1 Gambling Participation and Problem Gambling

GAMBLING PARTICIPATION AND PROBLEM GAMBLING PREVALENCE IN ONTARIO ETHNO-CULTURAL COMMUNITIES: MINING THE 2005 CPGI DATASET

Report prepared for the Ontario Problem Gambling Research Centre

Matthew M. Young, Ph.D. Agata Falkowski-Ham, MA Senior Research & Policy Analyst Falkowski-Ham Research Canadian Centre on Substance Abuse 9 HernshawCres. 75 Albert Street, Suite 500 Etobicoke, ON Ottawa, ON

July, 2011 2

TABLE OF CONTENTS LIST OF TABLES ...... 3 LIST OF FIGURES ...... 4 LIST OF APPENDICES ...... 5 ABSTRACT ...... 6 INTRODUCTION ...... 7 PART I: SYSTEMATIC SEARCH OF THE LITERATURE ...... 8

METHODS ...... 8 FINDINGS ...... 8 DISCUSSION ...... 10 PART II: ANALYSIS OF THE 2005 ONTARIO GAMBLING PREVALENCE STUDY DATA ...... 11

METHODS ...... 11 Original data collection ...... 11 Secondary Analysis ...... 11 RESULTS ...... 12 Gambling participation by ethnicity ...... 15 Past year participation in specific gambling activities by ethnicity ...... 16 Past year frequency of participation ...... 20 Past year frequency of participation by ethnicity ...... 22 Problem gambling by ethnicity ...... 25 Awareness of problem gambling services by ethnicity ...... 27 Summary of results ...... 32 DISCUSSION ...... 34 Limitations ...... 35 Recommendations ...... 35 REFERENCES ...... 36 APPENDIX A : GAMBLING PARTICIPATION AND PROBLEM GAMBLING PREVALENCE IN CANADA ...... 38 APPENDIX B : GAMBLING PARTICIPATION AND PROBLEM GAMBLING PREVALENCE IN ONTARIO ...... 48 APPENDIX C: GAMBLING PARTICIPATION AND PROBLEM GAMBLING PREVALENCE BY ETHNICITY IN ONTARIO . 55 APPENDIX D: ONTARIO 2005 QUESTIONNAIRE ...... 57 APPENDIX E: LIST OF EXLUDED SELF-IDENTIFIED ETHNICITIES NOT INCLUDED IN THE REPORT ...... 78

LIST OF TABLES

TABLE 1. DISTRIBUTION OF SELF-REPORTED ETHNICITY IN THE ONTARIO 2005 PREVALENCE STUDY DATA COMPARED TO CENSUS 2006 ...... 13 TABLE 2.PERCENTAGE OF RESPONDENTS REPORTING PAST YEAR GAMBLING PARTICIPATION BY SELF-REPORTED ETHNICITY ...... 16 TABLE 3.GAMBLING ACTIVITIES PARTICIPATED IN THE PAST YEAR (N=3550) ...... 17 TABLE 4A. PAST YEAR GAMBLING ACTIVITY PARTICIPATION BY SELF-REPORTED ETHNICITY ...... 18 TABLE 5.ROTATED FACTOR LOADINGS ON THE SIX COMPONENTS EXTRACTED BY PRINCIPAL COMPONENTS ANALYSIS OF THE FREQUENCY OF PARTICIPATION IN GAMBLING ACTIVITIES USING THE 2005 ONTARIO GAMBLING PREVALENCE DATA ...... 21 TABLE 6. SIX COMPONENTS EXTRACTED BY PRINCIPAL COMPONENTS ANALYSIS OF THE FREQUENCY PARTICIPATION IN GAMBLING ACTIVITIES USING THE 2005 ONTARIO GAMBLING PREVALENCE DATA ...... 21 TABLE 7.FREQUENCY OF PAST -YEAR GAMBLING BY ACTIVITY CLUSTER AMONG GAMBLERS ONLY (N=2,273) ...... 22 TABLE 8. GAMBLING FREQUENCY OF THOSE SELF-REPORTING AS AN ETHNICITY OTHER THAN CANADIAN VERSUS THOSE SELF-REPORTING AS CANADIAN ...... 22 TABLE 9. AVERAGE GAMBLING FREQUENCY SCORE FOR EACH ETHNICITY COMPARED TO SELF-IDENTIFIED AS CANADIAN ...... 23 TABLE 10. PGSI SCORE BY ETHNICITY...... 26 TABLE11.PERCENTAGE OF RESPONDENTS ENDORSING ONE OR MORE ITEM ON THE PGSI BY SELF-REPORTED ETHNICITY...... 27 TABLE 12: PERCENT OF RESPONDENTS AWARE OF THE RESPONSIBLE GAMBLING COUNCIL BY SELF-REPORTED ETHNICITY ...... 28 TABLE 13 PERCENT OF RESPONDENTS WHO HAVE SEEN A POSTER, SINGS, WARNING LABELS, OR OTHER FORMS OF PUBLIC SERVICE ANNOUNCEMENTS RELATED TO PROBLEM OR RESPONSIBLE GAMBLING BY SELF-IDENTIFIED ETHNICITY ...... 29 TABLE 14.AWARENESS OF THE TOLL-FREE GAMBLING HELPLINE IN ONTARIO BY SELF-IDENTIFIED ETHNICITY...... 30 TABLE 15. PERCENT OF RESPONDENTS WHO ARE AWARE OF ANY GAMBLING COUNSELING SERVICES AVAILABLE IN THEIR COMMUNITY BY SELF-IDENTIFIED ETHNICITY ...... 31

TABLE 16. SUMMARY TABLE OF RESULTS. UP ARROWS ( ) INDICATE THE GROUP MEAN /PERCENTAGE WAS SIGNIFICANTLY GREATER THAN THE COMPARISON GROUP (I.E., THOSE SELF-REPORTING AS ‘CANADIAN’) AND DOWN ARROWS ( ) INDICATE THE GROUP MEAN/PERCENTAGE WAS SIGNIFICANTLY LESS THAN THE COMPARISON GROUP...... 32

LIST OF FIGURES

FIGURE 1. FLOW DIAGRAM OUTLINING THE SEARCH STRATEGY EMPLOYED TO ASSESS THE PREVALENCE OF GAMBLING AND PROBLEM GAMBLING AMONG ETHNO-CULTURAL GROUPS IN CANADA IN GENERAL AND IN ONTARIO SPECIFICALLY...... 9 FIGURE 2. BAR CHART DEPICTING THE DISTRIBUTION OF ETHINIC GROUPS IN THE ONTARIO 2005 GAMBLING PREVALENCE STUDY COMPARED TO THE 2006 CENSUS DATA...... 15

LIST OF APPENDICES

APPENDIX A : GAMBLING PARTICIPATION AND PROBLEM GAMBLING PREVALENCE IN CANADA ...... 38 APPENDIX B : GAMBLING PARTICIPATION AND PROBLEM GAMBLING PREVALENCE IN ONTARIO ...... 48 APPENDIX C: GAMBLING PARTICIPATION AND PROBLEM GAMBLING PREVALENCE BY ETHNICITY IN ONTARIO ...... 55 APPENDIX D: ONTARIO 2005 QUESTIONNAIRE ...... 57 APPENDIX E: LIST OF EXLUDED SELF-IDENTIFIED ETHNICITIES NOT INCLUDED IN THE REPORT ...... 78

ABSTRACT

Prevalence studies indicate there may be a higher prevalence of problem gambling (PG) among some ethno-cultural communities (ECCs) than among the general population. However the prevalence of gambling and problem gambling in Ontario ECCs is largely unknown. The research presented in the following report was conducted to better understand the nature of gambling and problem gambling in Ontario ECCs. In Part I we conducted a systematic search of the literature and found only two recent (i.e., past decade) prevalence studies conducted in Ontario that assessed gambling and problem gambling in ECCs. Taken together, these studies revealed no clear pattern regarding the prevalence of gambling and PG among Ontario ECCs. In Part II of the current report we conducted secondary analysis of the 2005 Ontario Gambling Prevalence dataset in order to further assess the prevalence of gambling and PG among Ontario ECCs. In terms of gambling related problems, compared to those self-identifying as Canadian a significantly larger proportion of those self-identifying as Polish, South Asian (i.e., those self– identifying as Indian, South Asian, Sri Lankan, and Pakistani), East Asian (i.e., self–identifying as Asian, Filipino, Japanese, Korean, or Taiwanese but excluding Chinese), and African endorsed one or more item on the PGSI. Though the current report adds to the body of evidence regarding prevalence of gambling and PG in ECCs, there are limitations. Small sample sizes in many ECC groups and likely biased sampling procedure (due to the likelihood that many respondents from ECCs were screened out of the study for not being proficient in English) mean that care should be taken in interpreting the results. To accurately assess the prevalence of gambling and PG in ECCs it is recommended that a study that aims to survey ECCs as it‟s primary goal, be conducted. This survey would sample in such way to achieve adequate sample sizes of all the major ECCs in Ontario and would enable members of these communities to answer questions in their native language.

INTRODUCTION

Prevalence studies indicate there may be a higher prevalence of problem gambling (PG) among some ethno-cultural communities (ECCs) than among the general population both internationally (Murray, 1993; Raylu & Oei, 2004; Volberg, 1996; Welte, Barnes, Wieczorek, Tidwell, & Parker, 2001) and within Ontario (Insight Canada Research, 1993; McCready, Mann, Zhao, & Calla, 2007; Tepperman, Kwan, Jones, & Falkowski-Ham, 2004). However, there are only a few estimates of gambling participation and PG prevalence rates among Ontario ECCs (Insight Canada Research, 1993; McCready et al., 2007; Tepperman et al., 2004). Past research suggests some Ontario ECCs (e.g., South Asians, Aboriginal, and Chinese) may be at higher risk of developing gambling problems than the general population. However, some of the aforementioned studies produced conflicting findings for some ECCs (e.g., Irish, French and British ECCs), while for others the rates of PG are unclear (e.g., Black and Japanese). These mixed findings may be a result of the methods employed by researchers to identify ethnic subpopulations and measure their gambling problems. For example, McCready et al. (2007) used categories from the 2001 Census to identify groups (e.g., „South Asian‟ or „Black‟), while Tepperman and colleagues (2004) used different logic to group ECCs and their naming practice for each ECC was different than that used by McCready et al. (2007) (for example, East Indian vs. South Asian). Both reports (McCready et al., 2007; Tepperman et al., 2004) were based on secondary data analysis of population surveys, therefore, respondents in both reports were not selected on the basis of ethnicity. That is, the samples of ECCs used in both reports were simply a function of the sampling frame employed in each dataset, which was not stratified by ethnicity. Additionally, some groups discussed in the McCready study were not represented in the Tepperman paper as sample size was too small (e.g., Black/African). Though these studies provide valuable information regarding gambling and PG prevalence rates among ECCs, there is still a need for more studies in order to gain a more complete picture of gambling participation and PG among ECCs (Young, Sztainert, & Santoro, 2010). This more accurate understanding of gambling and PG in ECCs will in turn permit policy analysts, prevention specialists, treatment providers, and other stakeholders to develop more effective ways of treating/reaching these populations. The current research represents an effort to contribute to this picture by: (1) conducting a systematic search of the academic and grey literature on the prevalence of gambling and PG in Canada more broadly and in Ontario more specifically to ensure that all existing research on gambling participation and PG among ECCs has been examined; and (2) re-analysing existing data from the 2005 Ontario gambling prevalence study (Wiebe, Mun, & Kauffman, 2006) to assess gambling participation rates and prevalence of PG among Ontario ECCs. Specifically, using this dataset we assess which ECCs are most likely to gamble, which gambling activities they participate in and how frequently, and how aware they are of gambling support services (such as the Responsible Gambling Council of Ontario or the Problem Gambling Helpline).

PART I: SYSTEMATIC SEARCH OF THE LITERATURE

Methods No limitations were placed on search terms in order to maximize sensitivity. Searches were run to July 7, 2011 and were limited to the following databases: Project CORK, PsycINFO and PubMed. Search strategies varied based on the database‟s specific controlled vocabulary. In the Project Cork database, the term “gambling” was used in the keyword field, combined with each of the following terms in the abstract field: prevalence, survey, interview, random, telephone, and participation. For PubMed the following searches were conducted using Medical Subject Heading (MESH) terms: gambling AND prevalence, gambling/epidemiology, and gambling AND data collection. For PsycINFO the following search was conducted using index terms: gambling AND epidemiology. The numbers of initial records retuned for each search are indicated in Figure 1. Additional searches of the grey literature were conducted on the following Canadian gambling content related websites: l‟Institue de la statistique Québec (searched using the term “jeu de hazard”), the Canadian Centre on Substance Abuse (searched using the subject terms: gambling AND statistics, and gambling research), the Alberta Gaming Research Institute (scanned the Research page for relevant studies), and the Ontario Problem Gambling Research Centre (conducted a search by category and selected “Prevalence”). References to scholarly conference papers and posters were excluded unless detailed findings were available. Findings After removal of duplicate records this search resulted in a total of 379 records related to gambling participation and problem gambling prevalence. These records then underwent the first level of screening in which the Information Specialist conducted a visual scan of titles and abstracts and removed all non-Canadian records. The result was a set of 116 records that related to gambling participation and problem gambling prevalence in Canada (see Appendix A). The Information Specialist then conducted a second visual scan of titles and abstracts and removed all records that did not assess gambling or problem gambling prevalence in Ontario (Level 2 Screening). This resulted in 32 records (see Appendix B). The final 32 records underwent a full text scan. Records that did not assess/report the prevalence of gambling or problem gambling among ethnic groups were removed (Level 3 Screening). This final level of screening resulted in a total of 8 records (see Appendix C). Of the 8 records 5 were conducted within the past decade (Lai, 2006; McCready, Mann, Zhao, & Eves, 2005; McCready et al., 2007; Tepperman et al., 2004; Wynne & McCready, 2004)(Young et al., 2010). Of the remaining 5, two were specifically focused on seniors (Lai, 2006; McCready et al., 2005). This left two papers that examined gambling and problem gambling patterns among Ontario ECCs (McCready et al., 2007; Tepperman et al., 2004) The results of these two studies were originally summarized by Young, Sztainert, and Santoro (2010) as follows. McCready et al. (2007), found that mainstream Canadians were at greater risk of PG than some ECCs (i.e., Blacks and South Asians), however Italians, Ukrainians and Portuguese were at higher risk for PG than mainstream Canadians. Tepperman, Kwan, Jones and Falkowski-Ham (2004) re-examined data collected from the 2001 Ontario Prevalence Survey (Wiebe, Single and Falkowski-Ham, 2001). Examining the 14 largest ECCs in their sample, Tepperman and colleagues found that Aboriginal, Chinese and East Indian participants had higher rates of PG than Canadians, while French and Irish participants had lower rates of PG. In terms of gambling participation, they found that English, German, and French Ontarians were significantly more likely to be gamblers than non-gamblers. In terms of 9

Project CORK PsycINFO PubMed 144 records identified 140 records identified 158 records identified

3 records nominated by content expert 136 Duplicates removed

70 records identified by specific searches of Canadian gambling content related websites

379 records identified related to gambling participation and problem gambling

prevalence

Level 1 Screening:

263 records excluded

116 RECORDS IDENTIFIED RELATED TO GAMBLING PREVALENCE IN CANADA (DISCUSSION

Level 2 Screening: 84 records excluded

32 records identified related to gambling participation and problem gambling prevalence in Ontario (Appendix B)

