Cross National Consistency in Lower-Risk Gambling Limits: Linked Analyses Across Eight Countries

Background: A public health initiative that is common across jurisdictions is provision of advice to people to limit the frequency, amount of time and amount of money spent gambling in order to reduce the risk of gambling-related harm. The purpose of this study is to use consistent methodology with existing population-based prevalence surveys of gambling and related harms from different countries to identify quantitative limits for lower and higher risk gambling. Risk limits from different countries and for men and women are compared. Methods: Risk curve analyses were conducted with eleven high quality data sets from eight Western countries to identify optimal limits for predicting increased risk of gambling-related harms.  Gambling indicators were monthly expenditure, percentage of income spent on gambling, monthly frequency, duration of gambling sessions, and number of different types of gambling. Harm indicators included financial, emotional, health, and relationship impacts.  Findings: The limit ranges were remarkably consistent across harm indicators, cross nationally and between men and women. Reliable results were obtained for all gambling indicators except gambling session duration. Risk of gambling-related harm is likely to increase if an individual gambles at these levels of greater:  $60 to $120 CAD per month, five to eight times per month, spends more than 1 to 3% of gross monthly income or plays three to four different gambling types. Interpretation: This study provides evidence that lower-risk gambling guidelines can be based upon empirically derived lower-risk limits, which are relatively consistent across Western countries. Funding Statement: La Fondation Mise sur Toi Declaration of Interests: DH, MA, RB, NB, JMC, MD, SK, DOUR, AS, RV, LN, and SC report receiving personal fees from the Canadian Centre for Substance Use and Addiction during this project. MY, CP, and MCFP have no conflicts to report.