Benedetti Elisa, Lachi Alessio, Lombardi Gabriele, Molinaro Sabrina
Institute of Clinical Physiology, National Research Council, Rome, Italy.
Saint Camillus International University of Health and Medical Sciences, Rome, Italy.
J Epidemiol Community Health. 2025 Aug 8;79(9):726-732. doi: 10.1136/jech-2024-222474.
Electronic gambling machines (EGMs) are among the most harmful forms of gambling. Their widespread availability has been linked to increased gambling activity and a rise in harmful gambling. However, it remains unclear whether restricting the availability and accessibility of EGMs is effective in reducing gambling harms at the population level. We investigate those issues by leveraging the natural experiment of the region of Piedmont in northwest Italy, which in 2018 set limits on the location and operating hours of EGMs.
Data from the Gambling Adult Population Survey conducted in 2018 and 2022 were combined with information regarding the implementation of the policy in Piedmont municipalities and data on EGMs from the national monopoly holder. Our analysis uses a difference-in-difference design, which is appropriate given that only some municipalities in the region implemented the policy, each setting different operating time limits for EGMs. Sensitivity analyses were conducted to explore possible substitution effects towards bordering regions and online gambling.
Our findings reveal that policies aimed at reducing the operating hours of EGMs were effective in decreasing harmful gambling behaviour in the population, but only when a minimum daily operational suspension of 11 hours was implemented. No significant effect was observed from setting location limits, and no substitution effect was found.
While restricting EGM availability can help mitigate harmful gambling, it requires coordinated efforts across different levels of government to ensure uniform policy implementation, along with individual-level policies, such as banning advertising, and consideration of diverse gambling products and online gambling.
电子赌博机是危害最大的赌博形式之一。其广泛可得性与赌博活动增加及有害赌博行为增多有关。然而，限制电子赌博机的可得性和可及性是否能在人群层面有效减少赌博危害仍不明确。我们通过利用意大利西北部皮埃蒙特地区的自然实验来研究这些问题，该地区在2018年对电子赌博机的位置和运营时间设定了限制。
将2018年和2022年进行的赌博成年人口调查数据与皮埃蒙特各市政策实施情况的信息以及国家垄断运营商的电子赌博机数据相结合。我们的分析采用了差分设计，鉴于该地区只有部分城市实施了该政策，且每个城市对电子赌博机设定了不同的运营时间限制，这种设计是合适的。进行了敏感性分析，以探讨对周边地区和在线赌博可能的替代效应。
我们的研究结果表明，旨在减少电子赌博机运营时间的政策在减少人群中的有害赌博行为方面是有效的，但前提是每天至少暂停运营11小时。设定位置限制未观察到显著效果，也未发现替代效应。
虽然限制电子赌博机的可得性有助于减轻有害赌博行为，但需要各级政府共同努力以确保政策统一实施，同时还需要诸如禁止广告等个人层面的政策，并考虑多种赌博产品和在线赌博。