Level 3 Screening: 3 records identified 27 records excluded through reference list scan

8 records identified related to gambling participation and problem gambling prevalence by ethnicity in Ontario (Appendix C)

Figure 1. Flow diagram outlining the search strategy employed to assess the prevalence of gambling and problem gambling among ethno-cultural groups in Canada in general and in Ontario specifically

10 problematic gambling, Chinese and Aboriginal gamblers had significantly higher than average PGSI scores (indicating greater prevalence of PG) and Irish and English had significantly lower than average PGSI scores (indicating a lower prevalence of PG among these groups). When looking at the diversity of gambling activities the groups participate in , the Chinese sample were more narrow in their preference (tending to gamble primarily on casino table games) whereas Aboriginal respondents reported gambling on a great diversity of gambling activities (preferring Bingo, and casino gambling). In sum, the two studies suggest Ontario ECCs (e.g., Aboriginal, and Chinese) may be at higher risk of developing gambling problems than the general population. However, past research studies reported conflicting results regarding some ECCs (e.g., South Asian, Irish, French, and British ECCs). while for others the rates of PG are unclear (e.g., Arabs, Japanese). Discussion Though these Ontario based studies provide valuable information regarding PG prevalence rates among ECCs, there is still a need for more studies examining gambling and gambling participation among these groups as the studies reveal no clear pattern regarding the prevalence of gambling and PG among Ontario ECCs. 11

PART II: ANALYSIS OF THE 2005 ONTARIO GAMBLING PREVALENCE STUDY DATA

Given the paucity of research assessing the prevalence of gambling and PG in ECCs and the recommendation by Young, Sztainert, and Santoro (2010) that research aimed at determining the prevalence of PG among Ontario ECCs be conducted, the Ontario Problem Gambling Research Centre (OPGRC) requested that secondary analysis of the 2005 Ontario Gambling Prevalence data be conducted. The following section includes the results of that analysis. Methods Original data collection The secondary data analysis was conducted on data collected by the Responsible Gambling Council in 2005 (Wiebe et al., 2006). The 2005 Ontario Prevalence Study data were collected via telephone by the Hitachi Survey Research Center at the University of Toronto, with a total sample size of 3,604 adults 18 years and older residing in Ontario. The sample was generated by Random Digit Dialling (RDD), and to qualify for the survey, the interviewer asked to speak to an individual who was 18 years or older in the household. Responses were entered into computer-assisted telephone-interviewing system (CATI) in real time by trained telephone interviewers. Two response rates were calculated by the researchers: the response rate of 82.5% among those who were proficient in English and were able to complete the survey (i.e., physically or mentally able to complete the survey) and an overall response rate of 46.4% for all respondents regardless of their language or capacity. All respondents were asked about their past year participation in 18 gambling activities, and those who indicated that they participated in an activity were asked a series of follow-up questions. These included how often the respondents participated in the activity, the amount of time or money spent on each activity, and whether or not they had been negatively affected by someone else‟s gambling. Lastly, all respondents were asked about spending habits and basic demographics including age, gender, income, education, and ethnicity. For more detailed information on the methods employed to collect the data please refer to Wiebe et al. (2006). In order to ensure the representativeness of the sample, Wiebe et al. (2006) compared the sample gender and age demographics to Statistics Canada‟s population estimates of Ontario (Statistics Canada, 2006). The comparison revealed that while age distribution of the sample closely resembled the census data, female respondents were oversampled. As a result, the researchers calculated appropriate gender based weights, which were applied to all analyses conducted in this paper. Secondary Analysis For the secondary analysis, we were interested in a number of variables: self-reported ethnicity, overall participation and frequency of participation in gambling activities, problem gambling severity, and awareness of various problem gambling services. The following is a description of the variables analyzed in this paper: Self-reported ethnicity. The main independent variable of interest is self-reported ethnicity. In the 2005 Survey, respondents were asked to identify to what ethnic or cultural group they or their ancestors belonged to upon first coming to Canada. Initially, the respondent was not read any categories, but if it seemed that the respondent was confused, they were then given some examples of some ethnic or cultural groups. Out of all respondents, 97.7% chose to respond to this question. 12

Frequency of gambling. Participants were presented with a series of 18 gambling activities (see Appendix D) and were asked to respond on a scale of 0 to 4 how often they engaged in that activity (0 = never participated in this gambling activity, 1 = less than once in the past month, 2 = at least once a month, 3 = at least once a week, and 4 = daily. Problem gambling severity. To assess the degree of PG in the sample, the Problem Gambling Severity Index (PGSI: Ferris & Wynne, 2001) was employed. The PGSI is a 9-item instrument that is a sub-set of the Canadian Problem Gambling Index (CPGI: Ferris & Wynne, 2001). The PGSI is typically more conservative and yields lower prevalence rates than other more widely used measures such as the South Oaks Gambling Screen (SOGS: Lesieur & Blume, 1987) (For a discussion see Neal, Delfabbro, & O'Neil, 2005) The PGSI also assesses gambling problems specifically during the previous 12 months and is thus more conservative than lifetime prevalence measures. Participants respond to questions such as “Thinking about the last 12 months, how often have you bet more than you could really afford to lose?” or “Thinking about the last 12 months when you gambled, how often have you gone back another day to try to win back the money you lost?”. Responses are given on a 4-point Likert scale anchored at 1 (Never) and 4 (Almost always). Awareness of services. Respondents were asked a number of questions about their awareness of problem or responsible gambling services offered in Ontario. Specifically, they were asked if they aware of the Responsible Gambling Council of Ontario, whether they had seen any posters, signs, warning labels, or other forms of public service announcements related to problem or responsible gambling, if they were aware of the toll free gambling help line, and if they were aware of any gambling counselling services available in their community. Respondents answered yeas or no to these questions Results Self-reported ethnicity. The frequencies of respondent self-identified ethnicity are listed in Table 1. To assess gambling participation, problem gambling severity, and awareness of problem/responsible gambling services, we chose to use those self-identifying as „Canadian‟ as the comparison group for all analyses. We believe this is an appropriate comparison group as those who self-identify as Canadian are most likely those who have either been in the country for multiple generations or have acculturated to the degree to which they self-identify as Canadian and for whom „mainstream‟ treatment and prevention services and programs are targeted. As may be observed in Table 1, many of the self-identified ethnic groups are very small in number (some as few as 4). Conducting significance testing with small samples exposes the researcher to an unacceptable rate of Type II errors. While, there is no generally accepted minimum sample size, when examining sub-group differences in prevalence data sets most researchers accept a minimum sample size of 50 (Yates, Moore, & McCabe, 1999), while others would allow as few as 20 (Campbell, 2007). For the current secondary analysis we chose to analyse ethnic groups with 40 or more respondents, as it allowed us to include some additional ECCs. Since most of the analysis on ECCs will be done with 2x2 tables with a Chi-square test, the cut of n=40 will allow us to meet sample size assumptions for chi-square analysis. In cases where the sample size was too small, other techniques were utilized to appropriately analyse the data (i.e., recode response categories, calculate combined scores). To achieve groups of 40 or more some self-reported ethnicities were grouped together, thereby increasing sample size (see Table 1). For example, the number of respondents self-identifying as Polish was sufficiently large to form a group that could be analysed (n=56). However, a number of other Eastern 13

European ethnicities that had small sample sizes were combined into one category called “Other Eastern European (excluding Polish). Column one of Table 1 lists the grouping used in the present report. Column two indicates ethnicities identified in the 2005 Ontario Prevalence Study, and column three indicates the percentage of the total sample. Column four indicates the percentage of the Ontario population the group makes up according to the 2006 Census. Grouping in this manner meant that we were able to use 95% of the total Ontario 2005 Prevalence Study sample for this analysis while still having sufficient power to detect group differences in participation, problem gambling severity, and awareness of services. Groups that had less than 40 self-identifying respondents and those who could not be grouped into a larger group represented 5% of the sample (see Appendix E for a listing of these excluded groups).

Table 1. Distribution of self-reported ethnicity in the Ontario 2005 Prevalence Study Data Compared to Census 2006 Ethnic Groups ( used in report) Ethnic Categories Ontario 2005 Census 2006 (Ontario employed by the Prevalence Study Data single ethnicity) Prevalence Study % (N) % (N) Canadian Canadian 44.8 (1,571) 17.5 (1,201,130) British British 4.8 (169) N/A English 6.3 (220) N/A Total 11.1 (389) 9.3 (639,830) Irish Irish 4.9 (170) 3.1 (215,115) Scottish Scottish 4.8 (169) 3.8 (257,535) French French 4.5 (156) 2.7 (182,510) Dutch Dutch 1.5 (55) 2.4 (161,710) German German 2.2 (78) 3.2 (216,630) Polish Polish 1.6 (56) 2.5 (169,225) Other Eastern European (excluding Polish) Russian 0.5 (16) 0.6 (39,660) Ukrainian 0.7 (25) 1.3 (85,610) Slovak 0.1 (4) 0.2 (12,205) Czech 0.1 (4) 0.2 (10,995) Hungarian 0.4 (12) 0.7 (48,090) Romanian 0.2 (7) 0.5 (37,350) Latvian 0.1 (2) 0.1 (5,585) Lithuanian 0.1 (2) 0.1 (7,700) Total 2.1 (72) 3.6 (247,195) Italian Italian 2.9 (103) 7.1 (485,680) Other Southern European (excluding Italian) Albanian 0.1 (3) 0.2 (14,185) Bosnian 0.1 (2) 0.1 (7,980) Bulgarian 0.1 (2) 0.1 (8,450) Croatian 0.3 (12) 0.6 (38,790) Greek 0.4 (15) 1.2 (79,970) Macedonian 0.1 (2) 0.3 (17,585) Maltese 0.2 (6) 0.9 (12,210) Portuguese 0.9 (32) 2.8 (189,405) Serbian 0.1 (4) 0.5 (34,195) Spanish 0.3 (11) 0.5 (32,455) Yugoslavian 0.1 (4) 0.2 (12,440) Total 2.6 (93) 6.5 (447,665) 14

South Asian Indian 1.8 (62) 6.6 (454,365) South Asian 0.3 (12) 0.5 (35,550) Sri Lankan 0.3 (11) 1.0 (65,585) Pakistani 0.4 (15) 1.0 (65,800) Total 2.8 (100) 9.1 (621,300) Chinese 2.7 (94) 7.9 (543,320) Other East Asian (excluding Chinese) East Asian 0.1 (2) N/A Asian 0.8 (26) 0.0 (45) Filipino 0.6 (22) 2.3 (159,155) Japanese 0.1 (3) 0.3 (19,425) Korean 0.1 (3) 1.0 (67,430) Taiwanese 0.1 (2) 0.1 (3,250) Total 1.7 (58) 3.6 (249,305) West Indian/Caribbean West Indian 0.6 (19) 0.3 (21,690) Caribbean 0.6 (20) 0.1 (3,175) Jamaican 0.7 (24) 1.8 (120,355) Cuban 0.0 (1) 0.0 (2,245) Guyanese 0.2 (8) 0.4 (25,455) Trinidadian 0.0 (1) 0.3 (19,140) Total 2.1 (73) 2.8 (192,060) African African 1.4 (48) 0.4 (26,425) East African 0.0 (1) N/A South Africa 0.1 (4) N/A Total 1.5 (53) 0.4 (26,425) Middle Eastern Middle Eastern 0.2 (8) N/A Arabic 0.3 (9) 0.4 (23,880) Iranian 0.2 (6) 0.8 (57,825) Lebanese 0.2 (6) 0.6 (39,775) Iraqi 0.2 (6) 0.2 (16,290) Persian 0.1 (4) N/A Afghan 0.1 (2) 0.4 (26,915) Palestinian 0.0 (1) 0.1 (9,490) Egyptian 0.1 (3) 0.3 (19,510) Total 1.3 (45) 2.8 (193,685)

Table 1 includes the final list of ethnic groups that were used in the remainder of this study along with the comparisons to the Canadian Census 2006 ethnicity breakdown for the province of Ontario. Though the percentage of most ethnic groups included was similar to that observed in the census, there are several groups that the 2005 gambling prevalence data either over or under represented. Those who self-identified as Canadian were over represented in the Ontario Prevalence data compared to the 2006 Census. However, other ethnic groups were under-represented, such as Polish, Italian, or Portuguese.

Census 2006 (Ontario)

Ontario 2005 Prevalence

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Canadian British Irish Scottish French Dutch German Polish Other Eastern European (excluding Polish) Italian Other Southern European (excluding Italian) South Asian Chinese Other East Asian (excluding Chinese) West Indian/ Caribbean African Middle Eastern Figure 2. Bar chart depicting the distribution of ethinic groups in the Ontario 2005 Gambling Prevalence Study compared to the 2006 Census Data

Gambling participation by ethnicity In all but two of the ethnic groups examined, the majority of respondents (i.e., over 50%) indicated they had gambled in the past 12 months – the exceptions being respondents who identified themselves as Dutch or South Asian (see Table 2). The group with the highest prevalence of past-year gambling participation were those self-identifying as Middle Eastern, followed by Italian. Those self –identifying as Canadian were ranked 6th. In order to determine whether the ethnic groups differed significantly from the „mainstream‟ Canadian subgroup, chi- square tests of significance were conducted. Compared to those self-identifying as Canadian, a significantly smaller percentage of South Asian, Dutch, West Indian, and Other East Asian (excluding Chinese) reported past-year gambling.

Table 2.Percentage of respondents reporting past year gambling participation by self-reported ethnicity Self-reported ethnicity % (n) Canadian 65.7 (1032) Irish 63.2 (108) British 66.9 (261) Scottish 61.3 (103) French 66.7 (104) Dutch * 44.4 (24) German 57.7 (45) Polish 66.1 (37) Other Eastern Europe (excluding Polish) 63.5 (47) Italian 67.0 (69) Other Southern Europe (excluding Italian) 65.2 (60) South Asian * 42.0 (42) Chinese 58.1 (54) Other East Asian (excluding Chinese) * 50.8 (30) African 58.5 (31) West Indian/Caribbean * 50.0 (36) Middle Eastern 69.6 (32) * Indicates the results of a chi-square test indicating the proportion is significantly different from those self-reporting as Canadian (p<.05)

Past year participation in specific gambling activities by ethnicity Regardless of ethnicity, the most common gambling activities reported were lottery tickets, instant win/scratch tickets, or raffle tickets (see Table 3). Respondents who self- identified as Canadian were compared to all other ethnicities combined. Those who self- identified as Canadian were significantly more likely than other ethnicities to report purchasing scratch or raffle tickets, play coin slot machines at Ontario racetracks, or gamble in casinos outside of Ontario in the last 12 months.

