Scottish Health Survey 2012 - volume 1: main report

9 Gambling Behaviour

Heather Wardle

Summary

• In 2012, seven in ten adults in Scotland had gambled in the previous 12 months, with men significantly more likely than women to have done so (74% and 67% respectively).
• The most popular form of gambling activity that adults had taken part in the previous year was buying tickets for the National Lottery Draw (58%). Eighteen percent purchased scratchcards, 15% took part in other lotteries and one in ten (10%) bet on horses (not online).
• Gambling participation was typically highest among those aged 25 to 54. However, when National Lottery only play was excluded, participation rates were highest among those aged 16-24 (64% of men and 47% of women).
• One in twelve adults (8%) participated in online gambling (not including the National Lottery) in the previous 12 months (12% of men and 4% of women).
• In 2012, on average, adults took part in 1.6 types of gambling activities in the previous year with men participating in a greater number of activities than women (1.9 activities versus 1.3).
• Around one in ten adults (11%) took part in four or more different forms of gambling in the past year with younger people, and young men (particularly those aged 25-34), most likely to do so.
• Based on review of the number and types of activities engaged in, seven groups of gamblers were identified. This ranged from non-gamblers, to minimal interest gamblers through to multiple interest gamblers who engaged in eight or more activities.
• The profile of these groups of gamblers varied. Among non-gamblers, National Lottery only gamblers, and minimal interest (lottery and one other activity) gamblers there were more women than men.
• The vast majority of moderate interest gamblers (bettors and machines) and multiple interest gamblers (engaged in eight or more activities) were men (84% and 93% respectively).
• Over three-quarters of moderate interest gamblers (bettors and machines) and multiple interest gamblers (engaged in eight or more activities) were under the age of 45.
• In 2012, 0.7% of adults in Scotland were identified as problem gamblers according to the Diagnostic and Statistics Manual-IV (DSM-IV) screening tool (1.4% of men and 0.1% of women). A second screening tool, the Problem Gambling Severity Index (PGSI), also estimated problem gambling prevalence to be 0.7% (1.4% of men and 0.2% of women).
• The problem gambling rate for past year gamblers only was 1.0% according to the DSM-IV and 1.1% according to the PGSI.
• According to the PGSI, in 2012, a further 3% of adults were at 'low risk' of harm and 1% were at 'moderate risk.' Men were significantly more likely than women to be at low or moderate risk of harm.
• 5.5% of moderate interest gamblers (bettors and machine players) and 13.3% of multiple interest gamblers (engaged in eight or more activities) were problem gamblers (according to either the DSM-IV or the PGSI).
• The odds of being a problem gambler were 11.6 times higher for men than women.
• Those living in Scotland's most deprived areas (SIMD quintile 1) were around 7 times (odds ratio of 6.9) more likely to be a problem gambler than those in the least deprived areas (SIMD quintile 5).
• The odds of being a problem gambler were 5.6 times higher among those with a GHQ12 score of 4 or more than those with a score of zero. (A GHQ12 score of 4 or more is indicative of a possible psychiatric disorder, whereas a score of zero can be considered as indicative of psychological wellbeing).
• The odds of an adult displaying signs of possible alcohol dependence (AUDIT score of 20 or more) being a problem gambler were 7.1 times higher than for those with an AUDIT score of zero (low risk drinkers or abstinent).
• Adult parents that lived with their child/ren (under 16) were more likely to be problem gamblers than adults who were not parents (odds ratio of 2.6).

9.1 Introduction

Gambling behaviour is increasingly a subject of public health and policy interest in Britain. In the past decade, the gambling landscape in Britain has changed significantly. This is evident with the rise of online gambling opportunities and also with the implementation of the UK Gambling Act 2005. Fully implemented in 2007, this legislation overhauled the way commercial gambling is licensed, advertised and regulated in the UK.

In Britain, gambling is positioned as a legitimate recreational and leisure activity with policy responsibility held by the British Department for Culture, Media and Sport. While gambling policy is a reserved matter, some limited functions in relation to the setting of conditions for premises licenses are exercised by Scottish Ministers. There is widespread recognition among policy makers, industry and health care professionals that, like alcohol consumption, some people who engage in gambling activity can experience harm. Unlike alcohol consumption, there are no specific policy targets relating to harm minimisation. The Gambling Act 2005, however, contains three core licensing objectives. These are to:

• prevent gambling from being a source of crime or disorder, being associated with crime or disorder or being used to support crime,
• ensure that gambling is conducted in a fair and open way, and
• protect children and other vulnerable persons from being harmed or exploited by gambling^[202].

The final objective highlights the potential for some people who participate in gambling to experience harm as a result of their behaviour and states that these groups specifically should be protected.

Problem gambling is defined as 'gambling to a degree which compromises, disrupts or damages family, personal or recreational pursuits.'^[203] Its most severe form, pathological gambling, has been categorised as an impulse control disorder within the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders IV (DSM IV) and has been included in this manual since 1980^[204]. With the recent publication of the DSM V, disordered gambling has been recognised as a behavioural addiction^[205]. In 2007, the British Medical Association highlighted the insufficient treatment facilities available for gambling problems and argued that services for problem gambling should be provided through the NHS, similar to those for drug and alcohol problems^[206]. With one notable exception (The NHS National Problem Gambling Clinic in Soho, London) this gap in structured provision still remains.

Problem gamblers suffer from a range of adverse consequences. There is international evidence that problem gambling is associated with a range of mental and physical health issues, including experience of depression, insomnia, stress-related disorders as well as experience of comorbid disorders such as alcohol abuse or dependence^[207].

In 2010, the British Gambling Prevalence Survey (BGPS) estimated that between 0.7% and 0.9% of adults living in private households in Britain were problem gamblers. This equates to around 400,000 people^[208]. The BGPS also estimated that a further 7% of adults were 'at risk' of experiencing harm from their gambling. In 1999, it was estimated that either 0.7% or 1.0% of adults in Scotland (depending on how it was measured) were problem gamblers. To date, these are the only publicly available national statistics on problem gambling prevalence in Scotland (although the 2010 BGPS report did include some data on participation levels in Scotland).

In 2012, for the first time, questions on gambling activity were included in both the Scottish Health Survey and the Health Survey for England. This is the first detailed exploration of this important public health issue in Scotland. This chapter presents estimates of past year participation in all forms of gambling in Scotland followed by estimates of problem and at-risk gambling according to two different measurement instruments, the DSM-IV and the Problem Gambling Severity Index (PGSI)^[204]. The profiles of both gamblers in general and of problem gamblers in particular are also considered.

9.2 Methods And Definitions

9.2.1 Gambling participation in the last year - definition and methods

All adult participants (aged 16 and over) were asked to report whether they had spent any money on nineteen different forms of gambling activity in the past 12 months. The activities presented ranged from buying tickets for the National Lottery draw to online betting and gaming. The range of activities presented reflected all forms of commercial gambling currently available in Scotland and also included betting or gambling privately with family or friends to capture informal gambling activity. In this chapter, gambling participation is defined as having participated in any one of these activities in the past 12 months. This definition also includes the requirement that the participant spent his/her own money on the activity. This was to ensure that those occasions where someone else placed bets or purchased lottery tickets with a participant's money were included.

The list of gambling activities and descriptions presented to participants reflected those used in the BGPS 2007 as closely as possible^[209]. Exceptions included the addition of 'playing poker in pub or club' and of 'betting on sports activities' (like football) to reflect the growing popularity of these activities since the 2007 study.

As with the BGPS series, questions were asked using a confidential self-completion format. This was to encourage more honest reporting of a (potentially) sensitive activity and to ensure maximum comparability with the BGPS. Everyone who had gambled at least once in the last year was also asked to complete two screening instruments to identify problem or risky gambling behaviour (see Section 9.2.3).

9.2.2 Classification of gambling groups

A typology of past year gamblers was constructed using Latent Class Analysis (LCA). This is a statistical approach which categorises individuals into different groups, or 'latent classes,' based on their responses to a series of questions. In this chapter, LCA has been used to identify different groups or types of past year gamblers based on both the number and range of gambling activities undertaken by participants in the previous 12 months.

LCA operates by identifying the number of classes or groups that best fit the data and generating probabilities of membership of each group for every eligible participant. Once this is complete, a participant is assigned to the class for which they have the highest probability of membership. The first step is to identify how many different classes or groups best fit the data. To test this, a number of models, each containing a pre-specified number of classes, were produced. Models tested ranged from those with three classes to those with ten classes. Results from each model were compared and the most appropriate solution selected^[210].

