J Gambl Stud DOI 10.1007/s10899-015-9558-6 ORIGINAL PAPER
The Challenge of Online Gambling: The Effect of Legalization on the Increase in Online Gambling Addiction Mariano Cho´liz1,2
Springer Science+Business Media New York 2015
Abstract It is possible that the growth and promotion of online gambling will result in substantially increased use of these types of games in countries where they are legal. This may be especially true for young people due to their interest in such games. In this context, it is important to note that online gambling is more addictive than any other type of game due its structural characteristics, such as immediacy, accessibility, ease of betting, and so on. This study examined the effect of online gambling in Spain 2 years after its legalization. The sample included 1277 pathological gamblers in recovery at 26 gambling addiction treatment centers. Our results showed a significant increase in young pathological gamblers since the legalization of this activity. This is a very relevant issue because, as in the case of Spain, many countries are currently in process of legalization of many types of online games. Scientific research can be useful to adapt the adequate gambling policies in order to prevent the gambling addiction. Keywords
Gambling addiction Online gambling Gambling policies
Introduction In response to a long history of arguments mounted by those in the medical, social, and scientific fields (Petry 2006a; Potenza 2006), pathological gambling is now included in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) in the same category as drug dependency, alcoholism, and tobacco addiction (APA 2013). The American Psychiatric Association (APA) provided the following clear justification for this
& Mariano Cho´liz [email protected] 1
Psychology of Addictions, Psychology School, University of Valencia, Avda. Blasco Iba´n˜ez, 21, 46010 Valencia, Spain
2
Member of the Responsible Gambling Advisory Council, Ministry of Finances, Madrid, Spain
123
J Gambl Stud
change: ‘‘…behaviors, such as gambling, activate the brain reward system with effects similar to those of drugs of abuse…gambling disorder symptoms resemble substance use disorders to a certain extent.’’ Thus, this is a psychological disorder that is directly triggered by gambling. Although many variables affect the preference for specific types of gambling (e.g., personality or motivational dimensions (Balodis et al. 2013; Binde 2013), cultural or social conditions (Raylu and Oei 2004; Tanioka 2000), stage of development (Griffiths 2002), etc.), some forms of gambling are more closely associated with problem gambling than are others (Abbott and Volberg 1999; Binde 2011). As Griffiths et al. (2009) noted, the addictive potential of a particular type of gambling depends on: (1) situational aspects, such as availability (Storer et al. 2009; Welte et al. 2007) or accessibility (Hing and Haw 2009; Thomas et al. 2008), and (2) structural characteristics, such as the immediacy of reinforcement (Cho´liz 2010) or the speed and frequency of gambling (Parke and Griffiths 2007). Similar to the global situation, the appearance and promotion of new online gambling methods in Spain is sparking a veritable revolution in this sector, not only in terms of economic activity but also in terms of the patterns of consumption and the profiles of players. This is highly relevant because online gambling is more addictive than any other type of game (Griffiths 2003; Griffiths et al. 2006; LaBrie et al. 2007; McBride and Derevensky 2009; Meyer et al. 2011; Monaghan 2009; Petry 2006b; Smith and Rupp 2005; Wood et al. 2012). One of the clearest pieces of evidence for this assertion is that online gamblers have higher rates of gambling addiction compared with traditional gamblers (Williams and Wood 2007; Wood and Williams 2007a, b, 2009; Wood et al. 2012). Similarly, the introduction of new media in which to gamble (Internet gambling or mobile phone gambling) has greatly increased the accessibility of gambling throughout the world; as a result, the number of people seeking assistance for gambling-related problems has also increased (Abbott et al. 2004). Online gambling has been legal in Spain since the passage of Act 13/2011, although the Government did not provide authorization to the gambling companies until June 2012. In 2013, Spanish individuals spent 7.2 billion dollars on online gambling, which accounted for approximately 18 % of the total amount of money spent on all types of gambling and constituted more than was spent on casino and bingo games combined (DGOJ 2014). As a result of the growth in online gaming, traditional gambling companies have been forced to react by increasing the incentives associated with their games and opening new game rooms (DGOJ 2014) in which traditional and online games coexist. In this context, which is similar to that in many others countries, given that the legalization of online gambling is a global phenomenon, it is necessary to understand how the emergence of online gambling is affecting gambling addiction. The objective of this research was to analyze the evolution of gambling addiction in Spain using data obtained from 26 gambling recovery associations across the country for the purpose of assessing the effect of online gambling on the appearance of new cases of pathological gambling, especially in young people.
Method Objective This work had the main objective of analyzing the effect of new types of games (i.e., online gambling) on the incidence of pathological gambling, especially in young people, who are
123
J Gambl Stud
potentially more vulnerable to this type of gambling because they use such technological tools more regularly.
Participants A total of 1277 pathological gamblers aged 16–82 years of age and in recovery (1195 males and 82 females) were recruited from 26 Spanish associations federated under the Spanish Federation of Gamblers in Recovery (FEJAR).
