Report
Gambling participation and the prevalence of problem gambling survey: Experimental statistics stage
Gambling Commission report produced by NatCen on the experimental statistics stage of the gambling participation and the prevalence of problem gambling survey.
Contents
- Executive summary
- Introduction
- Methodology and response
- Testing an alternative approach to the selection of participants within households
- - Introduction
- - Completion rates in responding households
- - Adherence to participant-selection instructions
- - Duplicate cases
- - Household clustering
- - Prevalence of gambling behaviours
- - Conclusion
- Measuring gambling-related harms
- Testing different approaches to asking questions about gambling participation
Results
You can view tables referenced in this section by downloading the file Tables A1 to A48 - Gambling Survey - Experimental statistics stage (XLSX)
To look at the performance of the question with four answer categories (condition A), the basic patterns of responses to each question were first examined. The proportion of missing data (that is, individuals choosing not to answer this question for whatever reason) were looked at and compared with missing data for the binary answer options.
Response patterns
For harms to self questions, the response pattern was as expected, with fewer participants choosing more frequent answer categories. For example, 95 percent of participants answering these questions reported that they never felt isolated, whereas three percent reported that they occasionally felt this, one percent reported that they felt this fairly often and one percent reported they felt this very often. The same pattern was evident for men and women ('Figure 7: Responses to the harms to self-questions, condition A (scaled answer options)' as follows as well as, Table A.19, Response pattern to gambling harms to self, scaled answer options questions)).
Figure 7: Responses to the harms to self questions, condition A (scaled answer options)
| Response pattern for scaled answer options: harms to self questions | Responses to the harms to self questions: Never (percentage) |
Responses to the harms to self questions: Occasionally (percentage) |
Responses to the harms to self questions: Fairly often (percentage) |
Responses to the harms to self questions: Very often (percentage) |
|---|---|---|---|---|
| Reduced spending | 92.4% | 4.1% | 1.6% | 0.7% |
| Uses savings and/or borrows money to gamble | 94.2% | 2.9% | 1.1% | 0.6% |
| Conflict with others | 94.7% | 2.6% | 0.8% | 0.8% |
| Feels isolated | 94.7% | 2.7% | 0.9% | 0.6% |
| Lies to family | 93.7% | 3.5% | 0.9% | 0.9% |
| Absent from work and/or poor performance at work | 95.5% | 1.9% | 0.6% | 0.7% |
Figure 7 information
Note: 'Don't know' and 'refused' options are not shown on chart or in table, hence responses do not sum to 100 percent.
Missing data
For the harms to self questions, similar proportions of participants in the two conditions did not answer the questions (between 1.1 percent and 1.7 percent of those eligible to answer the questions did not). This level of non-response is lower than observed in the pilot, where between three and four percent of eligible participants did not answer these questions.
For the harms from others questions, the extent of missing data was minimal, with just 0.1 percent to 0.2 percent of participants who were eligible to answer these questions not doing so. There were no differences by condition (Tables A.21 Response pattern to gambling harms to self, scaled answer options questions and Table A.22 Response pattern to gambling harms to self, binary answer options questions). This replicates findings from the pilot which also had very low non-response to these questions.
Comparison of rates of experiencing harms
With scaled answer options, there are different ways that participants can be categorised as either experiencing the harm or not experiencing the harm. Participants could be classified as experiencing harm when they:
- At least occasionally experienced each harm.
- Fairly often or very often experienced each harm.
- Experienced each harm very often.
The proportion of participants classified as experiencing harms according to these three options were compared with those who said 'yes' when answering the binary answer options.
‘Figure 8 Prevalence of harms to self, by response options’ as follows, shows participants classified as experiencing harms across the four options for the harms to self questions. Including those who say they experience harms occasionally broadly doubles the rate of harms for each item compared with those answering 'yes' in condition B. However, the actual impact of occasionally experiencing each harm is unclear. These may represent fairly minor harms for some or, following suggestions by external reviewers, Prof Robert Williams and Dr Rachel Volberg16, could indicate the potential for harm rather than the experience of it.
Classifying harms as experiencing each one either fairly often or very often gives similar rates of endorsement to those responding yes in condition B. For example, in condition A, 2.4 percent of those who gambled said they 'fairly often' or 'very often' reduced their spending on other things to gamble compared with 2.8 percent of those who gambled and answered 'yes' to this question in condition B.
The largest difference between these two definitions was observed for lying to family and/or others to hide the extent of one’s gambling. In condition B, 3.1 percent of eligible participants reported this compared with 1.5 percent reporting this 'fairly often/very often' in condition A. For this harm, it appears the 'yes' answer option includes more individuals who might otherwise report doing this 'occasionally'. For the other harms considered, data suggest that the majority of those who may have otherwise reported doing this occasionally instead selected 'no' when faced with a binary answer option.
