2026/02/17 by Esther C. Moore, Robert Pryce, Hazel Squires +1 · 1 voice
Medicine · Psychology · #Gambling Behavior and Treatments #Spondyloarthritis Studies and Treatments #Substance Abuse Treatment and Outcomes
paper · pdf · doi:10.1111/add.70344
openalex publication_date 2026/02/17 · openalex created_date 2026/02/18 · openalex updated_date 2026/07/25
BACKGROUND AND AIMS: Health economic models can be used to assess the effectiveness and cost-effectiveness of public health policies for gambling. To develop such a model, we must understand how gambling behaviour is associated with risk of experiencing gambling-related harms. This study aimed to: (1) assess the strength of association between gambling frequency and the risk of gambling-related harm and to examine how these associations differ when lottery-only players are excluded; (2) apply the study's findings in a hypothetical policy model aimed at reducing gambling frequency. DESIGN: Observational study using six waves of cross-sectional data from the Health Survey for England and the Scottish Health Survey. SETTING: Survey conducted in England in 2015, 2016 and 2018 and Scotland in 2015, 2016 and 2017. PARTICIPANTS: The sample included 16 648 adults (aged 18 and over) who reported gambling in the past year, generally representative of the populations of England and Scotland. MEASUREMENTS: Gambling frequency was measured using 6 categories which indicated frequency in the past 12 months: (a) 2 or more times a week; (b) once a week; (c) less than once a week, more than once a month; (d) once a month; (e) every 2-3 months; (f) once or twice a year. Risk of gambling-related harm was assessed using Problem Gambling Severity Index (PGSI) score (0-27) and its four categories: no-risk (0), low-risk (1-2), moderate-risk (3-7) and high-risk (≥8). Control variables included age, sex, deprivation, social grade, presence of mental disorder and frequency of drinking alcohol. FINDINGS: Using multinomial logistic regression and zero-inflated negative binomial models we found that gambling at least twice weekly was associated with a statistically significantly higher PGSI score than gambling once or twice a year (incidence rate ratio = 3.528, 95% confidence interval = 2.040-6.103, P value < 0.001). Reducing gambling to guideline levels for people gambling at least twice weekly moved 10% of the sub-sample from higher PGSI categories (low, medium and high risk) to the no-risk category and shifted the distribution of PGSI scores down. CONCLUSIONS: There appears to be a statistically significant association between gambling frequency and risk of gambling-related harm. Data derived from this and similar analyses can be used to model gambling policies which impact gambling frequency.