Hypotheses Hypothesis 1 The number of pathological gamblers seeking treatment due to online gambling will have increased during the period since licenses for online gambling were first granted. Hypothesis 2 This change will be especially significant among young individuals, for whom online gambling will have become in the most harmful form of gambling.
Procedure FEJAR is a federation of gambling associations that offers treatment and rehabilitation to pathological gamblers. Unlike Gamblers Anonymous, the FEJAR associations include healthcare professionals (psychologists, psychiatrists, social workers, etc.) who can diagnose and treat gambling addictions. These professionals analyzed data from the clinical interviews with the pathological gamblers described in this study. Sociodemographic and clinical indicators of pathological gambling were included to identify which type of game was the principal cause of the disorder (e.g., slot machines, casino games, bingo, etc.) for each recovering pathological gambler. Four time periods were distinguished: Period 1: Period 2: Period 3: Period 4:
pathological gamblers who sought assistance before June 1, 2012, the date on which online gambling companies were authorized to operate in Spain pathological gamblers who sought assistance during the first year (between 06/1/2012 and 05/31/2013) pathological gamblers who sought assistance during the second year (between 06/1/2013 and 05/31/2014) pathological gamblers who sought assistance during the third year (between 06/1/2014 and 02/15/2015)
Results A total of 1277 short surveys were completed from among a sample of 1195 (93.6 %) males and 82 (6.4 %) females. The age range of participants was 16–82 years. The number of pathological gamblers who began treatment during each period is shown in Table 1. Those aged \26 years were classified as young gamblers. The games that represented the main forms of addiction are listed in Table 2. The data are expressed as percentages; for example, the value 80.26 for slot machines in Period 1 indicates that psychologists or psychiatrists considered slot machines to be the predominant
123
J Gambl Stud Table 1 Pathological gamblers in treatment
Total gamblers
Young gamblers (percentage of total)
Period 1
158
6 (4)
Period 2
235
19 (8)
Period 3
534
61 (11)
Period 4
350
56 (16)
Table 2 Main forms of gambling addiction Period 1
Period 2
Period 3
Period 4
Slot machines
122 (80.26 %)
173 (80.09 %)
385 (72.50 %)
228 (65.71 %)
Casino games
13 (8.23 %)
24 (11.11 %)
38 (7.16 %)
54 (15.56 %)
Bingo
16 (10.13 %)
23 (10.65 %)
39 (7.34 %)
25 (7.20 %)
Lotteries
9 (5.70 %)
6 (2.78 %)
22 (4.14 %)
6 (1.73 %)
Online gambling
4 (2.53 %)
20 (9.26 %)
57 (10.73 %)
84 (24.21 %)
form of gambling addiction in 80.26 % of cases). The number of cases of addiction associated with each type of game is also shown in Table 2, with percentages presented within parentheses. The sum of percentages exceeds 100 % because, in certain cases, pathological gambling was judged to have included more than one type of game. The percentage of pathological gamblers who engaged in online gambling increased between periods 1 and 4. The differences between periods 1 (before legalization) and 2 (F = 26.18, p \ .01), between periods 3 and 4 (the present time) (F = 115.39, p \ .001), and between periods 1 and 4 (F = 263.82, p \ .001) were statistically significant. In terms of the age of pathological gamblers, the proportion of young people in treatment due to gambling addiction progressively increased as a function of time. The differences between periods 1 and 2 (F = 12.26, p \ .001), between periods 2 and 3 (F = 8.32, p \ .001), betweens period 3 and 4 (F = 14.93, p \ .001), and between periods 1 and 4 (F = 79.10, p \ .001) were statistically significant among those in this age group. Finally, the percentage of young pathological gamblers who engaged in online gambling increased from 0 % in period 1 to 44.64 % in period 4 (F = 500.00, p \ .001) (see Fig. 1). Online gambling is now the predominant form of pathological gambling in younger people, accounting for 44.64 % of the total number of cases of pathological gambling in this population.
Discussion and Conclusions This work analyses how the legalization of online gambling has affected the emergence of pathological gamblers for whom the cause of the addiction is online gambling. We hypothesized that: (1) there would be an increasing number of cases of pathological gambling involving online games in the clinical population (due to the addictive potential of the online gambling), and (2) this would disproportionately affect young people, because online gambling targets this group (since young people are more frequent users of online technologies and find online games are more attractive than traditional games).
