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A systematic literature review of studies on attitudes towards gambling using the Attitudes Towards Gambling Scale (ATGS)

December 2022
International Gambling Studies

DOI:10.1080/14459795.2022.2143856

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Authors:

Joakim Hellumbråten Kristensen

University of Bergen

Julie Strand

Norwegian University of Science and Technology

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Several studies have investigated attitudes toward gambling using the Attitudes Towards Gambling Scale (ATGS), however, their findings have not previously been synthesized or systematically reported. Thus, we conducted a systematic literature review on studies employing the ATGS to summarize the current evidence. Database searches were conducted in January 2022 in Cinahl, Embase, PsycInfo, Pubmed, Web of Science, GreyNet, and Google Scholar. Papers were included if they presented data based on the ATGS and were published in a European language. Twenty-six papers presenting the results from 23 unique studies met the inclusion criteria. Two reviewers independently extracted the data and assessed the risk of bias. Most of the studies were cross-sectional and used the short (8-item) version of ATGS. The synthesis indicates an overall incline towards negative attitudes. More positive attitudes were associated with being male, younger age, and higher gambling frequency. Studies were divergent in findings concerning problem gambling and gambling attitudes, which could be due to variance in problem gambling severity in the samples. The current evidence base is encumbered by limitations in study quality and designs. Future research should emphasize longitudinal designs, include non-western samples, and investigate the directionality and causality of variables associated with attitudes towards gambling. ARTICLE HISTORY

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A systematic literature review of studies on

attitudes towards gambling using the Attitudes

Towards Gambling Scale (ATGS)

Joakim Hellumbråten Kristensen, Sandra Trifunovic, Julie Strand, Karen Kraft

Vistnes, André Syvertsen, Amin Zandi & Ståle Pallesen

To cite this article: Joakim Hellumbråten Kristensen, Sandra Trifunovic, Julie Strand, Karen Kraft

Vistnes, André Syvertsen, Amin Zandi & Ståle Pallesen (2022): A systematic literature review

of studies on attitudes towards gambling using the Attitudes Towards Gambling Scale (ATGS),

International Gambling Studies, DOI: 10.1080/14459795.2022.2143856

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REVIEW ARTICLE

A systematic literature review of studies on attitudes towards

gambling using the Attitudes Towards Gambling Scale (ATGS)

Joakim Hellumbråten Kristensen

a,b

, Sandra Trifunovic

, Julie Strand

Karen Kraft Vistnes

, André Syvertsen

a,b

, Amin Zandi

and Ståle Pallesen

a,b

Department of Psychosocial Science, University of Bergen, Bergen, Norway;

Norwegian Competence

Centre for Gambling and Gaming Research, University of Bergen, Bergen, Norway;

Faculty of Psychology

and Educational Sciences, University of Tehran, Tehran, Iran

ABSTRACT

Several studies have investigated attitudes toward gambling using

the Attitudes Towards Gambling Scale (ATGS), however, their nd-

ings have not previously been synthesized or systematically

reported. Thus, we conducted a systematic literature review on

studies employing the ATGS to summarize the current evidence.

Database searches were conducted in January 2022 in Cinahl,

Embase, PsycInfo, Pubmed, Web of Science, GreyNet, and Google

Scholar. Papers were included if they presented data based on the

ATGS and were published in a European language. Twenty-six

papers presenting the results from 23 unique studies met the

inclusion criteria. Two reviewers independently extracted the data

and assessed the risk of bias. Most of the studies were cross-

sectional and used the short (8-item) version of ATGS. The synthesis

indicates an overall incline towards negative attitudes. More posi-

tive attitudes were associated with being male, younger age, and

higher gambling frequency. Studies were divergent in ndings

concerning problem gambling and gambling attitudes, which

could be due to variance in problem gambling severity in the

samples. The current evidence base is encumbered by limitations

in study quality and designs. Future research should emphasize

longitudinal designs, include non-western samples, and investigate

the directionality and causality of variables associated with atti-

tudes towards gambling.

ARTICLE HISTORY

Received 19 July 2022

Accepted 31 October 2022

KEYWORDS

Gambling; attitudes;

gambling disorder; ATGS;

literature review

Introduction

Gambling is a popular, yet controversial activity. For many, gambling is an exciting

pastime activity oﬀering a way to socialize with friends, family and community (Latvala

et al., 2019). Gambling has also a positive impact on society in terms of employment,

increased state revenues, and by providing revenues for sporting clubs and humanitarian

organizations (Rossow & Hansen, 2016; Walker & Jackson, 2011). Many, however,

associate gambling with the negative consequences a minority of gamblers experience.

Problem gambling has been found to be associated with several adverse outcomes,

including ﬁnancial problems (e.g. unmanageable debts), legal problems, job loss,

CONTACT Joakim Hellumbråten Kristensen joakim.kristensen@uib.no

INTERNATIONAL GAMBLING STUDIES

https://doi.org/10.1080/14459795.2022.2143856

This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License

(http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any med-

ium, provided the original work is properly cited, and is not altered, transformed, or built upon in any way.

relationship problems, decreased mental and physical health, and even suicide (Adolphe

et al., 2019; Black et al., 2012; Karlsson & Håkansson, 2018; Lorains et al., 2011). Such

harms extend beyond the individual gambler as it often also aﬀects their close others,

extended family, employers, as well as society as a whole given the costs of e.g. treatment

and the need for regulation (Hofmarcher et al., 2020; Kalischuk et al., 2006). The

prevalence of problem gambling varies, but most studies report prevalence rates

among adults in the range of 0.12% to 5.8% across cultures (Calado & Griﬃths, 2016).

The presence, knowledge, and experience of positive and negative consequences

associated with gambling contribute to shaping people’s opinions or attitudes toward

gambling. Attitudes can be understood as ‘a relatively enduring and general evaluation of

an object, person, group, issue or concept on a dimension ranging from negative to

positive’ (American Psychological Association, n.d.). According to the theory of planned

behavior (Ajzen, 1991), attitudes indirectly inﬂuence behavior as attitudes, in addition to

subjective norms and perceived behavioral control, determine the intention to engage in

a behavior. Consequently, the theory postulates that to practice a given behavior one

possesses a particular attitude (Wood & Griﬃths, 2004). Based on this theoretical notion,

research on attitudes towards gambling has received increased interest in the past few

decades (Plotka et al., 2016). Aﬃrmatory with the theory of planned behavior, a number

of studies have found more acceptant or positive attitudes toward gambling to be

associated with a higher gambling frequency (Chiu & Storm, 2009; Delfabbro &

Thrupp, 2003; Hardoon & Derevensky, 2002; Williams et al., 2006; Wood & Griﬃths,

2004) and gambling-related problems (Chiu & Storm, 2009; Delfabbro & Thrupp, 2003;

Williams et al., 2006; Wood & Griﬃths, 2004), albeit the latter has not been found

consistently (Salonen et al., 2014). Hence, measuring attitudes towards gambling could

be useful for predicting gambling behavior and to possibly identify individuals with a risk

of developing problem gambling.

For most studies that have investigated attitudes toward gambling in the general

population, the mean score on attitudes towards gambling has generally been negative

or, at best, ambivalent (Delfabbro & King, 2020; Smith et al., 2011). Some studies have

found that males hold more positive attitudes compared to women (Buczkiewicz et al.,

2007; Jackson et al., 2008; Kassinove, 1998; Moore & Ohtsuka, 1997; Peltzer & Thole,

2000; Smith et al., 2011; Taormina, 2009; Wood & Griﬃths, 1998). The most common

ﬁnding regarding age is that young people tend to have more favorable attitudes towards

gambling than older people (Smith et al., 2011; Taormina, 2009).

A handful of instruments assessing attitudes toward gambling has been developed,

including the Gambling Attitude and Belief Survey (Breen & Zuckerman, 1999), the

Gambling Attitude Scale (Kassinove, 1998), and the Casino Attitude Scale (Sutton &

Griﬃths, 2008). However, ﬁndings based on these diﬀerent instruments have certain

limitations in terms of comparability as these measures diﬀer in the overall construct

captured (e.g. to the extent it includes cognitive biases) as well as vary in the speciﬁc

gambling activity considered. These issues lead to the development of the Attitudes

Towards Gambling Scale (ATGS; Orford et al., 2009). The ATGS was originally developed

for the British Gambling Prevalence Survey 2007 (Wardle et al., 2007), and has since

become a widely used measurement as it is regarded as a robust and standardized

measure of gambling attitudes that can be administered to gamblers as well as non-

gamblers (Canale et al., 2016). The scale diﬀers from previous measures of gambling

2J. HELLUMBRÅTEN KRISTENSEN ET AL.

attitudes, as it aims to measure more generic attitudes toward gambling that is indepen-

dent of the inﬂuence of attitudes related to particular forms of gambling activities (e.g.

casino gambling, horse track betting, lotteries) and gambling-related policy issues

(Orford et al., 2009). There are currently two versions of ATGS; the original longer

version consisting of 14 items (ATGS-14; Orford et al., 2009) and a shorter version

consisting of eight items (ATGS-8; Canale et al., 2016). Both scales include statements

that are scored on a 5-point Likert scale, ranging from strongly agree (1) to strongly

disagree (5). Half of the items in each scale are reversed when deriving the mean score.

Higher mean scores indicate more positive attitudes, and a total score above 42 on the

ATGS-14 or 24 on the ATGS-8 indicates a positive attitude toward gambling (Wardle

et al., 2007, 2010).

Although several studies on attitudes toward gambling have been conducted using the

ATGS, ﬁndings have been somewhat inconsistent across studies. Moreover, considering

the issues of comparability of ﬁndings deriving from diﬀerent studies using diﬀerent

instruments, a synthesis of studies employing the ATGS speciﬁcally would advance the

ﬁeld by consolidating the evidence base and clarifying conﬂicting ﬁndings. Against this

backdrop, we conducted a systematic literature review of studies on attitudes towards

gambling based on the ATGS. Two research questions were investigated: (1) ‘What

characterizes studies on attitudes towards gambling that have used the ATGS?’ and (2)

‘What are the main ﬁndings from the studies using the ATGS?’.

