REPORT TO TASMANIAN GOVERNMENT DEPARTMENT OF TREASURY AND FINANCE 22 DECEMBER 2017 FOURTH SOCIAL AND ECONOMIC IMPACT STUDY OF GAMBLING IN TASMANIA (2017) VOLUME 2: PREVALENCE SURVEY ACIL ALLEN CONSULTING PTY LTD ABN 68 102 652 148 LEVEL NINE 60 COLLINS STREET MELBOURNE VIC 3000 AUSTRALIA T+61 3 8650 6000 F+61 3 9654 6363 LEVEL ONE 50 PITT STREET SYDNEY NSW 2000 AUSTRALIA T+61 2 8272 5100 F+61 2 9247 2455 LEVEL FIFTEEN 127 CREEK STREET BRISBANE QLD 4000 AUSTRALIA T+61 7 3009 8700 F+61 7 3009 8799 LEVEL ONE 15 LONDON CIRCUIT CANBERRA ACT 2600 AUSTRALIA T+61 2 6103 8200 F+61 2 6103 8233 LEVEL TWELVE, BGC CENTRE 28 THE ESPLANADE PERTH WA 6000 AUSTRALIA T+61 8 9449 9600 F+61 8 9322 3955 P.O. BOX 546 HOBART TAS 7001 AUSTRALIA T+61 3 8650 6000 F+61 3 9654 6363 161 WAKEFIELD STREET ADELAIDE SA 5000 AUSTRALIA T +61 8 8122 4965 ACILALLEN.COM.AU SUGGESTED CITATION FOR THIS REPORT: ACIL ALLEN CONSULTING, DEAKIN UNIVERSITY, CENTRAL QUEENSLAND UNIVERSITY AND THE SOCIAL RESEARCH CENTRE. 2017. FOURTH SOCIAL AND ECONOMIC IMPACT STUDY OF GAMBLING IN TASMANIA: REPORT 2. TASMANIAN DEPARTMENT OF TREASURY AND FINANCE, HOBART. LKH © ACIL ALLEN CONSULTING 2017 CONTENTS GLOSSARY OF TERMS X EXECUTIVE SUMMARY XIII 1 Introduction 21 1.1 Study overview 21 1.2 Approach to Volume 2 analysis 22 1.3 About Volume 2 23 2 Survey method 24 2.1 Method 24 2.2 Weighting 25 2.3 Questionnaire 26 2.4 Ethics and quality assurance 27 PART I 3 Introduction to Part I 2 3.1 Overview 2 3.2 Analytical approach 2 3.3 Structure of Part I 4 4 Participation in gambling activities 5 4.1 Key findings 5 4.2 Gambling participation by activity in the previous 12 months 6 4.3 Gambling participation over time 6 4.4 Gambling participation by demographic characteristics 8 4.5 Gambling participation by location or medium 16 4.6 Gambling participation by location or medium over time 17 5 Gambling frequency 19 5.1 Key findings 19 5.2 Annual gambling frequency 20 5.3 Annual gambling frequency over time 21 5.4 Annual gambling frequency by demographic characteristics of gamblers 24 5.5 Annual gambling frequency by location or medium 29 5.6 Regular gamblers 32 6 Gambling expenditure 39 6.1 Key findings 39 CONTENTS 6.2 Annual gambling expenditure 40 6.3 Expenditure on gambling activities by demographic characteristic 43 6.4 Highest spend gambling activities 47 7 Prevalence of problem gambling 49 7.1 Key findings 49 7.2 Measuring gambling severity 50 7.3 Gambling severity over time 50 7.4 Gambling severity – comparisons with other states/territories 51 7.5 Gambling severity by selected characteristics 55 8 Additional details on EGM gambling / internet-based gambling 66 8.1 Key findings 66 8.2 Frequency of spending more than $1 per spin on EGMs 67 8.3 Participation in online gambling 68 8.4 Profile of online gamblers 71 9 Help seeking 75 9.1 Key findings 75 9.2 Self-exclusion 75 9.3 Help seeking for gambling problems 75 10 Psychosocial characteristics 77 10.1 Key findings 77 10.2 Quality of life 77 10.3 Substance use 80 10.4 Mental health 82 10.5 Health and wellbeing as predictors of gambling severity 83 PART II 11 Introduction to Part II 86 11.1 Introduction to gambling harms 86 11.2 Measuring gambling harms 87 