123
J Gambl Stud
Fig. 1 Main forms of gambling addiction
The results of this brief study are significant because, in all cases, the participants experienced numerous problems with gambling and were in the process of receiving treatment for their addiction when the research was carried out. The sample was also representative of typical gamblers in recovery in Spain, because it was relatively large (N = 1277) and pathological gamblers were recruited from 26 different gambling recovery associations situated within the most of the regions that comprise the country. Moreover, the analysis that identified the games that were most frequently associated with this disorder was performed using state-of-the-art statistical techniques. Furthermore, the psychologists or psychiatrists who rendered the pathological gambling diagnoses and judged the main cause of the disorder in each case were blinded; that is, they did not know the objective of the research. There were no differences with respect to the percentage of women in treatment between the period before the legalization of online gambling and the period after. It should be noted that males account for 93 % of the total number of pathological gamblers in treatment, reflecting the existence of gender differences in treatment-seeking pathological gamblers (Ladd and Petry 2002). Women find it more difficult to seek help for pathological gambling, which should be a very significant consideration in attempts to understand the problem of pathological gambling from a gender perspective, because there are clinical gender differences among pathological gamblers seeking treatment (Echeburu´a et al. 2011). Regarding the main objective of this study, namely to analyze the effect of the legalization of online gambling on pathological gambling, we observed an increase in cases of gambling addiction associated with the promotion of these new modalities. Although the most harmful game in the general population remains slot machines, online gambling already surpasses all of the other types of game (bingo, casino, etc.), and this occurred within the first months of its legalization. Online gambling represents the main cause of pathological gambling in 24.21 % of pathological gamblers in recovery. This is a remarkable result for two reasons. First, pathological gamblers typically seek professional help many years after the appearance of the disorder (i.e., 6–8 years after onset). However, in the case of online gambling, the prevalence of the disorder increased markedly within only a few months. Furthermore, the proportion of online gamblers reached a level not seen for any other game aside from slot machines, which represents the main cause of gambling addiction in Spain (there are machines not only in gaming halls and casinos but in almost all bars, pubs, and restaurants). Second, as predicted, this problem is especially serious among young people. This is highly relevant for two reasons. First, the incidence of young pathological gamblers in recovery in Spain increased markedly, from 3.8 % (before the legalization of online
123
J Gambl Stud
gambling) to 16 % (only 2 years later). Moreover, online gambling is currently the main form of pathological gambling among people younger than 26 years of age; 44.64 % of all young pathological gamblers express the disorder through online gambling, surpassing slot machines (33.92 %). All of these results highlight that it is imperative to regulate online gambling and employ effective public health policies to prevent the appearance of gambling addiction. We believe that these data are globally generalizable, because online gambling is practiced all over the world. Several limitations of the current study should be taken into account in interpreting the results. First, this research was not conducted as an epidemiological study with the aim of determining the prevalence of gambling disorder in society. Although we can infer that the number of pathological gamblers probably increased after the legalization of online gambling, due to an increase in the types of gambling on offer and the availability of games, this cannot be asserted with any certainty, due to the lack of a national survey of pathological gambling in Spain to establish prevalence rates. Second, even before licenses were granted to online gambling companies, some of these companies had already been operating in Spain for several years; however, the size and development of this industry during the years prior to legalization remains unknown. After the granting of licenses, 53 companies with 86 licenses offered online gambling in Spain. Since legalization, publicity and marketing activities have greatly increased, and online gambling is now widely promoted on TV, the radio and the Internet. In fact, online gambling companies spend approximately 61 % of gambling’s markup on publicity (DGOJ 2014). Therefore, we suggest that this brief report could serve to inform health policies in countries where online gambling is currently in the process of being legalized and to encourage governments to implement effective gambling-related policies based on the principles of responsible gambling (Blaszczynski et al. 2011), or on the ethical gambling (Cho´liz 2014). Acknowledgments I have not any funding by part of companies. This research has not any commercial interest. This work has been possible by the agreement between the Spanish Federation of Gamblers in Recovery (FEJAR) and the University of Valencia.
References Abbott, M. W., & Volberg, R. A. (1999). Gambling and problem gambling in the community: An international overview and critique. Report number one of the New Zealand Gaming Survey. Wellington: Department of Internal Affairs. Abbott, M. W., Volberg, R. A., Bellringer, M., & Reith, G. (2004). A review of research aspects of problem gambling. London: Responsibility in Gambling Trust. APA, American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: American Psychiatric Association. Balodis, S. R. S., Thomas, A. C., & Moore, S. M. (2013). Sensitivity to reward and punishment: Horse race and EGM gamblers compared. Personality and Individual Differences. E-publication ahead of print. doi:10.1016/j.paid.2013.08.015 Binde, P. (2011). What are the more harmful forms of gambling? Analyzing problem gambling prevalence surveys. Go¨teborg: CEFOS Working Paper 12. Binde, P. (2013). Why people gamble: A model with five motivational dimensions. International Gambling Studies, 13, 81–97.