Methods

Search strategy

The current systematic literature review was conducted in accordance with the Preferred

Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-guidelines (Page

et al., 2021). The review was pre-registered at the PROSPERO International prospective

CRD42022311675). Literature searches without time constraints were completed on

January 27

, 2022, and conducted in Cinahl, Embase, PsycInfo, Pubmed, Web of

Science, GreyNet, and Google Scholar electronic databases. Search items comprised

gambl* AND attitude* and were entered similarly in each database without the use of

any MeSH or other expanders. The database searches yielded 5188 initial results, with

628 hits in Cinahl, 920 in Embase, 1332 in PsycInfo, 1003 in Pubmed, 1105 in Web of

Science, 0 hits on GreyNet. Due to a large number of hits in Google Scholar (over 23,000

hits), only the 200 ﬁrst hits were included for screening. In addition, the reference lists of

included manuscripts were screened to identify potential manuscripts that were not

identiﬁed in the formal literature searches. The reference screening was conducted by

two reviewers which examined the titles of the referred papers for words related to

gambling and attitudes and then investigated whether the reference of interest had

previously been included in the formal search- and screening process. However, no

additional potentially relevant manuscripts were identiﬁed and included for further

screening by this method. Lastly, we included one gray literature report on problem

gambling (Pallesen et al., 2020) that was not identiﬁed by the formal literature searches as

we already were familiar with the contents of this report.

INTERNATIONAL GAMBLING STUDIES 3

Selection process

The identiﬁed records were imported into Endnote reference manager software

which was used to remove duplicate records and organize the selection process.

Two reviewers independently screened the title and abstracts of the records to sort

out non-relevant records before assessing the full-text manuscript against the inclu-

sion criteria. To be included in the present review, the studies had to: (1) present

original quantitative data on attitudes toward gambling based on the Attitude

Towards Gambling Scale (ATGS) and (2) be published in a European language.

No further restrictions were applied regarding data, geographic location, setting, or

study design. Exclusion criteria were that the articles were (1) reviews or other

papers presenting secondary data, (2) qualitative studies, and (3) abstracts or con-

ference presentations.

Data extraction and risk of bias assessment

Two reviewers extracted the data independently from the included articles using

a coding scheme made for the present review and compiled the data in an Excel

spreadsheet. The coding scheme encompassed information concerning the manu-

script’s registration details, study setting, participant’s characteristics, methodology,

and main ﬁndings. Manuscripts varied whether they reported adjusted estimates,

unadjusted estimates, or both. If the paper presented both adjusted and unadjusted

estimates, we chose to only extract and present ﬁndings based on adjusted estimates.

In several cases, the included articles did not contain the necessary information to

extract all relevant data or lacked proper descriptions of results. In such cases, the

corresponding authors were contacted and asked to provide the missing information

or clariﬁcations. Four out of 19 contacted authors replied, providing minor clar-

iﬁcations, but no additional data was provided. Following individual coding of

descriptive statistics and the main ﬁndings, the proportionate level of inter-

reviewer agreement was calculated to be 83.0%. Disagreements were resolved by

consulting the original article and through discussions.

The Mixed Methods Appraisal Tool 2018 version (MMAT; Hong et al., 2018) was

used to assess the risk of bias in the included studies. MMAT is an assessment tool

to appraise articles for reviews including multiple study designs. It reviews the

methodological quality of qualitative, quantitative, and mixed methods studies.

There are ﬁve quality criteria for each of the following ﬁve categories of study

designs: (1) qualitative, (2) randomized controlled, (3) non-randomized, (4) quanti-

tative descriptive, and (5) mixed methods. MMAT consists of a general screening

and a speciﬁc assessment related to the appropriate study design. The criteria are

rated by responding ‘yes’, ‘no’, or ‘can’t tell’, and provides a general assessment of

the study’s risk of bias. The MMAT assessment was conducted for each manuscript,

rather than for each unique study. The level of inter-reviewer agreement for coding

the risk of bias in MMAT was 78.1%. Discrepancies were settled by consulting the

original article and discussions between the reviewers.

4J. HELLUMBRÅTEN KRISTENSEN ET AL.

Results

Study selection

An overview of the study screening and selection process can be found in Figure 1. After

removing the duplicate records (N = 2098), the titles and abstracts of the remaining 3090

manuscripts were screened, resulting in 295 full-text manuscripts that were assessed

against the inclusion and exclusion criteria. From this pool, 270 manuscripts were

excluded as they did not speciﬁcally report data based on the ATGS. Thus, 26 manu-

scripts that reported results from 23 unique studies were assessed as eligible for inclusion

and were included in the current review. Disagreement between the authors in the study

full-text assessment was detected for ﬁve manuscripts which were resolved through

discussion. The total agreement percentage before the discussion amounted to 80%.

Study characteristics

The study characteristics and key ﬁndings are summarized in Table 1. There has been

a considerable increase in published studies using the ATGS after 2018. Most of the

studies include participants from Europe, Australia, and the USA, except for one sample

of Nigerian participants (Ayandele et al., 2021), and one study from Israel (Gavriel-Fried,

2015). In addition, one study (Delfabbro et al., 2021, 2021) compared participants from

Australia, Croatia, Israel, and Canada. For nine studies, the target populations comprised

the general population, one study comprised adults, while ten studies targeted youths/

adolescents and young adults (including high school and university students; see

Table 1). Two of the 23 studies included more speciﬁc samples of ex-oﬀenders (Rosen

et al., 2020) and individuals from Ukraine and Vietnam living in the Czech Republic

(Fiedor & Seidlova, 2021). Sample sizes ranged from N = 111 to N = 9037, and a total of

Records identified from*:

Cinahl (n= 628)

Embase (n= 920)

PsychInfo (n= 1332)

Pubmed (n= 1003)

Web of Science (n= 1105)

GreyNet (n= 0)

Google Scholar (n= 200)

Records removed before

screening:

Duplicate records removed

(n = 2098)

Records screened

(n = 3090)

Records excluded**

(n = 2795)

Reports sought for retrieval

(n = 295)

Reports not retrieved

(n = 0)

Reports assessed for eligibility

(n = 295) Reports excluded:

Did not present data on the

ATGS (n = 270)

Records identified from:

Citation searching (n = 0)

Additional grey literature report previously

known to the reviewers (n = 1; Pallesen et

al., 2020)

Reports assessed for eligibility

(n = 1)

Reports excluded (n = 0)

Studies included in review

(n = 23)

Reports of included studies

(n = 26)

Identification of studies via databases and registers Identification of studies via other methods

noitacifitnedI

Screening

Included

Reports sought for retrieval

(n = 1)

Reports not retrieved

(n = 0)

Figure 1. PRISMA ﬂow chart.

INTERNATIONAL GAMBLING STUDIES 5

Table 1. Study characteristics and key ﬁndings by the target population.

Reference NCountry Target population

Mean age

(SD)

women

ATGS

version

ATGS

mean

scores Key reported ﬁndings

General population

Àndra et al. (2021) 704 Italy General population – 54.4 8 – ●Problematic gamblers

reported higher ATGS

scores compared to

non-/non-

problematic

gamblers.

●No gender diﬀerence

on the ATGS was

found.

●Level of education

was inversely asso-

ciated with ATGS

scores.

Canale et al. (2016) 7746 United Kingdom General population 46.4 (–) 52.0 8 – ●ATGS scores were

positively associated

with gambling

frequency.

●ATGS scores were

positively associated

with levels of gam-

bling problems.

(Continued)

6J. HELLUMBRÅTEN KRISTENSEN ET AL.

Table 1. (Continued).

Reference NCountry Target population

Mean age

(SD)

women

ATGS

version

ATGS

mean

scores Key reported ﬁndings

Donaldson et al. (2015) 1794 Australia General population 55.4

(13.3)

52.8 14 32.5/18.6

●ATGS scores were

positively associated

with gambling fre-

quency, gambling

product diversity,

time last gambled

(recency), and game

intensity, and inver-

sely related to atti-

tudes toward harm

reduction and gam-

bling reform

legislation.

●ATGS scores were

inversely related to

PGSI score, being

a woman, full-time

employment, and

education.

(Continued)

INTERNATIONAL GAMBLING STUDIES 7

Table 1. (Continued).

Reference NCountry Target population

Mean age

(SD)

women

ATGS

version

ATGS

mean

scores Key reported ﬁndings

Fiedor et al. (2018) 1076 Czech Republic Inhabitants from a post-communist

country/the general population of the

Czech Republic

– – 8 17.8 ●ATGS scores were

positively related to

gambling frequency.

●‘Broader’ deﬁnition/

conception of gam-

bling was inversely

associated with the

ATGS.

●Younger age groups

(except 20–29 years)

reported more posi-

tive attitudes than

compared to older

age groups.

●Women reported

more negative atti-

tudes than men.

●Widows/widowers

and married partici-

pants reported more

negative attitudes

than single/divorced.

(Continued)

8J. HELLUMBRÅTEN KRISTENSEN ET AL.

Table 1. (Continued).

Reference NCountry Target population

Mean age

(SD)

women

ATGS

version

ATGS

mean

scores Key reported ﬁndings

McAllister (2013) 1213 Australia General population – – 8 3.9 (out of 10) ●Frequent gamblers

reported more posi-

tive attitudes than

less frequent

gamblers.

●Frequency of general

gambling was more

strongly related to

the ATGS than the

frequency of scratch/

lottery tickets.

●The ATGS was inver-

sely related to stricter

public attitudes

toward gambling

regulation and

explained a large

proportion of the

variance in the multi-

variate model.

●Frequent church

attendees had more

negative attitudes on

gambling than those

less frequent or not

attending church.

(Continued)

INTERNATIONAL GAMBLING STUDIES 9

Table 1. (Continued).

Reference NCountry Target population

Mean age

(SD)

women

ATGS

version

ATGS

mean

scores Key reported ﬁndings

Orford et al. (2009, 2010) 8872 United Kingdom General population – – 14 35.4/20.2

●Scores on the ATGS

were positively asso-

ciated with gambling

frequency, the

amount lost, amount

won, younger age

ﬁrst started to gam-

ble, scores on DSM-IV

problem gambling

criteria/PGSI, and

having a parent that

gambles.

●Having a parent or

close relative with

problem gambling

was inversely asso-

ciated with the ATGS.