11.3 Using quality of life measures to measure harms 89 11.4 Harms to affected others 90 11.5 Structure of Part II 91 12 Costs and benefits associated with gambling 92 12.1 Method 92 12.2 Results 94 CONTENTS 12.3 Discussion 96 13 Assessing harm from gambling using the Short Gambling Harms Screen 98 13.1 Introduction and context 98 13.2 Method 99 13.3 Results 100 13.4 Discussion 104 14 Developing a Short Gambling Harms Screen for Affected Others 106 14.1 Introduction and context 106 14.2 Method 106 14.3 Results 108 14.4 Discussion 110 14.5 Conclusion 111 15 Identification of low-risk gambling limits 113 15.1 Key findings 113 15.2 Background 114 15.3 Method 116 15.4 Results 119 15.5 Conclusion 122 PART III 16 Introduction to Part III 126 16.1 Introduction 126 16.2 Ecological Momentary Assessment overview 126 16.3 Interviews with gamblers 126 16.4 Interviews with affected others 127 16.5 Structure of Part III 127 17 Ecological Momentary Assessment 128 17.1 Key findings 128 17.2 Introduction 129 17.3 Method 130 17.4 Results 135 17.5 Discussion 150 17.6 Conclusion 151 18 Qualitative interviews on harms with gamblers 154 18.1 Key findings 154 CONTENTS 18.2 Method 155 18.3 Results 157 18.4 Conclusion 166 19 Qualitative interviews on harms with affected others 168 19.1 Key findings 168 19.2 Method 169 19.3 Results 170 19.4 Conclusion 197 REFERENCES 198 A Prevalence survey technical and method notes A–1 A.1 Sample design and stratification A–1 A.2 Sampling frames A–1 A.3 Respondent selection A–3 A.4 Call procedures A–3 A.5 Procedures to maximise response A–3 A.6 Fieldwork statistics A–4 A.7 Response rates A–5 A.8 Achieved sample profile A–6 A.9 Benchmarks used in weighting A–7 B Scales and derived items B–1 B.1 Problem gambling severity B–1 B.2 Quality of life B–2 B.3 Substance use B–2 B.4 Depression B–3 B.5 Anxiety B–3 C 2017 prevalence survey questionnaire C–1 FIGURES FIGURE 11.1 CONCEPTUAL FRAMEWORK OF GAMBLING-RELATED HARM 87 FIGURE 11.2 CONCEPTUAL MODEL OF THE RELATIONSHIP BETWEEN GAMBLING PROBLEMS AND QUALITY OF LIFE 88 FIGURE 11.3 CONCEPTUAL ILLUSTRATION OF THE DISTRIBUTION OF HARMS AND BENEFITS FROM GAMBLING IN THE POPULATION 90 FIGURE 13.1 MAPPING OF SGHS AND PGSI SCORES TO DISABILITY WEIGHTS 99 FIGURE 13.2 DISTRIBUTION OF SGHS NON-ZERO SCORES IN THE SAMPLE (EXCLUDING 2644 GAMBLERS SCORING ZERO ON THE SGHS) 100 CONTENTS FIGURE 13.3 YEARS OF LIFE DUE TO GAMBLING-RELATED HARM, BASED ON THE SGHS 101 FIGURE 13.4 BREAKDOWN OF YLL FROM GAMBLING-RELATED HARM BY AGE AND GENDER 101 FIGURE 13.5 QUALITY OF LIFE IMPACT (YLL) FROM GAMBLING BASED ON THE SGHS, BROKEN DOWN BY PGSI CATEGORY 102 FIGURE 17.1 PROXIMAL ANTECEDENTS, GAMBLING EPISODES AND GAMBLING CONSEQUENCES 130 FIGURE 17.2 PREDICTED PROBABILITY OF ENDORSING THE HIGHEST LEVEL OF SUBJECTIVE ALCOHOL INTOXICATION (SAI) AT THE SUBSEQUENT ASSESSMENT POINT FOR EACH LEVEL OF EXPENDITURE AND SUBJECTIVE ALCOHOL INTOXICATION WHILE GAMBLING 149 TABLES TABLE ES 1 PAST YEAR PARTICIPATION IN DIFFERENT GAMBLING ACTIVITIES OVER TIME - TASMANIAN ADULTS (2005, 2008, 2011, 2013 AND 2017) XIV TABLE ES 2 GAMBLING SEVERITY AMONG TASMANIAN ADULTS (2011, 2013 AND 2017) XVI TABLE 2.1 PREVALENCE SURVEY SAMPLE SIZE BY YEAR 