123
J Gambl Stud Blaszczynski, A., Collins, P., Fong, D., Ladouceur, R., Nower, L., Shaffer, H. J., et al. (2011). Responsible gambling: General principles and minimal requirements. Journal of Gambling Studies, 27, 565–573. Cho´liz, M. (2010). Experimental analysis of the game in pathological gamblers: Effect of the immediacy or the reward in slot machines. Journal of Gambling Studies, 26, 249–256. Cho´liz, M. (2014). Ethical gambling: A commitment to preventing gambling addiction from the political and social standpoints. Revista Espan˜ola de Drogodependencias, 39, 10–13. Retrieved from: www.aesed. com/descargas/revistas/v39n4_editorial2.pdf DGOJ, General Directorate of Gambling Regulation. (2014). Memoria anual 2013. Ministerio de Hacienda. http://www.ordenacionjuego.es/es/estudios-informes Echeburu´a, E., Gonza´lez-Ortega, I., Corral, P., & Polo-Lo´pez, R. (2011). Clinical gender differences among adult pathological gamblers seeking treatment: An exploratory study. Journal of Gambling Studies, 27, 215–227. Griffiths, M. D. (2002). Gambling and gaming addictions in adolescence. Leicester: British Psychological Society/Blackwells. Griffiths, M. D. (2003). Internet gambling: Issues, concerns and recommendations. CyberPsychology & Behavior, 6, 557–568. Griffiths, M. D., Hayer, T., & Meyer, G. (2009). Problem gambling: A European perspective. In G. Meyer, T. Hayer, & M. D. Griffiths (Eds.), Problem gaming in Europe: Challenges, prevention, and interventions (pp. xix–xxix). New York: Springer. Griffiths, M. D., Parke, A., Wood, R., & Parke, J. (2006). Internet gambling: An overview of psychosocial impacts. UNLV Gaming Research & Review Journal, 10, 27–39. Hing, N., & Haw, J. (2009). The development of a multi-dimensional gambling accessibility scale. Journal of Gambling Studies, 25, 569–581. LaBrie, R. A., LaPlante, D. A., Nelson, S. E., Schumann, A., & Shaffer, H. J. (2007). Assessing the playing field: A prospective longitudinal study of Internet sports gambling behavior. Journal of Gambling Studies, 23, 347–362. Ladd, G. T., & Petry, N. M. (2002). Gender differences among pathological gamblers seeking treatment. Experimental and Clinical Psychopharmacology, 10, 302–309. McBride, J., & Derevensky, J. (2009). Internet gambling behavior in a sample of online gamblers. International Journal of Mental & Health Addiction, 7, 149–167. Meyer, G., Fiebig, M., Hafeli, J., & Morsen, C. (2011). Development of an assessment tool to evaluate the risk potential of different gambling types. International Gambling Studies, 11, 221–236. Monaghan, S. (2009). Internet gambling—Not just a fad. International Gambling Studies, 9, 1–4. Parke, J., & Griffiths, M. (2007). The role of structural characteristics in gambling. In G. Smith, D. C. Hodgins, & R. J. Williams (Eds.), Research and measurement issues in gambling studies (pp. 217–249). Burlington, MA: Elsevier. Petry, N. M. (2006a). Should the scope of addictive behaviors be broadened to include pathological gambling? Addiction, 101, 152–160. Petry, N. M. (2006b). Internet gambling: An emerging concern in family practice medicine? Family Practice, 23, 421–426. Potenza, M. N. (2006). Should addictive disorders include non-substance related conditions? Addiction, 101, 142–151. Raylu, N., & Oei, T. P. (2004). Role of culture in gambling and problem gambling. Clinical Psychology Review, 23, 1087–1114. Smith, A. D., & Rupp, W. T. (2005). Service marketing aspects associated with the allure of e-gambling. Services Marketing Quarterly, 26, 83–103. Storer, J., Abbott, M., & Stubbs, J. (2009). Access or adaptation? A meta-analysis of surveys of problem gambling prevalence in Australia and New Zealand with respect to concentration of electronic gaming machines. International Gambling Studies, 9, 225–244. Tanioka, I. (2000). Pachinko and the Japanese society. Osaka, Japan: Osaka University of Commerce. Thomas, A. C., Sullivan, G. B., & Allen, F. C. L. (2008). A theoretical model of EGM problem gambling: More than a cognitive escape. International Journal of Mental Health and Addiction. doi:10.1007/ s11469-008-9152-6. Welte, J. W., Barnes, G. M., Wieczorek, W. F., Tidwell, M.-C. O., & Hoffman, J. H. (2007). Type of gambling and availability as risk factors for problem gambling: A Tobit regression analysis by age and gender. International Gambling Studies, 7, 183–198. Williams, R. J., & Wood, R. T. (2007). The proportion of Ontario gambling revenue derived from problem gamblers. Canadian Public Policy, 33, 367–387. Wood, R. T., & Williams, R. J. (2007a). Problem gambling on the Internet: Implications for Internet gambling policy in North America. New Media & Society, 9, 520–542.
123
J Gambl Stud Wood, R. T., & Williams, R. J. (2007b). Internet gambling: Past, present and future. In G. Smith, D. C. Hodgins, & R. J. Williams (Eds.), Research and measurement issues in gambling studies (pp. 486–502). Burlington, MA: Elsevier. Wood, R. T., & Williams, R. J. (2009). Internet gambling: Prevalence, patterns, problems, and policy options. Final Report to the Ontario Problem Gambling Research Centre. Guelph, ON: Ontario Problem Gambling Research Centre. http://hdl.handle.net/10133/693 Wood, R. T., Williams, R. J., & Parke, J. (2012). The relationship between problem gambling and Internet gambling. In R. J. Williams, R. T. Wood, & J. Parke (Eds.), Routledge international handbook of Internet gambling (pp. 200–211). London: Routledge.