Table 3.Gambling activities participated in the past year (N=3550)

Self-Identified Other Ethnic Canadian Identities Gambling Activities % (n) % (n) Lottery tickets 54.0 (849) 51.2 (1013) Instant win or scratch tickets * 29.3 (461) 21.5 (425) Raffles or fundraising tickets * 30.8 (483) 27.2 (539) Horse races 4.4 (69) 3.9 (77) Bingo 5.2 (82) 4.4 (88) Slots at Ontario Casinos 17.9 (115) 15.5 (119) Casino table games 7.3 (281) 6.0 (307) Slots at Ontario racetracks * 7.4 (116) 5.7 (112) Slots or VLTs outside of Ontario * 3.8 (60) 2.5 (49) Sport select like Pro line 4.0 (63) 4.6 (91) Sports pools or outcome of sporting events 3.8 (59) 4.6 (92) Cards or board games with family and friends 8.7 (136) 8.4 (166) Games of skill 3.5 (55) 3.9 (78) Arcade or video games 1.2 (19) 1.8 (36) Internet 1.5 (23) 1.8 (35) Sports with a bookie/bookmaker 0.2 (3) 0.5 (9) Short-term speculative stock 1.6 (25) 2.2 (43) Casinos out of province 5.9 (92) 4.4 (88) Total 100 (1571) 100 (1979) * Indicates the results of a chi-square test indicating the proportion is significantly different from those self-reporting as Canadian (p<.05)

Next we conducted a more specific analysis of self-reported ethnicity. Despite the low sample size, the analyses did reveal some significant relationships (see Table 4a & 4b). Other East Asian and South Asian respondents were less likely than Canadians to have purchased Lottery tickets in the last year. Similarly West Indian, Chinese, Italian, British and Other Eastern Europeans respondents were less likely than Canadians to have purchased instant win or scratch tickets. South Asian and German respondents were less likely than Canadians to have gambled on slot machines in Ontario casinos. British respondents indicated they were more than twice as likely as Canadians to have purchased short-terms stocks. Other Southern Europeans (excluding Italian) were more likely than Canadians to bet on sport pools or the outcome of sporting events. Finally, respondents who were of Other Eastern European (excluding Polish) descent were more likely than self-identified Canadians to bet on card or board games with family or friends. 18

Table 4a. Past year gambling activity participation by self-reported ethnicity Slots in Casino Slots at Lottery Scratch Raffle Horse Self-Identified Ethnicity N Bingo Ontario Table Ontario Tickets Tickets Tickets Races Casinos Games racetracks Canadian 1571 54.0%(849) 29.3%(461) 29.3%(461) 4.4%(69) 5.2%(82) 17.9%(281) 7.3%(115) 7.4%(116) Irish 171 54.4%(93) 31.2%(53) 35.1%(60) 4.1%(7) 3.5%(6) 13.5%(23) 4.7%(8) 4.1%(7) British 390 54.2%(211) 23.8%(93)* 33.9%(132) 4.1%(16) 5.4%(21) 16.9%(66) 5.4%(21) 6.7%(26) Scottish 169 53.0%(89) 24.9%(42) 27.4%(46) 7.1%(12) 4.1%(7) 18.9%(32) 7.1%(12) 7.1%(12) French 156 57.3%(90) 26.3%(41) 28.2%(44) 1.9%(3) 7.1%(11) 17.9%(28) 7.1%(11) 5.7%(9) Dutch 55 33.3%(18)* 16.7%(9)* 25.5%(14) 3.6%(2) 5.5%(3) 10.9%(6) 1.8%(1) 9.1%(5) German 78 46.2%(36) 24.4%(19) 24.4%(19) 2.6%(2) 3.8%(3) 7.7%(6)* 2.6%(2) 6.4%(5) Polish 56 58.9%(33) 25.0%(14) 26.3%(15) 1.8%(1) 5.3%(3) 21.1%(12) 3.6%(2) 8.9%(5) Other Eastern European (excluding Polish) 73 55.4%(41) 13.5%(10)* 31.1%(23) 4.1%(3) 1.4%(1) 17.6%(13) 6.8%(5) 4.1%(3) Italian 103 58.3%(60) 19.4%(20)* 29.8%(31) 6.7%(7) 1.9%(2) 17.5%(18) 12.6%(13) 7.8%(8) Other Southern European (excluding Italian) 91 53.3%(49) 22.0%(20) 21.7%(20) 4.3%(4) 7.6%(7) 19.6%(18) 9.8%(9) 7.6%(7) South Asian 99 35.0%(35)* 10.0%(10)* 8.1%(8)* 1.0%(1) 0.0%(0)* 6.0%(6) 2.0%(2)* 2.0%(2) Chinese 94 47.9%(45) 7.4%(7)* 17.0%(16)* 0.0%(0)* 1.1%(1) 13.8%(13) 2.2%(2) 1.1%(1)* Other East Asian (excluding Chinese) 58 35.6%(21)* 12.1%(7)* 22.0%(13) 1.7%(1) 3.4%(2) 15.5%(9) 6.9%(4) 6.9%(4) African 53 47.2%(25) 11.3%(6)* 18.5%(10) 1.9%(1) 1.9%(1) 15.1%(8) 3.8%(2) 3.7%(2) Middle Eastern 45 53.3%(24) 17.8%(8) 17.8%(8) 4.4%(2) 4.4%(2) 20.0%(9) 4.4%(2) 4.3%(2) West Indian/ Caribbean 73 43.8%(32) 17.8%(13)* 19.4%(14)* 4.1%(3) 5.5%(4) 16.4%(12) 1.4%(1) 5.5%(4) * Indicates the results of a chi-square test indicating the proportion is significantly different from those self-reporting as Canadian (p<.05)

Table 4b (continued) .Past year gambling activity participation by self-reported ethnicity. Slots or Cards or VLTs board Arcade Sports Casinos Sports Sport Games of N outside games with or video Internet with a Stocks out of select Pools Skill of family or games bookie province Ontario friends Canadian 1571 3.8%(60) 4.0%(63) 3.8%(59) 8.7%(136) 3.5%(55) 1.2%(19) 1.5%(23) 0.2%(3) 1.6%(25) 5.9%(92) Irish 171 1.8%(3) 6.5%(11) 4.1%(7) 8.8%(15) 5.3%(9) 1.2%(2) 2.4%(4) 0.0%(0) 1.2%(2) 2.9%(5) British 390 3.6%(14) 4.6%(18) 2.8%(11) 8.2%(32) 2.8%(11) 1.3%(5) 1.8%(7) 0.5%(2) 3.8%(15)* 5.1%(20) Scottish 169 1.8%(3) 4.7%(8) 6.0%(10) 8.9%(15) 4.1%(7) 0.6%(1) 0.6%(1) 0.6%(1) 1.2%(2) 4.1%(7) French 156 3.2%(5) 5.1%(8) 5.7%(9) 8.3%(13) 2.6%(4) 1.3%(2) 3.2%(5) 0.0%(0) 3.2%(5) 5.1%(8) Dutch 55 3.6%(2) 1.9%(1) 0.0%(0) 3.7%(2) 0.0%(0) 0.0%(0) 0.0%(0) 0.0%(0) 0.0%(0) 5.5%(3) German 78 1.3%(1) 2.6%(2) 1.3%(1) 2.6%(2) 1.3%(1) 0.0%(0) 1.3%(1) 0.0%(0) 1.3%(1) 2.6%(2) Polish 56 0.0%(0) 5.4%(3) 0.0%(0) 8.8%(5) 1.8%(1) 3.6%(2) 1.8%(1) 0.0%(0) 0.0%(0) 0.0%(0) Other Eastern European (excluding Polish) 73 2.7%(2) 4.1%(3) 8.1%(6) 16.4%(12)* 2.7%(2) 0.0%(0) 1.4%(1) 1.4%(1) 5.5%(4)* 6.8%(5) Italian 103 1.9%(2) 6.7%(7) 6.7%(7) 10.7%(11) 6.7%(7) 2.9%(3) 2.9%(3) 1.0%(1) 0.0%(0) 5.8%(6) Other Southern European (excluding Italian) 91 3.3%(3) 5.5%(5) 8.7%(8)* 6.6%(6) 5.4%(5) 1.1%(1) 1.1%(1) 0.0%(0) 1.1%(1) 2.2%(2) South Asian 99 1.0%(1) 0.0%(0) 4.0%(4) 2.0%(2)* 2.0%(2) 2.0%(2) 0.0%(0) 0.0%(0) 1.0%(1) 1.0%(1)* Chinese 94 1.1%(1) 3.2%(3) 1.1%(1) 2.2%(2)* 1.1%(1) 1.1%(1) 1.1%(1) 0.0%(0) 1.1%(1) 5.3%(5) Other East Asian (excluding Chinese) 58 0.0%(0) 3.4%(2) 5.2%(3) 12.1%(7) 6.9%(4) 1.7%(1) 1.7%(1) 0.0%(0) 0.0%(0) 5.2%(3) African 53 0.0%(0) 5.7%(3) 5.6%(3) 5.7%(3) 3.8%(2) 0.0%(0) 0.0%(0) 0.0%(0) 0.0%(0) 0.0%(0) Middle Eastern 45 4.4%(2) 2.2%(1) 0.0%(0) 11.1%(5) 4.4%(2) 6.7%(3)* 4.4%(2) 0.0%(0) 6.7%(3)* 2.2%(1) West Indian/ Caribbean 73 1.4%(1) 2.8%(2) 2.8%(2) 4.1%(3) 0.0%(0) 0.0%(0) 0.0%(0) 0.0%(0) 0.0%(0) 4.1%(3) * Indicates the results of a chi-square test indicating the proportion is significantly different from those self-reporting as Canadian (p<.05)

Past year frequency of participation As may be seen in Table 4a and 4b small sample sizes results in responses to questions about participation in many of the 18 gambling activities asked about in the survey are too small to conduct any meaningful analysis Therefore in order to assess whether the type of gambling activity asked about in the CPGI differs systematically by ethnicity, we decided to combine responses to gambling activities that have similar patterns of participation through the use of a common scaling technique –principal component analysis (PCA). In short, PCA allows us to form clusters of correlated gambling activities. Once we obtain the gaming clusters, we will then examine ethnic variations in game clusters, and variations in CPGI by game clusters. This technique increases the power of our analysis and was used by Tepperman et al.,(2004) to combine the number of distinct gaming categories and examine ethnic variations in game clusters. To evaluate the suitability of the data for PCA, we performed the Kaiser-Meyer-Olkin (KMO) and Bartlett‟s test for sphericity. Small values of KMO indicate that PCA may not be appropriate for the data. Values of .9 or higher are desirable, while values below .5 are unacceptable. For the current data the KMO statistic was .755, well-within the accepted range. We therefore felt comfortable proceeding with the PCA on the frequency of participation in the 18 gambling activities. This analysis was followed by a Varimax rotation with Kaiser normalization to identify the main components, or clusters and to maximize the statistical independence of the clusters identified. The rotated component loadings were sorted by size, and coefficient with values of less than .1 were suppressed. The PCA produced six components with eigenvalues greater than 1 (3.50, 1.81, 1.48, 1.14, 1.10, and 1.09) that explained 56.2% of the variance. The component loadings for each activity are presented in Table 5. The six components were labelled as follows: Social Betting, Sports Betting, Casino Betting, Casino Gaming Outside of Ontario, Stocks/Internet Betting, and Ticket Betting. Table 6, lists these labels and the activity clusters they represent.

Table 5.Rotated factor loadings on the six components extracted by principal components analysis of the frequency of participation in gambling activities using the 2005 Ontario Gambling Prevalence data Gambling Activities Component 1 2 3 4 5 6 Games of skill .754 .160 Cards or board games with family or friends .687 .155 .136 .145 Arcade or video games .665 .112 -.101 .195 Casino table games .456 .368 .207 .234 Sports with a bookie/bookmaker .731 .149 Sports pools or outcome of sporting events .340 .723 Sport select like Pro line .207 .652 .147 Slot machines at an Ontario racetrack .810 .102 Slot machines in ONTARIO casinos .118 .747 .199 -.101 Horse races .156 .306 .476 .326 Bingo .224 -.199 .379 .271 Casinos out of province .864 .107 Slot machines or VLTs OUTSIDE of Ontario .114 .854 Scratch tickets .106 .247 .696 Lottery tickets -.132 -.105 .675 .104 Raffles or fundraising tickets .153 .616 Short-term speculative stock .802 Internet .319 .108 .630 % of Variance 11.54 10.33 9.772 9.321 8.021 7.195 Cumulative % 11.54 21.87 31.64 40.96 48.98 56.18

Table 6. Six components extracted by principal components analysis of the frequency participation in gambling activities using the 2005 Ontario Gambling Prevalence data Component Label Gambling activity 1 Social Betting Games of skill Arcade or video games Cards or board games with family or friends Casino table games 2 Sports Betting Sports pools or outcome of sporting events Sport select like Pro line Sports with a bookie/bookmaker 3 Casino Betting Slot machines at an Ontario racetrack Slot machines in ONTARIO casinos Horse races Bingo 4 Casino Betting Outside of Ontario Casinos out of province Slot machines or VLTs OUTSIDE of Ontario 5 Stocks/Internet Betting Short-term speculative stock Internet 6 Ticket Betting Lottery tickets Scratch tickets Raffles or fundraising tickets

Past year frequency of participation by ethnicity Participant responses to gambling frequency questions for each gambling cluster were assessed by calculating the mean frequency of the activities that made up the cluster. For example, to assess gambling frequency of a participation in sports betting one would simply calculate the mean response to the three activities that comprise the cluster (i.e., Sports pools or outcome of sporting events, Sport select like Pro line, and Sports with a bookie/bookmaker). Scores ranged from 0 to 4 (M = 0.25, SD = 0.21). Table 7 lists the mean frequency scores for each of the 6 gambling activity clusters. The activities with the highest frequency of play are ticket betting, followed by social betting, and slots/horse race betting. The least frequent set is gambling in a venue outside of Ontario.

Table 7.Frequency of past -year gambling by activity cluster among gamblers only (N=2,273) Frequency Scores Mean SD Social Betting 0.13 0.34 Sports Betting 0.08 0.29 Casino Betting 0.16 0.31 Casinos Out of Province Betting 0.07 0.26 Stocks or Internet Betting 0.05 0.26 Ticket Betting 0.96 0.63

Next, we tested for significant relationships between the frequency scores for each activity cluster and whether the respondent self-identified as Canadian versus another ethnicity. Overall Canadians reported gambling significantly more frequently (M = 0.17, SD = 0.21) then those self-identifying as another ethnicity (M = 0.15, SD = 0.20), F(1,3 548) = 5.57, p < .02. When compared to other ethnic identities combined, respondents self-identified as Canadian gambled significantly more frequently on following gaming clusters: casino betting, casinos out of province and ticket betting (see Table 8).

Table 8. Gambling frequency of those self-reporting as an ethnicity other than Canadian versus those self- reporting as Canadian Frequency Scale Ethnic Identity Mean SD N

Social Betting Canadian 0.08 0.26 1571 Other 0.08 0.28 1979 Sports Betting Canadian 0.04 0.21 1571 Other 0.05 0.25 1979 Casino Betting * Canadian 0.11 0.27 1571 Other 0.09 0.24 1979 Casinos Out of Province Canadian 0.06 0.24 1571 Betting * Other 0.04 0.18 1979 Stocks or Internet Betting Canadian 0.02 0.17 1571 Other 0.04 0.24 1979 Ticket Betting * Canadian 0.65 0.71 1571 Other 0.57 0.65 1979 * Indicates significant results of an F-test indicating the proportion of those self-reporting as an ethnicity other than Canadian is significantly different from the proportion of those self-reporting as Canadian (p<.05)

When examining the gambling frequency score of those self-reporting as an ethnicity other than Canadian versus those self-reporting as Canadian, there were several significant relationships. For example, British, French, Middle Eastern and other Eastern Europeans (excluding Polish) engage more frequently than Canadians in stock market or internet betting. Italian respondents engage in social betting and sports betting more frequently than those self- identified as Canadian, while West Indian/ Caribbean respondents engage in social betting less frequently. South Asian, Chinese and Other East Asian (excluding Chinese), and African respondents engage less frequently in ticket betting, when compared to those who self-identified as Canadian. South Asian and Chinese respondents were also less likely to engage in casino betting. Both Dutch and African respondents had a lower overall gambling frequency score than respondents who self-identified as Canadian (see Table 9).

