Problem Gambling in Europe Challenges, Prevention, and Interventions Problem Gambling in Europe Challenges, Prevention, and Interventions Edited by Gerhard Meyer University of Bremen, Germany Tobias Hayer University of Bremen, Germany Mark Griffiths Nottingham Trent University, UK Editors Gerhard Meyer University of Bremen Germany Tobias Hayer University of Bremen Germany Mark Griffiths Nottingham Trent University UK ISBN: 978-0-387-09485-4 e-ISBN: 978-0-387-09486-1 DOI: 10.1007/978-0-387-09486-1 Library of Congress Control Number: 2008939371 © Springer Science+ Business Media, LLC 2009 All rights reserved This work may not be translated or copied in whole or in part without the written permission of the publisher (Springer Science+Business Media, LLC, 233 Spring Street, New York, NY 10013, USA), except for brief excerpts in connection with reviews or scholarly analysis Use in connection with any form of information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed is forbidden The use in this publication of trade names, trademarks, service marks, and similar terms, even if they are not identified as such, is not to be taken as an expression of opinion as to whether or not they are subject to proprietary rights Printed on acid-free paper springer.com Contents Contributors vii Foreword Jeffrey L Derevensky xv Problem Gambling: A European Perspective xix Mark Griffiths, Tobias Hayer, and Gerhard Meyer COUNTRY REPORTS Belgium Christophe Druine Denmark Jakob Linnet 17 Estonia Stella Laansoo and Toomas Niit 37 Finland Tapio Jaakkola 53 France Marc Valleur 71 Germany Gerhard Meyer and Tobias Hayer 85 v vi Contents Great Britain 103 Mark Griffiths Hungary 123 Zsolt Demetrovics Iceland 137 Daniel Thor Olason and Sigurdur J Gretarsson 10 Italy 153 Mauro Croce, Gioacchino Lavanco, Loredana Varveri, and Maoreten W.J Fiasco 11 Lithuania 173 Norbertas Skokauskas 12 The Netherlands 189 Anna E Goudriaan, Dick de Bruin, and Maoreten W.J Koeter 13 Norway 209 K Gunnar Götestam and Agneta Johansson 14 Poland 219 Bartłomiej Dzik 15 Romania 229 Viorel Lupu 16 Russia 243 Sergei Tsytsarev and Yakov Gilinsky 17 Slovak Republic 257 Hroznata Živný and Lubomír Okruhlica 18 Slovenia 265 Mirna Macur, Matej Makarovicˇ, and Borut Roncˇevic´ 19 Spain 281 Elisardo Becoña 20 Sweden 299 Jakob Jonsson and Sten Rönnberg 21 Switzerland 317 Jörg Häfeli Index 327 Contributors Elisardo Becoña, Elisardo Becoña, Professor of Clinical Psychology, works at the University of Santiago de Compostela, Faculty of Psychology, Spain He is an expert in addictive behaviours and author of several books and papers about substance and non-substance addictions, including pathological gambling Dick de Bruin, Dick de Bruin is a developmental psychologist who joined the Centrum Verslavings Onderzoek (CVO) in 1991 He is a Director of Quantitative Research and the Management Council Secretary His expertise is the development of quantitative measurement instruments and statistical analysis He is a leading specialist in gambling problems and gambling policy in the Netherlands His fields of interest are people’s development and course of life in an ecological perspective; influence of medicine, narcotic plants, and substance use on people’s health, well-being, and development; and harm-reduction strategies for substance use and addiction Mauro Croce, Mauro Croce was President of the Alea Association He is the Director of the Health Promotion Department of the Local Health Service (ASLVCO) and a member of the Council of Workers and Experts on Drug Addiction of the Ministry of Social Affairs, Rome He has edited the Italian version of H.S Becker’s “Outsiders”; M Dickerson’s “Compulsive Gamblers”; Le Breton’s “Passions du risque”, and, together with R Zerbetto, “Il gioco e l’azzardo” Mauro Croce has published several studies on gambling, health promotion, network intervention, and drug addiction He teaches at the University of Applied Science of Lugano (Switzerland) Zsolt Demetrovics, Zsolt Demetrovics is a clinical psychologist and cultural anthropologist, who received his Ph.D in addiction science He is the head of the Addiction Research Unit at the Eötvös Loránd University, Budapest, Hungary His main fields of research are the epidemiology of addictive behaviours, the psychological and family background of drug and behavioural addictions, and the social representation of drug addiction vii viii Contributors Jeffrey L Derevensky, Dr Derevensky is Professor and Director of Clinical Training, School/ Applied Child Psychology and Professor, Department of Psychiatry, McGill University He is the co-director of the International Centre for Youth Gambling Problems and High-Risk Behaviors and the co-director of the treatment program for youth with gambling-related problems Christophe Druine, Christophe Druine studied Psychology and received his diploma in 2001 He worked as a researcher on mental health topics at a Collaborating Centre of the World Health Organization in Brussels (2001–2003) From 2003 to 2007, he worked as a project leader at the Rodin Foundation in Brussels In this function, he was involved in several research projects on responsible gambling and the development and implementation of several prevention programs on problem gambling Since October 2007, he has worked as a consultant for Podium Perception Management (PPM) in Brussels Bartłomiej Dzik, sis an economist and Ph.D candidate in psychology at the Polish Academy of Sciences His research focuses on individual decision-making, especially problems of self-control and the analysis of gambling behaviour In addition to his current scientific work, he has several years of experience in the Polish civil service as an economic analyst Maurizio Fiasco, Maurizio Fiasco is involved in research and acts as a consultant He teaches training courses for the police and public/private organizations, and collaborates with customer associations and foundations for victims of loan sharks Maurizio Fiasco is sociologist and author of several books and journal papers Yakov Gilinsky, Yakov Gilinsky, J.D., Ph.D., is a Professor of the St Petersburg’s Juridical Institute of the General Prosecutor’s Office of the Russian Federation; and Head of the Department of Criminal Law of the Russian State University of Education His main scientific interests are criminology and sociology of deviance He is author of more than 390 scientific works K Gunnar Götestam, Educated as physician and psychologist, K Gunnar Götestam is a specialist in psychiatry, Assistant Professor in medical psychology (University of Uppsala), Professor in Psychiatry since 1977 (Norwegian University of Science and Technology [NTNU] Trondheim), and a Visiting Professor (Karolinska Institute, University of Uppsala, and Stanford University) Anna E Goudriaan, Anna E Goudriaan works at the Academic Medical Centre (AMC), Department of Psychiatry, as a researcher/neuropsychologist, with a three-year New Investigator Contributors ix Grant from the Dutch Scientific Society (NWO-ZonMw) In 2005, she obtained her doctorate (cum