Experimental Gambling Research Laboratory, School of Health, Medical and Applied Sciences, Central Queensland University, Australia.
J Behav Addict. 2024 May 14;13(2):635-649. doi: 10.1556/2006.2024.00025. Print 2024 Jun 26.
Understanding how gambling harm is distributed is essential to inform effective harm reduction measures. This first national Australian study of gambling harm-to-self examined the extent, distribution, risk factors, and health related quality of life (HRQoL) impacts of this harm.
A Random Digit Dialling sample of 15,000 Australian adults was weighted to key population variables. Key measures included the Gambling Harms Scale-10 (GHS-10), PGSI, SF-6D, gambling behaviours, and demographics. Analyses included ordinal logistic regression.
Amongst gamblers, 14.7% reported harm on the GHS-10, including 1.9% reporting high-level harm. While high-level harm occurred mainly in the problem gambling group (77.3%), other PGSI groups accounted for most of the more prevalent low (98.5%) and moderate (87.2%) harms reported. Proximal predictors of greater harm were use of online gambling and more frequent gambling on electronic gaming machines (EGMs), race betting sports betting, poker, skin gambling, scratchies, and loot box purchasing. Distal predictors were being younger, male, single, Aboriginal or Torres Strait Islander, and speaking a non-English language at home. At the population level, the greatest aggregate HRQoL impacts were amongst lower-risk gamblers, confirming the results of other studies regarding the 'prevention paradox'.
The distribution of harm across gambler risk groups indicates the need for preventive measures, not just interventions for problem gambling. Reducing harm requires modifying product features that amplify their risk, especially for EGMs, race betting and sports betting that are both inherently risky and widely used. Gambling harm exacerbates health disparities for disadvantaged and vulnerable groups, requiring targeted resources and support.
了解赌博伤害的分布情况对于制定有效的伤害预防措施至关重要。本项针对澳大利亚全国性的赌博伤害自伤行为研究首次对这种伤害的程度、分布情况、风险因素以及与健康相关的生活质量（HRQoL）影响进行了研究。
采用随机数字拨号法对 15000 名澳大利亚成年人进行抽样调查，并对关键人口变量进行加权处理。主要测量指标包括赌博伤害量表-10 项（GHS-10）、PGSI、SF-6D、赌博行为和人口统计学资料。分析采用有序逻辑回归。
在赌徒中，有 14.7%的人在 GHS-10 上报告了伤害，其中 1.9%的人报告了严重伤害。虽然严重伤害主要发生在有问题赌博的人群中（77.3%），但其他 PGSI 组报告了更常见的低水平（98.5%）和中度（87.2%）伤害。更严重伤害的近因预测因素包括在线赌博和更频繁地使用电子游戏赌博机（EGMs）、赛马投注、扑克、皮肤赌博、刮刮卡和战利品盒购买。远程预测因素包括年龄较小、男性、单身、原住民或托雷斯海峡岛民以及在家中说非英语。在人群层面上，较低风险赌徒的 HRQoL 影响最大，这证实了其他研究关于“预防悖论”的结果。
赌博者风险群体之间的伤害分布表明需要采取预防措施，而不仅仅是针对问题赌博者的干预措施。减少伤害需要修改产品特征，降低其风险，特别是针对 EGMs、赛马投注和体育投注，因为这些产品本身风险较高，且使用广泛。赌博伤害加剧了弱势和脆弱群体的健康差距，需要有针对性的资源和支持。