A seven class model was identified as the solution which best fit the data. This identified the following mutually exclusive groups:

• Non-gamblers
• National Lottery only gamblers
• Minimal interest gamblers - lotteries and one other gambling activity
• Minimal interest gamblers - other gambling activity, not lottery
• Moderate interest gamblers - lotteries and more than one other gambling activity
• Moderate interest gamblers - mainly bettors and machine players
• Multiple interest gamblers - engaged in eight or more activities.

The groups differed in terms of both the total number of activities engaged in and the type of activities undertaken. Minimal interest gamblers typically took part in one or two activities in the past year, moderate interest gamblers tended to take part in between three to seven activities and multiple interest gamblers took part in eight or more activities in the past 12 months (See Table 9.3). In this analysis, the terms minimal, moderate or multiple pertain entirely to the breadth of interest shown across a range of gambling activities. Data about frequency of gambling was not included in SHeS. Therefore these category descriptions do not reflect the depth of someone's gambling behaviour in terms of how often they engage in gambling activities only the breadth of their interest across a range of activities.

9.2.3 Problem gambling definition and measurement

Problem gambling is commonly accepted to involve 'gambling to a degree that compromises, disrupts or damages family, personal or recreational pursuits.'^[202] Despite this, there is no definitive definition of problem gambling and many different instruments or 'screens' exist to identify and measure problem gambling (with over 20 different types in existence)^[211]. As yet, there is no agreed 'gold standard' instrument recommended for use in population surveys.

Because of this, it has been common practice in Great Britain to include two different screening instruments in population-based surveys of gambling behaviour. As the instruments tend to capture different types of people, using both together, better reflects the broader range of issues associated with problematic gambling. The first of these is based on the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association (DSM-IV) and the second, the Problem Gambling Severity Index (PGSI)^[204],204 was developed in Canada specifically for use in population based studies. Both instruments have been widely used internationally and were the instruments of choice for the 2007 and 2010 BGPS. In 2012, SHeS included both the DSM-IV and the PGSI.

DSM-IV

The DSM-IV screening instrument contains ten diagnostic criteria ranging from chasing losses to committing a crime to fund gambling. Each DSM-IV item is assessed on a four-point scale, ranging from 'never' to 'very often.'^[212] Responses to each item are then dichotomised to show whether a person meets the criteria or not. A total score between zero and ten is possible. A threshold of meeting at least three of the DSM-IV criteria is used to define problem gambling. This cut-off point has been found to give good discrimination between criterion groups and has provided the closest match to prevalence estimated by alternative screens^[213]. Clinicians currently use an additional threshold of a DSM-IV score of five or more to represent pathological gambling^[204]. For a variety of reasons, this threshold is not presented in this chapter. Firstly, the number of people falling into this category would be too small to allow any detailed analysis to be carried out. Secondly, the term 'problem gambling' is preferred as it has less negative and medicalised conceptual issues associated with it than the term 'pathological gambling.' ^[204] Finally, it is likely that the label 'pathological gambling' will become obsolete as it has been renamed 'gambling disorder' in the recent publication of the DSM-V^[214]. The threshold and scoring criteria used to identify problem gamblers here are the same as those used in the BGPS series.

PGSI

The PGSI was developed for use among the general population rather than within a clinical context and was tested and validated within a general population survey. The instrument consists of nine items ranging from chasing losses to gambling causing health problems and feeling guilty about gambling. Each item is assessed on a four-point scale: never, sometimes, most of the time, almost always. Responses to each item are given the following scores: never = zero; sometimes = one; most of the time = two; almost always = three. Scores for each item are summed to give a total score ranging from zero to 27. A score of eight or over on the PGSI represent problem gambling. This is the threshold recommended by the developers of the PGSI and the threshold used in this report. The PGSI was also developed to give further information on sub-threshold problem gamblers. PGSI scores between three and seven are indicative of 'moderate risk' gambling and scores of one or two are indicative of 'low risk' gambling^[215]. As with the DSM-IV, the PGSI thresholds and scoring mechanisms used in SHeS are the same as those used in the BGPS.

Creating problem gambling scores

To produce problem gambling prevalence rates among all adults aged 16 and over, all non-gamblers were allocated a score of zero in both the DSM-IV and the PGSI screens. To be included in the final analysis for each instrument, participants were required to have answered at least five of the DSM-IV questions or at least four of the PGSI questions. Those who answered less than this were only included in the final analysis if their responses to the answered questions scored them as a problem gambler. Overall, around 15% of eligible adults did not have a valid DSM-IV or PGSI score. Inspection of the profile of those who did not respond to the screening instruments suggests that non-responders were slightly more likely to be from the youngest and oldest age groups and were somewhat more likely to be male (50% of non-responders were male compared with 48% of responders). This should be borne in mind when reviewing these results.

9.3 Gambling Participation In The Last Year

9.3.1 Participation in gambling activities in last year, 2012, by age and sex

In 2012, seven in ten adults (aged 16 and over) had gambled in the previous 12 months with men significantly more likely than women to have done so (74% and 67% respectively). Buying tickets for the National Lottery draw was the most popular form of gambling activity among all adults (58%). This was followed by purchasing scratchcards (18%), other lotteries (15%) and betting on horse races (not online) (10%). For each of the remaining activities asked about, prevalence was below 10%. Forty-five percent of adults participated in gambling that excluded National Lottery only play and one in twelve (8%) participated in online gambling (excluding the National Lottery).

In 2012, six in ten (59%) men bought tickets for the National Lottery draw. The next most popular activities among men were purchasing scratchcards (18%), buying tickets for other lotteries (15%), betting on horse races (not online) (14%), betting on other sports events (not online) and playing slot machines (both 12%) and betting online with a bookmaker (10%). For all other individual activities, the prevalence rate for men was less than 10%, with around one in 14 (7%) playing table games in a casino and around one in sixteen (6%) playing machines in a bookmakers.

Excluding the National Lottery, 12% of men reported either betting online or playing slot-style or casino-style games online.

Among women, after the National Lottery (57%), the next most popular activities were, as observed for men, purchasing scratchcards (19%) and buying tickets for other lotteries (15%). Unlike men, this was then followed by playing bingo (10%). Prevalence for all other activities was less than 10% for women. Betting on horse races (not online) (7%) and playing slot machines (4%) were the next most popular activities. For all other individual activities, past year prevalence rates were 2% or less.

Overall, 4% of women had either bet online or played slot-style or casino-style games online (excluding the National Lottery).

Figure 9A Past year gambling prevalence of most popular activities, 2012, by age and sex

These patterns indicate that not only were women less likely than men to gamble but that typically they also took part in a lesser range of activities than men. Only four activities (National Lottery, scratchcards, other lotteries and bingo) were undertaken by more than 10% of women whereas among men, seven different gambling activities had participation rates of more than 10%.

Gambling participation varied by age for both men and women. Typically, those aged 25 to 54 had the highest participation rates and those aged 16-24 or 75 and over had the lowest. Figure 9B demonstrates that the age-related pattern of participation was similar for both men and women.

Figure 9B Prevalence of past year gambling, 2012, by age and sex

This pattern is, however, dominated by participation rates in the National Lottery. As the most prevalent form of gambling activity, overall associations by age tend to be driven by patterns observed for National Lottery play only. When engagement in the National Lottery only was removed from the analysis, thus allowing associations for other forms of gambling to emerge, participation patterns by age changed (see Figure 9C). Here, participation rates were higher among the youngest age group (64% of men and 47% of women aged 16-24) and lowest among the oldest age group (35% of men and 26% of women aged 75 and over).

Figure 9C Prevalence of past year gambling (excluding National Lottery only), 2012, by age and sex

For both men and women, the age-related gradient evident in Figure 9C was replicated across many of the individual activities. Among men participation in slot machines, machines in a bookmakers, casino table games, poker played in pubs/clubs, online betting and online gambling, using betting exchanges, betting on sports events and private betting followed this broad pattern. Among women a similar age-related gradient was apparent for scratchcards, slot machines, machines in a bookmakers, casino table games and private betting.

For all other activities, participation varied by age but with no clear pattern, or followed a pattern by which participation was most prevalent among those in the middle-age groups and was lower among the youngest and oldest. Figure 9A, Figure 9B, Figure 9C, Table 9.1

9.3.2 Number of gambling activities undertaken in last year, 2012, by age and sex

In 2012, adults took part in 1.6 gambling activities, on average, in the previous year with men participating in a greater number of activities than women (1.9 compared with 1.3).

For both men and women, the mean number of gambling activities undertaken was highest among younger age groups and declined with advancing age. Men aged 16 to 44, on average, took part in more than two gambling activities whereas men aged 75 and over took part in around one activity. Among women, the mean number of gambling activities undertaken ranged from 1.5 for those aged 25 to 34 to 0.8 for those aged 75 and over.

