Gambling and video game problems in the general adult population of Norway

In all, 30,000 persons (gross sample), aged 16–74 years, were randomly selected from the National Population Registry of Norway and invited to participate in the survey. Initially, all were invited to respond to a web-based survey. Up to two reminders were sent, which also allowed for responding to a paper-based questionnaire. A total of 9,248 valid responses were received. After removing persons with wrong addresses, or non-response for reasons of illness, death, being abroad, being unable to read Norwegian etc. at the time of the survey, a response rate of 32.7 percent was obtained. A total of 63.6 percent had participated in gambling during the previous 12 months, which represented a significant increase since the previous survey conducted in 2015.

To assess the prevalence of gambling problems, the Canadian Problem Gambling Index was administered. Based on the total score obtained, the respondents were divided into the following four categories: Non-problem gambler (score = 0), low risk gambler (score = 1-2), moderate risk gambler (score = 3-7), and problem gambler (score = 8-27). The results showed that 8.8 percent of the adult population in Norway could be categorized as low risk gamblers (vs. 7.7 percent in 2015), 3.1 percent as moderate risk gamblers (vs. 2.3 percent in 2015), and 1.4 percent as problem gamblers (vs. 0.9% in 2015). Compared to the previous population based survey about gambling and gaming problems in Norway (conducted in autumn 2015) a statistically significant increase in the prevalence of gambling problems was detected. Possible causes for the increase in gambling problems include increases in the proportion of people participating in gambling, that gambling advertising exposure and influence from gambling advertising have increased, increased availability of internet gambling/more play on mobile phones than previously, increase in the gross gambling turnover, growth in participation in aggressive games, that the proportion of vulnerable groups in society has increased as well as a reduction of the demarcation between gambling and gaming. The increase in gambling problems was similar for females and males.

The current prevalence of gambling related problems is still somewhat lower compared to national surveys conducted between 2005 and 2010, albeit somewhat higher than the prevalences reported in national surveys conducted between 1997 and 2002 and between 2013 and 2015. Compared to international surveys the prevalence of gambling related problems in Norway is overall relatively low. The prevalence of gambling problems in Norway seems to be somewhat higher or at the same level as found in the other Nordic countries. However, direct comparisons of findings across countries are problematic due to large methodological differences across studies.

In the present study we found that the probability of being a moderate risk- or problem gambler was elevated in males, singles, those with daily care for 1-2 children, subjects with low education and low income, subjects with confirmed unemployment/disability pension/rehabilitation/work assessment allowance, subjects with place of birth outside Norway, and among those who had participated in video gaming during the last 6 months.

Attitudes towards gambling were assessed with the Attitudes Towards Gambling Scale-8. The results showed that the population overall holds weak negative attitudes. Men, older persons, those without care taking responsibilities for children, with low education, with low income, with a full-time position, who had participated in gaming, and who had participated in gambling as either a non-problem, low risk, or moderate risk gambler held more positive attitudes towards gambling then their relevant counterparts.

In terms of participation in different gambling activities, the majority of gamblers reported having participated in number games and scratch cards (paper based). Males had participated more frequently than females in most types of games. Paper based scratch cards were the only type of gambling where women participated more frequently than males.

Younger gamblers participated overall more frequently than elderly in typically novel types of gambling activities (typically internet based), whereas older gamblers participated more frequently than younger gamblers in more “traditional games” such as horse betting, football pools (not odds games) and number games. Moderate risk and problem gamblers participated more frequently in all types of games compared to those with lower scores, except for paper-based scratch cards, number games and the bottle deposit lottery. Belago, data bingo on a bingo premises, internet based bingo (not Norsk Tipping), Bingoria and internet based casino games (not Norsk Tipping) comprised the gambling categories with the highest proportion of gamblers reporting problems.

Overall, 58.3 percent of the gamblers had gambled via the internet during the last 12 months, a proportion that has increased substantially since 2015. Gambling on the internet occurred most frequently among males, younger subjects, and among moderate risk and problem gamblers. Most of those who gambled via the internet used a mobile phone for this purpose.