Finally, prevalence of harms was lowest when looking at those who reported experiencing each 'very often', falling between 0.6 percent and 0.9 percent of adults who had gambled in the past year. When compared with those responding 'yes' in condition B, the greatest difference was seen for lying to family or others (where the 'yes' group appears to include some people who may have said occasionally otherwise) and the smallest difference was for poor performance at work (0.7 percent 'very often' compared with 1.0 percent 'yes').
Figure 8: Prevalence of harms to self, by endorsement options
| Response pattern for scaled answer options: harms to self questions | Option 1: experience this at least occasionally (percentage) |
Option 2: experience this at least fairly often (percentage) |
Option 3: experience this very often (percentage) |
Option 4 (condition b): Yes, experiences this (percentage) |
|---|---|---|---|---|
| Reduced spending | 6.5% | 2.4% | 0.7% | 2.8% |
| Uses savings and/or borrows money to gamble | 4.7% | 1.8% | 0.6% | 1.9% |
| Conflict with others | 4.2% | 1.6% | 0.8% | 1.7% |
| Feels isolated | 4.2% | 1.5% | 0.6% | 1.1% |
| Lies to family | 5.3% | 1.5% | 0.9% | 3.1% |
| Absent from work and/or poor performance at work | 1.9% | 1.3% | 0.7% | 1.0% |
Figure 8 information
Note: 'Don't know' and 'refused' options are not shown on chart or in table, hence responses do not sum to 100 percent.
Similar patterns were observed for the harms from others questions. Option 1 (at least occasionally experiencing each harm) resulted in the highest prevalence of harms, being between two to three times higher than those answering 'yes' in condition B. Rates between those answering 'fairly often' or 'very often' were similar to those answering 'yes', with the exception of conflict with others and lies to conceal the extent of someone else’s gambling.
For both, those who may otherwise have answered that they 'occasionally' experienced this seemed more likely to have answered 'yes' when given a binary choice. Finally, as before, those answering 'very often' had the lowest prevalence rates ('Figure 9: Prevalence of harms from others, by response options' as follows).
Figure 9: Prevalence of harms from others, by endorsement options
| Response pattern for scaled answer options: harms from others questions | Option 1: experience this at least occasionally (percentage) |
Option 2: experience this at least fairly often (percentage) |
Option 3: experience this very often (percentage) |
Option 4 (condition b): Yes, experiences this (percentage) |
|---|---|---|---|---|
| Reduced spending | 4.3% | 1.6% | 0.5% | 2.0% |
| Uses savings and/or borrows money to gamble | 4.8% | 1.7% | 0.7% | 2.2% |
| Conflict with others | 8.7% | 2.8% | 1.0% | 4.5% |
| Feels isolated | 5.1% | 1.9% | 0.9% | 2.4% |
| Lies to family | 6.7% | 1.5% | 1.0% | 3.6% |
| Absent from work and/or poor performance at work | 3.6% | 1.3% | 0.5% | 1.1% |
Figure 9 information
Note: The table shows the percentages of respondents who answered at least 'occasionally' in response to this question. The table does not show the percentage of respondents who answered never, so the responses shown will not add up to 100 percent.
How experience of harms correlates with other factors
In order to better understand the impact of different ways of calculating rates of harms, the analysis looked at how well these options associated with other measures where a relationship would be expected. For example, with the harms to self questions, a strong relationship between the rate of participants classified as experiencing each harm and Problem Gambling Severity Index (PGSI) status would be expected. Further, those with lower levels of wellbeing and those engaged in other risky health behaviours (higher risk alcohol consumption and cigarette smoking), have poorer general health and have higher rates of impulsivity would be more likely to experience harms.
To assess this, a series of unadjusted binary logistic regression models were produced. The models looked at how each of these factors (wellbeing, general health, other high-risk health behaviours etc.) were associated with harms across the following three different outcome measures:
- outcome 1 - experienced this harm occasionally compared with never
- outcome 2 - experienced this harm fairly often or very often compared with occasionally or never
- outcome 3: yes, had experienced this harm compared with no, had not.
Harms to self
For reducing spending, gambling causing isolation and lying to others to conceal extent of gambling, all three outcome measures were significantly associated with PGSI status, cigarette smoking status, general health status, impulsivity, wellbeing scores and alcohol consumption. The patterns were as expected. For example, participants had greater odds of saying that they had reduced their spending or that gambling caused isolation, or they had lied to people about their gambling (irrespective of how endorsement was defined) if they had PGSI scores of eight or higher (compared with those with a PGSI score of 0). In short, whichever way endorsement was defined, these harms were associated with a range of health and wellbeing measures in the way expected.
This pattern broadly held true for using savings to fund gambling; experiencing conflict and being absent from work, with some minor exceptions.