Table 9. Average Gambling Frequency Score for each Ethnicity compared to Self-Identified as Canadian Mean SD

Canadian Overall Gambling Frequency Score 0.17 0.21 Social Betting 0.08 0.26 Sports Betting 0.04 0.21 Casino Betting 0.11 0.27 Casinos Out of Province Betting 0.06 0.24 Stocks or Internet Betting 0.02 0.17 Ticket Betting 0.65 0.71 Irish Overall Gambling Frequency Score 0.17 0.20 Social Betting 0.08 0.29 Sports Betting 0.05 0.22 Casino Betting 0.09 0.23 Casinos Out of Province Betting 0.04 0.28 Stocks or Internet Betting 0.03 0.18 Ticket Betting 0.67 0.72 British Overall Gambling Frequency Score 0.16 0.20 Social Betting 0.07 0.25 Sports Betting 0.04 0.22 Casino Betting 0.10 0.26 Casinos Out of Province Betting 0.04 0.19 Stocks or Internet Betting * 0.05 0.25 Ticket Betting 0.61 0.65 Scottish Overall Gambling Frequency Score 0.16 0.18 Social Betting 0.07 0.22 Sports Betting 0.07 0.29 Casino Betting 0.11 0.23 Casinos Out of Province Betting 0.03 0.15 Stocks or Internet Betting 0.02 0.17 Ticket Betting 0.61 0.66 French Overall Gambling Frequency Score 0.17 0.16 Social Betting 0.07 0.21 Sports Betting 0.04 0.18 Casino Betting 0.09 0.18 Casinos Out of Province Betting 0.04 0.19 Stocks or Internet Betting * 0.06 0.28 Ticket Betting 0.68 0.69 Dutch Overall Gambling Frequency Score * 0.11 0.16 24

Social Betting 0.02 0.09 Sports Betting 0.01 0.05 Casino Betting 0.09 0.22 Casinos Out of Province Betting 0.04 0.19 Stocks or Internet Betting 0.00 0.00 Ticket Betting 0.47 0.69 German Overall Gambling Frequency Score 0.12 0.14 Social Betting 0.02 0.10 Sports Betting 0.03 0.15 Casino Betting 0.07 0.21 Casinos Out of Province Betting 0.03 0.17 Stocks or Internet Betting 0.03 0.16 Ticket Betting 0.55 0.65 Polish Overall Gambling Frequency Score 0.16 0.18 Social Betting 0.08 0.25 Sports Betting 0.03 0.16 Casino Betting 0.11 0.26 Casinos Out of Province Betting 0.00 0.00 Stocks or Internet Betting 0.04 0.29 Ticket Betting 0.63 0.63 Other Eastern European Overall Gambling Frequency Score 0.17 0.21 (excluding Polish) Social Betting 0.10 0.25 Sports Betting 0.08 0.30 Casino Betting 0.10 0.24 Casinos Out of Province Betting 0.05 0.19 Stocks or Internet Betting * 0.07 0.29 Ticket Betting 0.61 0.68 Italian Overall Gambling Frequency Score 0.18 0.21 Social Betting * 0.15 0.46 Sports Betting * 0.09 0.33 Casino Betting 0.10 0.22 Casinos Out of Province Betting 0.04 0.17 Stocks or Internet Betting 0.03 0.17 Ticket Betting 0.61 0.59 Other Southern European Overall Gambling Frequency Score 0.16 0.20 (excluding Italian) Social Betting 0.11 0.29 Sports Betting 0.08 0.27 Casino Betting 0.11 0.24 Casinos Out of Province Betting 0.03 0.16 Stocks or Internet Betting 0.02 0.12 Ticket Betting 0.57 0.62 South Asian Overall Gambling Frequency Score * 0.06 0.11 Social Betting 0.03 0.16 Sports Betting 0.02 0.12 Casino Betting * 0.02 0.08 Casinos Out of Province Betting 0.01 0.08 Stocks or Internet Betting 0.02 0.22 Ticket Betting * 0.26 0.39 Chinese Overall Gambling Frequency Score * 0.09 0.11 Social Betting 0.03 0.12 Sports Betting 0.03 0.15 Casino Betting * 0.04 0.12 Casinos Out of Province Betting 0.03 0.14 25

Stocks or Internet Betting 0.02 0.12 Ticket Betting * 0.39 0.47 Other East Asian (excluding Overall Gambling Frequency Score 0.12 0.20 Chinese) Social Betting 0.11 0.30 Sports Betting 0.07 0.27 Casino Betting 0.07 0.17 Casinos Out of Province Betting 0.03 0.12 Stocks or Internet Betting 0.01 0.07 Ticket Betting * 0.40 0.59 African Overall Gambling Frequency Score* 0.11 0.15 Social Betting 0.05 0.17 Sports Betting 0.05 0.21 Casino Betting 0.07 0.19 Casinos Out of Province Betting 0.00 0.00 Stocks or Internet Betting 0.00 0.00 Ticket Betting * 0.45 0.58 Middle Eastern Overall Gambling Frequency Score 0.16 0.19 Social Betting 0.14 0.36 Sports Betting 0.03 0.16 Casino Betting 0.10 0.20 Casinos Out of Province Betting 0.03 0.16 Stocks or Internet Betting * 0.08 0.27 Ticket Betting 0.54 0.65 West Indian/ Caribbean Overall Gambling Frequency Score 0.12 0.18 Social Betting * 0.01 0.06 Sports Betting 0.03 0.15 Casino Betting 0.10 0.26 Casinos Out of Province Betting 0.03 0.14 Stocks or Internet Betting 0.00 0.00 Ticket Betting 0.54 0.73 * Indicates the results of a F-test indicating the proportion is significantly different from those self-reporting as Canadian (p<.05)

Problem gambling by ethnicity The average PGSI score for all respondents who have gambled in the last 12 months was 0.47 (SD=2.11). With the exception of British respondents, there were no significant differences between respondents who self-identified as Canadian and any other ethnic group (see Table 10). On average, British respondents scored lower on PGSI items than their Canadian counterparts. Although the relationship was not significant, respondents of West Indian and East Asian descent had a higher average PGSI score than Canadians.

Table 10. PGSI score by ethnicity. Self reported ethnicity % (n)

Canadian 13.2 (136) Irish 11.2 (12) British 10 (26) Scottish 11.7(12) French 13.5 (14) Dutch 4.2 (1) German 8.9 (4) Polish* 27.0 (10) Other Eastern European (excluding Polish) 19.1 (9) Italian 11.6 (8) Other Southern European (excluding Italian) 22.0 (13) South Asian* 26.2 (11) Chinese 14.8 (8) Other East Asian (excluding Chinese)* 34.5 (10) African* 32.3 (10) Middle eastern 18.8 (8) West Indian/Caribbean 22.2 (8) * Indicates the results of a F-test indicating the proportion is significantly different from those self-reporting as Canadian (p<.05)

The vast majority of respondents in each ethnic group were classified as non-problem gamblers. As a result, when conducting a cross tabs analysis of PGSI level by ethnicity cell sizes were too small to provide meaningful results. Therefore PGSI scores were recoded into two categories: non-problem gamblers (PGSI score of 0) versus those who have had encountered any problems with gambling (PGSI score of 1 or more). The analysis below compares ethnic groups based this division.

Table11.Percentage of respondents endorsing one or more item on the PGSI by self-reported ethnicity. Self reported ethnicity % (n) Canadian 13.2 (136) Irish 11.2 (12) British 10 (26) Scottish 11.7(12) French 13.5 (14) Italian 11.6 (8) Other Southern European (excluding Italian) 22.0 (13) Chinese 14.8 (8) German 8.9 (4) South Asian* 26.2 (11) Polish* 27.0 (10) Other Eastern European (excluding Polish) 19.1 (9) Dutch 4.2 (1) African* 32.3 (10) Middle eastern 18.8 (8) West Indian/Caribbean 22.2 (8) Other East Asian (excluding Chinese)* 34.5 (10) * Indicates the results of a chi-square test indicating the proportion is significantly different from those self-reporting as Canadian (p<.05)

Dutch and German respondents were the least likely group to experience any problems as a result of their gambling, while respondents self-identifying as South Asian, Polish, African, and East Asian were more likely than Canadians to have scored 1 or more on the PGSI scale (see Table11). Awareness of problem gambling services by ethnicity As part of the survey respondents were asked a number of questions about their awareness of various problem gambling services. First, they were asked if they were aware of the Responsible Gambling Council of Ontario (RGCO). The results are presented in Table 12. Overall, 28.5% of Canadians are aware of the RGCO. Among the ethinic groups, Germans were the most likely group to be aware of RGCO while those of Other East Asian descent were least likely to be aware of RGCO. Furthermore, German respondents were significantly more likely than Canadians to be aware of RGCO, while South Asian, Chinese and other East Asians, as well as those of African descent were significantly less likely than Canadians to be aware of RGCO.

Table 12: Percent of respondents aware of the Responsible Gambling Council by self-reported ethnicity Self-reported ethnicity % (n) Canadian 28.5(446) Irish 27.8(47) British 25.4(99) Scottish 30.8(52) French 22.3(35) Dutch 25.9(14) German * 41.0(32) Polish 26.8(15) Other Eastern European (excluding Polish) 31.1(23) Italian 30.1(31) Other Southern European (excluding Italian) 26.1(24) South Asian * 12.0(12) Chinese * 16.0(15) Other East Asian (excluding Chinese) * 8.5(5) African * 14.8(8) Middle Eastern 22.2(10) West Indian/Caribbean 20.5(15) * Indicates the results of a chi-square test indicating the proportion is significantly different from those self-reporting as Canadian (p<.05)

Next, respondents were asked if they had seen any posters, signs or other forms of public service announcements related to problem or responsible gambling. Almost half of self- identified Canadians respondents (46.4%) have seen some kind of public service announcement related to gambling. Overall, those of Scottish and Dutch descent were most likely ethnic groups to have seen such announcements, while those of South Asian descent were least likely. Overall, South Asian, Chinese and other East Asian respondents, African, Middle Eastern, and those from West Indies/Caribbean were significantly less likely than Canadians to have seen public service announcements related to problem or responsible gambling. These results are presented in Table 13.

Table 13 Percent of Respondents who have seen a poster, sings, warning labels, or other forms of public service announcements related to problem or responsible gambling by self-identified ethnicity Self-Identified Ethnicity % (n) Canadian 46.4(728) Irish 47.4(81) British 46.8(182) Scottish 51.5(87) French 49.4(77) Dutch 50.0(27) German 40.3(31) Polish 42.9(24) Other Eastern European (excluding Polish) 41.7(30) Italian 43.1(44) Other Southern European (excluding Italian) 44.6(41) South Asian * 16.0(16) Chinese * 26.6(25) Other East Asian (excluding Chinese) * 25.9(15) African * 24.1(13) Middle Eastern * 30.4(14) West Indian/Caribbean * 32.9(24) * Indicates the results of a chi-square test indicating the proportion is significantly different from those self-reporting as Canadian (p<.05)

Respondents were asked if they were aware of the toll-free gambling helpline in Ontario (see Table 14). Among those self-identifying as Canadian, 39% were aware of such service. Overall, Irish, Dutch, and Polish respondents were most likely to have heard of the toll-free gambling helpline, while Chinese respondents were the least likely group to have heard of this service. Other Eastern European (excluding Polish), South Asian, Chinese, African, and West Indian/Caribbean respondents were significantly less likely than Canadians to be aware of the toll-free gambling helpline in Ontario.

Table 14.Awareness of the toll-free gambling helpline in Ontario by self-identified ethnicity. Self-Identified Ethnicity % (n) Canadian 39.2(617) Irish 43.5(74) British 37.9(147) Scottish 36.3(61) French 37.8(59) Dutch 40.7(22) German 37.2(29) Polish 40.4(23) Other Eastern European (excluding Polish) * 23.3(17) Italian 33.0(34) Other Southern European (excluding Italian) 35.2(32) South Asian * 23.2(23) Chinese * 17.2(16) Other East Asian (excluding Chinese) 31.0(18) African * 24.1(13) Middle Eastern 30.4(14) West Indian/Caribbean * 22.5(16) * Indicates the results of a chi-square test indicating the proportion is significantly different from those self-reporting as Canadian (p<.05)

Finally, respondents were asked if they were aware of any gambling counseling services available in their community. Overall, few respondents were aware of such services, with only 18% of self-identified Canadians being aware of these counseling services. Other Eastern European (excluding Polish) and Irish respondents were most likely to have heard about gambling counseling services available in the community, while Dutch, West Indian/Caribbean and Dutch respondents were the least likely group to be aware of such service. In fact, Dutch, Other Southern European (excluding Italian) and West Indian/Caribbean respondents were significantly less likely to be aware of gambling counseling services in their community.

Table 15. Percent of respondents who are aware of any gambling counseling services available in their community by self-identified ethnicity Self-identified Ethnicity % (n) Canadian 18.4 (288) Irish 23.8 (40) British 17.8 (69) Scottish 16.1 (27) French 17.3 (27) Dutch * 7.5 (4) German 14.3 (11) Polish 16.1 (9) Other Eastern European (excluding Polish) 24.3 (18) Italian 18.6 (19) Other Southern European (excluding Italian) * 8.9 (8) South Asian 12.0(12) Chinese 10.8(10) Other East Asian (excluding Chinese) 11.9(7) African 11.1(6) Middle Eastern 17.8(8) West Indian/Caribbean * 8.3(6) * Indicates the results of a chi-square test indicating the proportion is significantly different from those self-reporting as Canadian (p<.05) 32

Summary of results Table 16. Summary table of results. Up arrows ( ) indicate the group mean /percentage was significantly greater than the comparison group (i.e., those self- reporting as ‘Canadian’) and down arrows ( ) indicate the group mean/percentage was significantly less than the comparison group. Self- Gambling Gambling Frequency on specific types of gambling a Problem Awareness of responsible/problem gambling services reported Participation Gambling ethnicity % who have Overall Social Sports Casino Casino Stocks/ Ticket % with % Heard of % reporting % aware % aware gambled in Betting Betting Betting Betting Internet Betting >= 1on the RGCO exposure to of toll of past 12 Outside Betting the PGSI problem or free gambling months Ontario responsible gamblin counseling gambling g help services information line Irish British

Scottish French

Dutch

German

Polish

Other

Eastern European (excluding Polish) Italian

Other Southern European (excluding Italian) South Asian

Chinese

Other East

Asian (excluding Chinese) 33

African

Middle

Eastern West Indian/

Caribbean a Scores range from 0 to 4 (0 = never participated in this gambling activity, 1 = less than once in the past month, 2 = at least once a month, 3 = at least once a week, and 4 = daily 34

DISCUSSION

The research presented in the preceding report was conducted to better understand the nature of gambling and problem gambling in Ontario Ethno-cultural communities. In Part I we conducted a systematic search of the literature and found only two recent (i.e., past decade) prevalence studies conducted in Ontario that assessed gambling and problem gambling in ECCs. Taken together, these studies revealed no clear pattern regarding the prevalence of gambling and PG among Ontario ECCs. However, both studies were secondary analyses of data collected for purposes other than to assess gambling and PG among ethnic communities. Therefore neither study used methods required to accurately assess gambling or PG prevalence rates in ECCs (e.g., stratified sampling designed to acquire representative samples from the largest ECCs in Ontario, offering the survey in multiple languages to avoid non-random response bias in favour of English speaking members of ECCs). In Part II of the current report we conducted secondary analysis of the 2005 Ontario Gambling Prevalence dataset in order to further assess the prevalence of gambling and PG among Ontario ECCs. The key findings are presented in Table 16 and are as follows.