The vast majority of respondents had been exposed to gambling related advertising during the previous 12 months. Young subjects reported greater exposure than older subjects. Moderate risk and problem gamblers reported more gambling related advertising exposure than non-problem and low risk gamblers. Compared to the population-based survey on gambling and gaming problems in Norway in 2015, the current survey showed a significant increase in exposure to gambling related advertising on TV and internet, and a decrease in exposure to gambling related advertising in newspapers. The respondents reported more frequent exposure to gambling related advertising from unregulated (foreign) gambling operators compared to the Norwegian operators, Norsk Tipping and Norsk Rikstoto. Gambling related advertising was generally rated as having relatively low credibility, especially for gambling related advertising from unregulated (foreign) gambling operators.

In line with the last national survey it was found that gambling related advertising had a considerable effect in terms of informing about games and game operators. Gambling related advertising was reported to influence gambling behavior and gamblers urge to gamble to a certain degree. Despite the fact that risky gambling was reported only to a small degree as having been triggered by gambling related advertising, the difference in perceived effect between those with and without gambling problems was particularly large on this item/topic. Overall, men, younger persons, and persons with gambling related problems reported being more influenced by gambling related advertising than their respective counterparts. Compared to the results from the 2015-survey, a general increase in the perceived impact of gambling related advertising was found.

The respondents held on average weak positive views on responsible gambling tools, which represents a change from the more neutral stance found in the previous national survey. Continuous feedback about losses, an upper loss limit set by the player him/herself, and an upper loss limit set by the game, comprised the three responsible gambling tools which were most favorably evaluated. Women, younger people, and moderate risk and problem gamblers had more positive views on responsible gambling tools compared to men, older persons, and persons with lower scores on the Canadian Problem Gambling Index.

A total of 13 potential gambling motives were listed in the questionnaire. The two most frequently reported motives, “for fun” and “to win” were endorsed by between 54 percent and 60 percent of the gamblers. Moderate risk and problem gamblers reported all motives more frequently than those with lower scores, except “for fun”. The motive “to support a good cause” was more frequently reported by non-problem and low risk gamblers compared to moderate risk and problem gamblers. Compared to the 2015 survey, seven of the motives were now more frequently reported. One motive was less frequently reported, whereas for four motives no change in the proportion reporting them was found.

Those who participated in gambling had a higher consumption of alcohol than those who did not. A higher proportion of smokers and snus users was found in gambling participants compared to non-participants. Among the gamblers, the lowest levels of alcohol consumption were found for normal gamblers and problems gamblers. The proportion of smokers was high (26%) among the problem gamblers. A total of 46.3 percent of the respondents had played video games during the last six months, which represents an increase since the 2015-survey. More males than females and more younger than older respondents had played. Excessive video game playing was assessed with the Game Addiction Scale for Adolescents. Based on the data from this scale, 93.6 percent were categorized as normal video game players (including those who had not played), 5.5 percent were categorized as video game problem players (vs. 2.8 percent in 2015), and 0.9 percent were categorized as video game addicts (vs 0.5% in 2015). The two latter percentages have increased significantly since the previous population based survey on gambling and gaming problems. Possible reasons for the increase include that a larger proportion of the population plays video games now than before, that gamers spend more time playing now than before, and that video games have become more addictive than before.

Being categorized as either a video game problem player or a video game addict was related to male gender, low age, low education, low income, receiving unemployment/disability pension/rehabilitation/work assessment allowance, and having Africa, Asia, or South- and Central America as place of birth.

Those playing video games had a somewhat higher alcohol consumption than non-players. Compared to those not playing, a larger proportion of those playing video games used snus, while a smaller proportion of the latter group smoked. Among those playing video games, problem category was unrelated to alcohol consumption and proportion of smokers. The proportions of snus users increased by problem category.

A total of 9.4 percent of the population had purchased loot boxes the last six months. This was associated with male gender, low age, having daily care for children living at home, low education, receiving unemployment/disability pension/rehabilitation/work assessment allowance, being born in Norway, and reporting problems with gambling and gaming. Most of those who had purchased loot boxes had bought them for themselves. Among the loot box purchasers, 4.6 percent reported that their spending on this was at a problematically high level. This was associated with having gaming problems. A total of 44.2 percent of those purchasing loot boxes reported having more general problems with loot boxes (based on an adaption of the Lie/bet questionnaire for gambling). This was associated with not having caretaking responsibilities for children and having problems with gambling and gaming.

Those who had purchased loot boxes had a somewhat higher alcohol consumption than those who had not. The proportion who used snus was higher among loot box purchasers compared to those who had not bought loot boxes. Those having general problems with loot boxes had a somewhat higher alcohol consumption than purchasers who did not have general problems with loot boxes.