●Male sex, younger

age, white/European

ethnicity, lowest

school qualiﬁcation,

lower-status occupa-

tions, higher house-

hold income, better

self-reported health,

smoking, and heavy

drinking were all

associated with less

negative attitudes

toward gambling.

(Continued)

10 J. HELLUMBRÅTEN KRISTENSEN ET AL.

Table 1. (Continued).

Reference NCountry Target population

Mean age

(SD)

women

ATGS

version

ATGS

mean

scores Key reported ﬁndings

Pallesen’s et al. (2020) 9037 Norway General population 44.6

(16.4)

51.3 8 F: 20.7

M: 22.7

●Gambling participa-

tion last 6 months

was positively asso-

ciated with ATGS

scores.

●Those who did not

gamble or were cate-

gorized as problem

gamblers (according

to the PGSI) reported

lower scores on the

ATGS than normal-,

low-risk- and moder-

ate-risk gamblers.

●Those being single,

not having children,

having a lower

income, and full-time

employment had

higher scores on the

ATGS than their

counterparts.

●Female gender, lower

age, and the highest

educational level

were inversely asso-

ciated with ATGS

scores.

(Continued)

INTERNATIONAL GAMBLING STUDIES 11

Table 1. (Continued).

Reference NCountry Target population

Mean age

(SD)

women

ATGS

version

ATGS

mean

scores Key reported ﬁndings

Salonen et al. (2014) 3497 Finland General population 48.2

(16.8)

52.8 8 22.7 ●Problem gambling

severity (SOGS) and

being a concerned

other of a problem

gambler were inver-

sely associated with

ATGS scores.

●Net wage

>2000 euro, and

risky alcohol con-

sumption were posi-

tively associated with

ATGS scores.

●Female gender,

higher age, and less

than 12 years of edu-

cation were inversely

related to ATGS

scores.

Salonen et al. (2017) S1:

4484

S2:

4515

Finland General population – S1:

52.8

S2:

48.9

8 2011 F: 21.4

2011 M: 23.9

2015 F: 22.9

2015 M: 25.2

●Participants reported

overall higher ATGS

scores in S2 com-

pared to S1.

●Change in ATGS score

was not signiﬁcant

among men aged 15-

17- and 18-24-years,

and women aged 15–

17 years.

●Women generally

reported lower ATGS

scores than men.

Adolescents/young

adults

(Continued)

12 J. HELLUMBRÅTEN KRISTENSEN ET AL.

Table 1. (Continued).

Reference NCountry Target population

Mean age

(SD)

women

ATGS

version

ATGS

mean

scores Key reported ﬁndings

Ayandele’s et al. (2021) 197 Nigeria Youths 22.8 (3.2) 16.2 8 28.2 ●Higher gambling fre-

quency was related to

higher ATGS scores.

●Age was inversely

associated with the

ATGS scores.

Calado et al. (2017) 988 United Kingdom Adolescents and young people 19.8 (–) 40.8 8 – ●ATGS scores did not

predict problem

gambling status.

Calado et al. (2019) 111 Portugal High school students 17.6 (1.6) 58.5 8 – ●Participants in the

intervention group

reported reduced

ATGS scores at the

last session of

intervention.

●Changes in ATGS

scores were not asso-

ciated with problem

gambling status. The

main eﬀect was not

signiﬁcant at follow-

up six weeks after the

intervention.

(Continued)

INTERNATIONAL GAMBLING STUDIES 13

Table 1. (Continued).

Reference NCountry Target population

Mean age

(SD)

women

ATGS

version

ATGS

mean

scores Key reported ﬁndings

Delfabbro et al.

(2021,2021)

1787 Australia Croatia

Israel Canada

University students Australia:

19.6 (2.1)

Israel:

23.3 (2.8)

Croatia:

21.6 (2.5)

Canada:

21.0 (2.4)

64.0 8 Australia: 19.8

Israel: 18.0

Croatia: 18.7

Canada: 21.4

●Canadian respon-

dents had the high-

est ATGS scores

followed by Australia,

Croatia and Israel.

●Participants who

gambled regularly

reported more posi-

tive attitudes toward

gambling than those

who were not regular

gamblers.

●Women reported

lower scores on the

ATGS than men.

●Gambling attitudes

correlated positively

with social accessibil-

ity and positive atti-

tudes toward (strict)

gambling regulation.

●Gambling attitudes

were inversely and

weakly related to

exposure to people

with gambling

problems.

●Gambling attitudes

were inversely asso-

ciated with stigma

(ostracism and

contempt).

(Continued)

14 J. HELLUMBRÅTEN KRISTENSEN ET AL.

Table 1. (Continued).

Reference NCountry Target population

Mean age

(SD)

women

ATGS

version

ATGS

mean

scores Key reported ﬁndings

Dowling et al. (2020) 499 Australia – 23.2 (–) 56.1 8 26.7 ●Women reported

higher ATGS scores

than men

●ATGS scores were

unrelated to problem

gambling.

Hanss et al. (2014, 2014) 1977 Norway Adolescents

Norwegian 17-year-olds

17 (–) 52.9 14 37.7/21.5

●Problematic gam-

bling (PGSI) was

inversely related to

ATGS scores.

●Lifetime gambling

and peer/family

approval of gambling

were positively asso-

ciated with ATGS

scores.

●ATGS scores were

inversely associated

with female gender,

agreeableness, and

positively associated

with sensation

seeking.

Kaakinen et al. (2019) S1:

1200

S2:

230

Finland Young people S1: 21.3

S2: 24.4

S1:

50.0

S2:

53.0

8 S1: 23.4

S2: 24.0

●Respondents with

more positive gam-

bling attitudes

reported higher posi-

tive interest in pro-

gambling messages

in a vignette

experiment.

(Continued)

INTERNATIONAL GAMBLING STUDIES 15

Table 1. (Continued).

Reference NCountry Target population

Mean age

(SD)

women

ATGS

version

ATGS

mean

scores Key reported ﬁndings

Oksanen et al. (2019) 1200 Finland Finnish young people 21.2 (2.8) 50.0 8 23.4 ●ATGS scores were

positively associated

with frequency of

competent- and

entertainment-type

gambling.

Pallesen et al. (2016) W1:

2055

W2:

1239

Norway Adolescents W1: 17.5

W2: 18.5

70.4 14 W1: 37.7/21.5

W2: 38.7/22.1

●Adolescent partici-

pants signiﬁcantly

had more positive

attitudes toward

gambling in W2

compared to W1.

●ATGS scores at W1,

gambling only at W2,

gambling both at W1

and W2, and family

and friends’ approval

of gambling posi-

tively predicted ATGS

scores at W2.

●Female gender and

neuroticism were

inversely related to

ATGS score.

(Continued)

16 J. HELLUMBRÅTEN KRISTENSEN ET AL.

Table 1. (Continued).

Reference NCountry Target population

Mean age

(SD)

women

ATGS

version

ATGS

mean

scores Key reported ﬁndings

Sanscartier et al. (2019) 1194 Canada Young adults 19.1 (1.5) 68.0 14 35.1/20.1

●Gambling frequency,

family/peer approval

of gambling, and

more permissive

drinking norms were

positively related to

ATGS scores.

●Problematic gam-

bling in the family,

higher perceived reli-

gious faith, higher

age,

Zhou et al. (2018) 122 Canada University undergraduate students F: 23.4

(5.2)

M: 23.4

(7.3)

75.4 8 22.6 ●ATGS scores corre-

lated weakly with

problem gambling

severity (SOGS).

●Men reported higher

ATGS scores than

women.

Adults

Gavriel-Fried (2015) 1000 Israel Jewish-Israeli adults 40.3

(14.1)

49.6 8 19.5 ●ATGS scores were

positively associated

with gambling fre-

quency and the

number of forms of

gambling engaged

in.

●PGSI score, female

gender, and higher

self-perceived religi-

osity were inversely

related to the ATGS.

Other

(Continued)

INTERNATIONAL GAMBLING STUDIES 17

Table 1. (Continued).

Reference NCountry Target population

Mean age

(SD)

women

ATGS

version

ATGS

mean

scores Key reported ﬁndings

Fiedor and Seidlova

(2021)

171 Czech Republic People from Vietnam and Ukraine living in

the Czech Republic

– – 8 Ukraine: 18.0

Vietnam: 18.3

●Individuals who parti-

cipated in more

games in the

past year reported

higher ATGS scores

than those who did

not- or participated in

fewer games

per year.

●The Ukrainians and

Vietnamese reported

slightly more positive

attitudes than the

Czech majority (com-

pared to the results

from Fiedor et al.,

2018).

Rosen et al. (2020) 126 USA Ex-oﬀenders 32.5 (7.3) 13.0 8 21.5 ●Ex-oﬀenders with

gambling disorder

reported higher ATGS

scores than ex-

oﬀenders without

gambling disorder.

●ATGS score was inver-

sely related to the

likelihood to seek

treatment for gam-

bling problems.

●Individuals with gam-

bling disorder

reported lower ATGS

scores after a brief

intervention, but the

interaction eﬀect of

time x condition

(treatment and con-

trol) was not

signiﬁcant.

– = did not report data on this variable, ATGS= Attitudes Towards Gambling Scale,

= The targeted population as reported by the individual manuscript,

= ATGS-14 score transformed to ATGS-

8 score by the authors, W1 = ﬁrst wave, W2 = second wave, S1 = ﬁrst study, S2 = second study, PGSI = the Problem Gambling Severity Index, SOGS = the South Oaks gambling Screen.

18 J. HELLUMBRÅTEN KRISTENSEN ET AL.

55,795 participants are included in the present synthesis. The mean age of the partici-

pants ranged from 17.0 to 55.4. However, seven studies did not report the mean age. For

the 19 studies that reported data on gender, the gender distribution ranged from 13.0% to

75.4% women in the samples.