Compared to those self-identifying as „Canadian‟:

 Those self-identifying as Irish, Scottish, and Other Southern European (excluding Italian) were not significantly different on any of the variables assessed  Those self-identifying as British and French reported gambling on stocks/internet significantly more frequently than „Canadians‟  A significantly smaller proportion of those self-identifying as Dutch reported past year gambling, reported gambling less frequently, and were significantly less likely to be aware of gambling counseling services  A significantly larger proportion of those self-identifying as Polish endorsed one or more item on the PGSI.  A significantly larger proportion of those self-identifying as German indicated they were aware of the RGCO.  Those who self-identified as another Eastern European (excluding Polish) ethnicity reported gambling on stocks/internet significantly more frequently and were less likely to be aware of the Ontario gambling help line or other gambling counseling services.  Those who self-identified as Italian reported social betting and sports betting significantly more frequently  A significantly smaller proportion of those self-identified as South Asian reported past year gambling, they also reported gambling less frequently (particularly so on Casino and ticket gambling). However a significantly greater proportion endorsed one or more symptom of problem gambling (PGSI). They were also less likely to be aware of responsible/problem gambling services.  Those who self-identified as Chinese reported gambling significantly less frequently (Casino betting, ticket betting). They were also less likely to be aware of responsible/problem gambling services.  A significantly smaller proportion of those self-identified as other East Asian (excluding Chinese) reported past year gambling, they also reported ticket betting. However a significantly greater proportion endorsed one or more symptom of problem 35

gambling (PGSI). They were also less likely to be aware of responsible/problem gambling services.  Those who self-identified as African reported gambling significantly less frequently (ticket betting less frequently). However a significantly greater proportion endorsed one or more symptom of problem gambling (PGSI). They were also less likely to be aware of responsible/problem gambling services.  The group with the highest prevalence of past-year gambling participation were those self-identifying as Middle Eastern (though not significantly greater than „Canadian‟). They also reported stock/internet betting significantly more frequently  Finally, a significantly smaller proportion of those self-identified as West Indian/Caribbean reported past year gambling. They also reported engaging in social betting significantly less frequently and were less likely to be aware of responsible/problem gambling services.

Limitations As the sample for this data set was selected via random digit dialling and not stratified by ethnicity, sample sizes of many ethnic groups were too small to detect significant differences from the mainstream population of respondents self-identifying as „Canadian‟. This was particularly true when assessing gambling problems, less so when examining gambling participation or awareness of responsible/problem gambling services. Another limitation to the current study is the response rate. Recall that two response rates were calculated for this study. The first calculation of 82.5% is the response rate among those who were proficient in English and were capable to complete the survey. The second response rate of 46.4% is the rate achieved without consideration of language or capacity. Given that it is possible many members of ECCs are not proficient in English, it is likely that they were perhaps screened out of the survey. If one is to accurately assess the gambling participation and PG rates among ECCs, the survey methodology will need to be capable of asking the questions in multiple languages. Otherwise it is likely that those who do not have a sufficient command of the English will be screened out. This will likely systematically influence estimates of gambling and PG among some groups given that language barriers may be a factor influencing PG rates among some ECCs (Young et al., 2010) Recommendations Though the current report adds to the body of evidence regarding prevalence of gambling and PG in ECCs, there are limitations. To accurately assess the prevalence of gambling and PG in ECCs it is recommended that a study that aims to survey ECCs as it‟s primary goal be conducted. This survey would sample in such way to achieve adequate sample sizes of all the major ECCs in Ontario and would enable members of these communities to answer questions in their native language.

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APPENDIX B : GAMBLING PARTICIPATION AND PROBLEM GAMBLING PREVALENCE IN ONTARIO

Adlaf, E. M., Demers, A., & Gliksman, L. (2005). Canadian campus survey 2004. Toronto, ON: Centre for Addiction and Mental Health. http://www.camh.net/Research/Areas_of_research/Population_Life_Course_Studies/CCS_ 2004_report.pdf

Adlaf, E. M., Paglia, A., & Beitchman, J. H. (2006). The mental health and well-being of Ontario students 1991-2005 : Detailed OSDUS findings. Toronto, ON: Centre for Addiction and Mental Health. http://www.camh.net/Research/Areas_of_research/Population_Life_Course_Studies/OSDU S/OSDUS2005_mental_detailed_fnl.pdf

Adlaf, E. M., & Ialomiteanu, A. (2000). Prevalence of problem gambling in adolescents: Findings form the 1999 ontario student drug use survey. The Canadian Journal of Psychiatry / La Revue Canadienne De Psychiatrie, 45(8), 752-755. Determined the prevalence of gambling disorders in adolescent students in Ontario and described the psychometric characteristics of the South Oaks Gambling Screen revised for adolescents (SOGS-RA). Data were based on a random survey of 2,371 Ontario students in grades 7 to 13 using the SOGS-RA. In total, 5.8% of students met the criteria for past-year problem gambling, and an additional 7.5% met the criteria for at-risk gambling. Gambling disorders were significantly higher among male students than female, but did not differ significantly by age or region. The SOGS-RA has a mean of 0.68 and standard deviation of 2.15 and a reliability alpha of 0.82, with distributions similar to those of other studies. The prevalence of gambling disorders among adolescents warrants thorough investigation and ongoing monitoring. (PsycINFO Database Record (c) 2010 APA, all rights reserved)

Alberta Alcohol and Drug Abuse Commission. (2003). Alberta, ontario and nova scotia substance use and gambling activities (profile). Edmonton, AB: Author. http://www.aadac.com/documents/profiles_ab_on_ns_substance_use.pdf

Azmier, J. J. (2000). Canadian gambling behaviour and attitudes : Main report (gambling in canada research report ; no. 11). Calgary, AB: Canada West Foundation.

Azmier, J. J. (2005). Gambling in canada 2005: Statistics and context. Calgary, AB: Canada West Foundation. https://dspace.ucalgary.ca/bitstream/1880/47412/1/GamblingInCanada.pdf

Azmier, J., & Smith, G. (1998). The state of gambling in canada : An interprovincial roadmap of gambling and its impact. Calgary, AB: Canada West Foundation.

Canadian Centre on Substance Abuse. (1998). Problem gambling across canada. Ottawa, ON: Author. http://www.ccsa.ca/2003%20and%20earlier%20CCSA%20Documents/ccsa-009383- 1998.pdf 49

Centre for Addiction and Mental Health. (2005). Internet gambling among ontario adults. CAMH Populations Studies Ebulletin, 6(4), 1-2. http://www.camh.net/Research/Areas_of_research/Population_Life_Course_Studies/eBulle tins/ebv6n4_InternetGambling200003.pdf

Chipman, M., Govoni, R., Jazmaji, V., Wilson, S., & Gao, P. (2008). High vs. low risk gambling: What is the difference?Ontario Problem Gambling Research Centre. http://www.gamblingresearch.org/download.php?docid=10542

Cox, B. J., Yu, N., Afifi, T. O., & Ladouceur, R. (2005). A national survey of gambling problems in canada. Canadian Journal of Psychiatry.Revue Canadienne De Psychiatrie, 50(4), 213-217. OBJECTIVE: The 1990s saw widespread expansion of new forms of legalized gambling involving video lottery terminals (VLTs) in community settings (that is, in bars and restaurant lounges) and permanent casinos in several Canadian provinces. To date, there has never been a national survey of gambling problems with representative interprovincial data. Using a new survey, we sought to compare prevalence figures across the 10 Canadian provinces. METHOD: Using the Canadian Problem Gambling Index, we investigated the current 12-month prevalence of gambling problems in the Canadian Community Health Survey: Cycle 1.2--Mental Health and Well-Being, in which a random sample of 34,770 community-dwelling respondents aged 15 years and over were interviewed. The response rate was 77%. The data are representative at the provincial level and were compared with the availability of VLTs per 1000 population and with the presence of permanent casinos for each province. RESULTS: Manitoba (2.9%) and Saskatchewan (also 2.9%) had the highest prevalence of gambling problems (specifically, moderate and severe problem levels combined). These 2 provinces had significantly higher levels than the 2 provinces with the lowest prevalence of gambling problems: Quebec (1.7%) and New Brunswick (1.5%). CONCLUSIONS: The 12-month prevalence of gambling problems in Canada was 2.0%, with interprovincial variability. The highest prevalence emerged in areas with high concentrations of VLTs in the community combined with permanent casinos. These findings support earlier predictions that the rapid and prolific expansion of new forms of legalized gambling in many regions of the country would be associated with a considerable public health cost.

Currie, S. R., Hodgins, D. C., Wang, J., el-Guebaly, N., Wynne, H., & Miller, N. V. (2008). Replication of low-risk gambling limits using canadian provincial gambling prevalence data. Journal of Gambling Studies / Co-Sponsored by the National Council on Problem Gambling and Institute for the Study of Gambling and Commercial Gaming, 24(3), 321- 335. A set of low-risk gambling limits were recently produced using Canadian epidemiological data on the intensity of gambling behavior and related consequences (Currie et al. Addiction 101:570-580, 2006). The empirically derived limits (gambling no more than two to three times per month, spending no more than $501-$100o CAN per year or no more than 1% of gross income spent on gambling) accurately predicted risk of gambling-related harm after controlling for other risk factors. The present study sought to replicate these limits on data collected in three independently conducted Canadian provincial gambling 50

surveys. Dose-response curves and logistic regression analyses were applied to gambling prevalence data collected in surveys conducted in 2001-2002 within the provinces of Alberta, British Columbia, and Ontario (combined sample N = 7,675). A comparable dose- response relationship between gambling intensity and risk of harm was found in each province. The optimal thresholds for defining an upper limit of low-risk gambling were similar across the three provinces despite variations in the availability and organization of legalized gambling opportunities within each region. These results provide additional evidence supporting the validity of the low-risk gambling limits. Quantitative limits could be used to augment existing responsible gambling guidelines.

Huang, J. H., & Boyer, R. (2007). Epidemiology of youth gambling problems in canada: A national prevalence study. Canadian Journal of Psychiatry.Revue Canadienne De Psychiatrie, 52(10), 657-665. OBJECTIVES: To describe the epidemiology of gambling problems among youth aged 15 to 24 years in Canada and to examine whether these gambling prevalence patterns differ by sex and (or) by geographic region. METHOD: We used data from The Canadian Community Health Survey: Mental Health and Well-Being. Gambling problems were determined according to the Canadian Problem Gambling Index. All prevalence estimates used appropriate sampling weights and bootstrap variance estimation procedures developed by Statistics Canada. Multivariate logistic regression modelling was also employed to supplement the above prevalence comparisons by age, sex, and region. RESULTS: Among Canadian youth aged 15 to 24 years (n=5666), 61.35% gambled in the past 12 months and the national prevalence of moderate-risk or problem gambling was 2.22% (3.30% in male respondents and 1.10% in female respondents). Male respondents had significantly higher prevalence of gambling problems than female respondents. Regional prevalence estimates of youth moderate-risk or problem gambling were 1.37% in British Columbia, 2.17% in the Prairie provinces, 2.75% in Ontario, 2.12% in Quebec, and 1.71% in the Atlantic provinces. CONCLUSIONS: Youth, particularly young men, are at greater risk for gambling problems than adults. More prevention and research efforts are also needed to address the observed sex differences and interregional variability in the prevalence of gambling problems among youth. The national prevalence estimates from this study provide important baseline data against which future cohorts of Canadians can be monitored and measured.

Insight Canada Research (1993). Prevalence of problem & pathological gambling in Ontario using the South Oaks Gambling Screen. Toronto, ON: Canadian Foundation on Compulsive Gambling (Ontario)

Lai, D. W. L. (2011). Gambling and experience of ethno-cultural minorities. A poster presentation at Lost in Translation: Seeking Answers in Addiction and Concurrent Disorders. University of British Columbia Point Grey Campus, Life Sciences Institute. https://dspace.ucalgary.ca/bitstream/1880/48427/1/Lai_Gambling_Ethnocultural_Minoritie s_Feb_2011.pdf

Lai, D. W. (2006). Gambling and the older chinese in canada. Journal of Gambling Studies / Co-Sponsored by the National Council on Problem Gambling and Institute for the Study of 51

Gambling and Commercial Gaming, 22(1), 121-141. In Canada, there is a lack of research on gambling among the older adults from ethnic minority groups, especially the older Chinese. In this study, two research questions were used to examine gambling among the older Chinese: (1) What is the pattern of gambling among the older Chinese in Canada? (2) What are the predictors associated with gambling among the older Chinese in Canada? The data for this study were collected as part of a multi-site study on health and well-being of 2272 older Chinese in Canada. Four main questions related to gambling were used in this study. Among the 2257 participants who answered the questions on gambling, 26.6% of them reported that they gambled. Results of the hierarchical logistic regression analysis showed that being male, having lived in Canada longer, having a higher level of social support, having more service barriers, and having a stronger level of Chinese ethnic identity would increase the probability for an older Chinese to participate in gambling. Conversely, having a post-secondary and above level of education and having a higher level of life satisfaction would reduce one's probability of gambling. Although city of residency was also significant in predicting gambling, further analysis showed that its effect was actually caused by other factors including services barriers, social support, life satisfaction, Chinese ethnic identity, and education.

MacNeil, P., & Webster, I. (1994). Canada's alcohol and other drugs survey 1994 : A discussion of the findings. Ottawa, ON: Health Canada. http://dsp-psd.pwgsc.gc.ca/Collection/H39-338-1-1994E.pdf

Munro, B. (2003). Seniors who gamble: A summary review of the literature. Edmonton, Alberta: The Alberta Gaming Research Institute. https://dspace.ucalgary.ca/bitstream/1880/1631/1/Munro_Seniors.pdf

Papoff, K. M., & Norris, J. E. (2009). Instant ticket purchasing by ontario baby boomers: Increasing risk for problem gamblers. Journal of Gambling Studies / Co-Sponsored by the National Council on Problem Gambling and Institute for the Study of Gambling and Commercial Gaming, 25(2), 185-199. Instant ticket purchase gambling (ITPG) is pervasive in Ontario and has features that mimic slot machine play. Previous researchers have reported that ITPG is one preferred activity for at-risk/problem gamblers. In the general Canadian population, rate of participation in ITPG is second only to lottery ticket gambling. Both are particularly favored by youth and seniors. The next cohort of seniors will be Canada's baby boomers, one-third of whom live in Ontario. Secondary analysis of Statistics Canada data revealed that adults in this cohort 52

who buy instant gambling tickets (N = 1781) are significantly different from the complete group of their age peers (N = 4266) in number of activities pursued and frequency of involvement. At-risk/problem gambling prevalence was 10.2% amongst Ontario baby boomers who participate in instant ticket gambling, significantly higher than the 6.7% found amongst the total group of baby boom gamblers. For those who reported experiencing one or more of the Canadian Problem Gambling Index indicators for problem gambling (N = 237), 73% were buying instant tickets. Future research should consider cohort effects and explore combinations of preferred gambling activities that may increase risk for problem gambling. Social policy recommendations include the use of all ITPG venues as key locations for promoting awareness of problem gambling treatment services.