laude) from the University of Amsterdam (Dissertation: Self-regulation in Pathological Gambling and Related Disorders: A Neurocognitive and Psychophysiological Investigation) She spent two years as a postdoctoral researcher at the University of Missouri–Columbia (USA), studying gambling patterns in college students and the relation between heavy alcohol use and risky decision making At the AMC, she focuses on cognitive–emotional processes in pathological gambling and alcohol dependence, using neuro-imaging techniques Sigurdur J Gretarsson, Dr Sigurdur J Gretarsson is a professor of psychology at the University of Iceland His main interests include developmental psychology and the nature of psychology as a science His recent works deal with parents’ estimates of their children, development, psychological systems in history, and (problem) gambling in Iceland Mark Griffiths, Dr Mark Griffiths is Professor of Gambling Studies at the Nottingham Trent University (United Kingdom) He is internationally known for his work on gambling and gaming addictions and has published over 200 refereed research papers, a number of books, 50 book chapters, and over 550 other articles He has won eight national and international awards for his work, including the John Rosecrance Prize (1994) and the Joseph Lister Prize (2004) Jörg Häfeli, Prof Jörg Häfeli, born in 1955, has been a lecturer and project leader at the Lucerne University of Applied Sciences and Arts since 1998 His main interest in lecturing and research is the prevention and early detection of addiction and other social problems Since 2001, his work has primarily focused on gambling in the context of the new Swiss federal law on gambling and the development and implementation of a Social Services Plan for several casinos in Switzerland Furthermore, he is an expert for political regulation of the gambling industry Tobias Hayer, Tobias Hayer is a psychologist and received his diploma in 2001 Since 2001, he has been working as a research assistant at the Institute of Psychology and Cognition Research at the University of Bremen (Germany) Tobias Hayer conducts research on issues related to problem gambling and school violence Currently, he is completing his doctoral dissertation on adolescent problem gambling Tapio Jaakkola, Tapio Jaakkola has been working with the issue of problem gambling since 2003 He is the developer and manager of the Finnish national gambling helpline Before this assignment, he worked for seven years as a managing director of one the biggest associations against drug abuse in Finland He has written several articles and guidebooks both on drugs and on problem gambling x Contributors Agneta Johansson, Agneta Johansson is a clinical psychologist and psychotherapist, who has worked in psychiatric hospitals in Sweden and Norway, and completed her doctoral dissertation on gambling in 2006 She resides in Stockholm (Sweden) Jakob Jonsson, Jakob Jonsson has worked as a clinical psychologist since 1995 He has been a member of the international gambling research team of Sweden since 1996; was involved in the prevalence study of 1997–1998 and was the main author of the follow-up study in 2003 He works as a senior consultant at the private company, Spelinstitutet, a company that, in the field of problem gambling, works with education, research, treatment, and responsible gaming Maarten W J Koeter, Maarten W J Koeter is an epidemiologist and works at the Amsterdam Medical Centre, Department of Psychiatry, as an associate professor of research methods in psychiatry and addiction His main interests in the addiction field are prolific criminal drugs addicts and gambling addiction Stella Laansoo, Stella Laansoo earned her M.Sc in psychology from Tallinn University She joined with Public Service Academy in 2003, where she is teaching different courses in psychology She conducts research on addictive disorders ranging from pathological gambling to substance use disorders Her primary research interests are personal and behavioural risk factors of addictive disorder Gioacchino Lavanco, Gioacchino Lavanco is a Professor of Community Psychology at Palermo University and a national board member of the Italian Society of Psychology of Community He has conducted several studies on group dynamics, group analytic models, formative dogmatism, and “mafia feeling” Recently, his research has focused on problems linked to the burnout syndrome in helping professions and on topics related to psychosocial problems of multiethnic communities Gioacchino Lavanco is member of prestigious international associations He has published over 300 scientific papers Jakob Linnet, Dr Linnet is a clinical psychologist and associate professor at the Center of Functionally Integrative Neuroscience at Aarhus University His research focuses on pathological gambling from a neuroscientific perspective His core interests are on gambling behaviour in relation to the dopamine system and cognitive biases Dr Linnet holds a postdoctoral degree from Harvard University; and a Ph.D and a Masters’ thesis from the University of Copenhagen Viorel Lupu, Viorel Lupu is a consultant psychiatrist to the Child and Adolescent Psychiatric Clinic of Cluj-Napoca, Romania (from 1994 to present) He is a cognitive–behavioral therapy (CBT) psychotherapist certified by the National Association of Cognitive–Behavioral Therapists 21 Switzerland • • • • years or over, whereas slot machines and casinos tend to be patronized by a younger age group (40% are younger than 35 years) That said, a strikingly high proportion (approximately 22%) of gamblers are of pensionable age At least three quarters of the weekly lottery and betting gamblers are Swiss nationals, the rest are foreign nationals In the slot machine/casino sector, the ratio is around two thirds to one third Compared with the general population aged 18 years and older, foreigners (18%) are more likely to take part in games of chance on a weekly basis than Swiss nationals Frequent gamblers are to be found across all strata of education However, there is a higher statistical representation of gamblers of a lower education level and a correspondingly lower representation of better-educated gamblers Frequent gamblers are also to be found across all income groups While there is barely any difference between gamblers from middle-income groups relative to the general population aged 18 years and over, people from lower-income groups are slightly over-represented, and those in the top income bracket markedly under-represented Data relating to the additional consumption of alcohol and tobacco indicate that frequent gamblers tend to consume more alcohol and to smoke more than the general population aged 18 years and over This is not the case for the consumption of illegal substances In terms of psychological well-being and contentment with leisure time, there is no difference between frequent lottery and betting gamblers and the general population aged 18 years and over Frequent slot machine/casino gamblers, on the other hand, score