The majority of studies were cross-sectional (k = 18), while one was longitudinal

(Pallesen et al., 2016), and four were experimental (Calado et al., 2019; Kaakinen et al.,

2019; Rosen et al., 2020; Zhou et al., 2018). Regarding participant sampling, two studies

(Gavriel-Fried, 2015; Kaakinen et al., 2019) used quota sampling, two (Fiedor & Seidlova,

2021; Rosen et al., 2020) used judgmental sampling, nine studies (Ayandele et al., 2021;

Calado et al., 2017, 2019; Delfabbro et al., 2021, 2021; Dowling et al., 2020; Oksanen et al.,

2019; Sanscartier et al., 2019; Zhou et al., 2018; Àndra et al., 2021) used convenience

sampling, while the remaining ten studies employed simple random sampling. All in all,

70% of the included studies used the ATGS-8 while the remaining used the ATGS-14 (see

Table 1). For most studies, the Cronbach’s alphas reported were above .70, except for four

studies (Calado et al., 2019; Delfabbro et al., 2021, 2021; Fiedor & Seidlova, 2021; Zhou

et al., 2018) which reported an alpha between .53 and .67, indicating an internal

consistency below the conventional acceptable level.

Main ndings

Out of the 23 unique included studies, 19 reported a mean score on the ATGS of which

17 studies reported a mean score indicative of negative attitudes toward gambling (i.e.

M > ATGS-14 = 42/ATGS-8 = 24, see Table 1). Only two studies (Ayandele et al., 2021;

Dowling et al., 2020) reported a mean score that indicated positive attitudes, in addition

to one sub-sample of men in one study (Salonen et al., 2017). In studies using the ATGS-

14, the mean scores ranged from 32.5 to 37.0. The corresponding range for studies using

the ATGS-8 was l7.8 to 28.2. One study (McAllister, 2013) transformed the response

alternative to a 0–10 scale, which precludes direct comparison of results. One study

(Salonen et al., 2017) compared attitudes towards gambling in two separate samples at

two diﬀerent time points. In that study, both men and women reported negative attitudes

in 2011, but in 2015 the male sample was positive whilst the majority of the female sample

remained negative. Pallesen et al. (2016) employed a longitudinal design to investigate

whether adolescents’ attitudes towards gambling would change when transcending from

underage (17 years) to legal gambling age (18 years). Their results showed that the

adolescents reported statistically signiﬁcantly more positive attitudes (though still overall

negative) towards gambling after they had turned 18 (wave 2) compared to one year

earlier (wave 1).

In terms of associated variables, the most commonly investigated variables were

gambling-related variables (i.e. gambling frequency and problem gambling severity),

gender, age, and education. All studies except one (Hanss et al., 2014, 2014) that

investigated gambling frequency found a positive relationship between gambling fre-

quency and ATGS scores. The reports of the association between attitudes toward

gambling and problem gambling were, however, somewhat more divergent. Two studies

(Calado et al., 2017; Dowling et al., 2020) did not ﬁnd any signiﬁcant association between

the ATGS and problem gambling severity. Four studies (Canale et al., 2016; Orford et al.,

2009, 2010; Zhou et al., 2018; Àndra et al., 2021) reported a positive association between

INTERNATIONAL GAMBLING STUDIES 19

problem gambling severity and attitudes towards gambling. Four studies (Donaldson

et al., 2015; Gavriel-Fried, 2015; Hanss et al., 2014, 2014; Salonen et al., 2014) reported the

opposite, indicating that higher problem gambling severity was associated with more

negative attitudes towards gambling. Lastly, one study (Pallesen et al., 2020) found that

participants that did not gamble or were categorized as a problem gambler reported more

negative attitudes than normal- low-risk- and moderate-risk gamblers. In addition, three

studies (Delfabbro et al., 2021, 2021; Orford et al., 2009, 2010; Sanscartier et al., 2019)

reported that being exposed to or being a concerned other to a problem gambler was

associated with more negative attitudes towards gambling compared to those not being

exposed to or being a concerned other to a problem gambler.

Out of the 15 studies that investigated the associations with gender, 12 reported

women to have more negative attitudes compared to men (see Table 1), while one

study (Dowling et al., 2020) reported the opposite, and two studies (Ayandele et al.,

2021; Àndra et al., 2021) did not ﬁnd a statistically signiﬁcant gender diﬀerence. Of the

ten studies that investigated the relationship between gambling attitudes and age, ﬁve

studies (Ayandele et al., 2021; Fiedor et al., 2018; Orford et al., 2009, 2010; Salonen et al.,

2014; Sanscartier et al., 2019) reported an inverse association between age and positive

attitudes. However, two studies (Pallesen et al., 2016, 2020) reported a positive associa-

tion between age and positive attitudes, and three studies (Donaldson et al., 2015;

Gavriel-Fried, 2015; McAllister, 2013) did not report a statistically signiﬁcant association

between gambling attitudes and age. Eight studies investigated education in relation to

gambling attitudes. Four studies (Donaldson et al., 2015; Orford et al., 2009, 2010;

Pallesen et al., 2020; Àndra et al., 2021) reported an inverse association between levels

of education and attitudes, while one study (Salonen et al., 2014) reported a positive

association between the ATGS and having 12 or more (in contrast to having less than 12)

years of education. The remaining three studies (Fiedor et al., 2018; Gavriel-Fried, 2015;

McAllister, 2013) did not ﬁnd statistically signiﬁcant associations between gambling

attitudes and education level.

Risk of bias

The risk of bias assessment using the MMAT is summarized in Table 2. Three of the ﬁve

categories in MMAT (qualitative, quantitative non-randomized controlled trials, and

mixed methods) were not used in the assessment as none of the included studies in the

present review were based on such designs. Four manuscripts were included in category

two (quantitative randomized controlled trials) and the remaining 22 were included in

category four (quantitative descriptive studies; see Table 2). Only ﬁve of the 26 manu-

scripts scored yes on all the categories in MMAT. Eight of the quantitative descriptive

studies did not have a representative sample and two did not provide suﬃcient informa-

tion to evaluate the representativeness (see Table 2). The risk of nonresponse bias was

evaluated as high for three manuscripts and as unclear for nine manuscripts (see Table 2).

All four experimental/intervention studies collected outcome data using self-report.

Therefore, the outcome assessors could not be blinded to the experimental condition.

Additionally, one study (Kaakinen et al., 2019) did not provide suﬃcient data to assess

whether the randomization was performed appropriately or if the participants adhered to

the assigned intervention.

20 J. HELLUMBRÅTEN KRISTENSEN ET AL.

Table 2. Results from the MMAT quality assessment.

Study

S1. Are

there clear

research

questions?

S2. Do the

collected

data allow

to address

the

research

questions?

2.1. Is

randomization

appropriately

performed?

2.2. Are the

groups

comparable

at baseline?

2.3. Are

there

complete

outcome

data?

2.4. Are

outcome

assessors

blinded to

the

intervention

provided?

2.5. Did the

participants

adhere to

the assigned

intervention?

4.1. Is the

sampling

strategy

relevant

to address

the

research

question?

4.2. Is the

sample

representative

of the target

population?

4.3. Are the

measurements

appropriate?

4.4. Is the risk

nonresponse

bias low?

4.5. Is the

statistical

analysis

appropriate

to answer

the research

question?

Àndra et al.

(2021)

Y Y Y N Y C C

Ayandele’s

et al.

(2021)

Y Y Y N Y C C

Calado

et al.

(2017)

Y Y Y N Y C C

Calado

et al.

(2019)

Y Y Y Y Y C Y

Canale

et al.

(2016)

Y Y Y Y Y Y Y

Delfabbro

et al.

(2021)

Y N N N Y N Y

Delfabbro

et al.

(2021)

Y Y Y N Y C C

Donaldson

et al.

(2015)

Y Y Y C Y C C

Dowling

et al.

(2020)

Y C C C Y C Y

(Continued)

INTERNATIONAL GAMBLING STUDIES 21

Table 2. (Continued).

Study

S1. Are

there clear

research

questions?

S2. Do the

collected

data allow

to address

the

research

questions?

2.1. Is

randomization

appropriately

performed?

2.2. Are the

groups

comparable

at baseline?

2.3. Are

there

complete

outcome

data?

2.4. Are

outcome

assessors

blinded to

the

intervention

provided?

2.5. Did the

participants

adhere to

the assigned

intervention?

4.1. Is the

sampling

strategy

relevant

to address

the

research

question?

4.2. Is the

sample

representative

of the target

population?

4.3. Are the

measurements

appropriate?

4.4. Is the risk

nonresponse

bias low?

4.5. Is the

statistical

analysis

appropriate

to answer

the research

question?

Fiedor et al.

(2018)

Y Y Y N Y Y Y

Fiedor and

Seidlova

(2021)

Y Y Y N Y C C

Gavriel-

Fried

(2015)

Y Y Y Y Y Y C

Hanss et al.

(2014)

Y Y Y Y Y N Y

Hanss et al.

(2014)

Y Y Y Y Y Y Y

Kaakinen

et al.

(2019)

Y Y C Y Y C C

McAllister

(2013)

Y Y Y Y Y N Y

Oksanen

et al.

(2019)

Y Y Y Y Y Y Y

Orford

et al.

(2009)

Y Y Y Y C Y C

Orford

et al.

(2010)

Y Y Y Y Y Y Y

(Continued)

22 J. HELLUMBRÅTEN KRISTENSEN ET AL.

Table 2. (Continued).

Study

S1. Are

there clear

research

questions?

S2. Do the

collected

data allow

to address

the

research

questions?

2.1. Is

randomization

appropriately

performed?

2.2. Are the

groups

comparable

at baseline?

2.3. Are

there

complete

outcome

data?

2.4. Are

outcome

assessors

blinded to

the

intervention

provided?

2.5. Did the

participants

adhere to

the assigned

intervention?

4.1. Is the

sampling

strategy

relevant

to address

the

research

question?

4.2. Is the

sample

representative

of the target

population?

4.3. Are the

measurements

appropriate?

4.4. Is the risk

nonresponse

bias low?

4.5. Is the

statistical

analysis

appropriate

to answer

the research

question?

Pallesen

et al.

(2016)

Y Y Y Y Y C Y

Pallesen’s

et al.

(2020)

N C Y Y Y Y Y

Rosen et al.

(2020)

Y Y Y Y Y C Y

Salonen

et al.

(2014)

Y Y Y Y Y Y Y

Salonen

et al.

(2017)

Y Y Y Y Y Y Y

Sanscartier

et al.

(2019)

Y Y Y N Y C Y

Zhou et al.