The number of gambling activities undertaken has been used as a proxy for identifying higher levels of gambling engagement, though no standard threshold for how many activities constitutes high engagement has been identified. Overall, 11% of adults took part in four or more different forms of gambling in the previous year. The proportion of men participating in four or more activities was nearly three times greater than that for women (17% and 6% respectively).

For both men and women, the proportion who took part in four or more activities was highest among younger age groups, indicating greater levels of gambling engagement among younger people and young men in particular (see Figure 9D). Figure 9D, Table 9.2

Figure 9D Prevalence of participating in 4+ gambling activities in the past year, 2012, by age and sex

9.3.3 Age and sex profile of gambling groups

Tables 9.1 and 9.2 demonstrate that there is a great deal of variety in both the level and type of gambling activities undertaken by different people. Some people are very engaged in all types of gambling while others only take part in certain forms of gambling like the National Lottery. Recognising the heterogeneity of gambling behaviour is important as it may have implications for differing levels of risk of harm.

To explore this further, latent class analysis (LCA) was used to identify distinct gambling groups (See Section 9.2.2 and Table 9.3 for a detailed discussion on how these groups were identified). The seven distinct gambling groups identified were:

• Non-gamblers (31% of adults)
• National Lottery only gamblers (25% of adults)
• Minimal interest gamblers - lotteries and one other gambling activity (16% of adults)
• Minimal interest gamblers - other gambling activity, not lottery (9% of adults)
• Moderate interest gamblers - lotteries and more than one other gambling activity (12% of adults)
• Moderate interest gamblers - mainly bettors and machine players (6% of adults)
• Multiple interest gamblers - engaged in eight or more activities (1% of adults).

The non-gamblers group was the largest with 31% of adults being classified as this. This was followed by National Lottery only gamblers who accounted for 25% of adults. Minimal interest gamblers (lotteries and one other activity) were the next largest group (16%) followed by moderate interest gamblers who took part in the lottery and more than one other activity (12%). This was followed by minimal interest gamblers (other activities) (9%) and moderate interest gamblers (mainly bettors) with 6% of adults being assigned to this group. Finally, 1% of adults were classified as multiple interest gamblers.

The age and sex profile of each of these gambling groups is presented in Table 9.4. More women than men were non-gamblers (58% female; 42% male), National Lottery only gamblers (55% female; 45% male) and minimal interest (lottery and other activity) gamblers (57% female; 43% male). Roughly equal proportions of men and women were minimal interest (other activities) gamblers (48% male; 52% female) or moderate interest gamblers (lotteries and other) (47% male; 53% female).The vast majority of moderate interest gamblers (bettors and machines) and multiple interest gamblers were male (84% and 93% respectively).

There was also variation between gambling groups with respect to their age profile. For example, the age profile of non-gamblers was relatively evenly distributed. Sixteen percent of this group were aged 16-24, between 14% and 16% were 25 to 64, 11% were 65-74 and 13% were aged 75 and over. National Lottery gamblers and minimal interest gamblers (lottery and other activity) tended to be aged between 35 and 64, with 61% of both groups having this age profile. Minimal interest (other activities) gamblers had a slightly younger age profile; two-thirds (68%) of this group were under 55 and 29% were aged 16-24. Of all the groups, moderate interest gamblers (bettors and machines) and multiple interest gamblers had the youngest age profiles. Over three-quarters of each group were under 45 (75% and 86% respectively). Table 9.3, Table 9.4

9.3.4 Socio-economic profile of gambling groups

Table 9.5 examines the profile of each of the gambling groups based on NS-SEC of the household reference person, equivalised household income and the Scottish Index of Multiple Deprivation (descriptions of each of these measures are provided in the Glossary at the end of this volume). To ensure that the comparisons presented are not confounded by the different age profiles of the groups (as seen in Table 9.4) the data have been age-standardised. Age-standardisation allows comparisons to be made across groups which are not confounded by their different age profiles (See the Glossary at the end of this volume for a detailed description of age-standardisation).

Once age was accounted for, the profile of each gambling group did not differ by equivalised household income or area deprivation. However, group membership did vary by NS-SEC of the household reference person. The proportion of each group who lived in managerial and professional households varied from 35% for minimal interest (lotteries and other activity) to 51% for moderate interest gamblers (bettors and machine players). Multiple interest gamblers, both minimal interest gamblers groups and moderate interest gamblers (lotteries and other activities) had fewest people who lived in managerial and professional households. Table 9.5

9.4 Problem Gambling

9.4.1 DSM-IV items, 2012, by age and sex

As discussed in Section 9.2.3, the DSM-IV problem gambling screening instrument consists of ten criteria ranging from chasing losses to committing a crime to fund gambling. Participants indicated the extent to which a statement applied to them in the past 12 months by choosing one of four possible answer options ranging from very often to never (for chasing losses the options ranged from every time I lost to never).

Response to each of the ten items, by age and sex, is shown in Table 9.6. The scoring applied here is the same as that used in the BGPS series. Overall, endorsement ranged from 1.4% of adults for chasing losses to 0.2% for committing a crime to fund gambling. The most endorsed items were chasing losses (1.4%), preoccupation with gambling (1.0%), gambling to escape (0.7%) and being restless when trying to stop gambling (0.6%). All other items were endorsed by 0.5% of adults or less.

With the exception of trying to cut back on gambling and failing, men were significantly more likely than women to positively endorse each item. Among men, the most highly endorsed items were chasing losses (2.1%), preoccupied with gambling (2.0%), gambling as escapism (1.3%), restlessness when trying to stop gambling (1.2%) and lying to family or friends (1.0%). All other items were endorsed by less than 1% of men. Rates were lower among women and the most highly endorsed items were chasing losses (0.7%), trying to cut back and failing (0.3%) and preoccupation with gambling (0.2%). Other items were endorsed by 0.1% of women or less. There were also three items (crime, risking relationships and financial crisis) which no female participants endorsed. However, this is likely to be a function of the sample size and should not be taken as indicating that women gamblers do not experience these problems.

Overall, there were no significant differences in endorsement rates by age for either men or women. The proportion of adults reporting trying to cut back and failing did vary significantly by age but with no clear pattern. Table 9.6

9.4.2 PGSI items, 2012, by age and sex

The PGSI problem gambling screen consists of nine different criteria. For each of the criteria participants were asked to choose the answer option that most closely applied to them in the previous 12 months. There were four answer options ranging from almost always to never. (See Section 9.2.3 for a detailed discussion of the PGSI instrument). Responses to the PGSI are shown in Table 9.7.

Endorsement rates (defined as experiencing the specific problem at least sometimes) ranged from 0.5% for borrowing money to finance gambling to 3% for chasing losses. After chasing losses, the most commonly endorsed items were betting more than you could afford to lose (2.3%), feeling guilty about gambling (1.7%) and needing to gamble with larger amounts for money (1.4%). These prevalence patterns were the same for both men and women.

As with responses to the DSM-IV, men endorsed each item at significantly higher rates than women. For example, 5.2% of men and 0.9% of women had (at least sometimes) chased losses and 4% of men and 0.8% of women had (at least sometimes) gambled with more money than they could afford to lose.

For some of the items, endorsement also varied by age. Needing to gamble with larger amounts of money and chasing losses tended to have higher endorsement rates among younger adults. Estimates for chasing losses ranged from 5.0% of those aged 25-34 to 1.0% of those aged 75 and over. For gambling with larger amounts of money, estimates varied between 2.9% to 0.2% for the same age groups. Those aged 25 to 44 had the highest rates of endorsing gambling as a source of health problems or causing feelings of guilt, whereas oldest and youngest adults were less likely to report this. Table 9.7

9.4.3 Problem gambling prevalence, 2012, by age and sex

In 2012, 0.7% of adults (aged 16 and over) in Scotland were identified as problem gamblers according to the DSM-IV. The 95% confidence interval for this estimate was 0.5%-1.1%, meaning we are 95% certain the true estimate lies between 0.5% and 1.1%. Rates were 1.4% for men and 0.1% for women.

According to the PGSI, the problem gambling rate in 2012 was also 0.7% of adults in Scotland. The confidence interval for this estimate was 0.5%-1.2%. PGSI rates for men and women were 1.4% and 0.2% respectively. Both screens identified men as significantly more likely than women to be problem gamblers.

These rates equates to around 30,500 problem gamblers in Scotland according to the DSM-IV or 32,300 according to the PGSI. These are likely to be cautious estimates as SHeS only includes adults living in private households and not those living in institutions like prisons, student halls of residence or the homeless populations, all of which are likely to have higher rates of problem gambling^[216].

