@Article{info:doi/10.2196/37837,
author="H{\aa}kansson, Anders
and {\AA}kesson, Gunny",
title="Multi-operator Self-exclusion as a Harm Reduction Measure in Problem Gambling: Retrospective Clinical Study on Gambling Relapse Despite Self-exclusion",
journal="JMIR Ment Health",
year="2022",
month="Aug",
day="19",
volume="9",
number="8",
pages="e37837",
keywords="web-based gambling; gambling disorder; behavioral addiction; self-exclusion; addiction; gambling; prevalence; harm reduction; abstain; problem gambling",
abstract="Background: Voluntary self-exclusion from gambling is a common harm reduction option for individuals with gambling problems. Multi-operator, nationwide self-exclusion services are rare, and a system introduced in the highly web-based gambling market of Sweden is a rare and recent example. However, where web-based casino gambling and web-based betting are the predominate gambling types in those seeking treatment, the risk of breaching one's own self-exclusion through overseas web-based operators may also be high. Objective: This study aims to assess the prevalence of a nationwide Spelpaus (``gambling break'') self-exclusion and the prevalence of gambling despite self-exclusion in patients seeking treatment for gambling disorder in 2021. Methods: Health care documentation of recent treatment seekers (January 1 through September 1, 2021, N=85) in a Swedish treatment facility was reviewed for data regarding problematic gambling types reported, history of self-exclusion, and history of breaching of that self-exclusion. Results: Common problem gambling types were web-based casino gambling (49/74, 66{\%}) and sports betting (19/74, 26{\%}). The majority who participated in this study (62/85, 73{\%}) were men. All women reported web-based casino gambling. Self-exclusion through Spelpaus was common (60/74, 81{\%}). Among self-excluders, gambling despite self-exclusion was common (41/60, 68{\%}), most commonly on unlicensed gambling websites. Conclusions: The nationwide, multi-operator self-exclusion service of Sweden appears to reach many patients with a gambling disorder. However, the remaining gambling options in an web-based gambling setting present a major challenge despite self-exclusion. The recent data calls for further treatment efforts and potential improvements in services aiming to help voluntary self-excluders abstain from gambling. ",
issn="2368-7959",
doi="10.2196/37837",
url="https://mental.jmir.org/2022/8/e37837",
url="https://doi.org/10.2196/37837",
url="http://www.ncbi.nlm.nih.gov/pubmed/35984678"
}