(2018)

Y Y Y Y Y C Y

Y = Yes, N = No, C = Can’t tell.

INTERNATIONAL GAMBLING STUDIES 23

Discussion

The aim of this systematic literature review was to investigate the characteristics and

synthesize the main ﬁndings of studies investigating attitudes toward gambling using the

ATGS. A total of 23 unique studies, including 55,795 participants from 12 diﬀerent

countries were included for review. The current synthesis shows a clear general disap-

proval of gambling, which is consistent with research where other instruments than the

ATGS have been used (Delfabbro & King, 2020; Smith et al., 2011). Although the

tendency for negative attitudes is apparent, several of the included studies that used the

ATGS-8 reported mean scores between 17–24, and 32–39 for all studies using the ATGS-

14. Given that the mean score indicative of neutral attitudes is 24 and 42 for the two

versions, respectively (Wardle et al., 2007, 2010), this suggests that the overall attitudes

are rather mildly inclined towards being negative.

Against the other studies, two of the included studies (Ayandele et al., 2021; Dowling

et al., 2020) reported positive attitudes just above neutral. This discrepancy from the

majority of included studies is most likely related to sampling strategy. Both Ayandele

et al. (2021) and Dowling et al. (2020) employed convenience sampling which could

result in a sample with similar demographic variables and attitudes (Biernacki &

Waldorf, 1981), as well as attract participants that are generally more interested in

gambling. Further, a large percentage of the participants were male in Ayandele’s et al.

(2021) study (83.8%), and the overall mean age was relatively low in both samples (22.8

and 23.2 in Ayandele et al., 2021; Dowling et al., 2020, respectively). Additionally,

Dowling et al. (2020) reported that 75% of the participants had participated in

a gambling activity during the past year. Hence, the combination of sampling technique

and sample characteristics (i.e. gender, age, gambling frequency) could explain why the

respondents in these two studies reported more positive attitudes than the majority of the

other included studies. However, as Ayandele’s et al. (2021) sample comprised one of

three samples not deriving from Europe or Australia, one cannot dismiss cultural factors

or diﬀerences in national gambling policies inﬂuencing the results. Speciﬁcally, distinct

cultural values and beliefs may have an impact on whether involvement in gambling is

encouraged or discouraged (Raylu & Oei, 2004). In this vein, research has suggested that

gambling is more common in more individualistic cultures as opposed to more collecti-

vistic-oriented cultures (Ozorio et al., 2010). This could be related to cultural variations

in risk-taking behavior more generally, where individualistic cultures to a larger extent

than collectivistic cultures encourage individuals to take risks for personal reward –

including risk-taking activities such as gambling (Ozorio et al., 2010; Raylu & Oei, 2004).

Further, expansion of gambling opportunities could conceivably either increase positive

or negative attitudes toward gambling. Liberalization of gambling could normalize

gambling and thus lead to more positive attitudes, but increased expansion might also

lead to experiences of oversaturation, i.e. people are fed up and grow distasteful towards

gambling in general. The latter has been observed in association with gambling advertis-

ing among Australians (Thomas et al., 2012). However, although the observed between-

study variance in ATGS scores in the current synthesis is probably to some extent

attributable to cultural diﬀerences and distinctive national gambling policies, drawing

conclusions on the magnitude of their impact on the current synthesis remains somewhat

speculative due to methodological inconsistencies.

24 J. HELLUMBRÅTEN KRISTENSEN ET AL.

A consistent ﬁnding in this review was that gambling attitudes were positively

associated with gambling frequency, suggesting that individuals who participate more

in gambling also report more positive attitudes toward gambling. This is consistent with

most studies on attitudes towards gambling using other instruments than the ATGS (e.g.

Chiu & Storm, 2009; Delfabbro & Thrupp, 2003; Hardoon & Derevensky, 2002; Williams

et al., 2006; Wood & Griﬃths, 2004). However, since none of the included studies

reported longitudinal data on this association, it is impossible to draw any conclusions

about directionality and/or causality. The evidence regarding the relationship between

problem gambling severity and gambling attitudes was somewhat conﬂicting in the

studies included in the present synthesis. Considering the association between gambling

frequency and gambling attitudes, it would be conceivable to expect that problem

gambling severity would be associated with more positive attitudes as noted by four

included studies (Donaldson et al., 2015; Gavriel-Fried, 2015; Hanss et al., 2014, 2014;

Salonen et al., 2014), seeing as those who struggle with gambling are likely to have a high

gambling frequency (Holtgraves, 2009; Pallesen et al., 2020). The positive association

could also be related to gambling motives, as problem gamblers are more likely to gamble

to cope with negative emotions or experiences, to socialize, as well as use gambling as

a way to ﬁx ﬁnancial issues compared to non-problem gamblers (Stewart & Zack, 2008;

Tabri et al., 2022). However, many problem gamblers experience several negative con-

sequences related to their excessive gambling, such as ﬁnancial problems, job loss,

relationship problems, and psychological harms (e.g. depression and anxiety; Potenza

et al., 2019). This could explain why four other studies (Donaldson et al., 2015; Gavriel-

Fried, 2015; Hanss et al., 2014, 2014; Salonen et al., 2014), found an inverse relationship,

suggesting that higher levels of problem gambling severity and associated consequences

could lead to more negative gambling attitudes. Correspondent with Pallesen’s et al.

(2020) ﬁndings that problem gamblers reported less positive attitudes towards gambling

than low-risk and moderate risk gamblers, it is possible that the gambler remains positive

towards gambling until the point where the gambling-related problems become apparent

or diﬃcult to manage. Hence, the inconsistency regarding ﬁndings on the association

between problem gambling severity and attitudes towards gambling in this synthesis

could be related to diﬀerences in the severity of gambling problems in the diﬀerent

samples. Additionally, problem gamblers could possibly have diﬀerent attitudes towards

gambling depending on what stage of change they are at. In line with the stages of change

model (Prochaska & DiClemente, 1983, 1992), problem gamblers may experience nega-

tive consequences while being unaware/avoiding that they themselves have a problem

(Petry, 2005). It is conceivable that this also aﬀects their attitudes towards gambling in

general.

A further general ﬁnding was that males reported having more positive attitudes than

women. This ﬁnding is also in line with former research using other instruments than the

ATGS (e.g. Buczkiewicz et al., 2007; Jackson et al., 2008; Kassinove, 1998; Moore &

Ohtsuka, 1997; Peltzer & Thole, 2000; Smith et al., 2011; Taormina, 2009; Wood &

Griﬃths, 1998). This could partly be explained by the fact that gambling is more common

among men than women (e.g. Abbott et al., 2014; Wardle et al., 2010), thus again

highlighting the relationship between gambling attitudes and gambling frequency. The

gender diﬀerence in gambling engagement could be related to the fact that men are

generally more impulsive and take more risks than women, which is supported by

INTERNATIONAL GAMBLING STUDIES 25

research that has shown impulsivity and risk-taking to mediate gender diﬀerences in

gambling engagement (Wong et al., 2013). The majority of studies that investigated the

relationship between gambling attitudes and age found an inverse relationship between

positive attitudes and increasing age (Ayandele et al., 2021; Fiedor et al., 2018; Orford

et al., 2009, 2010; Salonen et al., 2014; Sanscartier et al., 2019). This might reﬂect that

younger people do not have the same ﬁnancial responsibilities that older adults have,

such as a house, mortgage, or a family dependent on their income. Thus, losing money

could have fewer consequences for younger individuals, and consequently, younger

individuals might perceive gambling as less risky than older adults. This is also corre-

spondent with the notion that younger individuals are generally more willing to take risks

than older adults (Duell et al., 2018), which could render them more susceptible to

gambling and could in turn result in more positive gambling attitudes. Education was

only investigated in a few studies, of which four studies out of the ﬁve studies that found

a statistically signiﬁcant relationship indicated that educational level was inversely

associated with gambling attitudes. A possible explanation could be that people with

higher education might have a more conscious relationship with money. Alternatively,

one might hypothesize that higher educated people are more aware of thought errors and

superstitions related to gambling (Pallesen et al., 2020).

Limitations of the included studies

The current evidence base on the ATGS is somewhat limited as none of the survey-based

studies included in this review, except for Pallesen et al. (2016), employed a longitudinal

design. Consequently, no inferences can be drawn concerning directionality and caus-

ality on the relationships identiﬁed in this review. Further, nine of 23 studies recruited

participants using convenience sampling which could result in a sample with similar

demographic variables and attitudes (Biernacki & Waldorf, 1981), as well as attracting

participants that are generally more interested in or have more positive (or negative)

attitudes toward gambling, thus possibly skewing the results and limiting the representa-

tiveness of these samples. Another limitation is that all studies collected their data by self-

report measures. There are several known biases related to self-report, such as recall bias

and social desirability (Spencer et al., 2017; van de Mortel, 2008). Followingly, self-report

measures could lead to inaccurate reports of gambling behavior and/or other covariates

due to recall bias or participants adjusting their responses to what they perceive as more

socially acceptable. Moreover, many studies used relatively young samples with respon-

dents between 17 and 25 years of age (see Table 1). Consistent with the ﬁndings in this

synthesis, a large proportion of young participants could lead the reports on gambling

attitudes to be somewhat skewed towards the positive end. Further, with exception of one

sample from Nigeria (Ayandele et al., 2021) and one sample and one subsample from

Israel (Delfabbro et al., 2021, 2021; Gavriel-Fried, 2015), all the samples derived from

Europe, Australia, or the USA, suggesting that the current results might not be general-

izable beyond individuals from these countries. Lastly, the results from the risk of bias

assessment showed that very few of the studies endorsed the maximum score in all

categories of the MMAT (see Table 2). This suggests that there seems to be room for

improvement in terms of study quality as well as suﬃcient reporting in studies employing

the ATGS.

26 J. HELLUMBRÅTEN KRISTENSEN ET AL.

Limitations and strengths of the current review

The principal limitation of this synthesis is that the ATGS was employed in several quite

speciﬁc populations (e.g. students, ex-oﬀenders, young adults) in addition to more

representative samples. This causes some challenges in terms of comparability as there

can be diﬀerent predictors related to scores on the ATGS for e.g. adolescents and older

adults.