25 TABLE 2.2 STRUCTURE OF 2017 QUESTIONNAIRE 26 TABLE 4.1 PAST YEAR PARTICIPATION IN DIFFERENT GAMBLING ACTIVITIES AMONG TASMANIAN ADULTS 6 TABLE 4.2 PAST YEAR PARTICIPATION IN DIFFERENT GAMBLING ACTIVITIES OVER TIME - TASMANIAN ADULTS (2005, 2008, 2011, 2013 AND 2017) 7 TABLE 4.3 PAST YEAR PARTICIPATION IN DIFFERENT GAMBLING ACTIVITIES - TASMANIAN GAMBLERS (2011, 2013 AND 2017) 8 TABLE 4.4 NUMBER OF GAMBLING ACTIVITIES IN WHICH TASMANIAN ADULTS PARTICIPATED IN THE LAST 12 MONTHS (2011, 2013 AND 2017) 8 TABLE 4.5 OVERALL PARTICIPATION IN ANY GAMBLING ACTIVITY IN THE PAST 12 MONTHS BY SELECTED DEMOGRAPHIC CHARACTERISTICS (2017) 9 TABLE 4.6 PARTICIPATION IN SPECIFIC GAMBLING ACTIVITIES BY SELECTED DEMOGRAPHIC CHARACTERISTICS (2017) 13 TABLE 4.7 NUMBER OF SIGNIFICANTLY DIFFERENT GAMBLING ACTIVITIES BY DEMOGRAPHIC CHARACTERISTICS (2017) 15 TABLE 4.8 LOCATION OR MEDIUM OF GAMBLING PARTICIPATION - TASMANIAN ADULTS (2017) 16 TABLE 4.9 LOCATION OR MEDIUM OF GAMBLING PARTICIPATION OVER TIME - TASMANIAN ADULTS (2011, 2013 AND 2017) 18 TABLE 5.1 PAST YEAR FREQUENCY OF GAMBLING ACTIVITY – TASMANIAN ADULTS (2017) 20 TABLE 5.2 PAST YEAR FREQUENCY OF GAMBLING ACTIVITY – TASMANIAN GAMBLERS (2017) 21 TABLE 5.3 PAST YEAR FREQUENCY OF GAMBLING ACTIVITY OVER TIME – ALL TASMANIAN ADULTS (2011, 2013 AND 2017) 22 TABLE 5.4 PAST YEAR GAMBLING FREQUENCY BY TYPE OF GAMBLING ACTIVITY (2011, 2013 AND 2017) 23 TABLE 5.5 MEAN PAST YEAR GAMBLING FREQUENCY BY ACTIVITY BY SELECTED DEMOGRAPHIC CHARACTERISTICS (2017) 26 TABLE 5.6 MEAN PAST YEAR GAMBLING FREQUENCY BY ACTIVITY BY SELECTED DEMOGRAPHIC CHARACTERISTICS (2017) 28 TABLE 5.7 PAST YEAR GAMBLING FREQUENCY BY LOCATION OR MEDIUM (2017) 31 TABLE 5.8 REGULAR GAMBLERS BY SELECTED DEMOGRAPHIC CHARACTERISTICS (2017) 33 TABLE 5.9 GAMBLING ACTIVITY AMONG REGULAR AND NON-REGULAR GAMBLERS (2017) 34 TABLE 5.10 LOCATION OR MEDIUM OF GAMBLING PARTICIPATION AMONG REGULAR GAMBLERS (2017) 35 TABLE 5.11 NUMBER OF GAMBLING ACTIVITIES BY TYPE OF GAMBLER (2017) 36 TABLE 5.12 ANNUAL FREQUENCY OF GAMBLING ACTIVITY BY TYPE OF GAMBLER (2017) 37 TABLE 6.1 ESTIMATED TOTAL EXPENDITURE BY GAMBLING ACTIVITY—TASMANIA (2011, 2013 AND 2017 40 TABLE 6.2 ANNUAL GAMBLING EXPENDITURE BY ACTIVITY PER TASMANIAN ADULT (2011, 2013 AND 2017) 41 TABLE 6.3 ANNUAL GAMBLING EXPENDITURE BY ACTIVITY – PARTICIPANTS IN EACH ACTIVITY (2011, 2013 AND 2017) 42 CONTENTS TABLE 6.4 MEAN EXPENDITURE IN SELECTED GAMES BY PARTICIPANT BY DEMOGRAPHIC CHARACTERISTIC (2017) 45 TABLE 6.5 MEAN EXPENDITURE IN SELECTED GAMES BY PARTICIPANT BY DEMOGRAPHIC CHARACTERISTIC (2017) 46 TABLE 6.6 HIGHEST SPEND ACTIVITIES (2011, 2013 AND 2017) 47 TABLE 6.7 HIGHEST SPEND BY ACTIVITY – MEAN ANNUAL FREQUENCY AND MEAN ANNUAL EXPENDITURE (2017) 48 TABLE 7.1 GAMBLING SEVERITY AMONG TASMANIAN ADULTS (2011, 2013 AND 2017) 51 TABLE 7.2 PREVALENCE RATES BY PGSI CATEGORY: RECENT AUSTRALIAN STATE AND TERRITORY SURVEYS 53 TABLE 7.3 GAMBLING SEVERITY BY SELECTED DEMOGRAPHIC CHARACTERISTICS (2017) 55 TABLE 7.4 GAMBLING SEVERITY BY GAMBLING ACTIVITY (2017) 58 TABLE 7.5 GAMBLING SEVERITY BY GAMBLING LOCATION/MEDIUM (2017) 59 TABLE 7.6 GAMBLING SEVERITY BY NUMBER OF GAMBLING ACTIVITIES PARTICIPATED IN DURING PAST