rather lower in this respect than the population as a whole (Künzi et al 2004) 2.3 Incidence of Problem and Pathological Gambling The first Swiss prevalence data stem from a study by Osiek, Bondolfi, and Ferrero (1999) and the study relates to data collected in 1998 The authors based their study on a telephone poll of 2,536 people aged 18 years and older using random quotas with respect to region, gender, age, and occupation They used the South Oaks Gambling Screen (SOGS) as a tool for measuring pathological 321 gambling (last 12 months prevalence) They also deployed the CAGE tool to measure the abuse of alcohol in order to be able to assess the comorbidity of pathological gambling and excessive drinking The weighted data of the 2,526 respondents yielded the following results: • 2,451 respondents (97%) could be described as occasional or non-gamblers (SOGS score or 2) • 55 respondents (2.2%) were revealed as problem gamblers or potential pathological gamblers (SOGS score or 4) • 20 respondents (0.8%) were probable pathological gamblers (SOGS score and over) On the basis of the population aged 18 years and over in 1997, and a confidence interval of 95%, Osiek et al (1999) extrapolated their findings to arrive at a value of between 32,700 and 77,800 pathological gamblers in Switzerland and between 107,100 and 179,800 problem gamblers All told, this equates to roughly 145,000 to 230,000 people displaying gambling-related problems The study also reported high comorbidity between alcohol and pathological gambling, and demonstrated a link between the availability of games of chance (especially chance-based slot machines outside casinos) from region to region and the proportion of pathological and potentially pathological gamblers In contrast, the prevalence data determined by Brodbeck et al (2007) were based on the National Opinion Research Center Diagnostic and Statistical Manual of Mental Disorders (DSM) Screen for Gambling Problems (NODS) The lifetime prevalence of problem gambling (NODS score 3–4) in individuals aged 14 years and older was 0.6% and lifetime prevalence of pathological gambling (NODS score ³5) was 0.3% (weighted sample) At-risk gamblers (NODS score 1–2) make up 2% of the weighted sample In comparison with Osiek et al (1999), these prevalence rates appear to be considerably lower Brodbeck et al (2007) explain the differences with their survey methodology and the use of the NODS that contains comparatively strict diagnostic criteria 2.4 Demand for Treatment Offered by Drop-in Counselling Services Switzerland’s socio-medical care is a cantonal matter Every canton offers specialist dependency facilities (drugs and alcohol) These services also 322 counsel clients with gambling dependency issues, even if what is being offered is not specifically tailored to this group Alongside such help, it is open to clients to hire the services of private psychotherapists and psychiatrists, of which there are a large number Switzerland possesses just two specialist gambling-dependency counselling centres (Basel and Lausanne) and no specialist inpatient facilities, although some specialist dependency clinics offer gambling addiction therapy There is virtually no demand for this level of therapy It is a similar picture for self-help groups The number of active self-help groups across the whole of Switzerland has fluctuated between three and six over the last years There is no national internet or telephone helpline The reason for this unsatisfactory state of affairs lies in a lack of awareness on the part of Swiss health policy makers Improvements are likely to be brought in over the next few years As a consequence, there are no annual statistics relating specifically to counselling or treatment Künzi et al (2004) examined the demand for treatment offered by drop-in counselling services This revealed that there was a sharp increase in the number of people seeking help, from 146 people in 1998 to 751 people in 2003 Relative to the total number of clients seen by the counselling agencies, this equates to a fourfold proportional increase to 1.6% in 2003 These figures were sourced from the specialist addiction counselling services, and not include people seeking help directly from private psychiatrists and psychotherapists and drop-in psychiatric clinics Künzi et al (2004) estimated the total demand for help in 2003 as being between 1,000 and 1,500 people 2.5 Professional Help for Pathological Gamblers The situation regarding the help available must be seen as closely linked to the number of people seeking help for their problem gambling Frenchspeaking Switzerland possesses only one specialist problem gambling facility Where none is available, traditional addiction facilities help fill the gap Experts feared a rise in the numbers of problem gamblers in Switzerland following the ending of the casino prohibition A study conducted by the Lucerne School of Social Work (Häfeli & Schneider J Häfeli 2003) came to the conclusion that there was a lack of integrated policy making at the national level to provide a systematic and coordinated programme of help Professionals, it revealed, were critical of the country’s present incoherent addiction policies, such as the discrimination between legal and illegal drugs or the failure to take other forms of addiction—especially gambling—into account (Spinatsch 2004) The study identified gaps in the help available to problem gamblers, owing to which most people are directed to generic addiction services that are not particularly geared to dealing with the problems associated with gambling This group of clients receives, in worst-case scenarios, sub-optimum care (i.e., care that does not take into account the latest research findings on problem gambling) Action The last years have seen a huge transformation in the way Switzerland regulates its games of chance, the principal trigger for which was the introduction of the new Federal Games of Chance and Casinos Act of 1998 (Casino Act), the prohibition of chance-based slot machines outside casinos, and the self-regulation of the state lottery providers This section looks at the statutory social protection interventions, especially those provided for by the Casino Act 3.1 Responsible Gaming Interventions in the Lottery Sector For the first time, the framework of cantonal regulation in the lottery sector (outlined earlier) incorporates provisions for responsible gaming interventions Under an inter-cantonal agreement that came into force on July 1, 2006, transparency and the division of powers are to be improved and addiction prevention and treatment bolstered The lottery providers are levied 0.5% of their gross revenues This tax goes into a gambling addiction fund to be used for the prevention and treatment of problem gambling Other measures include informing gamblers about the risks inherent in lottery participation The programme also provides for responsible gaming interventions for young 21 Switzerland people and limits on advertising Regulation is in the hands of an independent state commission