Further, when processing the ﬁndings, we extracted only estimates deriving from

multivariate analyses rather than bivariate analyses if both adjusted and unadjusted

estimates were reported in the manuscript. This means that we refrained to report

signiﬁcant associations that were found in the bivariate analyses, but that were not

upheld in the multivariate analyses. Another limitation is that we did not perform

language-speciﬁc literature searches for all European languages, and thus only manu-

scripts that were written- or included a title, abstract, and/or keywords in English would

have been detected by the search strategy. As a consequence of this, and the fact that we

excluded manuscripts not written in a European language, there is a risk that the current

synthesis might to some degree be inﬂuenced by a language bias. A strength of this

systematic literature review is the utilization of a relatively broad search syntax which

reduces the risk that relevant manuscripts would not be identiﬁed by the literature search.

Further, two reviewers conducted the screening, selection, and data extraction indepen-

dently, which strengthens the reliability and internal validity of the synthesis.

Implications for future research, practice, and policy

The ﬁndings in this review suggest several future research avenues for research on

gambling attitudes using the ATGS. Future studies should aim to explore the cross-

cultural diversity of gambling attitudes, as well as investigate to a greater extent how the

ATGS performs in non-western populations. Further, it would be interesting to investi-

gate how diﬀerent deﬁnitions of gambling are related to gambling attitudes, such as

Fiedor et al. (2018) did in their study. When the deﬁnition of gambling varies between

studies, there is a risk of measuring attitudes toward diﬀerent conceptualizations of

gambling. As reported by Fiedor et al. (2018), people who e.g. do not consider lottery

tickets or raﬄes as gambling, may have diﬀerent attitudes than those who do. As almost

all the studies included in this review were cross-sectional, the evidence base would

advance by future studies employing longitudinal designs. In addition to allowing for

inferences on directionality, longitudinal data could allow for some clariﬁcation regard-

ing e.g. the role of age in gambling attitudes: Are the positive attitudes found in younger

people due to a generational change, or do they reﬂect a natural development in attitudes

as one matures? Further, all studies employed self-reports to measure gambling partici-

pation/frequency and symptoms of problem gambling. Future research would beneﬁt

from combining more objective measures of gambling behavior (e.g. player tracking data

and clinical assessment) with self-report measures of attitudes towards gambling to

reduce the inﬂuence of bias associated with self-reported gambling behavior, and to

investigate the relationship between attitudes and real gambling behavior. Importantly,

problem gamblers are not a homogeneous group in terms of severity. Investigating

nuances in problem gambling severity among problem gamblers (i.e. severity among

INTERNATIONAL GAMBLING STUDIES 27

individuals who score above the conventional cutoﬀ scores indicating problem gambling,

e.g. PGSI = 8+), including clinical samples, could shed light on the divergent ﬁndings on

problem gambling severity and gambling attitudes reported in the present synthesis. The

ATGS only measures explicit attitudes. However, there are cases where explicit attitudes

are not consistent with implicit attitudes, for example when there are social or cultural

values associated with the attitudes (Rydell et al., 2006). Therefore, people who report

negative explicit attitudes could have positive implicit attitudes or vice versa. Thus, future

research would beneﬁt to also include measures of implicit attitudes (e.g. by the implicit

association test; Greenwald et al., 1998), to assess if there is congruence between implicit

and explicit attitudes towards gambling. Lastly, as the gambling industry has increasingly

started to oﬀer gambling activities online in the last decade, it would be interesting to

investigate whether there are diﬀerent attitudes prevailing towards online gambling

compared to more traditional land-based gambling.

Finally, the current ﬁndings also have relevance for gambling practice and policy. The

fact that overall attitudes toward gambling were skewed to the negative side would

suggest that most people would generally exhibit an inherent skepticism concerning

the expansion of new gambling opportunities. Further, a general disapproval of gambling

would conceivably also suggest that the public will generally accept more strict regula-

tions regarding the gambling market, such as banning/removal of youth-targeted gam-

bling advertisements (Kristiansen & Severin-Nielsen, 2022) and enforcing mandatory

responsible gambling tools (e.g. spending-/loss limits or time breaks; Auer et al., 2020).

Such mandatory measures in conjunction with voluntarily applied responsible gambling

tools (e.g. self-exclusion, voluntary loss limits, self-testing for gambling problems, etc.)

have been found to be important and eﬀective in reducing gambling-related harm and

are also generally perceived as useful by gamblers (Engebø et al., 2019; Gainsbury et al.,

2013; Tanner et al., 2017).

Conclusion

The current literature review contributes to the ﬁeld of attitudes toward gambling by

being the ﬁrst study to consolidate the evidence on studies using the ATGS. Most studies

reported an overall tendency towards negative gambling attitudes. Men consistently

reported more positive attitudes than women, younger people reported generally more

positive attitudes than older people, and individuals with higher education seem to report

more negative attitudes towards gambling than individuals with lower education. Higher

gambling frequency was consistently shown to be associated with positive gambling

attitudes, but the evidence on the association between problem gambling severity and

attitudes towards gambling is currently divergent and in need of future clariﬁcation. The

current evidence base is somewhat encumbered by limitations in study quality and

designs, which highlights the need to employ the ATGS in more representative- and

cross-cultural samples as well as employment of longitudinal investigations.

Disclosure statement

The authors declare that no funding was received and no constraints on publishing nor conﬂicts of

interest exist that readers should know about in relation to this manuscript.

28 J. HELLUMBRÅTEN KRISTENSEN ET AL.

Notes on contributors

Joakim Hellumbråten Kristensen holds a master’s degree in social- and cognitive psychology and

is a Ph.D-candidate at the Department of psychosocial science, University of Bergen. His research

predominantly concerns behavioral addictions with an emphasis on gambling- and gaming

research.

Sandra Trifunovic holds a bachelor’s degree in general psychology from the University of Bergen.

She is currently working at the Faculty of Psychology, and will begin her master’s degree in

leadership and organizational psychology in the fall of 2022.

Julie Strand completed her bachelor’s degree in general psychology from the University of Bergen

in 2022. From the fall of 2022, she will begin her master’s degree in psychology with

a specialization in work and organizational psychology.

Karen Kraft Vistnes has a bachelor’s degree in general psychology from the University of Bergen.

Starting autumn of 2022, she will be a master’s student in psychology with a specialization in work

and organizational psychology.

André Syvertsen is a clinical psychologist (Cand. Psychol.) and Ph.D candidate the Department of

Psychosocial Science, University of Bergen. His main research interests include quantitative and

qualitative research on gaming and gambling problems.

Amin Zandi holds a master’s degree in clinical psychology from the Faculty of Psychology and

Educational Sciences, University of Tehran, Iran. His research concerns clinical psychology and

personality-environmental interactions.

Ståle Pallesen is a professor of psychology at the University of Bergen and Head of the Norwegian

Competence Center for Gambling Gaming Research. He has authored more than 100 papers on

gambling-related topics.

ORCID

Joakim Hellumbråten Kristensen http://orcid.org/0000-0002-0691-0334

André Syvertsen http://orcid.org/0000-0002-3881-3758

Amin Zandi http://orcid.org/0000-0001-9493-1313

Ståle Pallesen http://orcid.org/0000-0002-5831-0840

Ethical approval

This paper presents a systematic review based on previously published data.

Preregistration statement

https://www.crd.york.ac.uk/PROSPERO/; record ID: CRD42022311675

Data availability statement

The data that support the ﬁndings of this study are available on request from the corresponding

author.

INTERNATIONAL GAMBLING STUDIES 29

Open Scholarship

This article has earned the Center for Open Science badge for Preregistered. The materials are

openly accessible at https://www.crd.york.ac.uk/prospero/display_record.php?ID=

CRD42022311675

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34 J. HELLUMBRÅTEN KRISTENSEN ET AL.

How Does Problem Gambling Impact the Relationship Between Gambling Attitudes and Frequency?

Article

Full-text available

Mar 2025
J GAMBL STUD

Individuals’ beliefs and perceptions about gambling are known to influence gambling behaviours. However, the associations between gambling attitudes, gambling frequency, and problem gambling are unclear within the existing literature. The study aimed to elucidate the relationship between gambling attitudes, gambling behaviour, and problem gambling, using responses to the 2018 Northern Territory Gambling Prevalence and Wellbeing Survey. Data from 1629 participants (Mage = 49.87 years; SD = 14.58 years; 51.63% female) who completed the Attitudes Towards Gambling Survey (ATGS), Problem Gambling Severity Index (PGSI), and reported their gambling frequency were analysed. Prior to testing for moderation of the attitude-frequency path by PGSI risk category, the measurement model of the ATGS was assessed for invariance and one item was removed to improve its psychometric properties. Problem gambling severity moderated the relationship between attitudes towards gambling and gambling frequency. The relationship between attitudes towards gambling and gambling behaviour strengthened at higher levels of problem gambling. Results indicate that the higher the risk of problem gambling, the stronger the influence of gambling attitudes on gambling frequency. These findings are discussed in relation to cognitive dissonance, rationalisation, gambling motivation, and the potential implications for problem gambling prevention strategies.

An empirical study on attitudes toward gambling when sportswashing is involved

Article

Full-text available

Oct 2023

Sportswashing is defined as individuals, groups, companies, or countries/regimes’ involvement in sports to improve their own reputation and/or to distract from or normalize wrongdoing. This cross-sectional survey is the first empirical study on sportswashing in relation to gambling. The sample consisted of United Kingdom residents who reported past 12-month gambling (N = 786, 50% women, mean age = 45.6, SD = 15.2). We investigated how many were familiar with sportswashing and their attitudes toward gambling when sportswashing is involved. Exploratory and confirmatory factor analysis (CFA) were conducted on the attitudes scale that was developed for the current study. Multiple regressions were used to examine if individual differences in terms of age, gender, personality, moral foundations, political trust and efficacy, and/or gambling risk were associated with such attitudes. Finally, we examined the percentage of people who avoid gambling on teams/events when sportswashing is involved, including group differences in avoidance and motivations for avoidance according to gambling risk. The results showed that only 32% had heard about sportswashing prior to the survey. CFA indicated that attitudes toward sportswashing and gambling as conceptualized in the scale used in the current study can broadly be categorized into two dimensions: How individuals relate to sportswashing when gambling (“self-factor”) and how individuals think gambling companies and regulators should regulate sportswashing and gambling [an “external-factor,” p < 0.001, CFI = 0.0.996, RMSEA = 0.090, 90% CI (0.077, 0.104)]. Multiple regressions indicated that measures of individual differences explained a significant amount of variance in self-oriented (F (17, 765) = 7.19, p < 0.001, adjusted R² = 0.12) and external-oriented (F (17, 765) = 8.40, p < 0.001. adjusted R² = 0.14) attitude toward gambling and sportswashing. Avoidance of betting when sportswashing is involved was reported by 43%. The proportion was lower among those with moderate gambling risk/problem gambling (35%) compared to those with no/low gambling risk (45%). It is concluded that further scale development could help elucidate individual differences in attitudes toward sportswashing and gambling. Sportswashing remains an important social issue, and the present study indicates that this has high relevance for the gambling field.