These 2012 estimates are similar to those observed for Scotland in the BGPS 2010, which estimated that 1.1% (DSM-IV) and 0.9% (PGSI) adults in Scotland were problem gamblers^[217]. The confidence intervals around the BGPS estimates were large due to small bases sizes for Scotland. The 95% confidence interval for the BGPS DSM-IV estimate was 0.4% - 2.8% and for the PGSI was 0.4% - 2.2%. This meant that we were 95% confident that the true estimate fell between these figures. The figures produced for the Scottish Health Survey in 2012 (0.7%) are well within this range and are not statistically different from the BGPS estimates.

Among past year gamblers only (i.e. those who reported gambling in the previous year), problem gambling rates were 1.0% according to the DSM-IV and 1.1% for the PGSI. Estimates for male past year gamblers were 1.9% for both screening instruments and for female past year gamblers were 0.1% according to the DSM-IV and 0.3% according to the PGSI.

Table A: Problem gambling rates, 2012, for all adults and past year gamblers only

	DSM-IV	PGSI
	%	%
All adults
Men	1.4	1.4
Women	0.1	0.2
All	0.7	0.7
Past year gamblers only
Men	1.9	1.9
Women	0.1	0.3
All past year gamblers	1.0	1.1

For both DSM-IV and PGSI, problem gambling rates did not vary significantly by age. The lack of statistical significance is likely to be a function of the sample size as estimates ranged between 0.2% for those aged 75 and over to 1.2% for those aged 35-44 according to the DSM-IV and from 0.2% for those aged 75 and over to 1.5% for those aged 25 to 44 according to the PGSI.

The BGPS study has repeatedly demonstrated that different problem gambling screens capture different people. The same is true for SHeS. Overall, 0.5% of adults in Scotland were identified as problem gamblers according to both screens and 1.0% of adults were identified as problem gamblers according to either screen. Table 9.8

9.4.4 'At-risk' prevalence, 2012, by age and sex

The PGSI screen includes two further sub-categories of gambling behaviour - gamblers at 'low risk' of harm (a PGSI score of 1-2) and gamblers at 'moderate risk' of harm (a PGSI score of 3-7). Overall, 3.0% of adults were identified as low risk gamblers in 2012 and a further 1.0% as moderate risk gamblers. Taken together with problem-gambling prevalence, this means that in 2012, 4.7% of adults were identified as experiencing some kind of difficulty with their gambling behaviour in the past 12 months.

Therefore, approximately a further 175,300 adults in Scotland were identified as being at low or moderate risk of harm from gambling.

Men were significantly more likely than women to be either low risk or moderate risk gamblers. Estimates for men were 4.8% and 2.1% respectively whereas 1.4% of women were identified as low risk gamblers and none were identified as being at moderate risk. Again, the lack of women identified as at moderate risk is likely to be due to sample size rather than assuming that no women in Scotland fits this categorisation.

Low risk gambling prevalence also varied significantly by age with rates tending to be highest among younger people and lower among older adults. 5.2% of those aged 25-34 were low-risk gamblers compared with 1.1% of those aged 75 and over. There was no significant association between moderate risk gambling and age. Table 9.8

9.4.5 Problem gambling prevalence, 2012, by gambling groups

In Table 9.9, problem gambling prevalence rates are shown by past year gambling group. Due to small sample sizes the measure of problem gambling used was whether people were categorised as problem gamblers according to either the DSM-IV or the PGSI.

Problem gambling rates varied significantly by gambling group. Around 5.5% of moderate interest gamblers (bettors and machine players) and 13.3% of multiple interest gamblers were problem gamblers. This is unsurprising given that these groups tended to be male, to be younger and engaged in a greater range of gambling activities, all of which have been repeatedly shown to be associated with problem gambling (either in this chapter or within the BGPS series).

The associations between problem gambling and minimal, moderate or multiple interest gamblers were not necessarily linear. Problem gambling rates among moderate interest (lotteries and other activities) gamblers were lowest at 0.4% whereas 1.0% of minimal interest gamblers (other activities) and 0.6% of minimal interest gamblers (lottery and other activity) were problem gamblers. This highlights that whilst the range and number of activities undertaken does have a clear association with problem gambling, there are also some people who experience problems while having a clear gambling activity preference and partaking in a lesser range of activities^[218]. Table 9.9

9.5 Factors Associated With Problem Gambling

Multivariate logistic regression was used to examine the independent associations between a range of socio-demographic, economic and health and lifestyle behaviours and problem gambling. Because of sample sizes, problem gambling according to either screen (DSM-IV or PGSI) was used in this model. A series of cross-tabulations were run separately for DSM-IV and PGSI problem gambling to assess if broad associations by each outcome variable were similar (data not shown). As they were similar using the combined problem gambling variable was deemed appropriate. As there were too few female problem gamblers to run separate regression models for men and women the model was run for all adults.

The factors investigated included age, sex and measures of socio-economic status in terms of household income, economic activity of the individual and area deprivation. A number of other factors were included such as marital status and educational attainment. Finally, a range of behavioural characteristics explored in other chapters of this report such as cigarette smoking status, hazardous or harmful drinking behaviours (as measured by the Alcohol Use Disorders Identification Test score (AUDIT)) and mental-ill health status (as measured by the General Health Questionnaire -12 - GHQ12) and whether the participant was a parent to any child in the household were included. These factors have been shown to be correlated with problem gambling in both the BGPS series and other international prevalence surveys.

Results are presented as odds ratios and are shown in Table 9.10. For each categorical variable, the odds of being a problem gambler are presented relative to a reference category, which is given a value of 1. An odds ratio of greater than 1 indicates higher odds of being a problem gambler while an odds ratio of less than 1 indicates lower odds of being a problem gambler. 95% confidence intervals are shown for each odds ratio. If the confidence interval does not include 1, the odds ratio for that category is significantly different from the reference group.

The factors found to be significantly associated with problem gambling were: sex, area deprivation, GHQ12 status and AUDIT score. A list of the factors that were included in the model, but were not significant, is included in the endnote to the table.

The odds of being a problem gambler were 11.6 times higher among men than women.

The odds of being a problem gambler were also greater among those with high scores on the General Health Questionnaire-12 (GHQ12). A high GHQ12 score (of 4 or more) is indicative of a possible psychiatric disorder whereas a score of zero can be considered to be an indicator of psychological wellbeing. The odds of being a problem gambler were 5.6 times higher among those with a GHQ12 score of 4+ than those with a score of 0.

Odds ratios varied by AUDIT score. Higher AUDIT scores indicated more risky patterns of alcohol consumption. Those with an AUDIT score of 20 or more (indicating harmful patterns of alcohol consumption) were more likely to be problem gamblers; odds were 7.1 times higher among this group than those with an AUDIT score of 0. Other AUDIT scores did not vary significantly from those with a score of 0.

Area deprivation was also significantly associated with problem gambling, with those living in the most deprived areas (SIMD quintile 1) having odds of problem gambling around seven times (6.9) higher than those living in the least deprived areas (SIMD quintile 5).

Finally, parents with children (under the age of 16) living with them in their household were also more likely to be problem gamblers than those who were not parents. Odds were 2.6 times higher among these parents than non-parents.

The parental pattern is interesting as it was significant even after age was taken into account. This simple association tentatively suggests that family relationships and responsibilities may be related to gambling problems. Likewise, the relationship with area deprivation is of note, suggesting an association between where people live and their propensity to experience problems. This, potentially, contributes to further health inequalities as people living in the most deprived areas are more likely to experience harm. Findings relating to health status and alcohol consumption are unsurprising as it has been well documented that problem gambling is associated with poor health and, in some cases, substance abuse problems. However, these associations also suggest that problem gambling should be considered as a health issue given the poorer health status of those experiencing problems. Taken together, this range of associations suggests that account needs to be taken of the individual, their experiences and the broader circumstances which may influence behaviour in order to understand patterns of problem gambling. Table 9.10

Table list

Table 9.1 Gambling activities in the last 12 months, 2012, by age and sex

Table 9.2 Number of different gambling activities in the last 12 months, 2012, by age and sex

Table 9.3 Gambling group membership, 2012

Table 9.4 Gambling group membership, 2012, by age and sex

Table 9.5 Gambling group membership, 2012, by area deprivation (SIMD), equivalised household income and NS-SEC of the household reference person (age standardised)

Table 9.6 Response to DSM-IV items, 2012, by age and sex

Table 9.7 Response to PGSI items, 2012, by age and sex

Table 9.8 DSM-IV and PGSI scores for gambling in the last year, 2012, by age and sex