For using savings to fund gambling and being absent from work, only endorsement derived from scaled answer responses were significantly associated with alcohol consumption ('Figure 10: Odds ratios of using savings or borrowed money to gamble, by response options' as follows).
Likewise, for conflict with others, only answer options from the scaled responses were significantly associated with cigarette smoking status. In short, for these harms, the yes or no answer options did not have the same range of associations with health behaviours as the scaled answer options, though these were fairly minor differences.
Figure 10: Odds ratio of high risk alcohol consumption for using savings or borrowed money to gamble, by endorsement options
| Odds ratio for using savings to gamble | Odds ratio | 95 percent Confidence interval (lower) | 95 percent confidence interval (higher) |
|---|---|---|---|
| Option 1: Yes versus No | |||
| No high-risk alcohol consumption | 1 (reference) | Not applicable | Not applicable |
| High-risk alcohol consumption | 1.8 | 0.7 | 4.4 |
| Option 2: at least occasionally versus never | |||
| No high-risk alcohol consumption | 1 (reference) | Not applicable | Not applicable |
| High-risk alcohol consumption | 3.0 | 2.0 | 4.5 |
| Option 3: at least fairly often versus occasionally and/or never | |||
| No high-risk alcohol consumption | 1 (reference) | Not applicable | Not applicable |
| High-risk alcohol consumption | 3.8 | 2.0 | 7.1 |
Harms from others
When looking at responses to the harms from others questions, the same consistency between condition A (scaled answer options) and condition B (yes or no) responses and their association with health and wellbeing measures was less evident.
Condition B responses performed less well across the different harms asked about. For example, an association between experiencing harms from other people’s gambling and the participant’s own personal wellbeing would be expected. This was observed for all harms when endorsement was measured using the scaled answer options (condition A), but not for reducing spending, experiencing conflict or lying to hide the extent of someone else’s gambling in condition B (yes or no answer options).
Likewise, each harm measured using the scaled answer options had a relatively consistent association with alcohol and cigarette smoking status (whereby an individual was more likely to report experiencing each harm if they smoked or consumed alcohol at higher risk levels). But when endorsement was measured using binary responses, most harms were not associated with smoking status, and lying about other people’s gambling or being absent from work was not associated with alcohol consumption.
In short, when harms from other people’s gambling were measured using yes or no answer options, the experience did not correlate as well with measures of wellbeing or other health behaviours.
Harms from others questions: routing and answer options
Only those who reported that someone who is close to them gambled were routed to questions asking about harms from other people’s gambling. In the pilot there appeared to be a systematic underreporting of gambling by close others when compared with known gambling prevalence rates: only 28.5 percent of participants said that someone close to them gambled. This could potentially impact on the accuracy of any prevalence estimates produced from these questions, leading to underreporting of harms from others.
For this experimental statistics phase, the screening question was refined to remind participants about the types of gambling to include and to answer this question even if people close to them gambled only occasionally. In total, 57 percent of participants reported that someone close to them gambled, closer to the past year participation rates. Thus, refinements to this question appears to have addressed this underreporting.
Gambling-related suicidality questions
Using questions developed for the Adult Psychiatric Morbidity Survey (APMS), participants were asked to report if they had experienced suicidal thoughts in the last 12 months and whether they had attempted suicide in this period. Anyone who answered 'yes' to either of these questions were asked the extent to which this was related to their gambling. Answer options were 'not at all', 'a little' or 'a lot'.
Overall, 11.8 percent of participants reported thinking about suicide and 1.2 percent reported attempting suicide in the last 12 months. These estimates are higher than rates of suicidal thoughts and suicide attempts reported within the Adult Psychiatric Morbidity Survey: Mental Health and Wellbeing, England, 2014 (opens in new tab)(5.4 percent and 0.7 percent respectively).
Whilst the APMS 2014 survey notes an upward trend in the prevalence of suicidal thoughts, comparison with more up-to-date data is unlikely to fully explain these differences. This over-estimation should be borne in mind when using this data for future analysis.
Of the 668 individuals who reported any suicidal thoughts or attempts eight reported this was related to their own gambling 'a lot' and a further 25 participants reported this was due to their own gambling 'a little'. With regards to attributing these behaviours to gambling, it is unclear if these participants were thinking about their suicidal thoughts, suicide attempts or both when answering the gambling question. This creates the potential for analytical ambiguity in terms of what this data is representing, especially where people may have had multiple experiences of suicidal ideation and attempts in the past year.
References
16 Developing survey questions capturing gambling-related harms - Part A - Expert review of question development by Professor Robert Williams and Dr Rachel Volberg, Heather Wardle, Viktorija Kesaite, Robert Williams, Rachel Volberg (2022).
Testing different ways of asking about gambling harms Next section
Conclusion
Last updated: 11 July 2023
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