Midterm 3 Content Flashcards

Question

what is BC's public health framework?

Answer 1

* public health is preventative work * they think about what determines health, the conditions that we live in

Answer 2

* there is a federal prohibition against providing gambling services to individuals outside small scale charities and fairs * provinces have authority to "register" private operators to provide gambling services to the province * then the province makes them available to the piblic * two limitations: horseracing, single game sports betting

Answer 3

* bill C-210 legalized single/in game betting in 2021 following similar policy move in the US * all provinces except ontario give government crown corps monopolies to manage sports betting * ontario chose to open its market and license private online private operators * alberta followed ontario's lead and intends to license private online gambling for its residents

Answer 4

* looked at economic impacts of 3rd year of iGaming venture * $82.7B in wages (32% increase over previous year) * $69.6B from casino games * $11.4B from betting * $1.7B from peer-to-peer poker * gross revenue to governmnet was $3.2B (up $2.4B from year before) suggests there is a transition from online gambling to the casino

Answer 5

* increase in availability of gambling = increased gambling = increased harm * sports betting is seen as higher risk play * massive increase in promotion of gambling during major sporting events, exposure to youth is main concern * concerned that policy changes could increase overall normalization of gambling * more canadians are vulnerable to harm after the COVID epidemic

Answer 6

* online gambling is sisgnificantly riskier than other forms (accessibility) * compared to people who play the lottery, those who gambled online in the past year were... * 10x more likely to exceed lower-risk gambling thresholds * over 45x more likely to meet criteria for PG * more than 20x more likely to report high levels of gambling-related harm

Answer 7

* 1/3 young adults (32%) reported gambling online * among young adults (18-29) who gambled, 7/10 (69.4%) met criteria for PG * consistent across all demographic groups

Answer 8

* create a national strategy to prevent/address sports betting related harm * develop national advertising standards for sports betting * strengthen provincial crown corporations' monopoly over management of online gambling (more likley to prioritize population health over revenue) * develop pan-Canadian strategy to address gambling-related harm

Answer 9

* model of a “safe space” between social needs and ecological limits * inner ring: minimum conditions for people to live well * outer ring: planetary boundaries we must not exceed * aim: meet everyone’s needs without harming the planet * requires limiting extreme wealth so a few don’t hold more than millions * recognizes power dynamics that keep harmful cycles in place.

Answer 10

* corporate practices that shape health outcomes * drivers: unrestricted economic growth, globalized trade, expanding corporate influence * channels: marketing, supply chains, lobbying, and policy influence * outcomes: harm to the environment, consumers, and population health * overall idea: commercial interests shape policy to benefit themselves, often at the expense of health

Answer 11

* people who closely follow a sport can predict outcomes better than those who don’t * many young men misinterpret this as: “sports betting is an easy way to make money” * research (Cantinotti et al., 2004): experts predicted more matches correctly than random pickers but still didn’t profit

Answer 12

* results can feel obvious, which makes betting seem skill-based * to profit, you must outperform betting companies, they have all the data and set the odds * even correct predictions don’t guarantee profit because you must win all predictions in the bet

Answer 13

* Bill C-218 (2021) removed the rule allowing only parlay bets * this legalized single-event sports betting.

Answer 14

* parlay betting: must make 2+ bets in one wager; all picks must win * parlays = slower (bets placed before match) * single-event betting: allows betting on single outcomes + enables in-play betting (during and repeatedly within a match).

Answer 15

* in-play bets are fast, continuous, and allow chasing losses * turn slow lottery-style betting into a rapid, slot-machine–like game * appeals to high impulsivity * people who placed in-play bets had higher PGSI scores and impulsivity

Answer 16

* type of in-play bet on very short-term outcomes (next tennis serve, next baseball pitch) * in Russell et al. (2019), 1,813 Australian bettors were surveyed * 78% of people who placed micro-bets had likely gambling problems (high PGSI scores)

Answer 17

* tell young people sports betting is an easy way to make money * use themes of masculinity, alcohol, camaraderie, and peer influence * promote “trusting your instincts” (cognitive biases) * normalize gambling + make people believe they can win more than they actually can * this specific Ladbrokes ad was banned

Answer 18

* in 2021, Canada legalized single-event sports betting * previously only parlays were allowed (all picks must win) * Ontario opened betting to private companies with permits/websites * many companies launched at the same time → huge increase in marketing * includes other forms of advertising: sponsorships, commentators promoting betting during games

Answer 19

* in 2004, people living within 10 miles of a casino showed higher rates of problem gambling * this was before smartphones, so gambling required physically going to a casino * iphone wasn’t launched until 2007, so access to gambling has since become much easier