No study into the effect of this new agreement has yet been conducted Remarkably, there is no legally enforceable age limit for participation in a lottery 3.2 Responsible Gaming Interventions in the Casino Sector The Casino Act provides major safeguards for gamblers in the form of responsible gaming interventions Each of Switzerland’s casinos is obliged to prepare and implement what is known as a social concept It must make provisions for the following (Dombrowski, Gschwend, Steffen, Rehm & Uchtenhagen 2000): • Measures for the prevention of problem gambling and the early recognition of gamblers at risk • Training schemes for employees • Logging of data related to problem gambling 3.2.1 Preventive Interventions and Early Recognition A casino’s social concept must provide low-threshold access to information on the risks of gambling and, where necessary, to help in the form of bans, counselling, self-help groups, and so forth Casinos must also make available a self-assessment questionnaire that helps patrons find out the degree to which they are at risk of problem gambling Casino staff must be in possession of guidelines and a checklist to help them spot gamblers at risk and enter into a dialogue with them The criteria are designed to help the casino make the appropriate interventions All observations and interventions made must be logged To ensure the effectiveness of these measures, the casino sector is able to count on the support of external responsible gaming professionals October 2004 saw the launch of an integrated programme of support for casino patrons exhibiting problem gambling behaviors This arranges for the casino and patron to agree monthly visiting limits, which the patron must abide by Patrons will be turned away from the casino or any of the other Swiss casinos if they attempt to go over the limit This scheme does not apply to a patron who is already banned from gambling In compliance with the social concept, 323 casino staff are issued with a standardised reporting card in the form of a checklist that helps them spot patrons at risk of problem gambling 3.2.2 Staff Training Those casino employees entrusted with implementing the social concept must follow a one-off basic course of instruction provided by a qualified body, followed by an annual refresher course 3.2.3 Gambling Prohibitions and Bans The Casino Act provides for the prohibiting of specific groups of people from gambling There is a blanket prohibition, inter alia, on persons under the age of 18 years, on people banned from gambling, and on casino employees Bans are issued if it can be established or it is strongly suspected that a gambler is overly in debt, that the stakes being wagered bear little relation to their financial circumstances, or that they have a disrupting influence on the game A patron can also initiate a self-imposed ban In the event of a ban, self-imposed or otherwise, the casino must forward the identity of the patron to all the other Swiss casinos, as the ban applies throughout the country Swiss casinos’ electronic access systems and ID checks help to enforce the ban A ban is, in principle, of unlimited duration A patron can apply for a ban to be lifted year after its imposition at the earliest, although by requiring evidence of a patron’s financial affairs and proof that the patron is financially solvent, the procedure involved in lifting a ban is far from easy 3.2.4 Logging of Data on Pathological Gambling Each casino is required by the Casino Act to keep a register of gambling bans It must submit an annual report to the independent Federal Casino Commission detailing, inter alia, the following: The training undertaken by the staff The implementation of preventive interventions The implementation of early-recognition interventions The number of patrons referred to addiction prevention services, counselling services, or for therapy The gambling bans issued and the number of bans issued and lifted per month 324 J Häfeli 4,700,000 3.3 Effectiveness of Casinos’ Preventive Interventions In 2002, at the time the first Swiss casinos opened their doors for business, 4,559 people were already registered as banned for a variety of reasons By the end of 2005, this figure had risen to 13,700 The years 2003 to 2005 saw 9,393 persons banned from casinos (see Fig 21.1) Over the same period, 1,002 had their bans lifted Bans rose by 8.8% (300 people) between 2004 and 2005 The ability to compare the number of visits with the number of bans is important in terms of charting trends over the years or differences between casinos Figure 21.2 shows that, in 2003, one ban was issued per 1,351 visits In 2005, this had dropped to one ban per 1,038 visits Details relating to the characteristics of the banned gamblers could be sourced from three large casinos only Table 21.4 shows the demographic data of patrons banned, taken from the 2003 to 2005 financial reports of the Grand Casinos Baden, Bern, and Lucerne (Häfeli 2004; 2005; 2006) The data were gathered and electronically stored by casino staff by means of standard interviews conducted at the time the ban was pronounced The number of people interviewed varied widely, participation being voluntary Over that period, 2,443 individuals were surveyed at the three casinos for which figures were available 3,696 3,396 2,301 326 223 2003 Gambling bans 453 2004 2005 Lifted bans Fig 21.1 Number of bans pronounced and lifted 4,300,000 3,100,000 ban per 1,266 visits ban per 1,351 visits 2,301 2003 Number of visits ban per 1,038 visits 3,396 2004 3,696 2005 Number of gambling bans Fig 21.2 Number of gambling bans as a proportion of total visits Table 21.4 Demographic data on gambling bans 2003–2005 Bans by gender (n=2,443) Male 1,957 Female 486 Bans by age group (n=2,408) 18–30 682 31–40 770 41–50 554 51–64 339 65 and over 63 Bans by nationality (n=2,294) Swiss 974 Foreign, resident in Switzerland 1,236 Foreign, resident abroad 84 Bans by activity (n=1,786) Slot machines 1,026 Table games 395 Slot machines and table games 365 Frequency of visits of banned patrons (n=1,715) 4–7 per week 209 2–3 per week 594 2–4 per month 602 per month 143 Other/occasional 167 DSM-IV scores of the patrons banned (n=1,234) 0–2 points 310 3–4 points 477 5+ points 447 80% 20% 28% 32% 23% 14% 3% 42% 54% 4% 58% 22% 20% 12% 35% 35% 8% 10% 25% 39% 36% 21 Switzerland Male patrons constitute by far the largest proportion (80%) of banned people At 32%, the 31- to 40-year-old age group represents almost one third of all bans, followed by the 18- to 30-year-old group at 28%, and the 41- to 50-year-old group at 23% The balance is held by the 51- to 64-year-old age group (14%) and the over 65-year-old age group (3%) With regard to nationalities, the largest group banned is that of foreigners resident in Switzerland (54%), followed by Swiss nationals (42%), and foreigners resident abroad (4%) In relation to type of game played, 58% of patrons banned play only slot machines, 22% only table games, and 20% play both In terms of frequency of visits, 12% of those banned visited the