 months (Turja et al. 2012)
2,7% of the population (110,000 persons)- gambling problems
over last 12-month period (Turja et al. 2012)
1% of the population (40,000 persons)- probable gambling
addicts (with a SOGS score of at least 5 points)
Most popular games are lottery, scratch cards and slot
machines (Turja et al. 2012)
A recent study found that young gamblers were allowded to
play slot machines despite the age limits (Warpenius, Holmila
2012)
No statistically significant change in prevalence over the
period 2003-2007 (Yhteiskuntapolitiikka 10/2013)
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11. Health Behaviour and Health among the
Finnish Adult population (AVTK)
Survey conducted since 1978
The sample is derived from the population registry
On 2008 gambling questions were added
This study is based on 2010 Survey
Sample (n = 5 000) aged between 15 and 64 years
2826 individuals replied (1234 males and 1583 females)
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12. Method
• Gambling severity was measured by Finnish translated PGSI
(Problem gambling severity index)
• Also known as candian problem gambling severity index
(CPGSI)
• 9 items, maximum 27 point in a 4 point likert scale, 0=never to
3=almost always: Scoring 0=non-problem, 1 0r 2=low lovel of
problem 3-7=moderate and ≥8=severe
• Past 12 month Alcohol consumption level was assessed
• Risk level alcohol consumption-drinking 6 units at least once
a week
• 10 mostly played games and frequency was assessed
• Nicotine dependence was assessed
11/06/2014 Esityksen nimi / Tekijä 12
14. Gender differences (%) in problem gambling
level
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88.9
9
2.1
Male
low level
moderate level
Problem level
97
2.6 0.3
Female
16. Conclusion and limitation
• Most common form of gambling was lotto gambled by
56,45
• Males favoured the high risk games such as sports
betting
• Frequent betting was associated with more severe
problems
• Men and women tend to gamble for different reasons and
in different activities
• Limitations-Postal survey,response rate (56,52%)
• It is a part of health survey
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17. Discussion
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Sociodemographics
• Low socioeconomic factor-unemployment
• Males vulnerability
• Younger age
• Divorced and separated
• Education
Different game type
• Difference in content and structure
• Frequent internet betting was associated with more severe problem
Gender Difference
• Males favoured the high risk games such as sports betting
• personality factor
• Some people and some place might have adapted to the risk and
hazards of gambling (Adatation effect)
• Telescoping effect in women
18. Thank You
Contact information for the research group (firstname.lastname@thl.fi)
Tuuli Lahti, Adjunct professor of Neurophysiology
Hannu Alho, Professor of Addiction Medicine
Sari Castren, Psychologist and nurse
Syaron Basnet, Master of Health Science
Maiju Pankakoski, Statistician
Jenni-Emilia Ronkainen
Satu Helakorpi
Antti Uutela
Hinweis der Redaktion
1980- Appeared first in DSM III as impulse control disorder
DSM V-Committing illegal act has been omitted from diagnosis criteria
Elimination of criteria of illegal acts. Adding a specific time-line. Lower threshold – 4 of 9 instead of 5 of 10.
Preoccupation, tolerance, withdrawal, restlessness, escape, chasing, lying, jeopardizing relationships, bailing out
There are three specifiers in DSM 5
1.Nature
Episodic-Meeting diagnostic criteria more than one time point, with symptoms subsiding between periods of gambling disorder, for at least several months
Persistent: Experiencing continuous symptoms, to meet diagnostic criteria for multiple years
2. Threshold
In early remission: Although the full criteria has been previously met but none of them met now for at least 3 months but less than 12 months
In sustained remission: Although the full criteria has been previously met but none of them met now during 12 months or longer
3.Current severity
Mild 4-5 criteria met
Moderate: 6-7 criteria met
Severe:8-9 criteria met
Many definations of gambling addicition
Solvency is the ability of a business to have enough assets to cover its liabilities.
William & Volbergs (2012) meta analysis of 202 prevalence studies between 1975-2012
standardised past year prevalence between 0.5% to 7.6%
Average-2.3%
According to some researcher its highest in Finland among the nordic countries
Highest in Hongkong, South Korea, Great Britain,, Iceland, Hungary, Norway, France, and New Zealand
lowest standardized prevalence rates occur in Denmark, the Netherlands, and Germany.
Average rates occur in Sweden, Switzerland, Canada, Australia, United States, Estonia, Finland, and Italy.
Gambling monopoly usually seen as best way to keep the problem low but with virtualitity where are we heading?Now, the games and lottories are in our homes-Expousure theory hold true?
Are we the next ”jackpot junkies”, the term used to decribe state which depend heavly on gambling revenue
Liberalistaion and exp is related to exposure and adaptation in gambling
LaPlante 2004 first raised the idea that social toxin produces gambling-(Social equivalent of germ). -Expousure theory-Increased exposure to potential public health toxins eg. The casino employee have inclination to more problem and pathological gambling, alcohol problem (Shaffler et al 1999, 2002), also the 1990’s-2000’s era inc. Licensing inc venue inc exposure inc prevalence
Finland-Population-About 5 Million-HELSINKI (capital) 1.107 million (2009)
Gambling is operated under monopoly system-RAY- The Slot Machine Association(offers over 170 different games), Veikkaus Oy-The Finnish National Lottery provides lotteries and betting and Fintoto Oy runs pari-mutuel wagering, with the revenue being allocated to horse breeding, horse sports and trotting.
1 Casino (2nd Opening Soon in finnish Russian border ) Grand casino-300 machines, 32 table games, 43 racetracks (trotting) , 76 gaming arcades , over 250 restaurants with casino table games ,4,000 game retail outlets , 20,000 slot machines (Pelluri)
2009-2011-change in legislation-age limit (+18):supervision in venues
At pelluri helpline most cases are of slot machines
Purpose to study the helath related behaviour of working aged population
Key aspects of the survey: healt related behaviours such as smoking, dietary habits, alcohol consumption and physical activity
Two sections of gambling related questions
Cross sectional
Age difference between gender
60% of probelm gamblers were seperated or divorced
Females were significantly more educated
No gender differences in employment level
5.5% of the sample had moderate level problem.
Gender differences in all three categories of problem gambling
Male suffered from more severe problem gambling
Significant difference
Frequency of game was associated with severity of gambling-highly significant for lottories, slot machine and internet gambling
Age is analysed as a continious variable, refrence group is non problematic gamblers
Higher odds of having gambling problem in
Younger age
Male Gender
< twelve years of education
At risk alcohol consumer
Smokers
Whereas, unemployment and smoking predicted significantly for problem gambling.
The model was good according to likelihood ratio test (Sig P value), Correct classification rate of 79,2% obtained
Males favoured the high risk games such as sports betting
Frequent internet betting was associated with more severe problems
Prevalence-The cut off value for PGSI more than SOGS, moreover 5.5% had Problem gambling
Low socio-economic factor such as less education and is a vulnerability factor for GD