Answer 20

* gambling companies suggest betting makes games more exciting, and is framed as showing loyalty to your team * match-day programs include gambling ads, even in kids’ sections * 59% of children’s sections contained gambling logos/marketing (sharman et al., 2020) * “spot the difference” games use the gambling logo as the difference → makes kids pay attention to it overall effect: makes gambling seem normal and part of everyday sports culture

Answer 21

* global losses from online gambling are steadily increasing * BC was the first Canadian province to introduce online gambling in 2004 * PlayNow.com remains the only licensed, regulated site for BC residents * in contrast, Ontario (2022) shifted to a private licensing model for “iGaming,” opening the market to many companies

Answer 22

* online gambling is rapidly growing each year * land-based gambling is steady or declining * in some European countries, online gambling is now the dominant form * this shift is seen even in treatment settings, where most clients now gamble online

Answer 23

* online gamblers appear to have higher PGSI scores in many studies * but online gamblers also engage in more types of gambling overall (greater gambling breadth) * when researchers control for the number of gambling forms, online gambling by itself is not a reliable predictor of gambling problems key point: higher PGSI scores are due to variety of gambling activities, not simply being online

Answer 24

* behavioural play data: frequency, intensity, variability of gambling * demographic information: gender, age, time of day you gamble, location * financial behaviour: deposits, withdrawals, multiple deposits, account switches * operator communication: complaints, messages, text analysis * companies can track when you deposit or withdraw and use this info to identify (or exploit) risky behaviour

Answer 25

* large online datasets make it not viable to give DSM interviews or PGSI surveys, so platforms use markers like voluntary self-exclusion (VSE) to identify risk * ~75% of VSE enrollees are positive for problem gambling (74% in BC) however: * some people who enrol in VSE do not have gambling problems * many people with gambling problems never enrol in VSE * surveys are also incomplete because not everyone fills them out, so respondents aren’t representative of all users

Answer 26

primary: before harms are present, aimed at general population * objective: gambling literacy * strategy: educational program secondary: early signs of problems, aimed at regular gambers 'at risk' * objective: self-awareness, improved understanding * strategy: warning messages, app blockers tertiary: management of harm, aimed at PGs * objective: resources and options * strategy: treatment services

Answer 27

* allow a gambler to ban themselves from gambling for a fixed period of time * in BC, this is a provincially-operated program that covers all casinos + PlayNow website (Not lotteries) * currently, they are used as tertiary measures as people who enroll already have gambling problems * they are intended to be used as a secondary measure

Answer 28

75% of VSE enrollees screen positive for problem gambling

Answer 29

* involves no direct treatment, or no contact at all * administratively complex in countries with multiple operations

Answer 30

* behavioural data includes: number of bets, number/size of deposits, spending patterns * models can classify who has self-excluded with 75% accuracy (chance = 50%) * variability in spending was the strongest predictor of gambling problems (32% of signal) * pattern suggests loss chasing: controlled gambling mid-week, binge gambling on weekends

Answer 31

* platforms know how many users self-exclude and can detect similar behaviour in others * challenge: how to contact high-risk users ethically * suggested approach: provide screening tools (PGSI) and supportive messaging/awareness interventions

Answer 32

* ages 6-9: "do not bet on it" (south australia) * too early, kids don't fully understand most of the concepts * grades 3-8: "wanna bet" (minnesota) * ages 13-18: gambling: a stacked deck (alberta) * by age 18 in Alberta, lots of people have already started gambling, may be too late

Answer 33

1. awareness that gambling can be problematic 2. warning signs 3. math of gambing (house edge) 4. common gambling myths (gambler's fallacy, superstitions)

Answer 34

* compared 3 groups: 1. stats class using gambling examples 2. stats class with no gambling content 3. history/sociology class (control) * at 6-month follow-up, they measured: gambling fallacies, gambling attitudes, gambling involvement, and problem gambling * goal: see if teaching probability with gambling examples reduces gambling harm

Answer 35

* the intervention group improved and retained knowledge about gambling fallacies * however, this knowledge did not transfer to behaviour * 6 months later, they were no less likely to gamble * they were also no less likely to have gambling problems (PGSI) key issue: awareness increases, but it doesn’t change real-world gambling behaviour

Answer 36

* when we gamble, we shift into system 1 (fast, automatic thinking) * sevigny & ladouceur (2003): irrational thoughts increase during short periods of slot machine play, then return to normal afterward * training system 2 (slow, analytical thinking) does not prevent system 1 from taking over while gambling key challenge: how can educational programs reduce this switching into system 1 during gambling?