123
The Challenge of Online Gambling: The Effect of Legalization on the Increase in Online Gambling Addiction Mariano Cho´liz1,2
Springer Science+Business Media New York 2015
Abstract It is possible that the growth and promotion of online gambling will result in substantially increased use of these types of games in countries where they are legal. This may be especially true for young people due to their interest in such games. In this context, it is important to note that online gambling is more addictive than any other type of game due its structural characteristics, such as immediacy, accessibility, ease of betting, and so on. This study examined the effect of online gambling in Spain 2 years after its legalization. The sample included 1277 pathological gamblers in recovery at 26 gambling addiction treatment centers. Our results showed a significant increase in young pathological gamblers since the legalization of this activity. This is a very relevant issue because, as in the case of Spain, many countries are currently in process of legalization of many types of online games. Scientific research can be useful to adapt the adequate gambling policies in order to prevent the gambling addiction. Keywords
Gambling addiction Online gambling Gambling policies
Introduction In response to a long history of arguments mounted by those in the medical, social, and scientific fields (Petry 2006a; Potenza 2006), pathological gambling is now included in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) in the same category as drug dependency, alcoholism, and tobacco addiction (APA 2013). The American Psychiatric Association (APA) provided the following clear justification for this
& Mariano Cho´liz [email protected] 1
Psychology of Addictions, Psychology School, University of Valencia, Avda. Blasco Iba´n˜ez, 21, 46010 Valencia, Spain
2
Member of the Responsible Gambling Advisory Council, Ministry of Finances, Madrid, Spain
123
J Gambl Stud
change: ‘‘…behaviors, such as gambling, activate the brain reward system with effects similar to those of drugs of abuse…gambling disorder symptoms resemble substance use disorders to a certain extent.’’ Thus, this is a psychological disorder that is directly triggered by gambling. Although many variables affect the preference for specific types of gambling (e.g., personality or motivational dimensions (Balodis et al. 2013; Binde 2013), cultural or social conditions (Raylu and Oei 2004; Tanioka 2000), stage of development (Griffiths 2002), etc.), some forms of gambling are more closely associated with problem gambling than are others (Abbott and Volberg 1999; Binde 2011). As Griffiths et al. (2009) noted, the addictive potential of a particular type of gambling depends on: (1) situational aspects, such as availability (Storer et al. 2009; Welte et al. 2007) or accessibility (Hing and Haw 2009; Thomas et al. 2008), and (2) structural characteristics, such as the immediacy of reinforcement (Cho´liz 2010) or the speed and frequency of gambling (Parke and Griffiths 2007). Similar to the global situation, the appearance and promotion of new online gambling methods in Spain is sparking a veritable revolution in this sector, not only in terms of economic activity but also in terms of the patterns of consumption and the profiles of players. This is highly relevant because online gambling is more addictive than any other type of game (Griffiths 2003; Griffiths et al. 2006; LaBrie et al. 2007; McBride and Derevensky 2009; Meyer et al. 2011; Monaghan 2009; Petry 2006b; Smith and Rupp 2005; Wood et al. 2012). One of the clearest pieces of evidence for this assertion is that online gamblers have higher rates of gambling addiction compared with traditional gamblers (Williams and Wood 2007; Wood and Williams 2007a, b, 2009; Wood et al. 2012). Similarly, the introduction of new media in which to gamble (Internet gambling or mobile phone gambling) has greatly increased the accessibility of gambling throughout the world; as a result, the number of people seeking assistance for gambling-related problems has also increased (Abbott et al. 2004). Online gambling has been legal in Spain since the passage of Act 13/2011, although the Government did not provide authorization to the gambling companies until June 2012. In 2013, Spanish individuals spent 7.2 billion dollars on online gambling, which accounted for approximately 18 % of the total amount of money spent on all types of gambling and constituted more than was spent on casino and bingo games combined (DGOJ 2014). As a result of the growth in online gaming, traditional gambling companies have been forced to react by increasing the incentives associated with their games and opening new game rooms (DGOJ 2014) in which traditional and online games coexist. In this context, which is similar to that in many others countries, given that the legalization of online gambling is a global phenomenon, it is necessary to understand how the emergence of online gambling is affecting gambling addiction. The objective of this research was to analyze the evolution of gambling addiction in Spain using data obtained from 26 gambling recovery associations across the country for the purpose of assessing the effect of online gambling on the appearance of new cases of pathological gambling, especially in young people.
Method Objective This work had the main objective of analyzing the effect of new types of games (i.e., online gambling) on the incidence of pathological gambling, especially in young people, who are
123
J Gambl Stud
potentially more vulnerable to this type of gambling because they use such technological tools more regularly.
Participants A total of 1277 pathological gamblers aged 16–82 years of age and in recovery (1195 males and 82 females) were recruited from 26 Spanish associations federated under the Spanish Federation of Gamblers in Recovery (FEJAR).
