JMIR Publications

ABSTRACT

Background:

Problem gambling is an increasing public health issue characterized by poor help-seeking. Helplines and real-time chat services could reduce treatment gap.

Objective:

The aim of this study was to describe the characteristics of gamblers or relatives contacting a governmental help service, to study the evolution of the characteristics over time, to evaluate the differences between the subgroups, and to explore factors influencing referral to care.

Methods:

From January 2011 to December 2015, the governmental gambling helpline and real-time chat service in France received 9474 contacts from gamblers and 4038 from relatives of gamblers. Counselors filled in a form for each contact including demographics, gambling characteristics and referral. Time-series analyzes were plotted. Univariate logistic models were performed to assess subgroups differences. A multivariate analysis was conducted to determine the variables related to the effective referral.

Results:

Gamblers were predominantly male (74%), average age was 41 (SD 14). Compared to men, women were older (mean 50.7, SD 14.0 vs mean 37.9, SD 13.0; P<.001), were more often pure offline gamblers (n=1922 or 78.2% vs n=4386 or 62.5%; P<.001) and had a different pattern of gambling. Real-time chat contactors were more often male (n=124 or 82.7% vs n=3643 or 74.6%; P=.039), younger (mean 32.8, SD 12.9 vs mean 41.3, SD 14.3; P<.001), and gambled more often poker (n=41 or 27.3% vs n=592 or 12.1%; P<.001) and online (n=83 or 55.3% vs n=1462 or 30.0%; P<.001) than helpline contactors. The effective referral was positively associated with betting (AOR = 1.46, 95% CI = [1.27,1.67]; P<.001), playing casino games (AOR = 1.38, 95% CI = [1.21,1.57]; P<.001), playing scratch cards (AOR = 1.83, 95% CI = [1.58,2.12]; P<.001), playing poker (AOR = 1.35, 95% CI = [1.14,1.61]; P<.001) and lottery (AOR = 1.27, 95% CI = [1.03,1.56]; P=.029), gambling weekly (AOR = 1.73, 95% CI = [1.40,2.15]; P<.001), referral request (AOR = 17.76, 95% CI = [14.92,21.13]; P<.001) and having a history of suicide attempt (AOR = 2.13, 95% CI = [1.51,3.02]; P<.001) and negatively associated with online gambling (AOR=0.86, 95% CI = [0.75,0.98]; P=.030) and refusal to be referred (AOR=0.35, 95% CI = [0.26,0.49]; P<.001).

Conclusions:

The governmental help service contactors constituted a broad range of socio-demographics groups. It is important to propose different modalities of contact to help-seeking gamblers, covering the spectrum of preferences, and to actively offer gamblers referral beyond an explicit request. Clinical Trial: Approval: N°2018-031 Comité d’Evaluation de l’Ethique des projets de Recherche Biomédicale (CEERB) Paris Nord (Institutional Review Board -IRB 00006477- of HUPNVS, Paris 7 University, AP-HP) has reviewed and approved the study.