Answer 37

* some banks (mainly in the UK) offer gambling blocks that refuse direct payments to gambling sites * these blocks do not work if someone gambles with cash at a casino * apps like GamBan can block browser or phone access to gambling websites related measures include: * credit card bans for gambling transactions (UK 2021) * long-term self-exclusion (VSE) and short-term lock-out bans on gambling platforms

Answer 38

* harms: any measurable negative consequence caused by gambling * harms can affect other people (family, spouses, community) * symptom: experiences felt only by the gambler (urges, withdrawal) * symptoms are things you would go to a doctor for; harms are broader life impacts

Answer 39

* sleep problems from gambling stress * struggling to pay groceries or rent * reduction of savings * selling personal items * increased credit card debt * bankruptcy * crime (fraudulent cheques, theft) * suicide * plus harms to others: financial strain, relationship stress, lost time, conflict * a typical problem gambler affects six others

Answer 40

* less severe harms are common among subthreshold gamblers * severe harms (bankruptcy, crime, suicide) are rare at a population level public health approach focuses on reducing the high volume of mild-to-moderate harms, not only severe cases

Answer 41

the largest burden of harm comes from the low-risk/mildly affected individuals, not the small number of severe cases * only 15% of total harm comes from people with diagnostic-level problem gambling * most harm comes from low-risk and moderate-risk gamblers * occurs because less severe harms are extremely common, even among people who don’t meet criteria for a disorder * same concept is seen with alcohol

Answer 42

1. restricting access 2. restricting excessive use 3. awareness campaigns about harms 4. product-level safety features

Answer 43

1. age limits 2. gambling allowed only in designated venues (as in BC) 3. casino entry bans for residents (e.g., South Korea allows only tourists) follows accessibility/pathway models: reducing exposure reduces harm

Answer 44

1. limiting opening hours 2. restricting alcohol use in gambling venues (staff trained not to serve intoxicated people) 3. behavioural tracking to identify risky use patterns

Answer 45

1. advertising restrictions 2. “responsible gambling” information centres in venues 3. school-based education programs

Answer 46

1. pop-up / warning messages (remind players of time spent, re-anchor their reference point) 2. pre-commitment cards/limits (set spending limits before gambling starts) 3. maximum spending limits (e.g., mandated in Norway)

Answer 47

* some places use whistle-to-whistle bans: no gambling ads during sports broadcasts from kickoff to final whistle * Belgium banned all gambling advertising starting July 2023 * Ontario banned celebrities and athletes in gambling ads (some now promote safe gambling instead) * still lots of exposure to gambling logos, even with ad bans * prevention should include safe-gambling ads and counter-advertising, not just restrictions * need to be aware of backfire effects and unintended consequences of ad bans

Answer 48

* tested how well players recall warning messages on slot machines * study compared static warnings (stickers on the side) vs. dynamic warnings (scrolling / central pop-ups) * findings: players did not notice or remember static sticker messages * players recalled dynamic, centrally located warnings much better

Answer 49

Message Content: * purely informational vs. messages encouraging self-appraisal * warnings can invoke social norms (e.g., “you’ve been playing longer than most people”) * should warnings be repeated or varied? * graphic vs. text warnings — can gambling warnings ever convey emotional weight like cigarette labels? Message Delivery: * static vs. dynamic delivery matters (static often ignored; dynamic requires more attention) * targeted or personalized messages (based on age or gambling involvement) may increase effectiveness

Answer 50

* in 1997, Norway had the 3rd highest density of EGMs in the world (per capita) * EGMs had no age restrictions and were found in supermarkets + gas stations * by 2005, gambling made up 5% of disposable household income * EGMs accounted for 66% of the gambling market

Answer 51

* 2006: EGMs were turned off at night (12am–6am) * 2007: all EGMs removed for ~1.5 years * 2009: introduction of safer EGMs requiring: * personal ID card to play * fixed daily + monthly loss limits (“mandatory loss limits”) * players can lower their own limit (e.g., ~$800/month) Norway shifted from widespread, unregulated access to strict control + harm-prevention features

Answer 52

* helpline calls fell 62% (especially EGM-related) * treatment referrals fell 57% * gambling revenue dropped ~31% across all gambling * no evidence of an illegal EGM market or people switching to other gambling types revenue loss had consequences: * early 2000s: Norwegian Red Cross relied on EGMs for ~50% of income * parliament acknowledged reforms would hurt funding for humanitarian/health organizations

Answer 53

* early gaming era (1980–2005): revenue came from selling the physical game (cartridges, disks) * development costs have since increased a lot * players now expect games to be free or low-cost and download them digitally modern business model: in-game purchases (microtransactions) + in-game advertising