casino four to seven times per week, 35% two to three times per week, 35% two to four times per month, while of the remaining 8% visited once a month, and 10% described themselves as irregular in their playing habits When a ban is pronounced, the patrons affected are invited to fill out the DSM, 4th Edition (DSM-IV) questionnaire This revealed that 25% of those doing so did not appear to display any pathological gambling tendencies (0–2 points), 39% displayed indications of problem gambling behavior (3–4 points), while 36% showed signs of significant problems in their gambling behavior (5+ points) Overall, the above data suggest, at the very least, that the number of bans pronounced (which is large by international standards) is an indication that the proactive preventive interventions of Swiss casinos seem to be working All Swiss casinos’ preventive activities since 2006 have been conducted using standardised software solutions This will henceforth enable scientific and academic soundings to be taken of the effectiveness of casinos’ social concepts The aim of the Casino Act is to facilitate the early recognition of problem gambling behavior and to foster early intervention by casino staff The Casino Act provides for intensive training programmes with yearly refresher courses and annual quality audits by outside agencies—two accompanying measures aimed at securing the achievement of these ambitious goals 3.4 State Health Policy In Switzerland, the onus of preventing the onset of problem gambling is entirely on the providers of the gaming products, since the prevention and 325 treatment of gambling addiction plays a secondary role in the nation’s health policy Tobacco, alcohol, and illegal substances take pride of place in Switzerland’s policy on addiction and they are correspondingly endowed with a plethora of measures and financial means There is a widespread lack of awareness of the problems associated with gambling in the country’s strategy on health There are no public gambling addiction prevention programmes, and treatment facilities not have the necessary funds The lack of specialist treatment facilities is presumed to be having a direct impact on the demand that is undoubtedly there Conclusion Switzerland has no established tradition of involvement in games of chance The country’s embargo on casinos—in force for much of the 20th century—has only recently been lifted Lottery products have been in existence for decades, but they were never seen as gambling in the public consciousness The introduction of the new Casino Act (2000) served to revive the debate on games of chance in Switzerland This quite particular circumstance has allowed Switzerland to pass an innovative Casino Act that addresses the modern requirements of casinos’ socially acceptable offerings Experience of the country’s years of casino operations so far suggests that it is possible to strike a balance between commercial profitability—needed to raise tax revenues to satisfy the state’s fiscal interests— and the state’s social and health policy interests Nevertheless, more time is required before a proper assessment of the effects of the Casino Act can be undertaken However, what can be established is that the division of powers between the state, which oversees the casinos, and the cantons, which oversee lotteries and betting, is leading to a regrettable competitive environment—a situation that is fundamentally at odds with the country’s stated sociopolitical aims The lack of a national, and therefore coherent, policy on games of chance is seriously hampering the development of a transparent strategy on future challenges, such as online gambling The growing trend of cross-border online gambling is being viewed with concern in some quarters 326 Switzerland will be forced to rethink its veto on internet-based games of chance The appeal of online gambling grows as technology progresses The consequence is, on the one hand, that increasing amounts of gaming revenue are flowing abroad and, on the other hand, that gambling more and more often takes place in a socio-politically unprotected environment—a state of affairs incompatible with the aims of the Casino Act Were the veto on the use of telecommunications to conduct games of chance to be relaxed, the virtual market would come under regulation— concomitantly benefiting from social protection interventions not unlike those that apply to the physical casino sector—and some, at least, of the gaming revenues flowing abroad, would henceforth remain in the country and be taxed accordingly Switzerland’s coming generations are, for the first time in the Confederation’s history, having to contend with the reality of the universal availability of gambling, ranging from conventional lottery vouchers all the way to telecommunication-based gambling opportunities—a situation that presents the country’s health policy with a whole new set of challenges Preventive programmes providing factual information on all aspects of games of chance and promoting the skills needed to gamble responsibly need to be launched sooner, not later References Brodbeck, J., Dürrenberger, S., & Znoj, H (2007) Grundlagenstudie Spielsucht: Prävalenzen, Nutzung der Glücksspielangebote und deren Einfluss auf die Diagnose des Pathologischen Spielens [Baseline study: Prevalences and consumption of games of chance and their influence on the diagnosis of pathological gambling] Bern: University of Bern Cabot, A N., Thompson, W N., Tottenham, A., & Braunlich C G (Eds.) (1999) International Casino Law (3rd edition) Reno: University of Nevada Dombrowski, D., Gschwend, P., Steffen, T., Rehm, J., & Uchtenhagen, A (2000) Spielbanken Ausführungen J Häfeli und Materialien zum Sozialkonzept [Casinos Social concept models and materials] Zürich: Institute of Addiction Research Goldmedia (2006) Online Betting & Gambling 2010: Marktpotenziale für Online-Glücksspiele in Deutschland, Österreich und der Schweiz [Online Betting & Gambling 2010: Market potential for online games of chance in Germany, Austria, and Switzerland] Berlin Häfeli, J (2004) Bericht Umsetzung Sozialkonzept 1.1 03—31 12.03 in den Grand Casinos Baden, Bern und Luzern [Report on implementing the social concept 1.1 03—31 12.03 in the Baden, Bern and Lucerne Grand Casinos] Lucerne: HSA Häfeli, J (2005) Bericht Umsetzung Sozialkonzept 1.1 04—31 12.04 in den Grand Casinos Baden, Bern und Luzern [Report on implementing the social concept 1.1 04—31 12.04 in the Baden, Bern and Lucerne Grand Casinos] Lucerne: HSA Häfeli, J (2006) Bericht Umsetzung Sozialkonzept 1.1 05—31 12.05 in den Grand Casinos Baden, Bern und Luzern [Report on implementing the social concept 1.1 05—31 12.05 in the Baden, Bern and Lucerne Grand Casinos] Lucerne: HSA Häfeli, J., & Schneider, C (2003) Versorgungssituation von Glücksspielsüchtigen in der Schweiz—Eine Bestandesaufnahme 2003 [Care provision for gambling addicts in Switzerland—A stock-take] Lucerne: HSA Künzi, K., Fritschi, T., & Egger T (2004) Glücksspiel und Spielsucht in der Schweiz—Empirische Untersuchung von Spielpraxis, Entwicklung, Sucht und Konsequenzen [Games of chance and gambling dependency in Switzerland—An empirical study of practice, development, addiction, and consequences] Bern: Büro BASS Osiek, C., Bondolfi, G., & Ferrero, F (1999) Étude de prÉvalence du jeu pathologique en Suisse [Study on the prevalence of pathological gambling in Switzerland] DÉpartement de Psychiatrie Hôpitaux Universitaires de Genève Spinatsch, M (2004) Eine neue Suchtpolitik für die Schweiz? Bericht zuhanden des Bundesamtes für Gesundheit [New dependency policy for Switzerland? Report for the Federal Office of Health] Bern Swiss Federal Gaming Board (2002) Jahresbericht 2002 [Annual Report 2002] Bern: ESBK Index A Abbott, M.W., 106, 118, 212, 302, 304, 306 Achour-Gaillard, A., 76 Adolescent gambling age risk factor and cut-off points, 61–62 slot machine gambling, 62 vs betting and internet poker, 62–63 Adult gambling, 106–109 Ahrens, U.