Table 9.9 Gambling group membership, 2012, by problem gambling and sex

Table 9.10 Estimated odds ratios, 2012, for problem gambling

Table 9.1 Gambling activities in the last 12 months, 2012, by age and sex

Aged 16 and over	2012
Activity money spent on	Age							Total
	16-24	25-34	35-44	45-54	55-64	65-74	75+
	%	%	%	%	%	%	%	%
Men
National Lottery	34	56	72	69	64	63	48	59
Scratchcards	25	27	27	13	9	7	8	18
Other lotteries	8	16	16	14	19	17	16	15
Football pools	14	16	7	4	6	8	5	9
Bingo (not online)	2	4	4	3	2	3	5	3
Slot machines	23	20	13	8	4	5	3	12
Machines in a bookmakers	17	12	6	1	2	1	1	6
Casino table games (not online)	14	16	5	3	2	1	0	7
Poker played in pubs or clubs	6	6	3	1	1	1	-	3
Online gambling on slots, casino or bingo games	7	8	4	1	2	2	2	4
Online betting with a bookmaker	17	22	13	4	3	3	2	10
Betting exchange	3	4	2	1	1	1	-	2
Horse races (not online)	11	16	19	13	10	12	11	14
Dog races (not online)	6	4	7	4	2	5	5	5
Sports events (not online)	19	19	18	9	6	4	3	12
Other events or sports (not online)	2	6	4	3	2	2	1	3
Spread-betting	1	4	1	1	-	0	-	1
Private betting	17	14	6	3	2	3	-	7
Any other gambling	6	3	3	3	1	1	2	3
Any gambling activity	70	76	79	76	74	73	56	74
Any gambling (excluding National Lottery only)	64	61	56	41	42	40	35	50
Any online gambling (excludes National Lottery)	21	27	15	5	5	5	3	12
Women
National Lottery	36	61	63	66	61	55	42	57
Scratchcards	27	28	25	17	13	10	8	19
Other lotteries	11	13	15	17	18	15	13	15
Football pools	2	2	0	1	1	3	2	1
Bingo (not online)	11	12	10	7	11	8	8	10
Slot machines	6	6	5	4	2	2	0	4
Machines in a bookmakers	4	0	1	0	0	1	-	1
Casino table games (not online)	4	5	3	2	2	1	-	2
Poker played in pubs or clubs	0	-	-	-	0	1	-	0
Online gambling on slots, casino or bingo games	2	3	3	1	2	1	-	2
Online betting with a bookmaker	3	3	4	2	2	1	0	2
Betting exchange	-	0	0	-	0	1	0	0
Horse races (not online)	9	8	11	7	6	4	2	7
Dog races (not online)	2	0	-	0	0	1	-	0
Sports events (not online)	1	3	3	1	1	1	0	2
Other events or sports (not online)	-	0	0	0	1	1	-	0
Spread-betting	-	-	-	-	-	1	-	0
Private betting	3	3	0	1	0	1	-	1
Any other gambling	1	1	0	1	1	1	-	1
Any gambling activity	57	72	71	72	70	68	54	67
Any gambling (excluding National Lottery only)	47	47	47	40	38	36	26	41
Any online gambling (excludes National Lottery)	5	6	7	3	3	1	0	4
All Adults
National Lottery	35	59	67	68	62	59	44	58
Scratchcards	26	27	26	15	11	9	8	18
Other lotteries	9	14	15	16	19	16	14	15
Football pools	8	9	4	2	3	5	3	5
Bingo (not online)	7	8	7	5	7	6	7	7
Slot machines	15	13	9	6	3	3	2	8
Machines in a bookmakers	11	6	3	1	1	1	0	3
Casino table games (not online)	10	10	4	2	2	1	0	4
Poker played in pubs or clubs	4	3	1	1	1	1	-	1
Online gambling on slots, casino or bingo games	5	6	3	1	2	1	1	3
Online betting with a bookmaker	10	12	9	3	2	2	1	6
Betting exchange	2	2	1	1	1	1	0	1
Horse races (not online)	10	12	15	10	8	8	5	10
Dog races (not online)	4	2	3	2	1	3	2	2
Sports events (not online)	10	11	10	5	3	3	1	7
Other events or sports (not online)	1	3	2	2	1	1	0	2
Spread-betting	1	2	1	1	-	1	-	1
Private betting	10	8	3	2	1	2	-	4
Any other gambling	4	2	1	2	1	1	1	2
Any gambling activity	64	74	75	74	72	70	55	70
Any gambling (excluding National Lottery only)	56	54	51	41	40	38	29	45
Any online gambling (excludes National Lottery)	13	16	11	4	4	3	1	8
Bases (weighted)a:
Men	289	340	345	386	324	229	131	2045
Women	276	349	383	413	362	254	221	2259
All adults	566	690	728	799	686	483	353	4304
Bases (unweighted)a:
Men	149	203	315	379	327	348	172	1893
Women	194	304	442	457	417	340	273	2427
All adults	343	507	757	836	744	688	445	4320
a Bases shown are for any form of gambling. Bases for individual activities vary.

Table 9.2 Number of different gambling activities in the last 12 months, 2012, by age and sex

Aged 16 and over	2012
Number of different gambling activities	Age							Total
	16-24	25-34	35-44	45-54	55-64	65-74	75+
	%	%	%	%	%	%	%	%
Men
0	30	24	21	24	26	27	44	26
1	21	18	26	38	38	37	28	29
2	14	17	18	19	22	19	12	18
3	11	8	15	9	5	10	10	10
4 or more	25	32	21	10	8	7	7	17
Mean number of activities	2.4	2.7	2.3	1.6	1.4	1.4	1.1	1.9
SE of mean	0.25	0.23	0.17	0.09	0.09	0.09	0.12	0.07
Women
0	43	28	29	28	30	32	46	33
1	23	31	29	36	40	41	38	34
2	17	18	22	23	21	23	9	20
3	9	12	11	10	5	3	6	9
4 or more	8	10	9	4	5	1	1	6
Mean number of activities	1.2	1.5	1.4	1.3	1.2	1.1	0.8	1.3
SE of mean	0.13	0.09	0.07	0.06	0.08	0.09	0.06	0.03
All adults
0	36	26	25	26	28	30	45	30
1	22	25	27	37	39	39	35	32
2	15	18	20	21	21	21	10	19
3	10	10	13	10	5	6	7	9
4 or more	17	21	14	7	6	4	3	11
Mean number of activities	1.8	2.1	1.9	1.4	1.3	1.2	0.9	1.6
SE of mean	0.16	0.13	0.08	0.06	0.06	0.07	0.06	0.04
Bases (weighted):
Men	289	340	345	386	324	229	131	2045
Women	276	349	383	413	362	254	221	2259
All adults	566	690	728	799	686	483	353	4304
Bases (unweighted):
Men	149	203	315	379	327	348	172	1893
Women	194	304	442	457	417	340	273	2427
All adults	343	507	757	836	744	688	445	4320

Table 9.3 Gambling group membership, 2012

Aged 16 and over	2012
Gambling activities	Gambling group type
	Non-gamblers	National Lottery only	Minimal interest - lotteries and other activity	Minimal interest - other activities	Moderate interest - lotteries and other activities	Moderate interest - mainly betting and machines	Multi interest gambler
	%	%	%	%	%	%	%
National Lottery	-	100	100	-	96	69	85
Scratchcards	-	-	35	24	60	39	64
Other lotteries	-	-	27	27	46	28	62
Football pools	-	-	3	6	9	28	63
Bingo (not online)	-	-	10	12	23	9	28
Slot machines	-	-	3	12	19	46	71
Machines in a bookmakers	-	-	0	2	1	33	71
Casino table games (not online)	-	-	2	4	11	27	55
Poker played in pubs or clubs	-	-	0	1	1	11	34
Online gambling on slots, casino or bingo games	-	-	1	1	7	14	50
Online betting with a bookmaker	-	-	2	5	11	41	76
Betting exchange	-	-	0	1	0	6	24
Horse races (not online)	-	-	9	14	25	49	80
Dog races (not online)	-	-	0	1	2	20	51
Sports events (not online)	-	-	3	6	9	51	89
Other events or sports (not online)	-	-	0	0	0	11	50
Spread-betting	-	-	0	1	1	1	22
Private betting	-	-	2	6	9	21	47
Any other gambling	-	-	1	3	5	6	24
Number of gambling activities
None	100	-	-	-	-	-	-
One	-	100	-	72	-	-	-
Two	-	-	100	28	-	-	-
Three	-	-	-	-	70	8	-
Four	-	-	-	-	24	24	-
Five	-	-	-	-	5	32	-
Six	-	-	-	-	0	23	-
Seven	-	-	-	-	-	13	-
Eight or more	-	-	-	-	-	-	100
Bases (weighted):	1272	1038	667	355	490	263	57
Bases (unweighted):	1353	1085	681	326	466	198	50