Hypotheses Hypothesis 1 The number of pathological gamblers seeking treatment due to online gambling will have increased during the period since licenses for online gambling were first granted. Hypothesis 2 This change will be especially significant among young individuals, for whom online gambling will have become in the most harmful form of gambling.
Procedure FEJAR is a federation of gambling associations that offers treatment and rehabilitation to pathological gamblers. Unlike Gamblers Anonymous, the FEJAR associations include healthcare professionals (psychologists, psychiatrists, social workers, etc.) who can diagnose and treat gambling addictions. These professionals analyzed data from the clinical interviews with the pathological gamblers described in this study. Sociodemographic and clinical indicators of pathological gambling were included to identify which type of game was the principal cause of the disorder (e.g., slot machines, casino games, bingo, etc.) for each recovering pathological gambler. Four time periods were distinguished: Period 1: Period 2: Period 3: Period 4:
pathological gamblers who sought assistance before June 1, 2012, the date on which online gambling companies were authorized to operate in Spain pathological gamblers who sought assistance during the first year (between 06/1/2012 and 05/31/2013) pathological gamblers who sought assistance during the second year (between 06/1/2013 and 05/31/2014) pathological gamblers who sought assistance during the third year (between 06/1/2014 and 02/15/2015)
Results A total of 1277 short surveys were completed from among a sample of 1195 (93.6 %) males and 82 (6.4 %) females. The age range of participants was 16–82 years. The number of pathological gamblers who began treatment during each period is shown in Table 1. Those aged \26 years were classified as young gamblers. The games that represented the main forms of addiction are listed in Table 2. The data are expressed as percentages; for example, the value 80.26 for slot machines in Period 1 indicates that psychologists or psychiatrists considered slot machines to be the predominant
123
J Gambl Stud Table 1 Pathological gamblers in treatment
Total gamblers
Young gamblers (percentage of total)
Period 1
158
6 (4)
Period 2
235
19 (8)
Period 3
534
61 (11)
Period 4
350
56 (16)
Table 2 Main forms of gambling addiction Period 1
Period 2
Period 3
Period 4
Slot machines
122 (80.26 %)
173 (80.09 %)
385 (72.50 %)
228 (65.71 %)
Casino games
13 (8.23 %)
24 (11.11 %)
38 (7.16 %)
54 (15.56 %)
Bingo
16 (10.13 %)
23 (10.65 %)
39 (7.34 %)
25 (7.20 %)
Lotteries
9 (5.70 %)
6 (2.78 %)
22 (4.14 %)
6 (1.73 %)
Online gambling
4 (2.53 %)
20 (9.26 %)
57 (10.73 %)
84 (24.21 %)
form of gambling addiction in 80.26 % of cases). The number of cases of addiction associated with each type of game is also shown in Table 2, with percentages presented within parentheses. The sum of percentages exceeds 100 % because, in certain cases, pathological gambling was judged to have included more than one type of game. The percentage of pathological gamblers who engaged in online gambling increased between periods 1 and 4. The differences between periods 1 (before legalization) and 2 (F = 26.18, p \ .01), between periods 3 and 4 (the present time) (F = 115.39, p \ .001), and between periods 1 and 4 (F = 263.82, p \ .001) were statistically significant. In terms of the age of pathological gamblers, the proportion of young people in treatment due to gambling addiction progressively increased as a function of time. The differences between periods 1 and 2 (F = 12.26, p \ .001), between periods 2 and 3 (F = 8.32, p \ .001), betweens period 3 and 4 (F = 14.93, p \ .001), and between periods 1 and 4 (F = 79.10, p \ .001) were statistically significant among those in this age group. Finally, the percentage of young pathological gamblers who engaged in online gambling increased from 0 % in period 1 to 44.64 % in period 4 (F = 500.00, p \ .001) (see Fig. 1). Online gambling is now the predominant form of pathological gambling in younger people, accounting for 44.64 % of the total number of cases of pathological gambling in this population.
Discussion and Conclusions This work analyses how the legalization of online gambling has affected the emergence of pathological gamblers for whom the cause of the addiction is online gambling. We hypothesized that: (1) there would be an increasing number of cases of pathological gambling involving online games in the clinical population (due to the addictive potential of the online gambling), and (2) this would disproportionately affect young people, because online gambling targets this group (since young people are more frequent users of online technologies and find online games are more attractive than traditional games).