-B., 302 Andrén, A., 304, 306 Attention deficit hyperactivity disorder (ADHD), 141, 145–147 Azzimondi, F., 158 B Báez, C., 286, 293 Baˇrbuneanu, R., 232 Barnett, A.H., 268 Barudotti, S.K., 140, 141 Becoña, E., 286–288 Belgium gambling participation and problems, 5–6 gambling prevention strategies primary, 11–12 secondary, 12–13 tertiary, 13–14 gambling sectors betting legislation, 4–5 games of chance law, mobile telephones and television phone-in quizzes, national lottery, 3–4 internet gambling disadvantages, influencing factors, 10 vs non-internet gambling, 9–10 Bellio, G., 162 Benci, S., 162 Berg, C., 302 Berntsen, W., 215 Betting legislation, 4–5 Biganzoli, A., 158, 159 Binde, P., 308, 309 Björ, J., 302 Blaszczynski, A., 162 Blume, S.B., 42 Bole, V., 268 Bondolfi, G., 321 Bonicolini, C., 162 Bonke, J., 23, 30 Bonnaire, C., 78 Borodkin, F., 253 Boro, M.S., 235, 237 Borregaard, K., 23, 30 British gambling prevalence survey (BGPS), 105–107 Brodbeck, J., 320, 321 Bühringer, G., 90 Buth, S., 88, 90, 91 C Cabanes, M., 286 Capitanucci, D., 158, 159 Caplan, G., 93 Carbonero, M., 286 Casinos density, 319 levy, 319 type A and type B, 318–319 Castilla, R., 286 Chantal, Y., 114 Cice, R., 158 327 328 Cocci, V., 162 Cognitive distortion questionnaire (CDQ), 141, 146 Connolly, D., 269 Coroamaˇ B., 232 Croce, M., 158 Csorba, C., 132, 134 Custer, R.L., 249 D Davidescu, L., 232 Davidson, I., 246 Denmark gambling activity legislation casinos, 18 internet and media gambling, 19 lotteries, scratchcards, and bingo games, 18 slot machines, 18–19 gambling addiction anthropological and sociological studies, 20–22 cognitive bias, 26 Danish prevalence study, 22–23 dopaminergic reward mechanisms, 26–27 game providers, 31–32 policy makers and administrators, 31 structural characteristics, 27–28 treatment, 28–30 lottery grants fund distribution, 19–20 gambling turnover and distribution, 19 pathological gambling, treatment Center for Ludomani, 23–24 Frederiksbergcentret, 24 treatment evaluation, 24–25 Dimauro, P.E., 162 Donskikh, T.A., 248 Dowling, N., Duarte, J., 286 Dürrenberger, S., 320, 321 E Echeburúa, E., 286, 293 Eerola, T., 66 Egger, T., 320, 322 Eisenstein, N., 215 Engelhart, C., 215 Erbas, B., 95 Erkkilä, J., 66 Estonia gambling market casino games, 39–40 lotteries, 39 lottery and casino turnovers, 38–39 regulation, 40–41 gambling problem national policy, 48 Index responsible gambling, 49–50 treatment options, 48–49 surveys gambling participation and problems, 42–44 high-risk group identification, 44–46 instruments, 42 risk factors, 46–48 samples, 41–42 Estonian gambling operator association (EGOA), 49–50 F Fassel, D., 251 Fernández-Alba, A., 295 Fernández, J., 286 Fernández-Montalvo, J., 293 Ferrero, F., 321 Finland adolescent gambling, 61–63 gambling age restrictions, 55–56 Ålands Penningautomatförening (PAF), 56 Fintoto Oy, 55 gambling market, 53–54 national policy, problem tackling, 63–65 opportunities, 56–57 Raha-automaattiyhdistys (RAY), 54 sales volumes and total public revenue, 57–58 strengths and weaknesses, 67–68 treatment options, 65–67 Veikkaus Oy, national lottery, 55 gambling participation and problems, 59–61 Fiorin, A., 162 Fisher, S., 90, 288 France gambling casinos, 73 casino self-exclusion, 81–82 clubs and internet, 73–74 Française des Jeux, 72 gamblers types, 77–79 gambling market evolution, 74–75 history and legislation, 71–72 informative and preventive measures, 80–81 Pari Mutuel Urbain, 72–73 prohibition and monopoly, 79–80 treatment, 82–83 types and risk factors, 76–77 pathological gambling, 75–76 Fritschi, T., 320, 322 G Gambling Belgium gambling participation and problems, 5–6 Index gambling prevention strategies, 11–14 gambling sectors, 3–5 internet gambling, 9–10 Denmark gambling legislation, 18–19 gambling addiction, 20–30 lottery grants, 19–20 pathological gambling, treatment, 23–25 Estonia casino games, 39–40 gambling problems, 48–50 lotteries, 39 lottery and casino turnovers, 38–39 regulation, 40–41 surveys, 42–48 Finland adolescent gambling, 61–63 age restrictions, 55–56 Ålands Penningautomatförening ( PAF ), 56 Fintoto Oy, 55 gambling market, 53–54 gambling participation and problems, 59–61 national policy, problem tackling, 63–65 opportunities, 56–57 Raha-automaattiyhdistys (RAY), 54 sales volumes and total public revenue, 57–58 strengths and weaknesses, 67–68 treatment options, 65–67 Veikkaus Oy, national lottery, 55 France casinos, 73 casino self-exclusion, 81–82 clubs and internet, 73–74 Française des Jeux, 72 gamblers types, 77–79 gambling market evolution, 74–75 history and legislation, 71–72 informative and preventive measures, 80–81 Pari Mutuel Urbain, 72–73 prohibition and monopoly, 79–80 risk factors, 76–77 treatment, 82–83 Germany gambling market, 85 gaming arcades, 87 lottery agencies, 86–87 pathological gamblimg, 88–92 private gaming, 88 problem gambling prevention, 93–99 telephone gaming, 87–88 Great Britain addiction treatment, 114–117 adolescent gambling, 111–112 adult gambling, 106–109 gaming machines, 105 329 internet and remote gambling, 112–113 legal framework, 103 national lottery, 104 problem gamblers, 116–119 Hungary epidemiological research, 130 gambling prevalence, 131–132 national gambling market, 123–125 problem gambling, prevention, 132–133 problem gambling, treatment, 133–134 Iceland adolescents and adult problems, 140–147 gambling machines distribution, 148 gambling market, 137–138 gambling problems, 142–148 gambling research, 139–140 Italy community interventions, 168–169 epidemiological research and social policies, 165 market, 153–155 motivations, 159–160 national policy and treatment, 161–162 private associations, 163–164 psychoactive substances, 162–163 research, 156–158 self-help groups, 164 Lithuania action, 185–187 evidence, 180–185 law on games and lotteries, 174–176 market overview, 176–180 pathological gambling, 174 Poland–Lithuania Union, 173 Netherlands, The area-specific prevention measures, 201 existing treatment options, 202–204 gambling and popularity, 191–192 legal framework, 189–191 national policy, 199–200 participation, 192 pathological gambling, 197–199 problem gambling