Characteristics of Gamblers Seeking Help in France (2010-2015)
The study analyzes characteristics of individuals seeking help for problem gambling in France between 2010 and 2015 through a national help-line service. It discusses prevalence rates, help-seeking behaviors, and the use of internet forums and help-lines to facilitate assistance. The research highlights the importance of understanding and addressing problem gambling as an emergent public health issue.
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Presentation Transcript
Characteristics of gamblers using a national help-line for problem gambling in France between 2010 and 2015 St phane DARB DA1,2,3,4, Amandine LUQUIENS1,2,5, Henri-Jean AUBIN1,2,5, Michel LEJOYEUX1,4 1. CESP-Inserm UMR-1018 quipe Addictologie, Villejuif, France 2. Universit Paris Sud, Villejuif, France 3. Universit Pierre et Marie Curie, Paris, France 4. Groupement Hospitalier de Territoire Paris, Secteur de Psychiatrie 75G22, AP-HP, Groupe Hospitalier Paris Nord Val de Seine, Service de Psychiatrie et d Addictologie, Universit Paris Diderot, Paris, France 5. AP-HP, Groupe Hospitalier Paris Sud, Service de Psychiatrie et d Addictologie, Villejuif, France
Prevalence Problem gambling is an emergent public health issue. Past-year gambling prevalence, varies : (1) Across the world : 0.12% - 5.8% In Europe : 0.12% - 3.4% In France in 2014, among the general population : (2) PG : 0.5% Gamblers with moderate risk : 2.2% (1)Calado F, Griffiths MD. Problem gambling worldwide: An update and systematic review of empirical research (2000 2015). J Behav Addict. 2016 Dec;5(4):592 613. (2)Costes J-M, Eroukmanoff V, Richard J-B, Tovar M-L. Les jeux d argentet de hasard en France en 2014. Notes Obs Jeux. 2015;(6):9.
Help seeking Poor help seeking (1) Help seeking increase with severity of gambling (2,3) In France, in 2014 : (3) 2% of gamblers with moderate risk 21% of pathological gamblers (1)Cunningham JA. Little use of treatment among problem gamblers. Psychiatr Serv Wash DC. 2005 Aug;56(8):1024 5 (2) Suurvali H, Hodgins D, Toneatto T, Cunningham J. Treatment seeking among Ontario problem gamblers: results of a population survey. Psychiatr Serv Wash DC. 2008 Nov;59(11):1343 6. (3)Costes J-M, Eroukmanoff V, Richard J-B, Tovar M-L. Les jeux d argent et de hasard en France en 2014. Notes Obs Jeux. 2015;(6):9.
Help-line service The use of Internet forums and help-lines could facilitate help seeking (1,2) Optimized counseling using a motivational approach could promote orientation to face- to-face settings after initial phone contact.(1,3) (1)LedgerwoodDM, Arfken CL, WiedemannA, Bates KE, Holmes D, Jones L. Who goes to treatment? Predictors of treatment initiation among gambling help-line callers. Am J Addict. 2013 Jan;22(1):33 8. (2)Weinstock J, Burton S, Rash CJ, Moran S, Biller W, Krudelbach N, et al. Predictors of engaging in problem gambling treatment: data from the West Virginia Problem Gamblers Help Network. PsycholAddict Behav J Soc PsycholAddict Behav. 2011 Jun;25(2):372 9. (3)Khayyat-AbuaitaU, OstojicD, WiedemannA, Arfken CL, LedgerwoodDM. Barriers to and Reasons for Treatment Initiation Among Gambling Help-line Callers. J Nerv Ment Dis. 2015 Aug;203(8):641 5.
The French help-line service 1990 : national help-line service for drug addiction Law of 12 May 2010 : competition and regulation of the French online gambling market June 2010 : French national help-line for problem gambling
The French help-line service (2) Since 2010 : Phone help-line Joueurs Info Service Trained professional helpers From 2 a.m. to 7 a.m. Since 2013 : website with real time chat service
Objectives and Hypotheses Objectives : to describe the characteristics and the evolution over the time of gamblers using the national help-line to compare gamblers according to their gender and the media they chose. Hypotheses : Over the years, there is an increase in calls for online gambling; The populations using the online chat and the telephone line are probably different: online chat users are younger and have a greater use of online gambling.
Data collection For each call helpers systematically collected : modality used to contact Adalis (telephone or online chat, duration of the calls) characteristics of the callers: age and gender gambling related characteristics: gambling types (bets, casino, scratch cards, poker, lottery and other games), frequency (less than weekly or weekly or more), duration of gambling, media for gambling (offline, online or both) orientation (oriented to the national helpline and website, to medical or non-medical support or no orientation)
Data analysis Missing data were imputed by multiple imputation by chained equations (MICE). Time-based analyzes : the time series and a univariate linear regression line were plotted Differences between subgroups ( men versus women, weekly versus non-weekly gamblers) : Binary univariate logistic models A p<5% was chosen as the threshold of significance. The data were analyzed using the software R 3.4.1.
Description of gamblers Predominantly male (74.0%) Mean age was 41.3 years (SD = 14.4, IQR = [30.0 51.0]) The average duration of calls was 14.4 minutes The main types of gambling were bets, casino, scratch cards and poker. The majority of gamblers used physical gambling only, just over a quarter used only the internet and about 5% used both. The gamblers have on average started gambling 16 years ago (SD = 10.2). Very few gamblers reported having a history of suicide attempt (2.0%) and 5.0% reported being banned from casino.
Evolution over the time The number of calls, gender, age of gamblers and the duration of the calls, the number of weekly gamblers and calls for online gambling were stable; Type of gambling : bets, casino and scratch cards were stable Poker ( = -4.13; 95% CI = [-5.11 -3.15]; p<0.001), Lottery ( = -1.16; 95% CI = [-2.25 -0.07]; p<0.05) Other games ( = -1.37; 95% CI = [-2.0 -0.78]; p<0.001).
Evolution over the time Online gambling : non significant decrease
Evolution over the time Type of gambling : bets, casino and scratch cards were stable Poker ( = -4.13; 95% CI = [-5.11 -3.15]; p<0.001) Lottery ( = -1.16; 95% CI = [-2.25 -0.07]; p<0.05) Other games ( = -1.37; 95% CI = [-2.0 -0.78]; p<0.001)
Evolution over the time Poker : = -4.13; 95% CI = [-5.11 -3.15]; p<0.001
Evolution over the time Lottery : = -1.16; 95% CI = [-2.25 -0.07]; p<0.05
Evolution over the time Other games : = -1.37; 95% CI = [-2.0 -0.78]; p<0.001
Discussion Data from the national help line is the biggest database of gamblers using a help-line in France Contrary to our hypothesis, between 2011 and 2015, we observed a non-significant decrease in calls regarding online gambling. Real time chat users are a different population
Limitations No screening or diagnosis scale Retrospective study the database was not built for research useful variables are unworkable because of missing data
Conclusions Help-line services could help to remove barriers to treatment A substitute for face-to-face treatment ?