123
J Gambl Stud
Fig. 1 Main forms of gambling addiction
The results of this brief study are significant because, in all cases, the participants experienced numerous problems with gambling and were in the process of receiving treatment for their addiction when the research was carried out. The sample was also representative of typical gamblers in recovery in Spain, because it was relatively large (N = 1277) and pathological gamblers were recruited from 26 different gambling recovery associations situated within the most of the regions that comprise the country. Moreover, the analysis that identified the games that were most frequently associated with this disorder was performed using state-of-the-art statistical techniques. Furthermore, the psychologists or psychiatrists who rendered the pathological gambling diagnoses and judged the main cause of the disorder in each case were blinded; that is, they did not know the objective of the research. There were no differences with respect to the percentage of women in treatment between the period before the legalization of online gambling and the period after. It should be noted that males account for 93 % of the total number of pathological gamblers in treatment, reflecting the existence of gender differences in treatment-seeking pathological gamblers (Ladd and Petry 2002). Women find it more difficult to seek help for pathological gambling, which should be a very significant consideration in attempts to understand the problem of pathological gambling from a gender perspective, because there are clinical gender differences among pathological gamblers seeking treatment (Echeburu´a et al. 2011). Regarding the main objective of this study, namely to analyze the effect of the legalization of online gambling on pathological gambling, we observed an increase in cases of gambling addiction associated with the promotion of these new modalities. Although the most harmful game in the general population remains slot machines, online gambling already surpasses all of the other types of game (bingo, casino, etc.), and this occurred within the first months of its legalization. Online gambling represents the main cause of pathological gambling in 24.21 % of pathological gamblers in recovery. This is a remarkable result for two reasons. First, pathological gamblers typically seek professional help many years after the appearance of the disorder (i.e., 6–8 years after onset). However, in the case of online gambling, the prevalence of the disorder increased markedly within only a few months. Furthermore, the proportion of online gamblers reached a level not seen for any other game aside from slot machines, which represents the main cause of gambling addiction in Spain (there are machines not only in gaming halls and casinos but in almost all bars, pubs, and restaurants). Second, as predicted, this problem is especially serious among young people. This is highly relevant for two reasons. First, the incidence of young pathological gamblers in recovery in Spain increased markedly, from 3.8 % (before the legalization of online
123
J Gambl Stud
gambling) to 16 % (only 2 years later). Moreover, online gambling is currently the main form of pathological gambling among people younger than 26 years of age; 44.64 % of all young pathological gamblers express the disorder through online gambling, surpassing slot machines (33.92 %). All of these results highlight that it is imperative to regulate online gambling and employ effective public health policies to prevent the appearance of gambling addiction. We believe that these data are globally generalizable, because online gambling is practiced all over the world. Several limitations of the current study should be taken into account in interpreting the results. First, this research was not conducted as an epidemiological study with the aim of determining the prevalence of gambling disorder in society. Although we can infer that the number of pathological gamblers probably increased after the legalization of online gambling, due to an increase in the types of gambling on offer and the availability of games, this cannot be asserted with any certainty, due to the lack of a national survey of pathological gambling in Spain to establish prevalence rates. Second, even before licenses were granted to online gambling companies, some of these companies had already been operating in Spain for several years; however, the size and development of this industry during the years prior to legalization remains unknown. After the granting of licenses, 53 companies with 86 licenses offered online gambling in Spain. Since legalization, publicity and marketing activities have greatly increased, and online gambling is now widely promoted on TV, the radio and the Internet. In fact, online gambling companies spend approximately 61 % of gambling’s markup on publicity (DGOJ 2014). Therefore, we suggest that this brief report could serve to inform health policies in countries where online gambling is currently in the process of being legalized and to encourage governments to implement effective gambling-related policies based on the principles of responsible gambling (Blaszczynski et al. 2011), or on the ethical gambling (Cho´liz 2014). Acknowledgments I have not any funding by part of companies. This research has not any commercial interest. This work has been possible by the agreement between the Spanish Federation of Gamblers in Recovery (FEJAR) and the University of Valencia.
References Abbott, M. W., & Volberg, R. A. (1999). Gambling and problem gambling in the community: An international overview and critique. Report number one of the New Zealand Gaming Survey. Wellington: Department of Internal Affairs. Abbott, M. W., Volberg, R. A., Bellringer, M., & Reith, G. (2004). A review of research aspects of problem gambling. London: Responsibility in Gambling Trust. APA, American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: American Psychiatric Association. Balodis, S. R. S., Thomas, A. C., & Moore, S. M. (2013). Sensitivity to reward and punishment: Horse race and EGM gamblers compared. Personality and Individual Differences. E-publication ahead of print. doi:10.1016/j.paid.2013.08.015 Binde, P. (2011). What are the more harmful forms of gambling? Analyzing problem gambling prevalence surveys. Go¨teborg: CEFOS Working Paper 12. Binde, P. (2013). Why people gamble: A model with five motivational dimensions. International Gambling Studies, 13, 81–97.