Table 9.4 Gambling group membership, 2012, by age and sex

Aged 16 and over	2012
Age and sex	Gambling group type
	Non-gamblers	National Lottery only	Minimal interest - lotteries and other activity	Minimal interest - other activities	Moderate interest - lotteries and other activities	Moderate interest - mainly betting and machines	Multi interest gambler
	%	%	%	%	%	%	%
Sex
Men	42	45	43	48	47	84	93
Women	58	55	57	52	53	16	7
Men
16-24	16	4	5	35	12	23	[24]
25-34	15	10	13	19	21	30	[42]
35-44	13	17	19	8	27	20	[23]
45-54	17	27	22	11	18	12	[4]
55-64	16	21	23	13	9	8	[3]
65-75	12	15	13	9	8	5	[2]
75 and over	11	6	5	5	6	2	[2]
Women
16-24	16	5	9	24	11	[39]	*
25-34	13	15	15	15	26	[21]	*
35-44	15	16	20	14	24	[24]	*
45-54	16	23	23	10	19	[6]	*
55-64	15	20	16	15	10	[11]	*
65-75	11	13	13	11	3	[-]	*
75 and over	14	10	4	11	5	[0]	*
All adults
16-24	16	4	8	29	12	25	24
25-34	14	13	14	17	24	29	39
35-44	15	16	20	11	25	21	22
45-54	16	25	22	11	19	11	4
55-64	15	20	19	14	10	9	2
65-75	11	14	13	10	5	4	5
75 and over	13	8	5	8	6	1	2
Bases (weighted):
Men	538	468	287	170	232	220	53
Women	734	570	381	185	257	43	4
All	1272	1038	667	355	490	263	57
Bases (unweighted):
Men	531	474	275	136	206	162	45
Women	822	611	406	190	260	36	5
All	1353	1085	681	326	466	198	50

Table 9.5 Gambling group membership, 2012, by area deprivation (SIMD), equivalised household income and NS-SEC of the household reference person (age standardised)

Aged 16 and over	2012
Area deprivation (SIMD), Household income, and NS-SEC	Gambling group type
	Non-gamblers	National Lottery only	Minimal interest - lotteries and other activity	Minimal interest - other activities	Moderate interest - lotteries and other activities	Moderate interest - mainly betting and machines	Multi interest gambler
	%	%	%	%	%	%	%
Area deprivation (SIMD)
5th (least deprived)	24	22	17	21	22	24	22
4th	24	20	19	21	15	18	23
3rd	19	20	23	20	22	19	14
2nd	18	20	22	18	22	22	27
1st (most deprived)	15	17	19	20	19	18	14
Equivalised household income
1st (highest)	23	21	19	29	23	23	[22]
2nd	21	20	19	22	21	27	[20]
3rd	17	22	22	14	21	25	[29]
4th	18	19	22	20	22	11	[10]
5th (lowest)	21	17	19	15	14	14	[19]
NS-SEC of household reference person
Managerial and professional	48	41	35	37	38	51	[37]
Intermediate	8	10	11	12	13	7	[8]
Small employers and own account workers	8	9	8	15	9	5	[15]
Lower supervisory and technical	8	10	10	7	10	8	[17]
Semi-routine	28	30	35	29	29	30	[23]
Bases (weighted):
Area deprivation	1268	1045	668	359	488	261	59
Equivalised household income	1105	871	583	334	419	221	52
NS-SEC	1233	1024	658	359	484	252	60
Bases (unweighted):
Area deprivation	1353	1085	681	326	466	198	50
Equivalised household income	1155	966	606	289	413	183	46
NS-SEC	1324	1076	667	320	463	195	49

Table 9.6 Response to DSM-IV items, 2012, by age and sex

Aged 16 and over	2012
DSM-IV item	Age							Total
	16-24	25-34	35-44	45-54	55-64	65-74	75+
	%	%	%	%	%	%	%	%
Men
Chased losses
Most times/every time	3.2	2.9	2.2	0.8	2.4	1.4	1.0	2.1
Never/sometimes	96.8	97.1	97.8	99.2	97.6	98.6	99.0	97.9
Preoccupation with gambling
Fairly often/very often	1.8	1.8	2.6	2.3	1.5	1.9	1.3	2.0
Never/occasionally	98.2	98.2	97.4	97.7	98.5	98.1	98.7	98.0
Needed to gamble with increasing amounts of money
Fairly often/very often	0.2	1.5	1.5	1.2	0.4	0.7	-	0.9
Never/occasionally	99.8	98.5	98.5	98.8	99.6	99.3	100.0	99.1
Been restless or irritable when trying to stop gambling
Fairly often/very often	-	1.7	2.5	0.3	1.1	1.8	0.5	1.2
Never/occasionally	100.0	98.3	97.5	99.7	98.9	98.2	99.5	98.8
Gambling as escapism
Fairly often/very often	1.6	1.0	2.7	0.6	0.8	0.8	1.3	1.3
Never/occasionally	98.4	99.0	97.3	99.4	99.2	99.2	98.7	98.7
Lied to people to conceal extent of gambling
Fairly often/very often	1.1	1.9	1.5	0.3	0.7	0.8	-	1.0
Never/occasionally	98.9	98.1	98.5	99.7	99.3	99.2	100.0	99.0
Tried but failed to cut back on gambling
Fairly often/very often	0.3	0.9	1.8	0.1	0.4	1.2	0.8	0.8
Never/occasionally	99.7	99.1	98.2	99.9	99.6	98.8	99.2	99.2
Committed a crime to fund gambling
Occasionally/Fairly often/very often	0.3	0.9	-	0.5	-	0.8	-	0.4
Never	99.7	99.1	100.0	99.5	100.0	99.2	100.0	99.6
Risked or lost a relationship/job/educational opportunity because of gambling
Occasionally/Fairly often/very often	0.3	1.3	1.2	0.7	-	1.0	-	0.7
Never	99.7	98.7	98.8	99.3	100.0	99.0	100.0	99.3
Relied on others to help with financial crisis caused by gambling
Occasionally/Fairly often/very often	0.4	0.9	0.9	1.2	0.8	1.0	-	0.8
Never	99.6	99.1	99.1	98.8	99.2	99.0	100.0	99.2
Women
Chased losses
Most times/every time	1.3	0.9	1.2	0.3	0.8	0.3	0.1	0.7
Never/sometimes	98.7	99.1	98.8	99.7	99.2	99.7	99.9	99.3
Preoccupation with gambling
Fairly often/very often	0.3	-	0.6	-	-	-	-	0.2
Never/occasionally	99.7	100.0	99.4	100.0	100.0	100.0	100.0	99.8
Needed to gamble with increasing amounts of money
Fairly often/very often	1.0	-	-	-	-	-	-	0.1
Never/occasionally	99.0	100.0	100.0	100.0	100.0	100.0	100.0	99.9
Been restless or irritable when trying to stop gambling
Fairly often/very often	0.3	-	-	-	-	-	-	0.0
Never/occasionally	99.7	100.0	100.0	100.0	100.0	100.0	100.0	100.0
Gambling as escapism
Fairly often/very often	-	-	0.3	0.4	-	0.4	-	0.1
Never/occasionally	100.0	100.0	99.7	99.6	100.0	99.6	100.0	99.9
Lied to people to conceal extent of gambling
Fairly often/very often	-	-	0.6	-	-	-	-	0.1
Never/occasionally	100.0	100.0	99.4	100.0	100.0	100.0	100.0	99.9
Tried but failed to cut back on gambling
Fairly often/very often	-	0.9	0.8	-	-	-	-	0.3
Never/occasionally	100.0	99.1	99.2	100.0	100.0	100.0	100.0	99.7
Committed a crime to fund gambling
Occasionally/Fairly often/very often	-	-	-	-	-	-	-	-
Never	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0
Risked or lost a relationship/job/educational opportunity because of gambling
Occasionally/Fairly often/very often	-	-	-	-	-	-	-	-
Never	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0
Relied on others to help with financial crisis caused by gambling
Occasionally/Fairly often/very often	-	-	-	-	-	-	-	-
Never	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0
All Adults
Chased losses
Most times/every time	2.3	1.9	1.7	0.5	1.5	0.9	0.4	1.4
Never/sometimes	97.7	98.1	98.3	99.5	98.5	99.1	99.6	98.6
Preoccupation with gambling
Fairly often/very often	1.1	0.9	1.6	1.1	0.7	0.9	0.5	1.0
Never/occasionally	98.9	99.1	98.4	98.9	99.3	99.1	99.5	99.0
Needed to gamble with increasing amounts of money
Fairly often/very often	0.6	0.7	0.7	0.6	0.2	0.4	-	0.5
Never/occasionally	99.4	99.3	99.3	99.4	99.8	99.6	100.0	99.5
Been restless or irritable when trying to stop gambling
Fairly often/very often	0.2	0.8	1.2	0.1	0.5	0.9	0.2	0.6
Never/occasionally	99.8	99.2	98.8	99.9	99.5	99.1	99.8	99.4
Gambling as escapism
Fairly often/very often	0.8	0.5	1.4	0.5	0.4	0.6	0.5	0.7
Never/occasionally	99.2	99.5	98.6	99.5	99.6	99.4	99.5	99.3
Lied to people to conceal extent of gambling
Fairly often/very often	0.6	1.0	1.0	0.1	0.3	0.4	-	0.5
Never/occasionally	99.4	99.0	99.0	99.9	99.7	99.6	100.0	99.5
Tried but failed to cut back on gambling
Fairly often/very often	0.1	0.9	1.3	0.0	0.2	0.6	0.3	0.5
Never/occasionally	99.9	99.1	98.7	100.0	99.8	99.4	99.7	99.5
Committed a crime to fund gambling
Occasionally/Fairly often/very often	0.1	0.5	-	0.2	-	0.4	-	0.2
Never	99.9	99.5	100.0	99.8	100.0	99.6	100.0	99.8
Risked or lost a relationship/job/educational opportunity because of gambling
Occasionally/Fairly often/very often	0.1	0.7	0.6	0.4	-	0.5	-	0.3
Never	99.9	99.3	99.4	99.6	100.0	99.5	100.0	99.7
Relied on others to help with financial crisis caused by gambling
Occasionally/Fairly often/very often	0.2	0.5	0.4	0.6	0.4	0.5	-	0.4
Never	99.8	99.5	99.6	99.4	99.6	99.5	100.0	99.6
Bases (weighted)a:
Men	277	337	339	367	300	220	123	1962
Women	270	339	372	392	348	231	203	2156
All adults	548	676	711	758	648	451	326	4118
Bases (unweighted)a:
Men	144	201	308	359	306	331	163	1812
Women	189	296	430	434	399	309	252	2309
All adults	333	497	738	793	705	640	415	4121
a Bases shown are for DSM IV item 1 (chasing losses). Bases for other items vary.

