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      The prevention paradox applies to some but not all gambling harms: Results from a Finnish population-representative survey


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          Background and aims

          The Prevention Paradox (PP) suggests that a large proportion of aggregate harm from gambling occurs to people who do not have a gambling disorder. However, it has not yet been tested using a population-representative sample. We aimed to test whether the PP applies to gambling in Finland. The prevalence rates of diverse harmful consequences from gambling were surveyed amongst a population-representative sample of past-year gamblers.


          The study used first wave data ( N = 7,186) of Finnish Gambling Harms survey, collected via online and postal surveys in 2017. A subset of 3,795 adults (≥18 years), who had gambled at least monthly in 2016, were selected for analysis.


          Gambling-related harms were evaluated with the 72-item Harms Checklist. Problem and Pathological Gambling Measure (PPGM) measured respondents’ probable disordered gambling from the subset of items for impaired control (4 questions) and other issues (3 questions).


          Consistent with previous findings, the majority of harms were reported by those in the less severe PPGM categories (i.e. scoring <5). However, considering each domain separately, this was true only for financial, emotional/psychological, and work/study harms. The PP was not supported for health, relationship, or social deviance harms.


          The population prevalence of the most serious harms (e.g. unsafe living conditions) is concentrated among those with severe impaired control issues. However, even excluding the ∼15% of harms occurring to occasional gamblers, most financial, emotional and work/study impacts occur to those with lower levels of control issues. Efforts at harm reduction should focus on the entire spectrum of issues that people experience from their gambling.

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          Most cited references46

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          The South Oaks Gambling Screen (SOGS): a new instrument for the identification of pathological gamblers

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            Understanding gambling related harm: a proposed definition, conceptual framework, and taxonomy of harms

            Background Harm from gambling is known to impact individuals, families, and communities; and these harms are not restricted to people with a gambling disorder. Currently, there is no robust and inclusive internationally agreed upon definition of gambling harm. In addition, the current landscape of gambling policy and research uses inadequate proxy measures of harm, such as problem gambling symptomology, that contribute to a limited understanding of gambling harms. These issues impede efforts to address gambling from a public health perspective. Methods Data regarding harms from gambling was gathered using four separate methodologies, a literature review, focus groups and interviews with professionals involved in the support and treatment of gambling problems, interviews with people who gamble and their affected others, and an analysis of public forum posts for people experiencing problems with gambling and their affected others. The experience of harm related to gambling was examined to generate a conceptual framework. The catalogue of harms experienced were organised as a taxonomy. Results The current paper proposes a definition and conceptual framework of gambling related harm that captures the full breadth of harms that gambling can contribute to; as well as a taxonomy of harms to facilitate the development of more appropriate measures of harm. Conclusions Our aim is to create a dialogue that will lead to a more coherent interpretation of gambling harm across treatment providers, policy makers and researchers.
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              A pathways model of problem and pathological gambling


                Author and article information

                J Behav Addict
                J Behav Addict
                Journal of Behavioral Addictions
                Akadémiai Kiadó (Budapest )
                June 2020
                07 July 2020
                : 9
                : 2
                : 371-382
                [1 ]Central Queensland University Bundaberg , Australia
                [2 ]School of Public Health and Health Sciences , University of Massachusetts Amherst, USA
                [3 ]Finnish Institute for Health and Welfare , Department of Public Health Solutions, Helsinki, Finland
                [4 ]University of Eastern Finland , Faculty of Health Sciences, Finland
                Author notes
                [* ]Corresponding author's e-mail: m.browne@ 123456cqu.edu.au
                © 2020 The Author(s)

                Open Access statement. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( https://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and reproduction in any medium for non-commercial purposes, provided the original author and source are credited, a link to the CC License is provided, and changes – if any – are indicated.

                : 07 February 2020
                : 01 April 2020
                : 22 April 2020
                Page count
                Figures: 10, References: 47, Pages: 12
                Funded by: Ministry of Social Affairs and Health, Helsinki, Finland (based on section 52 of the Appropriation of the lotteries Act)
                Full-length Report

                gambling harms,population survey,problem gambling,prevention paradox


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