Room, R., Turner, N. E., & Ialomiteanu, A. (1999). Community effects of the opening of the niagara casino. Addiction (Abingdon, England), 94(10), 1449-1466. AIMS: The impacts on the community of the opening of a casino in Niagara Falls are studied. DESIGN: The study uses a pre/post design for the community data, with pre/post data from Ontario as a whole as a comparison. SETTING: The study site is the city of Niagara Falls, Ontario, where a casino opened in early December, 1996. PARTICIPANTS: Using random-digit dialing, telephone interviews were conducted with adult residents of Niagara Falls in 1996 and 1997, and with adult residents of Ontario in 1995 and 1997. MEASUREMENTS: Aside from demographic variables, measures included general attitudes to gambling, expectations about (1996) and experiences with (1997) the casino's opening, extent of participation in 11 types of gambling and 18 items on problems with gambling: five key items from a standard gambling problems score (SOGS), five life-area problems items, and items on pressures from others concerning the respondent's gambling and on gambling problems among family and friends. FINDINGS: Attitudes to gambling remained stable in Niagara Falls, while there was some evidence of decline in approval in Ontario as a whole. While strong majorities of 1996 respondents had expected many positive and negative effects on The Community of the Casino's opening, Significantly fewer respondents in 1997 reported actually experiencing most of these effects. While a small increase in employment was found, it fell far below projections, a result probably reflecting displacement effects. The rate and level of casino gambling increased in Ontario, but increased even more in Niagara Falls, with little displacement of other gambling. Reported gambling problems increased significantly in Niagara Falls for two of 10 gambling problem items and for the short SOGS score, while rates were generally stable or declining in the province. Pressure from others about gambling rose significantly in Niagara Falls (in contrast to the province), and reported rates of family members or friends with gambling problems also rose substantially. There was an increasing trend in Niagara Falls for all 18 problem indicators. CONCLUSIONS: The casino's opening brought more gambling by local residents, and an increase in reported gambling problems; yet support for the casino, already strong, if anything grew. At least in the short term, problems from the increased availability of gambling manifested themselves not in the public arena but rather in the arena of private life.

This study examined geographic variation in the prevalence of problem gambling in Ontario and the association with various demographic factors and proximity to treatment for problem gambling and gambling venues. Drawing upon multiple sources, secondary data analysis was undertaken based on multivariate statistical methods and techniques of geographic information systems (GIS). Regional variation in prevalence of problem gambling was found in the province. Prevalence of problem gambling was associated with many demographic characteristics, as well as mental disorders, co-occurring substance abuse problems, and physical health status. Geographic access to treatment was not associated with the risk of being a problem gambler. However, proximity to gambling venues was marginally important in predicting risk of problem gambling. Results are interpreted in the context of needs-based planning of treatment and prevention programs for problem gambling. (PsycINFO Database Record (c) 2010 APA, all rights reserved)

Smart, R. G., & Ferris, J. (1996). Alcohol, drugs and gambling in the ontario adult population, 1994. Canadian Journal of Psychiatry.Revue Canadienne De Psychiatrie, 41(1), 36-45. OBJECTIVE: To demonstrate the link between gambling, alcohol and drug problems among Ontario adults and to present information on the relationship between expenditures on gambling and type of gambling with gambling problems. METHOD: Using data collected in a 1994 telephone survey of 2,016 randomly chosen Ontario adults, gambling problems are related to the CAGE scale of alcohol problems and the ICD-10 measure of alcohol dependence, as well as smoking, other drug use, and demographic variables. Descriptive tables based on crosstabulations and means are provided, as well as a series of 9 logistic regression models. RESULTS: The most significant predictor of gambling problems was the amount spent on gambling in the preceding 30 days, with alcohol dependence on the ICD-10 scale and age also important predictors. Lottery players, compared to other gamblers, are more likely to be male, relatively less affluent, older on average, more likely to report alcohol problems (but not dependence) and be currently smoking. CONCLUSIONS: The results make clear that heavy drinking and drinking problems are associated with higher levels of spending on gambling and reports of gambling problems. This leads to the suggestion that treatment programs for those with gambling, alcohol or other drug problems should assess that possibility of comorbidity, since the presence of more than one of these problems can significantly affect the success of treatment and contribute to relapse.

Tepperman, L., Kwan, A., Jones, C., & Falkowski-Ham, A. (2004). Dreaming the Numbers: Ethnocultural Gambling in Ontario. Guelph, Ontario: Ontario Problem Gambling Research Centre. http://www.gamblingresearch.org/download.php?docid=6273

Wiebe, J., Single, E., & Falkowski-Ham, A. (2001). Measuring gambling and problem gambling in ontarioCanadian Centre on Substance Abuse, Responsible Gambling Council 54

(Ontario). http://www.responsiblegambling.org/articles/CPGI_report-Dec4.pdf

Wiebe, J., & Turner, N. (2008). Gambling patterns & problem gambling service utilization by ontario local health integration networksOntario Problem Gambling Research Centre. http://www.gamblingresearch.org/download.php?docid=10415

Williams, R. J., & Volberg, R. A. (2010). Best practices in the population assessment of problem gambling. Guelph, Ontario: Ontario Problem Gambling Research Centre. http://www.gamblingresearch.org/download.php?docid=11224

Williams, R. J., & Wood, R. T. (2007). Internet gambling: A comprehensive review and synthesis of the literature. Guelph, Ontario: Ontario Problem Gambling. http://www.uleth.ca/dspace/bitstream/10133/432/1/2007-InternetReview-OPGRC.pdf

Wood, R. T., & Williams, R. J. (2008). Internet gambling: Prevalence, patterns, problems, and policy options. Guelph, Ontario: Ontario Problem Gambling Research Centre. https://www.uleth.ca/dspace/bitstream/handle/10133/693/2009-InternetPPPP- OPGRC.pdf?sequence=4

Young, M., Sztainert, T., & Santoro, M. (2010). The treatment and prevention of problem gambling in ontario ethno-cultural communitiesOntario Problem Gambling Research Centre.

APPENDIX C: GAMBLING PARTICIPATION AND PROBLEM GAMBLING PREVALENCE BY ETHNICITY IN ONTARIO

Faveri, A., & Gainer, L. (1995). A report on gambling activities and related issues among clients of multicultural service providers in ontario. Toronto: Addiction Research Foundation, University Settlement Recreation Centre and Chinese Family Life Services of Metro Toronto.

Insight Canada Research (1993). Prevalence of problem & pathological gambling in Ontario using the South Oaks Gambling Screen. Toronto, ON: Canadian Foundation on Compulsive Gambling (Ontario).

Kwan, K. (1998). Gambling alcohol and other drug uses among chinese adults in greater toronto: A summary report of a telephone survey. Toronto: Chinese Family Life Services of Metro Toronto.

Lai, D. W. (2006). Gambling and the older chinese in canada. Journal of Gambling Studies / Co-Sponsored by the National Council on Problem Gambling and Institute for the Study of Gambling and Commercial Gaming, 22(1), 121-141. In Canada, there is a lack of research on gambling among the older adults from ethnic minority groups, especially the older Chinese. In this study, two research questions were used to examine gambling among the older Chinese: (1) What is the pattern of gambling among the older Chinese in Canada? (2) What are the predictors associated with gambling among the older Chinese in Canada? The data for this study were collected as part of a multi-site study on health and well-being of 2272 older Chinese in Canada. Four main questions related to gambling were used in this study. Among the 2257 participants who answered the questions on gambling, 26.6% of them reported that they gambled. Results of the hierarchical logistic regression analysis showed that being male, having lived in Canada longer, having a higher level of social support, having more service barriers, and having a stronger level of Chinese ethnic identity would increase the probability for an older Chinese to participate in gambling. Conversely, having a post-secondary and above level of education and having a higher level of life satisfaction would reduce one's probability of gambling. Although city of residency was also significant in predicting gambling, further analysis showed that its effect was actually caused by other factors including services barriers, social support, life satisfaction, Chinese ethnic identity, and education.

APPENDIX D: ONTARIO 2005 QUESTIONNAIRE

HITACHI RESEARCH

INTERVIEWER: PHONE: ( ______) - ______- ______

(1) Hi, my name is (first & last) and I‟m calling from a research Centre at the University of Toronto. We are (describe organization)……….. and today we‟re calling a random sample of 3000 Ontario residents on behalf of the Responsible Gambling Council of Ontario, a non-profit organization aimed at reducing gambling-related problems. As you probably know, in recent years opportunities to gamble have become more common in Ontario and this has resulted in both positive and negative effects on individuals as well as society. The Responsible Gambling Council is conducting a study to determine adult Ontarians‟ attitudes and behaviours towards gambling and we would like to include your views, regardless of whether you gamble or not. Your input is most valuable for determining the extent of gambling participation in Ontario and minimizing any related problems. For the purposes of this study we would like to speak to the person living in your household who is 18 or over, and whose birthday will come next. Would that be you?

IF NO, ASK TO SPEAK TO THE PERSON WHO DOES MEET THE REQUIREMENTS. IF THE PERSON WHO MEETS THE REQUIREMENTS IS NOT AT HOME, ASK FOR ANY PERSON WHO IS 18 OR OVER. IF NO ONE PRESENTLY AT HOME QUALIFIES, ARRANGE A TIME TO CALL BACK.

(2) The survey will take no more than 20 minutes of your time. You can quit the survey at any time, or refuse to answer any question. All of your answers will remain confidential; you will not be identified in any report that may arise from this study. Only the researchers on this project will have access to all of the information collected. If the data is shared with other researchers in the future, all identifiers would be removed.

(3) If you want further information on this study, you may call a toll free number from the University of Toronto (insert U of T number here) or the Responsible Gambling Council (1-888-391-1111)

(4) Would you be willing to participate?

(5) The survey will ask you questions in the following areas: • Gambling behaviours and other leisure spending activities • Difficulties you may have experienced from your own or someone else‟s gambling • Your background such as level of education, and marital and financial status

AWARENESS Q1 Before this survey, had you heard of the Responsible Gambling Council of Ontario? Yes...... #1 No...... #2 Don‟t know...... #3 Refused...... #4

Q2 Have you seen any posters, signs, warning labels, or other forms of public service announcements related to problem or responsible gambling? Yes...... #1 No...... #2 GO TO Q3 Don‟t know...... #5 GO TO Q3 Refused...... #6 GO TO Q3

Q2A Where did you see them? (CHECK ALL THAT APPLY) At gambling venues (e.g., casinos, racetracks)...... #1 On gaming products themselves (e.g., lottery tickets, slots)...... #2 Television advertisement/PSA...... #3 Television program (e.g., talk show, news programs)...... #4 Radio...... #5 Newspaper/Magazines...... #6 Internet...... #7 Outdoor advertisement ...... #8 School...... #9 Books/other media...... #10 Mail...... #11 Conversation with others ...... #12 Don‟t know...... #13 Refused...... #14

Q3 Are you aware of the toll free gambling help line in Ontario? Yes...... #1 No...... #2 Don‟t know...... #3 Refused...... #4

Q4 Are you aware of any gambling counseling services available in your community? Yes...... #1 No...... #2 GO TO Q5 Don‟t know...... #3 GO TO Q5 Refused...... #4 GO TO Q5

Q4A What are they? (CHECK ALL THAT APPLY) Gamblers Anonymous...... #1 Doctors/medical professions (e.g., psychiatrist)...... #2 Addictions Centre...... #3 Psychologist/social worker...... #4 Other (specify)...... #5 Don‟t know...... #3 GO TO Q5 Refused...... #4 GO TO Q5

GAMBLING ACTIVITIES INTERVIEWER: IF NON-GAMBLER STARTS GETTING IMPATIENT: Please bear with me, I need to take about 30 seconds to ask about these activities to ensure that you get the proper questions. a) Lottery tickets like 649, Super 7, Pick 3 or Lottario b) Instant win or scratch tickets like break open, pull tab or Nevada strips c) Raffles or fundraising tickets d) Horse races - both live at track and off track betting e) Bingo f) Coin slot machines in ONTARIO COMMERCIAL or CHARITY casino g) Games other than slot machines at an ONTARIO COMMERCIAL or CHARITY casino such as poker, blackjack, roulette or keno g) Coin slot machines at an Ontario RACETRACK i) Coin slot machines or video lottery terminals (VLTs) OUTSIDE of Ontario j) Sport select like Pro line, over/under and point spread k) Sports pools or outcome of sporting events l) Cards or board games anywhere other than at a casino such as at home, a friends house, work or card rooms m) Games of skill such as pool, bowling or darts n) Arcade or video games o) Internet which includes day trading, casino table games, VLTs/slot machines, poker and sports betting p) Sports with a bookie/bookmaker q) Short-term speculative stock or commodity purchases such as day trading,but not including long term investments such as mutual funds or RRSPs r) Casinos out of province such as at Las Vegas, Atlantic City or another province

For those that are “yes” go to frequency questions

Q5 In the past 12 months, how often did you spend money on Lottery tickets like the 649, Super 7, Pick 3 or Lottario? Would you say daily, at least once a week (but not daily), at least once a month (but not weekly), less than once a month or never? Daily...... #1 At least once a week...... #2 At least once a month...... #3 Less than once a month...... #4 Never...... #5 (DO NOT READ) Don‟t know...... #6 Refused...... #7

Q6 In the past 12 months, how often did you spend money on instant win or scratch tickets like break open, pull tab or Nevada strips? Would you say daily, at least once a week (but not daily), at least once a month (but not weekly), less than once a month or never? Daily...... #1 At least once a week...... #2 At least once a month...... #3 Less than once a month...... #4 Never...... #5 (DO NOT READ) 60

Don‟t know...... #6 Refused...... #7

Q7 In the past 12 months, how often did you bet or spend money on raffles or fundraising tickets? Would you say daily, at least once a week (but not daily), at least once a month (but not weekly), less than once a month or never? Daily...... #1 At least once a week...... #2 At least once a month...... #3 Less than once a month...... #4 Never...... #5 (DO NOT READ) Don‟t know...... #6 Refused...... #7

Q8 In the past 12 months, how often did you bet or spend money on horseraces (i.e. live at the track or off track)? Would you say daily, at least once a week (but not daily), at least once a month (but not weekly), less than once a month or never? Daily...... #1 At least once a week...... #2 At least once a month...... #3 Less than once a month...... #4 Never...... #5 GO TO Q9 (DO NOT READ) Don‟t know...... #6 GO TO Q9 Refused...... #7 GO TO Q9

Q8A Roughly how much time do you spend on horse races in a typical month? IF ONLY MINUTES, ENTER 0 FOR HOURS. Hours______Don‟t know...... #98 Refused...... #99

Q8B Roughly how much money do you spend on horse races in a typical month? (ENTER NUMBER OF DOLLARS). ROUND UP TO NEAREST DOLLAR. $______Don‟t know...... #98 Refused...... #99