Table 9.7 Response to PGSI items, 2012, by age and sex

Aged 16 and over	2012
How often PGSI item occurred	Age							Total
	16-24	25-34	35-44	45-54	55-64	65-74	75+
	%	%	%	%	%	%	%	%
Men
Bet more than could afford to lose
Almost always	-	-	0.5	0.7	-	-	-	0.2
Most of the time	1.3	1.3	0.5	-	0.3	-	-	0.6
Sometimes	1.1	6.0	3.3	3.0	2.6	1.8	5.3	3.2
Never	97.6	92.6	95.7	96.3	97.1	98.2	94.7	96.0
Needed to gamble with larger amounts of money
Almost always	-	-	0.2	0.5	-	-	-	0.1
Most of the time	0.2	-	0.8	-	0.3	0.4	-	0.3
Sometimes	3.1	5.8	3.2	1.1	0.5	0.4	0.4	2.3
Never	96.7	94.2	95.8	98.4	99.2	99.2	99.6	97.3
Chased losses
Almost always	-	-	0.2	0.3	0.3	0.3	-	0.2
Most of the time	-	0.8	1.0	0.5	-	-	-	0.4
Sometimes	5.8	8.7	4.7	1.8	3.9	3.9	2.7	4.6
Never	94.2	90.5	94.1	97.4	95.8	95.8	97.3	94.8
Borrowed money/sold items to finance gambling
Almost always	-	-	-	0.3	-	-	-	0.0
Most of the time	-	0.3	-	-	-	-	-	0.1
Sometimes	1.1	2.9	0.9	-	0.3	0.5	-	0.9
Never	98.9	96.7	99.1	99.7	99.7	99.5	100.0	99.0
Felt that might have a gambling problem
Almost always	-	0.6	0.7	-	-	-	-	0.2
Most of the time	-	-	1.3	0.3	-	0.4	-	0.3
Sometimes	1.1	3.0	1.5	0.5	2.0	1.9	3.1	1.7
Never	98.9	96.4	96.4	99.2	98.0	97.7	96.9	97.7
Gambling caused health problems (including stress)
Almost always	-	-	0.5	0.3	-	-	-	0.1
Most of the time	-	0.3	1.0	-	-	0.4	-	0.3
Sometimes	1.1	4.9	1.5	1.2	0.8	-	-	1.6
Never	98.9	94.7	96.9	98.5	99.2	99.6	100.0	98.0
People criticised gambling behaviour
Almost always	-	-	1.0	0.3	-	-	-	0.2
Most of the time	-	0.6	0.6	-	0.4	-	-	0.3
Sometimes	2.9	4.6	1.6	0.8	1.4	1.8	2.3	2.2
Never	97.1	94.8	96.8	98.9	98.2	98.2	97.7	97.3
Gambling caused financial problems
Almost always	-	-	0.5	0.3	-	-	-	0.1
Most of the time	1.1	0.6	1.5	-	-	0.8	0.5	0.6
Sometimes	0.5	3.2	0.3	-	0.7	0.2	1.8	0.9
Never	98.4	96.2	97.7	99.7	99.3	99.0	97.7	98.3
Felt guilty about gambling
Almost always	-	-	1.5	-	-	-	-	0.3
Most of the time	-	0.9	0.2	0.5	0.7	0.4	0.5	0.5
Sometimes	1.9	6.5	2.0	0.7	1.3	2.4	1.8	2.4
Never	98.1	92.6	96.2	98.8	97.9	97.2	97.7	96.8
Women
Bet more than could afford to lose
Almost always	-	-	0.3	-	0.4	-	-	0.1
Most of the time	-	-	-	-	-	-	-	-
Sometimes	0.3	1.0	1.9	0.7	-	0.6	-	0.7
Never	99.7	99.0	97.9	99.3	99.6	99.4	100.0	99.2
Needed to gamble with larger amounts of money
Almost always	-	-	-	-	0.4	-	-	0.1
Most of the time	-	-	-	-	-	-	-	-
Sometimes	-	-	0.3	-	-	-	-	0.0
Never	100.0	100.0	99.7	100.0	99.6	100.0	100.0	99.9
Chased losses
Almost always	-	-	-	-	0.4	-	-	0.1
Most of the time	-	-	-	-	-	-	-	-
Sometimes	1.9	0.5	1.7	0.4	0.6	0.4	-	0.8
Never	98.1	99.5	98.3	99.6	98.9	99.6	100.0	99.1
Borrowed money/sold items to finance gambling
Almost always	-	-	-	-	0.4	-	-	0.1
Most of the time	-	-	-	-	-	-	-	-
Sometimes	-	-	0.2	-	-	-	-	0.0
Never	100.0	100.0	99.8	100.0	99.6	100.0	100.0	99.9
Felt that might have a gambling problem
Almost always	-	-	0.6	-	0.4	-	-	0.2
Most of the time	-	-	-	-	-	-	-	-
Sometimes	-	-	-	-	-	-	-	-
Never	100.0	100.0	99.4	100.0	99.6	100.0	100.0	99.8
Gambling caused health problems (including stress)
Almost always	-	-	0.3	-	0.4	-	-	0.1
Most of the time	-	-	0.3	-	-	-	-	0.0
Sometimes	-	-	-	-	-	-	-	-
Never	100.0	100.0	99.4	100.0	99.6	100.0	100.0	99.8
People criticised gambling behaviour
Almost always	-	-	0.3	-	0.4	-	-	0.1
Most of the time	-	-	-	-	-	-	-	-
Sometimes	-	-	-	-	-	-	-	-
Never	100.0	100.0	99.7	100.0	99.6	100.0	100.0	99.9
Gambling caused financial problems
Almost always	-	-	0.3	-	0.4	-	-	0.1
Most of the time	-	-	0.3	-	-	-	-	0.0
Sometimes	-	-	-	-	-	-	-	-
Never	100.0	100.0	99.4	100.0	99.6	100.0	100.0	99.8
Felt guilty about gambling
Almost always	-	-	0.3	-	0.4	-	-	0.1
Most of the time	-	-	0.3	-	-	-	-	0.0
Sometimes	-	-	0.5	-	-	-	-	0.1
Never	100.0	100.0	98.9	100.0	99.6	100.0	100.0	99.7
All Adults
Bet more than could afford to lose
Almost always	-	-	0.4	0.4	0.2	-	-	0.2
Most of the time	0.7	0.7	0.2	-	0.2	-	-	0.3
Sometimes	0.7	3.5	2.6	1.8	1.2	1.2	2.0	1.9
Never	98.6	95.9	96.8	97.8	98.4	98.8	98.0	97.7
Needed to gamble with larger amounts of money
Almost always	-	-	0.1	0.2	0.2	-	-	0.1
Most of the time	0.1	-	0.4	-	0.2	0.2	-	0.1
Sometimes	1.6	2.9	1.7	0.5	0.2	0.2	0.2	1.1
Never	98.3	97.1	97.9	99.2	99.4	99.6	99.8	98.6
Chased losses
Almost always	-	-	0.1	0.1	0.4	0.2	-	0.1
Most of the time	-	0.4	0.5	0.2	-	-	-	0.2
Sometimes	3.9	4.6	3.1	1.1	2.1	2.1	1.0	2.6
Never	96.1	95.0	96.3	98.6	97.5	97.8	99.0	97.0
Borrowed money/sold items to finance gambling
Almost always	-	-	-	0.1	0.2	-	-	0.1
Most of the time	-	0.2	-	-	-	-	-	0.0
Sometimes	0.6	1.5	0.5	-	0.2	0.3	-	0.5
Never	99.4	98.4	99.5	99.9	99.6	99.7	100.0	99.5
Felt that might have a gambling problem
Almost always	-	0.3	0.7	-	0.2	-	-	0.2
Most of the time	-	-	0.6	0.1	-	0.2	-	0.2
Sometimes	0.6	1.5	0.7	0.2	0.9	1.0	1.2	0.8
Never	99.4	98.2	98.0	99.6	98.9	98.8	98.8	98.8
Gambling caused health problems (including stress)
Almost always	-	-	0.4	0.1	0.2	-	-	0.1
Most of the time	-	0.2	0.6	-	-	0.2	-	0.2
Sometimes	0.6	2.4	0.7	0.6	0.4	-	-	0.8
Never	99.4	97.4	98.2	99.3	99.4	99.8	100.0	98.9
People criticised gambling behaviour
Almost always	-	-	0.7	0.1	0.2	-	-	0.2
Most of the time	-	0.3	0.3	-	0.2	-	-	0.1
Sometimes	1.5	2.3	0.7	0.4	0.6	0.9	0.9	1.0
Never	98.5	97.4	98.3	99.5	98.9	99.1	99.1	98.7
Gambling caused financial problems
Almost always	-	-	0.4	0.1	0.2	-	-	0.1
Most of the time	0.6	0.3	0.8	-	-	0.4	0.2	0.3
Sometimes	0.3	1.6	0.2	-	0.3	0.1	0.7	0.4
Never	99.2	98.1	98.6	99.9	99.4	99.5	99.1	99.1
Felt guilty about gambling
Almost always	-	-	0.9	-	0.2	-	-	0.2
Most of the time	-	0.5	0.2	0.2	0.3	0.2	0.2	0.3
Sometimes	1.0	3.2	1.2	0.3	0.6	1.2	0.7	1.2
Never	99.0	96.3	97.6	99.4	98.8	98.6	99.1	98.3
Bases (weighted)a:
Men	277	329	336	360	299	217	122	1941
Women	266	337	365	393	344	227	202	2134
All adults	544	666	701	753	643	444	324	4075
Bases (unweighted)a:
Men	144	196	306	354	305	326	162	1793
Women	187	293	423	436	395	305	251	2290
All adults	331	489	729	790	700	631	413	4083
a Bases shown are for PGSI item 1 (betting more than could afford to lose). Bases for other items vary.