prevention policy, 201–202 problems and prevalence, 192–194 protective factors identification, 194–197 Norway gambling market, 209–211 gambling problems, 215–216 governmental action, 216–217 lie/bet screen (LBS), 215 pathological gambling, 211–214 problematic gambling, 216 Poland commercial gaming operators, 222 330 drug addiction, 219 evidence, 222 gross revenues, 220 policies and casinos, 224–225 public debate, 223–224 state monopoly, 225–226 treatment, 222–223 video lottery terminals (VLTs), 221 wagering law, 220–221 Romania laws, 229–231 national politics, 237–239 opportunities, 231–233 pathological gambling, 234–237 Russia attitudes, 246–247 contemporary gambling industry, 245–246 current government policy, 251–252 historic background, 244–245 motivational perspective, 249–251 pathological gambling, 247–249 socio-criminological perspective, 252–254 Soviet Union, 245 technological backwardness, 244 Slovak Republic CPLDZ Bratislava, 263 expenditures and revenues, 261, 262 gambling situation, 257–258 legislation, 258–260 national level initiatives, 262 negative and positive aspects, 264 operation conditions, 261 preliminary issues, 261–262 recommendation, 264 regulation, 260–261 therapeutic programme, 263 Slovenia average annual social costs, 272, 273 care system evaluation, 275–276 economy, 265 foreign and Slovenian visitors, 270 history and current market, 265–267 impact of Slovenian casinos, 271 pathological gamblers, 276 preliminary problem evaluation approach, 273–274 preventive mechanisms evaluation, 274–275 Slovenian casino visitors, 267 treatment facilities, 277–278 Spain educational and preventive strategies, 293–294 expenses, 283–285 gambling products vs year of creation, 282 legalisation and expansion, 282–283 legislation and policies, 290–291 Index pathological gambling, 285–293 regulatory structures, strong and weak points, 294 risk and protective factors, 289–290 vulnerable groups, 288–289 structural and situational characteristics, 113–114 Sweden advertising, 308–309 gambling problems, 302–304 problem gamblers, 304–307 regulation and authorities, 301–302 responsible gaming, 311–312 Swedish National Institute of Public Health (SNIPH), 309–311 Switzerland casinos’ preventive interventions, 324–325 drop-in counselling services, 321–322 gamblers’ characteristics, 320–321 gambling participation, 320 pathological gambling and gamblers, 321–322 responsible gaming interventions, 322–323 state health policy, 325 Gambling Act 2005, 117–118 Gambling addiction treatment intervention options, 114–115 referral paths, 114–117 German Democratic Republic (GDR), 86, 87, 91 Germany gambling market, 85 gaming arcades, 87 lottery agencies, 86–87 pathological gambling criminal behavior, 92 representative survey, 88–90 risk factors, 91–92 private gaming, 88 problem gambling prevention ban on gambling, 94–95 goals and regulations, 98–99 national policy, 97–98 preventative strategies, 93–94 treatment options, 95–97 telephone gaming, 87–88 Geru, A., 235, 237 Götestam, K.G., 211, 213 Grant, J.E., 211 Great Britain adolescent gambling, 111–112 adult gambling, 106–109 gambling addiction treatment intervention options, 114–115 referral paths, 114–117 gambling legalisation, 103 gaming machines, 105 Index internet and remote gambling, 112–113 national lottery, 104 problem gambling Gambling Act 2005, 117–118 health services, 116–117 service providers, 118–119 Gretarsson, S.J., 140, 141 Griffiths, M.D., 6, 10, 113 Gromová, S., 261 Gutiérrez, B., 286 H Hame, R.M., 215 Hansen, M., 28 Healthcare professionals, 118 Helenius, K., 302 Hodgins, D.C., 47 Horse betting, Hungary epidemiological research, 130–131 gambling prevalence, 131–132 history, 123 national gambling market current regulatory framework, 125 gambling opportunities, 125–128 political changes, 124–125 total public revenue, 128–130 problem gambling prevention, 132–133 problem gambling treatment, 133–134 Huotari, K., 67 Hurrelmann, K., 90, 91 I Iceland adolescents and adults gambling participation, 141–142 problem gambling prevalence, 142–144 problem gambling risk factors, 144–147 gambling machines distribution, 148 gambling market, 137–138 gambling research, 139–140 problem gambling prevalence in adolescents, 144 prevalence in adults, 142–143 risk factors, 144–147 treatment and prevention, 147–148 Iftene, F., 235, 237 Internet gambling, 112–113 Belgium disadvantages, influencing factors, 10 vs non-internet gambling, 9–10 Denmark, 19 France, 73–74 331 Italy gambling community interventions, 168–169 epidemiological research and social policies, 165 market, 153–155 motivations, 159–160 national policy and treatment, 161–162 policy, 155–156 private associations, 163–164 psychoactive substances, 162–163 research, 156–158 self-help groups, 164 population research, 158–159 J Jakli, M., 267–269 Jere, Ž., 268 Johansson, A., 211, 213 Johnson, E.E., 215 Jonsdottir, J.E., 140, 141 Jonsson, J., 304, 306 K Kähnert, H., 90, 91 Kassinove, J.I., 246 Kavli, H., 215 Kidman, R., 295 Kim, S.W., 211 Kindstedt, A., 304, 306 Kneževi-Cvelbar, L., 268, 269 Kneževi, L., 268, 270 Korolenko, C.P., 248 Kraus, L., 90 Kühlhorn, E., 302 Künzi, K., 320, 322 Kurkela, R., 66 L Labrador, F.J., 295 Lavanco, G., 158, 159 Leifman, H., 302 Lesieur, H.R., 42 Linnet, J., 30 Lithuania evidence adolescent pathological gambling, 180–185 adulthood gambling, 185 gambling market overview business, 178–179 casino, bingo and machine, 176 companies, 179 financial indexes, 179–180 Lithuania (cont.) internet, 177 332 lotteries, 176–177 totalisator and betting, 176 law on games and law on lotteries gambling lotteries types, 174–175 state gaming control commission, 175–176 pathological gambling, 174 Poland–Lithuania Union, 173 preventive actions demographic characteristics, 186 Lo Re, T., 158 Lottery, 125–126 Loughnan, T., 114 Luin, D., 265 Lupu, V., 235, 237 M Macur, M., 268, 270, 271 Mafia and crime, 165–166 Makarovicˇ, M., 268, 270, 271 Media gambling, 19 Meyer, G., 92 Mikaelsson, M., 140, 141 Minet, S., 9, 13 Miu, A., 235, 237 Møller, A., 30 Moore, L., 304, 306 Munch, I.M.K., 212 Munck, I., 304, 306 Murto, L., 63 N Nábielek, L., 261 National anti-drug association (NAA), 237 National gambling market, Hungary current regulatory framework, 125 gambling opportunities casino market, 128 lottery, 125–126 slot machine market, 126–128 political changes, 124–125 total public revenue, 128–130 Nazmutdinov, A.B., 248 Németh, A., 132, 134 Netherlands, The area-specific prevention measures, 201 existing treatment options addiction treatment, 202–203 future development, 204 Gamblers Anonymous, 203–204 gambling and popularity addiction, 191–192 monopolies, 191 participation, 192 Index gambling problems and prevalence Dutch population, 192–193 Holland Casino, 194 pathological gambling, 193–194 SOGS score, 193 legal framework Dutch gambling act, 189 gambling activities, 190 gaming monopolies, 190–191 objectives, 189–190 national policy gambling strategies, 199 Holland Casino, 199–200 pathological gambling internet, 198–199 scratchcard, 197–198 integral problem gambling prevention policy, 