Short-term effectiveness of gambling treatment in the Daily Clinic for Gambling Addiction

Article

Full-text available

Mar 2025

In response to the high prevalence of gambling addiction within the population, a specialised Daily Clinic for Gambling Addiction was established at the University Psychiatric Hospital “St. John” in Zagreb (Croatia). This clinic offers a unique three-month, semi-structured, intensive multidimensional and multidisciplinary treatment approach delivered by a team of specialised mental health professionals. Treatment interventions include individual and group psychotherapy, socioemotional skills training, family therapy, support groups and other modalities. In collaboration with researchers from the University of Zagreb Faculty of Education and Rehabilitation Sciences, the study team is conducting a scientific evaluation to determine the outcomes of the treatment. This study presents results on its’ short-term effectiveness, based on a sample of N = 209 patients (Mean Age = 33.54; Males = 92.8%; Females = 7.2%) who underwent treatment between 2017 and 2021. To assess the effectiveness of the treatment, a research design incorporating two measurement sessions (pre-test and post-test) was employed. This design utilised a comprehensive battery of validated instruments, each targeting specific constructs or domains of psychosocial functioning that the intervention aims to address. The assessment tools included: (1) Problem Gambling Severity Index-PGSI, (2) Gambling Attitudes Scale—GAS, (3) Coping Inventory for Stressful Situations—CISS, (4) The Gambling Beliefs Scale—short version, (5) Problem Solving and Refusal Skills Scale, (6) Depression, Anxiety, Stress Scale—DASS-21, (7) Generalised Self-Efficacy Scale—GSE, and (8) Multidimensional Scale of Perceived Social Support. The results indicate significant positive improvements in gamblers’ psychosocial functioning with the following large effect sizes: gambling-related consequences (r = 0.84), task oriented coping (Cohen’s d = 0.79), emotion oriented coping (Cohen’s d = 1.06), attitudes (r = 0.67), superstition (r = 0.61), illusion of control (r = 0.62), depression (r = 0.78), anxiety (r = 0.71), stress (r = 0.73), problem-solving skills (r = 0.73) and general self-efficacy (r = 0.61). The effects on refusal skills (Cohen’s d = 0.48) as well as on alcohol (Cohen’s d = 0.24) and marihuana (r = 0.26) were small to medium. Findings are discussed in terms of appropriate treatment approaches for gambling addiction, methodological challenges in measuring effects and implications for future evaluation research. In general, this treatment protocol provides promising effects for gambling addiction.

Using latent class analysis to identify Finnish gambler types and potential risk

Article

Sep 2024

Trends in attitudes towards gambling among Finnish women and men: Cross-sectional population studies 2011, 2015, 2019 and 2023

Article

Mar 2025
Nordisk Alkohol Nark

Aims: To compare the attitudes towards gambling in Finland by age among women and men from 2011 to 2023. Methods: Four cross-sectional random sample data sets of 15–74-year-olds were collected in 2011, 2015, 2019 and 2023. The data were weighted based on gender, age and residential area. The eight-item Attitude Towards Gambling Scale (ATGS-8) was used. Results: Overall, public attitudes towards gambling were generally unfavourable each year, apart from 2015, when attitudes were favourable. Among women, attitudes became more unfavourable for those aged 15–29 years, whereas they became more favourable for those aged 45 to 74. Among men, attitudes became more unfavourable for those aged 15–44 years, whereas they became more favourable for those aged 60–74 years. Men aged 45–59 years were the only age group with favourable attitudes in 2023. Conclusions: Attitudes towards gambling were mainly unfavourable, with no notable shift observed between 2011 and 2023. The Finnish gambling monopoly system is set to be replaced by a licensing system, opening the online gambling market to competition. Because of this change, it is increasingly important to monitor attitudes towards gambling and possible changes in them in the coming years.

Attitudes, perceptions, and intentions toward sports betting legalization: a cluster analysis of California residents

Article

Nov 2024

Brandon Mastromartino

An Exploratory Study to Assess the Barriers to Help Seeking among Male Patients with Gambling Disorder

Article

Jun 2024

Context Gambling disorder is a significant public health problem. Despite the significant negative consequences of problem gambling, a relatively small proportion actively seek help for their issues. Aims This study was conducted to understand the reasons why people did not seek help for gambling disorders. Settings and Design The study was conducted at a public-funded tertiary care centre (National Drug Dependence Treatment Centre [NDDTC], Ghaziabad). The study was a cross sectional and observational design. Materials and Methods A total of 486 subjects visiting outpatient as well as inpatient settings were screened for gambling. Fifty participants were diagnosed with gambling disorder and were included in the study. Data were collected using a structured sociodemographic pro forma, Gambling Readiness to Change Scale, Attitude toward Gambling Scale, Gambling Perceived Stigma Scale, Gambling Experiences Stigma Scale, and Barriers to Treatment Inventory. Statistical Analysis Pearson’s product-moment coefficient and Kendall’s Tau correlation coefficients were computed. Independent sample t -test, ANOVA, Mann–Whitney U, and Kruskal–Wallis H -test were used for comparisons. Results The study identified denial of the problem, perceived and experienced stigma, time conflict, and limited availability and accessibility of treatment facilities as significant barriers to treatment for problem gamblers. Conclusion There exists a pressing necessity to impart comprehensive awareness, education, and training to various community stakeholders, including family members, friends, and health-care professionals. It is vital for treatment centers to proactively communicate their broader focus, encompassing not only substance and alcohol use challenges but also problems related to gambling.

Sikap Remaja terhadap Perilaku Perjudian

Article

Full-text available

Nov 2023

Triyana Harlia Putri

Judi merupakan permainan yang umum dilakukan oleh remaja hampir di seluruh dunia. Namun, berbagai permasalahan perjudian dapat mengancam kesehatan masyarakat, untuk itu penting untuk mengevaluasi sikap remaja dalam berjudi yang menjadi alasan remaja memutuskan untuk berkontribusi dalam perjudian. Penelitian ini bertujuan untuk mengetahui sikap terhadap perilaku perjudian pada remaja. Penelitian ini menggunakan pendekatan cross sectional, jumlah populasi adalah 594 siswa SMP yang seluruhnya berpartisipasi dalam pengisian kuesioner, sehingga sampel diambil dengan menggunakan teknik total sampling. Instrumen yang digunakan dalam penelitian ini adalah skala Sikap terhadap perjudian (ATGS-8). Penelitian ini melaporkan mayoritas berada pada usia 14 tahun, berjenis kelamin perempuan, mayoritas merupakan remaja dengan riwayat keluarga berstatus ekonomi sedang, mayoritas memiliki riwayat keluarga tidak pernah berjudi dan tidak pernah mengonsumsi rokok dan minuman beralkohol. Hasil ATGS-8 menunjukkan bahwa separuh remaja menggambarkan sikap negatif, namun memiliki kecenderungan netral terhadap perjudian sebesar 52,5% atau rata-rata sikap sebesar 23,14 (±3,31). Penelitian ini melaporkan bahwa separuh remaja menggambarkan sikap negatif, namun cenderung netral terhadap perjudian.

Stages and processes of self-change of smoking: Toward an integrative model of change

Article

Full-text available

Jun 1983

An integrative model of change was applied to the study of 872 Ss (mean age 40 yrs) who were changing their smoking habits on their own. Ss represented the following 5 stages of change: precontemplation, contemplation, action, maintenance, and relapse. 10 processes of change were expected to receive differential emphases during particular stages of change. Results indicate that Ss (a) used the fewest processes of change during precontemplation; (b) emphasized consciousness raising during the contemplation stage; (c) emphasized self-reevaluation in both contemplation and action stages; (d) emphasized self-liberation, a helping relationship, and reinforcement management during the action stage; and (e) used counterconditioning and stimulus control the most in both action and maintenance stages. Relapsers responded as a combination of contemplaters and people in action would. Results are discussed in terms of developing a model of self-change of smoking and enhancing a more integrative general model of change. (14 ref)

What Contributes to Public Stigma Towards Problem Gambling?: A Comparative Analysis of University Students in Australia, Canada, Croatia and Israel

Article

Full-text available

Nov 2021
J GAMBL STUD

Stigma refers to the attribution of negative sentiments towards a particular entity, object or individual. Stigma can be public, perceived, or self-referential and can have negative consequences for individuals, including losses of self-esteem, self-efficacy, social isolation and a reluctance to seek help. Problem gambling is known to be a stigmatized activity, but less is known about what factors are associated with this perception and how it might vary in different countries. The current study examines the relationship between perceived stigma towards problem gamblers and gambling attitudes. perceptions of gambling regulations, gambling involvement, perceived accessibility to gambling, and exposure to people with gambling problems. The sample comprised 1787 university students aged 18–30 years from four countries: Australia, Canada, Croatia and Israel. The results indicated that greater perceived stigma was associated with more negative gambling attitudes, less engagement with gambling, and lower perceived social accessibility (the perception that others approve of the activity). Respondents from Croatia, the country with a newer gambling market, reported the most stigma towards problem gamblers as compared with Australia and Canada where gambling is longer established. The findings appear consistent with exposure–adaptation theory, in which tolerance towards people with problem gambling can develop over time in line with greater social acceptance or familiarity with the activity and its consequences. It is suggested that community campaigns and educational programs draw a distinction between attitudes towards gambling in general and those who are negatively affected by the activity.