Table 9.8 DSM-IV and PGSI scores for gambling in the last year, 2012, by age and sex

Aged 16 and over	2012
DSM-IV score / PGSI score	Age							Total
	16-24	25-34	35-44	45-54	55-64	65-74	75+
	%	%	%	%	%	%	%
Men
DSM-IV scores
Non problem gambler	98.4	98.3	97.7	99.3	99.3	98.5	99.5	98.6
Problem gambler 3 and above	1.6	1.7	2.3	0.7	0.7	1.5	0.5	1.4
PGSI scores
Non problem gambler/non gambler	92.6	83.7	92.0	94.8	94.0	93.8	93.7	91.8
Low risk gambler	5.6	9.4	4.1	2.7	3.9	3.4	2.8	4.8
Moderate risk gambler	0.7	3.9	1.4	1.8	1.7	2.4	3.1	2.1
Problem gambler	1.1	3.0	2.5	0.7	0.3	0.4	0.5	1.4
Women
DSM-IV scores
Non problem gambler	99.7	100.0	99.7	100.0	100.0	100.0	100.0	99.9
Problem gambler 3 and above	0.3	-	0.3	-	-	-	-	0.1
PGSI scores
Non problem gambler/non gambler	97.8	98.8	96.4	98.9	98.9	99.0	100.0	98.4
Low risk gambler	2.2	1.2	3.0	1.1	0.6	1.0	-	1.4
Moderate risk gambler	-	-	-	-	-	-	-	-
Problem gambler	-	-	0.6	-	0.4	-	-	0.2
All Adults
DSM-IV scores
Non problem gambler	99.0	99.2	98.8	99.6	99.7	99.2	99.8	99.3
Problem gambler 3 and above	1.0	0.8	1.2	0.4	0.3	0.8	0.2	0.7
PGSI scores
Non problem gambler/non gambler	95.1	91.4	94.3	96.9	96.6	96.5	97.6	95.3
Low risk gambler	3.9	5.2	3.5	1.9	2.2	2.2	1.1	3.0
Moderate risk gambler	0.4	1.9	0.7	0.9	0.8	1.2	1.2	1.0
Problem gambler	0.6	1.5	1.5	0.4	0.4	0.2	0.2	0.7
Bases (weighted):
Men DSM score	274	331	336	360	298	217	122	1937
Men PGSI score	277	329	336	360	299	217	122	1940
Women DSM score	268	335	365	392	345	226	203	2134
Women PGSI score	266	337	365	393	344	225	202	2132
All adults DSM score	542	666	701	752	642	443	325	4071
All adults PGSI score	544	666	701	752	643	442	324	4072
Bases (unweighted):
Men DSM score	143	198	306	354	304	326	161	1792
Men PGSI score	144	196	306	354	305	326	161	1792
Women DSM score	188	292	423	434	396	304	252	2289
Women PGSI score	187	293	423	435	395	303	251	2287
All adults DSM score	331	490	729	788	700	630	413	4081
All adults PGSI score	331	489	729	789	700	629	412	4079

Table 9.9 Gambling group membership, 2012, by problem gambling and sex

Aged 16 and over	2012
Problem gambler according to either screena	Gambling group type
	Non-gamblers	National Lottery only	Minimal interest - lotteries and other activity	Minimal interest - other activities	Moderate interest - lotteries and other activities	Moderate interest - mainly betting and machines	Multi interest gambler
	%	%	%	%	%	%	%
Men
Problem gambler according to either screen	-	-	1.4	0.8	1.6	5.6	[14.1]
Women
Problem gambler according to either screen	-	-	-	-	0.4	[5.0]	*
All adults
Problem gambler according to either screen	-	-	0.6	0.4	1.0	5.5	[13.3]
Bases (weighted):
Men	538	410	268	161	224	220	53
Women	734	507	353	173	250	43	3
All	1272	916	621	334	474	263	56
Bases (unweighted):
Men	531	414	258	127	200	162	45
Women	822	542	375	176	252	36	4
All	1353	956	633	303	452	198	49
a DSM-IV and PGSI

Table 9.10 Estimated odds ratios, 2012, for problem gambling

Aged 16 and over	2012
Independent variables
	Base (weighted)	Odds ratio	95% Confidence Intervala
	4082
Sex		(p<0.001)
Women	2138	1.00
Men	1943	11.6	4.0	,	33.6
General Health Questionnaire Score		(p<0.01)
0	2493	1.00
1 to 3	909	3.3	1.2	,	8.8
4 or more	609	5.6	2.0	,	15.5
Not answered	71	12.8	2.4	,	68.2
SIMD		(p<0.05)
3rd (least deprived)	1393	1.00
2nd	1414	4.0	1.1	,	15.2
1st (most deprived)	1274	6.9	1.9	,	24.9
Alcohol Use Disorders Identification Test score		(p<0.05)
0 to 7	3215	1.00
8 to 15	619	2.1	0.8	,	5.2
16 to 19	81	2.4	0.3	,	21.6
20 or more	49	7.1	1.4	,	34.7
Not answered	117	5.3	1.4		20.5
Whether parent to any child in the household		(p<0.05)
No	3036	1.0
Yes	1046	2.6	1.1	,	5.9
a Confidence interval