Q9 In the past 12 months, how often did you bet or spend money on bingo? Would you say daily, at least once a week (but not daily), at least once a month (but not weekly), less than once a month or never? Daily...... #1 At least once a week...... #2 At least once a month...... #3 Less than once a month...... #4 Never...... #5 GO TO Q10 (DO NOT READ) Don‟t know...... #6 GO TO Q10 Refused...... #7 GO TO Q10

Q9A Roughly how much time do you spend on bingo in a typical month? IF ONLY MINUTES, ENTER 0 FOR HOURS. Hours______Don‟t know...... #98 Refused...... #99

Q9B Roughly how much money do you spend on bingo in a typical month? (ENTER NUMBER OF DOLLARS). ROUND UP TO NEAREST DOLLAR. $______Don‟t know...... #98 Refused...... #99

Q10 In the past 12 months, how often did you bet or spend money on coin slot machines in an Ontario commercial or charity casino? Would you say dailyat least once a week (but not daily), at least once a month (but not weekly), less than once a month or never? Daily...... #1 At least once a week...... #2 At least once a month...... #3 Less than once a month...... #4 Never...... #5 GO TO Q11 (DO NOT READ) Don‟t know...... #6 GO TO Q11 Refused...... #7 GO TO Q11

Q10A Roughly how much time do you spend on these coin slot machines in a typical month? IF ONLY MINUTES, ENTER 0 FOR HOURS. Hours______Don‟t know...... #98 Refused...... #99

Q10B Roughly how much money do you spend on these coin slot machines a typical month? (ENTER NUMBER OF DOLLARS). ROUND UP TO NEAREST DOLLAR. $______...... Don‟t know...... #98 Refused...... #99

Q11 In the past 12 months, how often did you bet or spend money on games other than slot machines in an Ontario commercial or charity casino such as poker, blackjack, roulette or keno? Would you say daily, at least once a week (but not daily), at least once a month (but not weekly), less than once a month or never? Daily...... #1 At least once a week...... #2 At least once a month...... #3 Less than once a month...... #4 Never...... #5 GO TO Q12 (DO NOT READ) Don‟t know...... #6 GO TO Q12 Refused...... #7 GO TO Q12

Q11A Roughly how much time do you spend on these games in a typical month? 62

IF ONLY MINUTES, ENTER 0 FOR HOURS. Hours______Don‟t know...... #98 Refused...... #99

Q11B Roughly how much money do you spend on these games in a typical month? (ENTER NUMBER OF DOLLARS). ROUND UP TO NEAREST DOLLAR. $______Don‟t know...... #98 Refused...... #99

Q12 In the past 12 months, how often did you bet or spend money on coin slot machines at an Ontario racetrack? Would you say daily, at least once a week (but not daily), at least once a month (but not weekly), less than once a month or never? Daily...... #1 At least once a week...... #2 At least once a month...... #3 Less than once a month...... #4 Never...... #5 GO TO Q13 (DO NOT READ) Don‟t know...... #6 GO TO Q13 Refused...... #7 GO TO Q13

Q12A Roughly how much time do you spend on these coin slot machines in a typical month? IF ONLY MINUTES, ENTER 0 FOR HOURS. Hours______Minutes______More than 8 hours...... #97 Don‟t know...... #98 Refused...... #99

Q12B Roughly how much money do you spend on these coin slot machines in a typical month? (ENTER NUMBER OF DOLLARS). ROUND UP TO NEAREST DOLLAR. $______Don‟t know...... #98 Refused...... #99

Q13 In the past 12 months, how often did you bet or spend money on coin slot machines or video lottery terminals located outside of Ontario? Would you say daily, at least once a week (but not daily), at least once a month (but not weekly), less than once a month or never? Daily...... #1 At least once a week...... #2 At least once a month...... #3 Less than once a month...... #4 Never...... #5 GO TO Q14 (DO NOT READ) Don‟t know...... #6 GO TO Q14 Refused...... #7 GO TO Q14 Q13A Where were they? (province/state) ______Don‟t know...... #98 Refused...... #99 63

Q14 In the past 12 months, how often did you bet or spend money on Sport Select (e.g. Pro Line, Over/Under, Point Spread)? Would you say daily, at least once a week (but not daily), at least once a month (but not weekly), less than once a month or never? Daily...... #1 At least once a week...... #2 At least once a month...... #3 Less than once a month...... #4 Never...... #5 (DO NOT READ) Don‟t know...... #6 Refused...... #7

Q15 In the past 12 months, how often did you bet or spend money on sports pools or the outcome of sporting events? Would you say daily, at least once a week (but not daily), at least once a month (but not weekly), less than once a month or never? Daily...... #1 At least once a week...... #2 At least once a month...... #3 Less than once a month...... #4 Never...... #5 (DO NOT READ) Don‟t know...... #6 Refused...... #7

Q16 In the past 12 months, how often did you bet or spend money on cards or board games anywhere other than at casinos (at home, friends‟ homes, work, card rooms, etc.)? Would you say daily, at least once a week (but not daily), at least once a month (but not weekly), less than once a month or never? Daily...... #1 At least once a week...... #2 At least once a month...... #3 Less than once a month...... #4 Never...... #5 (DO NOT READ) Don‟t know...... #6 Refused...... #7

Q17 In the past 12 months, how often did you bet or spend money on games of skill such as pool, bowling or darts? Would you say daily, at least once a week (but not daily), at least once a month (but not weekly), less than once a month or never? Daily...... #1 At least once a week...... #2 At least once a month...... #3 Less than once a month...... #4 Never...... #5 (DO NOT READ) Don‟t know...... #6 Refused...... #7

Q18 In the past 12 months, how often did you bet or spend money on arcade or video games? 64

Would you say daily, at least once a week (but not daily), at least once a month (but not weekly), less than once a month or never? Daily...... #1 At least once a week...... #2 At least once a month...... #3 Less than once a month...... #4 Never...... #5 (DO NOT READ) Don‟t know...... #6 Refused...... #7

Q19 In the past 12 months, how often did you bet or spend money gambling on the Internet? Would you say daily, at least once a week (but not daily), at least once a month (but not weekly), less than once a month or never? Daily...... #1 At least once a week...... #2 At least once a month...... #3 Less than once a month...... #4 Never...... #5 GO TO Q20 (DO NOT READ) Don‟t know...... #6 GO TO Q20 Refused...... #7 GO TO Q20

Q19A What activities did you bet on? (CHECK ALL THAT APPLY) Day trading...... #1 Casino table games...... #2 VLTs/slots machines...... #3 Sports betting...... #4 Poker...... #5 Other (specify)...... #6

Q19B Roughly how much time do you spend on gambling in a typical month? IF ONLY MINUTES, ENTER 0 FOR HOURS. Hours______Don‟t know...... #98 Refused...... #99 Q19C Roughly how much money do you spend on Internet gambling in a typical month? (ENTER NUMBER OF DOLLARS). ROUND UP TO NEAREST DOLLAR. $______Don‟t know...... #98 Refused...... #99

Q20 In the past 12 months, how often did you bet or spend money gambling on sports with a bookie/bookmaker? Would you say daily, at least once a week (but not daily), at least once a month (but not weekly), less than once a month or never? Daily...... #1 At least once a week...... #2 At least once a month...... #3 Less than once a month...... #4 Never...... #5 GO TO Q21 65

(DO NOT READ) Don‟t know...... #6 GO TO Q21 Refused...... #7 GO TO Q21

Q20A Roughly how much money do you spend on sports betting with a bookie in a typical month? (ENTER NUMBER OF DOLLARS). ROUND UP TO NEAREST DOLLAR. $______Don‟t know...... #98 Refused...... #99

Q21 In the past 12 months, how often have you made short-term speculative stock or commodity purchases such as day trading, not including long-term investments such as mutual funds or RRSPs? Would you say daily, at least once a week (but not daily), at least once a month (but not weekly), less than once a month or never? Daily...... #1 At least once a week...... #2 At least once a month...... #3 Less than once a month...... #4 Never...... #5 GO TO Q22 (DO NOT READ) Don‟t know...... #6 GO TO Q22 Refused...... #7 GO TO Q22

Q21A Roughly how much money do you spend on these kinds of short-term speculative purchases in a typical month? (ENTER NUMBER OF DOLLARS). ROUND UP TO NEAREST DOLLAR. $______Don‟t know...... #98 Refused...... #99

Q22 In the past 12 months, how often did you bet or spend money gambling in casinos out of province (e.g. at Las Vegas or Atlantic City or casinos in other Canadian provinces)? Would you say daily, at least once a week (but not daily), at least once a month (but not weekly), less than once a month or never? Daily...... #1 At least once a week...... #2 At least once a month...... #3 Less than once a month...... #4 Never...... #5 GO TO Q23 (DO NOT READ) Don‟t know...... #6 GO TO Q23 Refused...... #7 GO TO Q23

Q22A Where were the casinos located? (CHECK ALL THAT APPLY) Other Canadian province/territory...... #1 United States...... #2 Overseas...... #3 Cruise ship...... #4 Other (specify)...... #5 ______66

______Don‟t know...... #6 Refused...... #7

IF A PERSON HAS NOT GAMBLED ON ANY OF THESE ACTIVITIES IN THE PAST YEAR, GO DIRECTLY TO Q47

Q23 Roughly how many hours or minutes do you spend each month on all of these gambling activities? Please give the total amount of time spent on gambling in an average month. [ASK OF EACH ACTIVITY THEY PARTICIPATED IN] IF ONLY MINUTES, ENTER 0 FOR HOURS. Hours______Minutes______Don‟t know...... #98 Refused...... #99

Q24 Considering all the amounts you have won and lost from gambling in the past year how would you describe the overall outcome? READ LIST I won a lot...... #1 I won a little...... #2 I broke even...... #3 I lost a little...... #4 I lost a lot...... #5 (DO NOT READ) Don‟t know...... #6 Refused...... #7

CPGI Thinking about the last 12 months, would you say you never, sometimes, most of the time or almost always … ROTATE. (IF THEY ANSWER YES (I.E., #2-#4) ASK WHETHER THEY DID IT IN THE PAST 6 MONTHS AND PAST MONTH (SEE Q25A-Q33A BELOW) YOU MAY CHECK BOTH IF RESPONDENT DID IT IN BOTH PAST 6 MONTHS AND PAST MONTH)

FREQUENCY Most of the Almost Never Sometimes time always DK REF Q25 Bet more than you could really afford to lose? #1 #2 #3 #4 #5 #6 Q26 Need to gamble with larger amounts of money to get the same feeling of excitement? #1 #2 #3 #4 #5 #6 Q27 Go back another day to try to win back the money you lost? #1 #2 #3 #4 #5 #6 Q28 Borrow money or sold anything to get money to gamble? #1 #2 #3 #4 #5 #6 Q29 Feel that you might have a problem with gambling? #1 #2 #3 #4 #5 #6 Q30 Feel gambling has caused you any health problems, including stress or anxiety? #1 #2 #3 #4 #5 #6 Q31 Have people criticizing your betting or telling you that you have a gambling problem, regardless of whether or not you think it is true? #1 #2 #3 #4 #5 #6 67

Q32 Feel your gambling has caused financial problems for you or your household? #1 #2 #3 #4 #5 #6 Q33 Feel guilty about the way you gamble or what happens when you gamble? #1 #2 #3 #4 #5 #6

RECENCY

Past 6 Past Months? month? DK REF Q25A Bet more than you could really afford to lose? #1 #2 #3 #4 Q26A Need to gamble with larger amounts of money to get the same feeling of excitement? #1 #2 #3 #4 Q27A Go back another day to try to win back the money you lost? #1 #2 #3 #4 Q28A Borrow money or sold anything to get money to gamble? #1 #2 #3 #4 Q29A Feel that you might have a problem with gambling? #1 #2 #3 #4 Q30A Feel gambling has caused you any health problems, including stress or anxiety? #1 #2 #3 #4 Q31A Have people criticizing your betting or telling you that you have a gambling problem, regardless of whether or not you think it is true? #1 #2 #3 #4 Q32A Feel your gambling has caused financial problems for you or your household? #1 #2 #3 #4 Q33A Feel guilty about the way you gamble or what happens when you gamble? #1 #2 #3 #4

DIFFICULTIES RELATED TO GAMBLING

The next series of questions asks if you have had any difficulties related to your own gambling. By difficulties in general I mean at work, finances, with relationships or any other area I have not mentioned.

Q34 Have you ever had any difficulties related to your gambling? Yes...... #1 No...... #2 GO TO Q44 Don‟t know...... #3 GO TO Q44 Refused...... #4 GO TO Q44

Q35 When last did you have these difficulties? Less than 3 months ago...... #1 4-6 months ago...... #2 7-12 months ago...... #3 13 - 24 months ago...... #4 Over two years ago...... #5 Don‟t know...... #6 Refused...... #7

Q36 When did these difficulties first occur? Less than 3 months ago...... #1 4-6 months ago...... #2 7-12 months ago...... #3 13-24 months ago...... #4 Over two years ago...... #5 Don‟t know...... #6 Refused...... #7

Q37 Did your difficulties from gambling start gradually, building slowly over time, or was it a fairly abrupt or sudden change in your play? Gradual start...... #1 Sudden change...... #2 (DO NOT READ) Don‟t know...... #3 Refused...... #4

Q38 At the time you started developing difficulties with your gambling was there anything in particular or different going on in your life? (CHECK ALL THAT APPLY) Nothing...... #1 Change in job...... #2 Loss of job...... #3 Retired from job...... #4 Problems with spouse/partner...... #5 Loss of spouse/partner...... #6 Divorce/separation...... #7 Spouse/partner absent/away working ...... #8 Children leaving home...... #9 Illness...... #10 Lonely...... #11 Bored ...... #12 Depressed...... #13 Financial problems...... #14 Other (specify)...... #15 Don‟t know...... #16 Refused...... #17

Q39 Thinking of the last 12 months, have you experienced any of the following? If yes, please indicate how severe a problem it was for you with 1=Not much of a problem 2=A little bit of a problem 3=A large problem 4=A very large problem 5=An overwhelming problem

Severity Problems Yes (if yes) No Maybe DK REF Q39A A personal relationship (e.g., marriage, friendship) has been negatively affected due to my gambling #1 Q39AS #2 #3 #4 #5 Q39B My gambling made it harder to make money last from one payday to the next #1 Q39BS #2 #3 #4 #5 Q39C My gambling negatively affected my performance at work (includes study, home duties, care duties, voluntary work among others) or employment status #1 Q39CS #2 #3 #4 #5 69

Q39D I thought about committing suicide because of the difficulties related to my gambling behaviour. #1 Q39DS #2 #3 #4 #5 Q39E Gambling led me to obtain money illegally (even if I intended to pay it back) #1 Q39ES #2 #3 #4 #5 Q39F I used credit cards for a cash advance to gamble #1 Q39FS #2 #3 #4 #5 Q39G I gambled to make money #1 Q39GS #2 #3 #4 #5 Q39H I Gambled with money that was budgeted for something else #1 Q39HS #2 #3 #4 #5

These next questions concern any gambling-related difficulties you‟ve experienced whether or not they occurred in the past 12 months.