Associations between financial gambling motives, gambling frequency, and level of problem gambling: A meta‐analytic review

Article

Full-text available

Jul 2021

Background and aims Money is central to psychological definitions of gambling, but contemporary accounts are ambiguous regarding the role of financial motives in disordered gambling. The aims of the current research were to obtain meta-analytic weighted effect sizes for zero-order associations of financial motives against gambling frequency and level of problem gambling, as well as partial associations after controlling for other motives (e.g., coping). Methods A meta-analysis of the literature through February 2021 was undertaken. Studies were identified from multiple sources (e.g., database search, other researchers). PRISMA standards were followed when screening identified records and extracting relevant data. The data analytic plan was pre-registered. We included 44 cross-sectional studies that involved student, community, and clinical samples of people who gamble (sample sizes ranged from 22 to 5,666), using validated self-report measures of financial gambling motives alongside measures of either gambling frequency and/or problem gambling. Results Financial gambling motives were positively associated with gambling frequency, r = .29, [.21, .37], N= 22,738 and level of problem gambling, r = .35, [.31, .38], N = 38,204 with moderate effect sizes. Partial associations after controlling for overlapping variance with other gambling motives were also positive (gambling frequency: β = .14, [.05, .22], N = 13,844; level of problem gambling: β = .18, [.13, .22], N = 28,146), with small-to-moderate effect sizes. Effect sizes were heterogeneous and the extent of heterogeneity was high. Analyses of the zero-order association involving gambling frequency indicated that gambling motives measure (greater for Gambling Motives Questionnaire-Financial) and sample mean age (greater for younger samples) were moderators. No other moderators were statistically significant. Conclusions Financial gambling motives appear to be reliably and positively associated with both gambling frequency and level of problem gambling.

Differences in Perceived and Experienced Stigma Between Problematic Gamblers and Non-gamblers in a General Population Survey

Article

Full-text available

Jun 2022
J GAMBL STUD

We consider a sample of about 700 people, interviewed on the streets, who are sorted into two groups by a self-report, screening questionnaire: namely, non-problematic gamblers/non-gamblers and problematic gamblers. Within each group, we compare both social (perceived) stigma and self-perceived (experienced) stigma, measured by means of other two self-report questionnaires, and we seek for relations between stigma and socio-demographic variables that can help targeting possible interventions to reduce gambling-related stigma. We, then, compare stigma between the two groups of non-(problematic) gamblers and problematic ones, and we also check the hypothesis that higher social stigma is related to higher self-perceived stigma, as well as higher stigma is related to lesser help-seeking. The latter hypothesis is of utmost importance, given that stigma is recognised to be one of the major causes for hindering help-seeking by problematic gamblers. The research is carried out in Italy, one of the first countries in the world for the money spent per capita in gambling activity every year.

Gambling Patterns Among People from Vietnam and Ukraine Living in the Czech Republic

Article

Full-text available

Jun 2021
J GAMBL STUD

In 2019, a questionnaire was conducted among foreigners living in the Czech Republic focused on gambling, in which 110 respondents from Vietnam and 80 respondents from Ukraine answered. Firstly, the Attitudes towards gambling scale (ATGS-8) was used to discover respondents’ attitudes to gambling. Secondly, their experience with gambling was examined with the help of the Problem Gambling Severity Index (PGSI) which allowed, among others, to estimate the level of prevalence of problem gambling in these groups. The methods used allowed us to compare both the Ukrainians to Vietnamese as well as Ukrainians and Vietnamese to Czechs, as similar survey was conducted among the major population of the country in 2017. The overall score of attitudes to gambling is slightly higher for the citizens of Ukraine (17.97) and Vietnam (18.29) compared to the majority. The Vietnamese living in the Czech Republic also have a significantly higher proportion of people in the category of pathological gamblers as based on the PGSI index (Vietnamese 4.2%), whilst the value of this index for Ukrainians (0.7%) is similar to the one of the majority. The analysis of immigrants’ gambling behaviour shows that Ukrainians are more like the majority population. The Vietnamese immigrants differ from both the majority population and Ukrainians in terms of attitudes whilst gambling is for them as common problem as alcohol consumption, and an even bigger problem than smoking.

Gambling Characteristics and Demographic Differences as Determinants of Attitudes Towards Gambling Among Youths in Lagos, Nigeria

Article

Full-text available

Mar 2021

In this cross-sectional survey study, we investigated gambling characteristics (''quick'' money syndrome, frequency of gambling, preferred gambling products and platforms) and demographic (age and gender) differences as determinants of attitudes towards gambling among youths in Lagos. We used a purposive snowball technique to recruit 179 respondents in Lagos (men: n = 165 [83.8% of participants]; women: n = 32) with a history of gambling activities. Gambling characteristics, demographics, and attitudes towards gambling were measured by using a gambling characteristics profile, the bio-data of the respondents, and the short form of the Attitudes Towards Gambling Scale (ATGS-8), respectively. The results showed that respondents believed that to make quick money, one needed to gamble once a week or more (67%), wager on sports betting (37.1%), and bet online (65.5%). The mean ATGS-8 composite score (28.2 ± 4.75) indicated overall positive attitudes among respondents. Independent sample t tests showed a significant difference between older (24-34 years) and younger (18-23 years) youths in their attitudes towards gambling (t =-2.30, p o .05) but no significant gender differences (t = 0.06, p 4 .05). One-way analysis of variance revealed a significant difference in attitudes towards gambling based on gambling frequency, F(3, 196) = 6.86, p o .05, with those who gamble monthly having the highest score. Participants displayed the belief that the easiest way to quick money is to gamble at least once weekly and to bet online. Younger participants and those who gamble at least once a month reported more positive attitudes towards gambling. Youths need to be made aware that gambling is not a viable source of income.

The societal costs of problem gambling in Sweden

Article

Full-text available

Dec 2020
BMC PUBLIC HEALTH

Background: Problem gambling is a public health issue affecting both the gamblers, their families, their employers, and society as a whole. Recent law changes in Sweden oblige local and regional health authorities to invest more in prevention and treatment of problem gambling. The economic consequences of gambling, and thereby the potential economic consequences of policy changes in the area, are unknown, as the cost of problem gambling to society has remained largely unexplored in Sweden and similar settings. Methods: A prevalence-based cost-of-illness study for Sweden for the year 2018 was conducted. A societal approach was chosen in order to include direct costs (such as health care and legal costs), indirect costs (such as lost productivity due to unemployment), and intangible costs (such as reduced quality of life due to emotional distress). Costs were estimated by combining epidemiological and unit cost data. Results: The societal costs of problem gambling amounted to 1.42 billion euros in 2018, corresponding to 0.30% of the gross domestic product. Direct costs accounted only for 13% of the total costs. Indirect costs accounted for more than half (59%) of the total costs, while intangible costs accounted for 28%. The societal costs were more than twice as high as the tax revenue from gambling in 2018. Direct and indirect costs of problem gambling combined amounted to one third of the equivalent costs of smoking and one sixth of the costs of alcohol consumption in Sweden. Conclusions: Problem gambling is increasingly recognized as a public health issue. The societal costs of it are not negligible, also in relation to major public health issues of an addictive nature such as smoking and alcohol consumption. Direct costs for prevention and treatment are very low. A stronger focus on prevention and treatment might help to reduce many of the very high indirect and intangible costs in the future.

Adolescent gambling advertising awareness: A national survey

Article

Jun 2021

While influence of gambling advertisements on adolescents in some jurisdictions is recognised as an important public health issue, research examining this influence is currently limited. The present study examined gambling advertising awareness among adolescents, how they perceive gambling advertisement's impact, and how gambling advertisement awareness relates to adolescent's gambling behaviour. A sample of Danish adolescents (n = 1137) aged 12–16 were surveyed using a self‐administered web questionnaire. It was found that (a) participants reported high exposure to gambling advertising with males reporting higher exposure to advertising than females, (b) the general self‐perceived impact of these advertisements was relatively low, and (c) self‐perceived impact of gambling advertising was associated with monetary spending on gambling activities and at‐risk or a problematic gambling. Restrictions on gambling advertisements and collaboration between national gambling authorities with social media platforms in order to identify and remove youth‐targeted gambling advertisements were specified as relevant policy implications.

The PRISMA 2020 statement: An updated guideline for reporting systematic reviews

Article

Mar 2021
Int J Surg

The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement, published in 2009, was designed to help systematic reviewers transparently report why the review was done, what the authors did, and what they found. Over the past decade, advances in systematic review methodology and terminology have necessitated an update to the guideline. The PRISMA 2020 statement replaces the 2009 statement and includes new reporting guidance that reflects advances in methods to identify, select, appraise, and synthesise studies. The structure and presentation of the items have been modified to facilitate implementation. In this article, we present the PRISMA 2020 27-item checklist, an expanded checklist that details reporting recommendations for each item, the PRISMA 2020 abstract checklist, and the revised flow diagrams for original and updated reviews.

Attitudes toward gambling in young people: a cross-national study of Australia, Canada, Croatia and Israel

Article

Feb 2021

Public attitudes toward gambling have important implications for people’s engagement in the activity and receptivity to regulatory reforms. Such views are likely, however, to be influenced by variations in market conditions, perceptions of regulations and personal exposure to gambling. This article examines whether differences in gambling attitudes are related to differences in the perceived social, cognitive, and physical accessibility of gambling in four countries (Australia, Israel, Croatia and Canada). These countries were selected because they cover a range of gambling regulations, from established liberalized markets (Australia, Canada), to a recently liberalized market (Croatia) to a relatively restricted market (Israel). University student respondents (n = 1787, aged 18–30) were surveyed in these four countries to control for educational differences. Within- gender analyses controlled for differences in gender profile across countries. More positive attitudes were associated with greater social accessibility and more stringent regulations. Australian and Canadian respondents reported more positive attitudes toward gambling and regulations. Israeli respondents reported less positive attitudes and exposure to problem gambling. Croatian respondents reported more positive attitudes, but considered gambling to be poorly regulated and overly available. Overall, attitudes were related to perceptions of regulation as well as the duration of exposure to liberalized markets.

A systematic literature review of studies on attitudes towards gambling using the Attitudes Towards Gambling Scale (ATGS)

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