123
J Gambl Stud Blaszczynski, A., Collins, P., Fong, D., Ladouceur, R., Nower, L., Shaffer, H. J., et al. (2011). Responsible gambling: General principles and minimal requirements. Journal of Gambling Studies, 27, 565–573. Cho´liz, M. (2010). Experimental analysis of the game in pathological gamblers: Effect of the immediacy or the reward in slot machines. Journal of Gambling Studies, 26, 249–256. Cho´liz, M. (2014). Ethical gambling: A commitment to preventing gambling addiction from the political and social standpoints. Revista Espan˜ola de Drogodependencias, 39, 10–13. Retrieved from: www.aesed. com/descargas/revistas/v39n4_editorial2.pdf DGOJ, General Directorate of Gambling Regulation. (2014). Memoria anual 2013. Ministerio de Hacienda. http://www.ordenacionjuego.es/es/estudios-informes Echeburu´a, E., Gonza´lez-Ortega, I., Corral, P., & Polo-Lo´pez, R. (2011). Clinical gender differences among adult pathological gamblers seeking treatment: An exploratory study. Journal of Gambling Studies, 27, 215–227. Griffiths, M. D. (2002). Gambling and gaming addictions in adolescence. Leicester: British Psychological Society/Blackwells. Griffiths, M. D. (2003). Internet gambling: Issues, concerns and recommendations. CyberPsychology & Behavior, 6, 557–568. Griffiths, M. D., Hayer, T., & Meyer, G. (2009). Problem gambling: A European perspective. In G. Meyer, T. Hayer, & M. D. Griffiths (Eds.), Problem gaming in Europe: Challenges, prevention, and interventions (pp. xix–xxix). New York: Springer. Griffiths, M. D., Parke, A., Wood, R., & Parke, J. (2006). Internet gambling: An overview of psychosocial impacts. UNLV Gaming Research & Review Journal, 10, 27–39. Hing, N., & Haw, J. (2009). The development of a multi-dimensional gambling accessibility scale. Journal of Gambling Studies, 25, 569–581. LaBrie, R. A., LaPlante, D. A., Nelson, S. E., Schumann, A., & Shaffer, H. J. (2007). Assessing the playing field: A prospective longitudinal study of Internet sports gambling behavior. Journal of Gambling Studies, 23, 347–362. Ladd, G. T., & Petry, N. M. (2002). Gender differences among pathological gamblers seeking treatment. Experimental and Clinical Psychopharmacology, 10, 302–309. McBride, J., & Derevensky, J. (2009). Internet gambling behavior in a sample of online gamblers. International Journal of Mental & Health Addiction, 7, 149–167. Meyer, G., Fiebig, M., Hafeli, J., & Morsen, C. (2011). Development of an assessment tool to evaluate the risk potential of different gambling types. International Gambling Studies, 11, 221–236. Monaghan, S. (2009). Internet gambling—Not just a fad. International Gambling Studies, 9, 1–4. Parke, J., & Griffiths, M. (2007). The role of structural characteristics in gambling. In G. Smith, D. C. Hodgins, & R. J. Williams (Eds.), Research and measurement issues in gambling studies (pp. 217–249). Burlington, MA: Elsevier. Petry, N. M. (2006a). Should the scope of addictive behaviors be broadened to include pathological gambling? Addiction, 101, 152–160. Petry, N. M. (2006b). Internet gambling: An emerging concern in family practice medicine? Family Practice, 23, 421–426. Potenza, M. N. (2006). Should addictive disorders include non-substance related conditions? Addiction, 101, 142–151. Raylu, N., & Oei, T. P. (2004). Role of culture in gambling and problem gambling. Clinical Psychology Review, 23, 1087–1114. Smith, A. D., & Rupp, W. T. (2005). Service marketing aspects associated with the allure of e-gambling. Services Marketing Quarterly, 26, 83–103. Storer, J., Abbott, M., & Stubbs, J. (2009). Access or adaptation? A meta-analysis of surveys of problem gambling prevalence in Australia and New Zealand with respect to concentration of electronic gaming machines. International Gambling Studies, 9, 225–244. Tanioka, I. (2000). Pachinko and the Japanese society. Osaka, Japan: Osaka University of Commerce. Thomas, A. C., Sullivan, G. B., & Allen, F. C. L. (2008). A theoretical model of EGM problem gambling: More than a cognitive escape. International Journal of Mental Health and Addiction. doi:10.1007/ s11469-008-9152-6. Welte, J. W., Barnes, G. M., Wieczorek, W. F., Tidwell, M.-C. O., & Hoffman, J. H. (2007). Type of gambling and availability as risk factors for problem gambling: A Tobit regression analysis by age and gender. International Gambling Studies, 7, 183–198. Williams, R. J., & Wood, R. T. (2007). The proportion of Ontario gambling revenue derived from problem gamblers. Canadian Public Policy, 33, 367–387. Wood, R. T., & Williams, R. J. (2007a). Problem gambling on the Internet: Implications for Internet gambling policy in North America. New Media & Society, 9, 520–542.
123
J Gambl Stud Wood, R. T., & Williams, R. J. (2007b). Internet gambling: Past, present and future. In G. Smith, D. C. Hodgins, & R. J. Williams (Eds.), Research and measurement issues in gambling studies (pp. 486–502). Burlington, MA: Elsevier. Wood, R. T., & Williams, R. J. (2009). Internet gambling: Prevalence, patterns, problems, and policy options. Final Report to the Ontario Problem Gambling Research Centre. Guelph, ON: Ontario Problem Gambling Research Centre. http://hdl.handle.net/10133/693 Wood, R. T., Williams, R. J., & Parke, J. (2012). The relationship between problem gambling and Internet gambling. In R. J. Williams, R. T. Wood, & J. Parke (Eds.), Routledge international handbook of Internet gambling (pp. 200–211). London: Routledge.
123