Q40 Is there a specific type or several types of gambling activity that causes or caused difficulties for you? Yes...... #1 No...... #2 GO TO Q44 Don‟t know...... #3 GO TO Q44 Refused...... #4 GO TO Q44

Q41 Which activities cause or caused you difficulties? (CHECK ALL THAT APPLY) VLTs/Slots...... #1 Bingo...... #2 Lottery/scratch tickets...... #3 Horse races...... #4 Casino table games...... #5 Speculative investments...... #6 Sports betting with bookie...... #7 Internet...... #8 Sports select...... #9 Card or board games with friends etc...... #10 Other (please specify)...... #11 Don‟t know...... #12 Refused...... #13

Q42 How long have or had you been gambling on this activity? (IF ONLY MONTHS, ENTER 0 FOR YEARS) „

Q43 Did you do any of the following to address these gambling-related difficulties? (CHECK ALL THAT APPLY) Limited access to money...... #1 Increased other activities...... #2 Stopped gambling...... #3 ASK Q43A Other (please specify)...... #4 Sought professional help (e.g., counselor, psychologist)...... #5 ASK Q43B & Q43C Did not do anything...... #6 ASK Q43D Refused...... #7

Q43A How successful were you in stopping gambling? READ LIST Not at all (I was never able to stop)...... #1 70

Somewhat (I was for a while but then started again)...... #2 Very (I was for a long time, but then started again)...... #3 Extremely (I still do not gamble)...... #4 (DO NOT READ) Don‟t know...... #5 Refused...... #6

Q43B For how long did you receive this professional help? ______months Don‟t know...... #98 Refused...... #99

Q43C How helpful was the professional assistance you received in making a difference for the better with your gambling? READ LIST Very helpful...... #1 Somewhat helpful...... #2 A little helpful...... #3 Not at all helpful...... #4 (DO NOT READ) Don‟t know...... #5 Refused...... #6

Q43D Why didn‟t you seek professional help? Was it because: Did not know where to get it...... #1 Thought I could solve it myself...... #2 I was not concerned enough (not serious enough)...... #3 Embarrassed (did not want anyone to know)...... #4 It was inconvenient for me...... #5 Other (specify)...... #6 Don‟t know...... #7 Refused...... #8

RESPONSIBLE GAMBLING ATTITUDES AND BEHAVIOURS

Now I would like to ask you some questions regarding your gambling spending behaviour.

Q44 In the past 12 months, how often did you do any of the following to manage your gambling?

Very Strategy Never Sometimes Often Often DK REF Q44ALimit amount of time playing #1 #2 #3 #4 #5 #6 Q44B Limit how often you play #1 #2 #3 #4 #5 #6 Q44C Reduce the bet level per wager #1 #2 #3 #4 #5 #6 Q44D Restrict access to additional cash (i.e., leaving bank cards at home) #1 #2 #3 #4 #5 #6 Q44E Play with friends and/or family present #1 #2 #3 #4 #5 #6 Q44F Have spouse or someone else control your finances #1 #2 #3 #4 #5 #6 Q44G Get involved in other activities instead of gambling #1 #2 #3 #4 #5 #6 Q44H Set a predetermined spending limit or #1GO #2GO TO #3GO #4GO #5GO #6GO 71 budget where you decided in advance how TO Q45 Q44HI TO TO TO TO much you would spend gambling Q44HI Q44HI Q45 Q45

Q44HI What percentage of the time that you set a budget did you exceed it? 0%...... #1 1%-25%...... #2 26%-50%...... #3 51%-75%...... #4 76%-100%...... #5 Don‟t know...... #6 Refused...... #7

Q45 How much do you agree with the following statement: “If I lose money at gambling, I just consider it another way to spend money on a recreational activity.” READ LIST I completely agree...... #1 I somewhat agree...... #2 I somewhat disagree...... #3 I completely agree...... #4 (DO NOT READ) Don‟t know...... #5 Refused...... #6

Q46 When you‟re placing a bet, which of the following best describes how you feel? READ LIST Chances are good that you will win...... #1 50/50 chance...... #2 Chances are good that you will lose...... #3 (DO NOT READ) Don‟t know...... #4 Refused...... #5

AFFECTED ISSUES

Q47 Have you ever experienced difficulties from someone else‟s gambling? By difficulties in general I mean at work, finances, with relationships or any other area I have not mentioned. Yes...... #1 No...... #2 GO TO Q53 Don‟t know...... #3 GO TO Q53 Refused...... #4 GO TO Q53

Q48 What is the nature of the difficulties you experienced as a result of this person‟s gambling? (CHECK ALL THAT APPLY) Been threatened by this person...... #1 Had money or credit cards stolen or used without permission...#2 Had other valuables taken or sold...... #3 Been pushed, hit, or physically abused in any way...... #4 Had loans not paid back...... #5 Manipulated into lending money...... #6 Been neglected/abandoned...... #7 Other (specify)...... #8 72

Refused...... #9

Q49 What is this person‟s relationship to you? Spouse ...... #1 Partner...... #2 Child...... #3 Sibling...... #4 Grandchild...... #5 Grandparent...... #6 Parent...... #7 Other relative (e.g. uncle, cousin)...... #8 Friend...... #9 Acquaintance...... #10 Co-worker...... #5 Employee...... #6 Neighbour...... #7 Other...... #8 Don‟t know...... #9 Refused...... #10

Q50 How often did or do you gamble with this person? READ LIST Never...... #1 I used to, but not any more...... #2 Rarely...... #3 Occasionally...... #4 Sometimes...... #5 Often...... #6 Always...... #7 (DO NOT READ) Don‟t know...... #8 Refused...... #9

FINANCIAL SITUATION

The following are some questions concerning your general spending behaviour and financial situation.

Q51 During the past 12 months how often did you spend more than you could afford on drinking and/or socializing? READ LIST Very often...... #1 Somewhat often...... #2 Once in a while...... #3 Never...... #4 (DO NOT READ) Don‟t know...... #5 Refused...... #6

Q52 During this same period how often did you spend more than you could afford on eating out or ordering take-out? READ LIST Very often...... #1 Somewhat often...... #2 Once in a while...... #3 73

Never...... #4 (DO NOT READ) Don‟t know...... #5 Refused...... #6

Q53 Again during the past 12 months, how often did you spend more than you could afford to see a sporting event, movies or other entertainment events? READ LIST Very often...... #1 Somewhat often...... #2 Once in a while...... #3 Never...... #4 (DO NOT READ) Don‟t know...... #5 Refused...... #6

Q54 Please indicate in the past 12 months, how often each of the following occurred due to a shortage of money:

Never Somewhat Very happened Sometimes Often Often DK REF Q54A Went without meals #1 #2 #3 #4 #5 #6 Q54B Borrowed money or used credit cards to pay for items you used to pay for with cash #1 #2 #3 #4 #5 #6 Q54C Sought assistance or financial help from friends/family or welfare/community organization #1 #2 #3 #4 #5 #6 Q54D Pawned or sold something #1 #2 #3 #4 #5 #6 Q54E Could not pay rent on time #1 #2 #3 #4 #5 #6 Q54F Could not pay utility/ telephone bill on time #1 #2 #3 #4 #5 #6 Q54G A collection agency called about an overdue bill #1 #2 #3 #4 #5 #6

DEMOGRAPHICS Finally, we would like to ask you some basic demographic questions. Like all your other answers, this information will be kept strictly confidential.

Z1 RECORD GENDER (DO NOT READ) Male...... #1 Female...... #2 Z2 What is your age? (if unwilling, go to Z2A)

Z2A Instead of giving us your exact year of birth, could you please tell us to which of the following age categories you belong? READ LIST. 18 to 24...... #1 25 to 34...... #2 35 to 49...... #3 50 to 59...... #4 60 or over...... #5 (DO NOT READ) Don‟t know...... #6 Refused...... #7 74

Z3 Currently are you married, living with a partner, widowed, divorced, separated or have you never been married? Married (incl widowed and divorced who remarried)...... #1 Living with a partner...... #2 Widowed (not remarried)...... #3 Divorced or separated (not remarried)...... #4 Separated...... #5 Single, never married...... #6 Never married...... #7 (DO NOT READ) Don‟t know...... #8 Refused...... #9

Z4 To what ethnic or cultural group did you or your ancestors belong on first coming to this country? IF RESPONDENT IS NOT CLEAR SAY “Are you Scottish, Chinese, Greek or something else?” IF RESPONDENT SAYS CANADIAN ASK ”In addition to being Canadian, to what ethnic or cultural group did you or your ancestors belong on first coming to this country?” (CHECK ALL THAT APPLY) Native Indian, Inuit...... #01 Australian...... #02 Austrian...... #03 Bahamian...... #04 Bangladeshi...... #05 Black / African...... #06 Dutch / Netherlands / Holland...... #07 English / British...... #08 Canadian...... #09 Chilean...... #10 Chinese...... #11 Croatian...... #12 Czech...... #13 Danish...... #14 East Indian...... #15 El Salvadorian...... #16 Ethiopian...... #17 Finnish...... #18 French...... #19 German...... #20 Greek...... #21 Guyanese...... #22 Haitian...... #23 Hungarian...... #24 Inuit...... #25 Irish...... #26 Israeli...... #27 Italian...... #28 Jamaican...... #29 Japanese...... #30 Jewish...... #31 Korean...... #32 Lebanese...... #33 75

Macedonian...... #34 Metis...... #35 New Zealander...... #36 Nigerian...... #37 Norwegian...... #38 Pakistani...... #39 Philipino...... #39 Polish...... #41 Portugese...... #42 Russian...... #43 Scottish...... #44 Serbian...... #45 Sikh...... #46 Slovakian...... #47 Somalian...... #48 Spanish...... #49 Sri Lankan...... #50 Swedish...... #51 Tamil...... #52 Trinidadian...... #53 Ukrainian...... #54 Vietnamese...... #55 Welsh...... #56 Yugoslavian...... #57 Other (specify below)...... #58 Don‟t know...... #59 Refused...... #60

Z5 What is the highest level of education you have completed? Some high school / junior high or less...... #1 Completed high school...... #2 Some post secondary school...... #3 Completed post secondary school...... #4 Completed post graduate education...... #5 Don‟t know...... #6 Refused...... #7

Z6 How many people under the age of 18 live with you? None...... #1 One...... #2 Two...... #3 Three...... #4 Four...... #5 Five...... #6 Six...... #7 Seven or more...... #8 Don‟t know...... #9 Refused...... #10

Z7 What is your present job status? Are you employed full time, employed part time, unemployed, a student, retired or a homemaker? IF RESPONDENT GIVES MORE THAN ONE ANSWER, RECORD THE ONE THAT APPEARS FIRST ON THE LIST. Employed full time (30 or more hrs/wk)...... #1 Employed part time (less than 30 hrs/wk)...... #2 Unemployed...... #3 GO TO Z9 Student – employed part or full time...... #4 Student – not employed...... #5 GO TO Z9 Retired...... #6 GO TO Z9 Homemaker...... #7 GO TO Z9 Other (specify)______...... #8 GO TO Z9 Don‟t know...... #9 GO TO Z9 Refused...... #10 GO TO Z9

Z8 What type of work do you currently do (or do you do when you are employed)? Job title. ______

Z9 What is your best estimate of your total PERSONAL income last year, please include income from all sources such as savings, pensions, rent and employment? ______dollars Don‟t know...... #1 Refused...... #2 IF HESITATION, READ INCOME RANGES Less than $20,000...... #1 Between $20,000 and $39,999...... #2 Between $40,000 and $59,999...... #3 Between $60,000 and $79,999...... #4 Between $80,000 and $99,999...... #5 Between $100,000 and $119,999...... #6 Between $120,000 and $139,999...... #7 Between $140,000 and $159,999...... #8 Between $160,000 and $179,999...... #9 Between $180,000 and $199,999...... #10 $200,000 or more...... #12 (DO NOT READ) Don‟t know...... #13 Refused...... #14

Z10 Could you please tell me how much income you and other members of your household received in the year ending December 31st 1999. Please include income form all sources such as savings, pensions, rent and employment insurance as well as wages? We don‟t need the exact amount: could you tell me which of these broad categories it falls into.. READ LIST. ______dollars Don‟t know...... #1 Refused...... #2 IF HESITATION, READ INCOME RANGES Less than $20,000...... #1 Between $20,000 and $39,999...... #2 Between $40,000 and $59,999...... #3 77

Between $60,000 and $79,999...... #4 Between $80,000 and $99,999...... #5 Between $100,000 and $119,999...... #6 Between $120,000 and $139,999...... #7 Between $140,000 and $159,999...... #8 Between $160,000 and $179,999...... #9 Between $180,000 and $199,999...... #10 $200,000 or more...... #12 (DO NOT READ) Don‟t know...... #13 Refused...... #14

Z11 Can I just confirm that the first three digits of your postal code are ______

Z12 We hope to speak to some people again. May we call you for a short follow up? Yes...... #1 No...... #2 GOTO END Don‟t know / Refused...... #3 GOTO END

Z13 (IF YES) Can I have your first name so that I make sure that it is you I speak to when I call back? ______

Z14 May I just confirm that your phone number is (READ NUMBER DIALED) ( ______) ______- ______

Z15 In order to make future contact easier, if applicable, may we also have your email address? ______

In case we have trouble reaching you at this number, is there another telephone number, like a work number, where we could try to reach you? We would only try this number if we weren‟t able to reach you at your home number and we wouldn‟t reveal to anyone who answered the reason why we are calling.

Could you give me the phone number of a friend or relative who would know how we could contact you, in case we have trouble reaching you? Again, we would only try this number if we weren‟t able to reach you at the other numbers and we wouldn‟t reveal to anyone why we are calling.

Friend or relatives name

I‟d like to thank-you for taking the time to participate in this survey and to advise you that my supervisor may be calling you later to verify your participation.

END

We‟ve reached the end of the interview. I would like to thank you very much for your participation. 78

APPENDIX E: LIST OF EXLUDED SELF-IDENTIFIED ETHNICITIES NOT INCLUDED IN THE REPORT

Ontario 2005 Prevalence Study Census 2006 (Ontario Data single ethnicity) Self-Reported Ethnicity % (N) % (N) Jewish 0.47 (17) 1.12 (76,750) North American Indian Total 0.69 (24) 1.28 (87,900) Aboriginal 0.42 (15) Native American 0.17 (6) First Nations 0.07 (2) N. American Indian 0.03 (1) Métis 0.12 (4) 0.14 (9,825) American 0.42 (15) 0.14 (9,360) South East Asian 0.23 (8) 0.06 (3,840) Austrian 0.2 (7) 0.15 (9,940) Welsh 0.19 (7) 0.17 (11,800) Vietnamese 0.16 (5) 0.92 (63,390) Belgian 0.16 (5) 0.17 (11,430) Finnish 0.14 (5) 0.27 (18,445) Israeli 0.11 (4) 0.02 (1,625) Mexican 0.09 (3) 0.16 (11,005) Brazilian 0.08 (3) 0.04 (2,780) Swedish 0.06 (2) 0.08 (5,370) Scandinavian 0.05 (2) 0.01 (895) Latin American 0.07 (2) 0.09 (6,325) Chilean 0.07 (2) 0.1 (6,720) Colombian 0.06 (2) 0.23 (15,525) Uruguayan 0.06 (2) 0.01 (965) Turkish 0.06 (2) 0.19 (13,255) Celtic 0.03 (1) Nicaraguan 0.03 (1) 0.05 (3,740) Armenian 0.03 (1) 0.22 (14,905) New Zealander 0.03 (1) 0.0 (245) Specify (Other) 1.34 (47)