201–202 protective factors identification casino gamblers, 196 ethnic minorities, 195 pathological gambling, 194–195 problematic gambling, 196–197 Nielsen, P., 23, 25, 29 Niemelä, J., 63 Nilsson, T., 304, 306 Nora, R., 215 Norway gambling market lotteries, 209 Norsk Tipping, 210–211 pathological gambling, 210 gambling problems, 215–216 governmental action, 216–217 lie/bet screen (LBS), 215 pathological gambling adolescence, 213 technological addictions, 213–214 problematic gambling, 216 Norwegian University of Science and Technology (NTNU), 211 Nowatzki, N., 269 Nower, L., 162 O Odlaug, B.L., 211 Olason, D.T., 140, 141 Örnberg, J.C., 17 Osiek, C., 321 P Páez, D., 286 Pahor, M., 268–270 Pasternak, A.V., 249 Index Pathological gambling Denmark Center for Ludomani, 23–24 Frederiksbergcentret, 24 treatment evaluation, 24–25 France, 75–76 Germany criminal behaviour, 92 epidemiological survey, 90–91 representative survey, 88–90 risk factors, 91–92 Netherlands, The gambling problems and prevalence, 193–194 internet, 198–199 protective factors identification, 194–195 scratchcard, 197–198 Romania adolescents, 234–237 anonymous, 234–235 ICD classification, 237 psychosocial problems, 239 risk factors, 236–237 treatment methods, 237–238 sensation seeking and alexithymia, 78 Slovak Republic CPLDZ Bratislava, 263 therapeutic programme, 263 Slovenia annual social costs, 272, 276 Spain DSM-III, DSM-IIIR, and SOGS, 285–286 DSM-IV and NODS, 287 treatment options, 292–293 Switzerland, 321 Peden, N., 47 Petry, J., 96, 97 Pierce, M., 114 Poland drug addiction, 219 evidence, 222 gambling commercial gaming operators, 222 gross revenues, 220 video lottery terminals (VLTs), 221 wagering law, 220–221 gambling policies and casinos, 224–225 public debate, 223–224 state monopoly, 225–226 treatment, 222–223 Poteri, R., 66 Prašnikar, J., 268, 270 333 Q Queri, S., 95 R Rahapelifoorumi, 64 Ramírez, J N., 286 Reith, G., 269 Remote gambling, 112–113 Responsibility in Gambling Trust (RIGT), 117 Responsible gambling Estonian Gambling Operator Association (EGOA), 49–50 new draft Act, 40–41 Røjkjær, S., 23, 25, 29 Romania gambling opportunities advantages, 231–232 Caritas, 233 Insomar, 231 sports betting, 232–233 laws gambling, 230–231 Parilotto and Pideolottery, 229–230 national politics pathological gambling, 237–239 treatment methods, 237–238 pathological gambling adolescents, 234–237 adults, 234 Roncˇevicˇ, B., 268, 270, 271 Rönnberg, S., 212, 302, 304, 306 Russia current government policy laws, 252 gambling attitudes, 246–247 contemporary gambling industry, 245–246 historic background, 244–245 Soviet Union, 245 motivational perspective analysis, 249 psychological mechanisms, 250–251 therapeutic strategies, 251 pathological gambling classification stages, 249 environmental factors, 248–249 psychiatrists, 248 socio-economic classes, 247 socio-criminological perspective, 252–254 technological backwardness, 244 S Sagris, A., 114 Saidulina, A.F., 249 334 Schaef, A., 251 Schmidt, L., 90, 91 Shaffer, H.J., 295 Skarphedinsson, G.A., 140, 141 Slot machine legislation Danish prevalence study, 29 game providers, 31–32 policy makers and administrators, 31 research projects, 21 treatment and research funds, 22 treatment centers Center for Ludomani, 23–24 Frederiksbergcentret, 24–25 Slot machine market, 126–128 Slovak Republic CPLDZ Bratislava, 263 evidence expenditures and revenues, 261, 262 initiatives at national level, 262 legislation Act defining gambling games, 258–259 betting games, 260 casino gambling games, 259–260 internet-operated games, 260 lottery games, 259 machine-operated games, 260 technical equipment operated games, 260 operation conditions, 261 recommendation, 264 regulation, 260–261 therapeutic programme, pathological gamblers, 263 Sloveniaf average annual social costs, 272, 273 care system evaluation, 275–276 economy, 265 evidence preliminary results, 268 problem and pathological gambling estimates, 268–272 foreign and Slovenian visitors, 270 gambling history and current market, 265–267 pathological gamblers, 276 preliminary problem evaluation approach, 273–274 preventive mechanisms evaluation, 274–275 Slovenian casinos, impact, 271 Slovenian casinos, visitors, 267 treatment facilities health and social care, 278 problems, 277–278 Smaniotto, R., 159 Smith, D., Sonntag, D., 90, 91 South Oaks Gambling Screen (SOGS), 158–159, 193 Soyka, M., 95 Index Spain educational and preventive strategies, 293–294 expenses, 283–285 gambling products vs year of creation, 282 legalisation and expansion, 282–283 legislation and policies from 1977, 290–291 participation, 285 pathological gambling in children, adolescents, and university students, 288 DSM-III, DSM-IIIR, and SOGS, 285–286 DSM-IV and NODS, 287 in Spanish adult population, 286 treatment options, 292–293 in various countries, 287 risk and protective factors, 289–290 strong and weak points on regulatory structures, 294 tourism and the leisure industry, 281 vulnerable groups, 288–289 Stadler, M., 92 Stinchfield, R., 88, 90, 287 Stöver, H., 88, 90, 91 Svensson, O., 304, 306 Sweden advertising, 308–309 community impacts of casinos casino evaluation, 308 Westfelt’s Studies, 308 economy, 299 gambling market, 300–301 gambling problems, 302–304 gambling types, 307–308 Penninglotteriet, 299–300 policies and research, 302 problem gamblers childhood circumstances, 304–305 comorbidity, 305–306 young people, 306–307 regulation and authorities, 301–302 responsible gaming educating retailers, 312 information for customers, 312 at international casinos, 311–312 poker on internet, 312 Swedish National Institute of Public Health (SNIPH), 309–311 Tipstjänst, 299–300 turnover for popular games, 301 Switzerland casinos’ preventive interventions, 324–325 chance market, 318–320 drop-in counselling services, 321–322 gamblers’ characteristics, 320–321 gambling participation, 320 pathological gambling and gamblers, 321–322 Index responsible gaming interventions casino sector, 323 lottery sector, 322–323 state health policy, 325 T Tan, B.H., 215 Thomas, T., Tóth, A., 132, 134 Tourunen, J., 66 Tsytsarev, S.V., 246 V Vallerand, R.J., 114 Vehovar, U., 268, 270, 271 Video poker machine, 160 Viloria, C., 288 Volberg, R Volberg, R.A., 212, 302, 304, 306 Vongrej, J., 261 335 W Walker, D.M., 268 Westfelt, L., 307 Williams, J.R., 269 Wood, R.T., 269 Y Yeoman, T., 111 Z Zagoršek, H., 267–269 Zaitsev, V.V., 249 Živný, H., 261 Znoj, H., 320, 321 Zorec, K., 268, 270, 271 Zori, J., 267 ... etc.); training materials (e.g., training videos about problem gambling shown in schools, job centres, etc.); training of gambling industry personnel (e.g., training managers of gambling establishments,... protecting and preventing youth gambling problems need to be incorporated into organized, national policies toward addressing problem gambling Such prevention initiatives are largely lacking and... that the introduction of new gambling types or the expansion of existing gambling opportunities causes an increase in the incidence of gambling- related problems, although these can be minimised