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Full citation
Mazar, A., Volberg, R. A., Williams, R. J., & Stanek, E. J. (2020). Problem gambling, gambling involvement, gambling intensity, and gambling formats: Evidence from Massachusetts population data. BMC Public Health, 20, 711. https://doi.org/10.1186/s12889-020-08822-2
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Region & Target Population
- Region: Massachusetts, United States
- Target population: Adults aged 18 years and older residing in Massachusetts65
Study Design
- Cross-sectional population study using pooled data
- Combines two large baseline surveys to increase statistical power for problem gambling analyses:
- Baseline General Population Survey (BGPS)
- Baseline Online Panel Survey (BOPS)
Sample Characteristics (with data-collection years)
- Baseline General Population Survey (BGPS)
- N = 9,523 adults (18+)
- Address-based probability sample
- Data collection: September 2013 – May 2014
- Baseline Online Panel Survey (BOPS)
- N = 5,046 adults (18+)
- Stratified online panel matched to census demographics
- Data collection: October 2013 – March 2014
- Analytic sample: n = 5,852 regular gamblers (monthly or more frequent participation)
- Problem gambling prevalence (PPGM): 7.62% among regular gamblers
Measures Used
- Problem gambling:
- Problem and Pathological Gambling Measure (PPGM; 14 items)
- Four categories: non-gambler, recreational, at-risk, problem/pathological
- Gambling formats (8 major forms):
- Casino table games
- Bingo
- Sports betting
- Private betting
- Daily lottery games
- Traditional lottery products
- Instant / scratch tickets
- Other regulated formats
- Gambling involvement:
- Number of gambling formats participated in monthly or more often
- Gambling intensity:
- Annual money spent on gambling
- Maximum gambling frequency in the past year (proxy for time spent)
Research Questions
- Are some gambling formats more strongly associated with problem gambling than others in a US context?
- Does higher gambling involvement increase the likelihood of problem gambling?
- Is gambling involvement associated with greater gambling intensity?
- Do specific gambling formats mediate the relationship between involvement and problem gambling?
Key Findings
Format-specific harm
- Regular participation in casino games, bingo, and sports betting showed the highest proportions of problem gambling:
- Casino games: up to 26% problem gambling prevalence
- Bingo and sports betting: consistently elevated riskLotteries and scratch tickets showed the lowest proportions of problem gambling (7–11%)
Involvement and risk
- Gambling involvement was strongly associated with problem gambling. However: 43.5% of individuals with gambling problems participated regularly in only one or two formats
Intensity as a mechanism
- The authors argue that intensity partly explains why involvement predicts harm, but does not fully account for format differences
Format × involvement interaction
- Casino gambling showed high problem-gambling prevalence even at low involvement
- Bingo showed particularly high harm at very high involvement levels
- Lottery products remained below average harm across involvement levels
Study Conclusion
The authors conclude that problem gambling in Massachusetts is shaped by both gambling involvement and the structural characteristics of specific gambling formats. While participating in multiple gambling formats increases risk, largely through increased intensity, format choice still matters substantially.
Crucially, the study shows that:
- High-risk formats (casino games, bingo, sports betting) can produce harm even when individuals are not highly involved across many products
- A significant proportion of problem gamblers concentrate their gambling on one or two high-risk formats
- Lotteries and scratch tickets, while widely used, are comparatively lower-risk but not risk-free
The authors explicitly caution against policy approaches that treat gambling harm as a simple function of “too much gambling” and argue instead for format-sensitive regulation, noting that the risk profile of a gambling product is context-dependent and market-specific.
