A research plan to define Canada’s first low-risk gambling guidelines

Currie, Shawn R.; Flores‐Pajot, Marie‐Claire; Hodgins, David C.; Nadeau, Louise; Paradis, Catherine; Robillard, Chantal; Young, Matthew M.

doi:10.1093/heapro/day074

Cited by 21 publications

(30 citation statements)

References 48 publications

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“…This research clearly shows that the more one gambles, the greater the likelihood of harm [11][12][13]. Gambling shares many of the same characteristics as alcohol in terms of the relationship between consumption levels and harm [14]. Like alcohol, gambling shows a reproducible dose-response relationship with increasing consumption leading to harm in most individuals [15][16][17][18].…”

Section: Introductionmentioning

confidence: 73%

Predicting Future Harm from Gambling over a Five-Year period in a General Population Sample: A Survival Analysis

Currie

Hodgins

Williams

et al. 2020

Preprint

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Background. There is little longitudinal evidence on the cumulative risk of harm from gambling associated with excess spending and frequency of play. The present study sought to assess the risk of gambling problems over a five-year period in adults who exceed previously derived low-risk gambling limits compared to those who remain within the limits after controlling for other modifiable risk factors. Methods. Participants were adults (N = 4212) drawn from two independent Canadian longitudinal cohort studies who reported gambling in the past year and were free of problem gambling at time 1. Multivariate Cox regression was employed to assess the impact over time of gambling above low-risk gambling thresholds (frequency ≥ 8 times per month; expenditure ≥ 75CAD per month; percent of household income spent on gambling ≥ 1.7%) on developing moderate harm and problem gambling. Covariates included presence of a DSM5 addiction or mental health disorder at time 1, irrational gambling beliefs, number of stressful life events in past 12 months, number of game types played each year, and playing electronic gaming machines or casino games. Results. In both samples, exceeding the low-risk gambling limits at time 1 significantly increased the risk of moderate harm (defined as ≥ 2 consequences on the Problem Gambling Severity Index [PGSI]) within five years after controlling for other modifiable risk factors. Other significant predictors of harm were presence of a mental disorder at time 1, cognitive distortions about gambling, stressful life events, and playing electronic gaming machines or casino games. In one sample, the five-year cumulative survival rate for moderate harm among individuals who stayed below all the low-risk limits was 95% compared to 83% among gamblers who exceeded all limits. Each additional low-risk limit exceeded increased the cumulative probability of harm by 30%. Similar results were found in models when the outcome was problem gambling.Conclusions. Level of gambling involvement represents a highly modifiable risk factor for later harm. Staying below empirically derived safe gambling thresholds reduces the risk of harm over time.

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Section: Introductionmentioning

confidence: 73%

Predicting Future Harm from Gambling over a Five-Year period in a General Population Sample: A Survival Analysis

Currie

Hodgins

Williams

et al. 2020

Preprint

Self Cite

View full text Add to dashboard Cite

show abstract

“…The present study should help to inform the expansion of responsible gambling advice to include quantitative thresholds. Canada’s work in developing low-risk gambling limits has since expanded to include many international collaborative partners who have expressed the desire to adopt the limits for their own country [ 14 ]. With endorsement by multiple stakeholders including treatment providers, responsible gambling advocacy groups, and government regulators, low-risk gambling limits will eventually enjoy broad circulation with other public health initiatives.…”

Section: Discussionmentioning

confidence: 99%

“…This research clearly shows that the more one gambles, the greater the likelihood of harm [ 11 – 13 ]. Gambling shares many of the same characteristics as alcohol in terms of the relationship between consumption levels and harm [ 14 ]. Like alcohol, gambling shows a reproducible dose-response relationship with increasing consumption leading to harm in most individuals [ 15 – 18 ].…”