Answer 54

* sharp increase in in-game monetization features from ~2012–2014 * includes cosmetic microtransactions, loot boxes, and pay-to-win items * by mid-2010s, most popular Steam games contained loot boxes and cosmetic purchases * represents a sudden shift in how games monetize players

Answer 55

* first academic paper on loot boxes: Zendle et al. (2018) * occurred years after monetization features had already become widespread * highlights a lag between industry changes and academic/policy response * companies were able to adopt microtransactions and loot boxes long before regulations caught up

Answer 56

* high frequency of reinforcement * strong audiovisual feedback (even more immersive than EGMs) * near misses that encourage continued play * fast + continuous gameplay loops (game over → play again)

Answer 57

* concurrent schedules (working on many goals/quests at once) * immersive storylines * avatars that strengthen self-identity and emotional engagement * skill + skill adjustment (difficulty increases as the player improves)

Answer 58

1. loot boxes: micro-transactions with random-reward mechanics 2. social casino games: look like gambling games but no real money involved 3. simulated gambling mini-games: GTA V casino using in-game currency 4. esports betting 5. skins betting: using cosmetic items as currency for wagers

Answer 59

* gambling has 3 elements: consideration, chance, prize 1. consideration → loot boxes can be bought with real money or earned in-game 2. chance → rewards are randomly determined (you always get something, but rarity varies) 3. prize → rare items; legal debate depends on whether items can be traded/sold * if a marketplace exists inside the game, loot boxes would meet gambling criteria * most trading happens on third-party sites, so they usually fall outside gambling law

Answer 60

Pathway 1: Migration pathway * exposure to loot boxes → later engagement in real gambling * longitudinal evidence: people who spent on loot boxes were more likely to gamble later (study didn’t track PGSI) Pathway 2: Reverse pathway * people who already gamble are more attracted to loot boxes in games * pathways are not mutually exclusive loot box spending correlates with PGSI, but causality differs by pathway

Answer 61

* free-to-play gambling-style games (slots, poker) * no real-money payouts, but allow in-game purchases to continue playing * not regulated → can rig outcomes (e.g., “beginner’s luck”) * mimic gambling structure: wins, losses, audiovisual feedback, continuous play * raise questions about why players engage despite no monetary reward

Answer 62

* we don’t get the same physiological arousal as real gambling * social features: chat rooms, community, social reinforcement * addiction substitution: gamblers in recovery may use SCGs to satisfy cravings – could be adaptive (harm reduction) or maladaptive * easy access + constant reinforcement loops make them engaging despite no payout

Answer 63

* evidence that SCGs can be linked to migration to real gambling * some SCG platforms have business connections with real-money gambling operators * in-game spending may normalize microtransactions and gambling-like mechanics * dtructural similarity (near misses, variable rewards) may prime players for gambling * potential risk pathway: SCGs → cravings satisfied → eventual transition to real gambling

Answer 64

* gambling-like activities embedded in regular games (no real money) * examples: GTA Online virtual casino, poker in Red Dead Redemption 2 * use in-game currency but mimic real gambling mechanics * very realistic → can feel similar to actual gambling

Answer 65

* normalizes gambling in a non-gambling environment * highly realistic experiences → may increase interest in gambling * especially concerning for young players * GTA’s virtual casino raised concern because it mimics real gambling settings

Answer 66

* extremely accessible to youth → exposure through spectating, not direct play * based on social learning theory: watching others gamble normalizes the behaviour * before regulations, users could watch high-stakes gambling similar to watching gaming streams * streamers often win huge amounts → creates distorted perceptions of how gambling “works.” * we are not sure if gambling streams increase cravings or help control cravings

Answer 67

* casino games modeled after video games: Pac-Man, basketball). * combine skill + randomization, but still include a house edge * designed to attract younger gamblers by mimicking video-game mechanics * academics worried these games might increase the illusion of control * did not catch on because they're inefficient: take up more floor space than multiple slot machines – not profitable: players prefer traditional EGMs – still rely on randomness → didn’t deliver meaningful skill advantage

Answer 68

do virtual items have real value if they can’t be officially sold? * many items still gain value via third-party marketplaces → blurs gambling boundaries * regulatory uncertainty: – Should the game be age-restricted? – Or just the feature (e.g., loot boxes)? * loot boxes can have sentimental value or “perceived value” even without monetary value

Answer 69

* there are risks of financial harm for adults, not just youth * time-limited offers and promotions may create urgency and chasing behaviour * suggests the need for consumer protection frameworks

Midterm 3 Content Flashcards

(93 cards)