Section: Introductionmentioning

confidence: 99%

Predicting future harm from gambling over a five-year period in a general population sample: a survival analysis

et al. 2021

Self Cite

View full text Add to dashboard Cite

Background There is little longitudinal evidence on the cumulative risk of harm from gambling associated with excess spending and frequency of play. The present study sought to assess the risk of gambling problems over a five-year period in adults who exceed previously derived low-risk gambling limits compared to those who remain within the limits after controlling for other modifiable risk factors. Methods Participants were adults (N = 4212) drawn from two independent Canadian longitudinal cohort studies who reported gambling in the past year and were free of problem gambling at time 1. Multivariate Cox regression was employed to assess the impact over time of gambling above low-risk gambling thresholds (frequency ≥ 8 times per month; expenditure ≥75CAD per month; percent of household income spent on gambling ≥1.7%) on developing moderate harm and problem gambling. Covariates included presence of a DSM5 addiction or mental health disorder at time 1, irrational gambling beliefs, number of stressful life events in past 12 months, number of game types played each year, and playing electronic gaming machines or casino games. Results In both samples, exceeding the low-risk gambling limits at time 1 significantly increased the risk of moderate harm (defined as ≥2 consequences on the Problem Gambling Severity Index [PGSI]) within 5 years after controlling for other modifiable risk factors. Other significant predictors of harm were presence of a mental disorder at time 1, cognitive distortions about gambling, stressful life events, and playing electronic gaming machines or casino games. In one sample, the five-year cumulative survival rate for moderate harm among individuals who stayed below all the low-risk limits was 95% compared to 83% among gamblers who exceeded all limits. Each additional low-risk limit exceeded increased the cumulative probability of harm by 30%. Similar results were found in models when the outcome was problem gambling. Conclusions Level of gambling involvement represents a highly modifiable risk factor for later harm. Staying below empirically derived safe gambling thresholds reduces the risk of harm over time.

show abstract

“…The present study should help to inform the expansion of responsible gambling advice to include quantitative thresholds. Canada's work in developing low-risk gambling limits has since expanded to include many international collaborative partners who have expressed the desire to adopt the limits for their own country [48]. With endorsement by multiple stakeholders including treatment providers, responsible gambling advocacy groups, and government regulators, low-risk gambling limits will eventually enjoy broad circulation with other public health initiatives.…”

Section: Limitationsmentioning

confidence: 99%

Predicting Future Harm from Gambling over a Five-Year period in a General Population Sample: A Survival Analysis

Currie

Hodgins

Williams

et al. 2020

Preprint

Self Cite

View full text Add to dashboard Cite

Background There is little longitudinal evidence on the cumulative risk of harm from gambling associated with excess spending and frequency of play. The present study sought to assess over a five-year period the risk of gambling problems in adults who exceed previously derived low-risk gambling limits compared to those who remain within the limits after controlling for other modifiable psychosocial risk factors. Methods Participants were adults (N = 4212) drawn from two independent Canadian longitudinal cohort studies (Quinte Longitudinal Study and Leisure, Lifestyle, and Lifecycle Project) who reported gambling in the past year and were free of problem gambling at time 1. Multivariate Cox regression was employed to assess the impact of gambling above low-risk gambling thresholds (frequency ≥ 8 times per month; expenditure ≥ $75CAN per month; percent of household income spent on gambling ≥ 1.7%) on developing gambling problems over time. Covariates included presence of a DSM 5 addiction or mental health disorder at time 1, irrational gambling beliefs, number of stressful life events in past 12 months, number of game types played each year, and playing electronic gaming machines or casino games. Results In both samples, exceeding the low-risk gambling limits at time 1 significantly increased the risk of moderate harm within five years after controlling for other modifiable risk factors. Other significant predictors of harm were presence of a mental disorder at time 1, cognitive distortions about gambling, stressful life events, and playing electronic gaming machines or casino games. In the QLS sample, the five-year cumulative survival rate among individuals who stayed below all the low-risk limits was 95% compared to 83% among gamblers who exceeded all limits. Each additional low-risk limit exceeded increased the cumulative probability of harm by 30%. Conclusions Level of gambling involvement represents a highly modifiable risk factor for later harm. Staying below empirically derived safe gambling thresholds reduces the risk of harm over time.

show abstract

A research plan to define Canada’s first low-risk gambling guidelines

Cited by 21 publications

References 48 publications

Predicting Future Harm from Gambling over a Five-Year period in a General Population Sample: A Survival Analysis

Predicting Future Harm from Gambling over a Five-Year period in a General Population Sample: A Survival Analysis

Predicting future harm from gambling over a five-year period in a general population sample: a survival analysis

Predicting Future Harm from Gambling over a Five-Year period in a General Population Sample: A Survival Analysis

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