{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,19]],"date-time":"2026-07-19T16:47:26Z","timestamp":1784479646893,"version":"3.55.0"},"reference-count":37,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2017,8,2]],"date-time":"2017-08-02T00:00:00Z","timestamp":1501632000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100007553","name":"Gambling Research Exchange Ontario","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007553","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2017,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and aims<\/jats:title><jats:p>Little research has examined the relationship between incentives used by gambling venues to attract customers and the experience of gambling\u2010related harm. Organized and subsidized bus tours are a common example of such incentives. The aim of this study was to examine whether bus\u2010tour patronage was associated with increased odds of problem gambling among older adults. This study also compared rates of bus\u2010tour use by socio\u2010demographic characteristics and gambling behaviours.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Pearson's \u03c7<jats:sup>2<\/jats:sup>tests and Mann\u2013Whitney<jats:italic>U<\/jats:italic>\u2010tests were applied for bivariate analyses. Multivariate generalized mixed\u2010effects regression modelling was used to examine the relationship between bus\u2010tour patronage and problem gambling while controlling for possible confounding factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Seven gambling venues located in Central and Southwestern Ontario, Canada.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>A total of 1978 gambling venue patrons over the age of 55\u00a0years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements<\/jats:title><jats:p>Problem gambling as indicated by the Problem Gambling Severity Index, bus\u2010tour patronage in the 12\u00a0months prior to the survey, spending per gambling visit and past\u2010month slot machine participation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>Regression analyses showed that bus\u2010tour patronage was associated with higher odds of problem gambling [odds ratio (OR)\u00a0=\u00a01.71, confidence interval (CI)\u00a0=\u00a01.06, 2.76] after controlling for several demographic characteristics, type of gambling and gambling expenditures. Bivariate analyses showed past\u2010year bus\u2010tour patronage was associated with more frequent slot machine play (\u03c7<jats:sup>2<\/jats:sup>=\u00a048.16,<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001), more past\u2010year gambling venue visits (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001) and lower spending on gambling per casino visit (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001). Compared with non\u2010patrons, bus tour patrons were more likely to be female (\u03c7<jats:sup>2<\/jats:sup>=\u00a021.92,<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001), born outside Canada (\u03c7<jats:sup>2<\/jats:sup>=\u00a0113.18,<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001), above the age of 75 (\u03c7<jats:sup>2<\/jats:sup>=\u00a024.02,<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001) and retired (\u03c7<jats:sup>2<\/jats:sup>=\u00a016.60,<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>When adjusting for potential confounders among older adults, using bus tours to access Canadian gambling venues is associated with increased risk of problem gambling. Bus\u2010tour patrons are more likely to be female, born outside Canada and above the age of 75\u00a0years.<\/jats:p><\/jats:sec>","DOI":"10.1111\/add.13914","type":"journal-article","created":{"date-parts":[[2017,6,23]],"date-time":"2017-06-23T13:12:38Z","timestamp":1498223558000},"page":"2217-2224","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["A free ride? An analysis of the association of casino bus tours and problem gambling among older adults"],"prefix":"10.1111","volume":"112","author":[{"given":"Mark","family":"van der Maas","sequence":"first","affiliation":[{"name":"Institute for Mental Health Policy Research, Centre for Addiction and Mental Health Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert E.","family":"Mann","sequence":"additional","affiliation":[{"name":"Institute for Mental Health Policy Research, Centre for Addiction and Mental Health Toronto Ontario Canada"},{"name":"Dalla Lana School of Public Health University of Toronto Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flora I.","family":"Matheson","sequence":"additional","affiliation":[{"name":"Dalla Lana School of Public Health University of Toronto Toronto Ontario Canada"},{"name":"Centre for Urban Health Solutions, St. Michael's Hospital Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nigel E.","family":"Turner","sequence":"additional","affiliation":[{"name":"Institute for Mental Health Policy Research, Centre for Addiction and Mental Health Toronto Ontario Canada"},{"name":"Dalla Lana School of Public Health University of Toronto Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8583-5872","authenticated-orcid":false,"given":"Hayley A.","family":"Hamilton","sequence":"additional","affiliation":[{"name":"Institute for Mental Health Policy Research, Centre for Addiction and Mental Health Toronto Ontario Canada"},{"name":"Dalla Lana School of Public Health University of Toronto Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"McCready","sequence":"additional","affiliation":[{"name":"Healthy Horizons Consulting Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,8,2]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/0891988716673468"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/004728759603400307"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10899-007-9079-z"},{"key":"e_1_2_9_5_1","doi-asserted-by":"crossref","first-page":"63","DOI":"10.9741\/2327-8455.1145","article-title":"An analysis of elderly gamers\u2019 trip characteristics and gambling behavior: comparing the elderly with their younger counterparts","volume":"10","author":"Moufakkir O.","year":"2012","journal-title":"UNLV Gaming Res Rev J"},{"key":"e_1_2_9_6_1","volume-title":"The Influence of Venue Characteristics on a Player's Decision to Attend a Gambling Venue","author":"Hing N.","year":"2010"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0144686X03001582"},{"key":"e_1_2_9_8_1","volume-title":"Gambling impact and Behavior Study: Report to the National Gambling Impact Study Commission","author":"Gerstein D.","year":"1999"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/jech.2007.068114"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.4309\/jgi.2007.20.6"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1080\/14459795.2012.664159"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1089\/glre.2014.1824"},{"key":"e_1_2_9_13_1","volume-title":"Measuring gambling and problem gambling in Ontario","author":"Wiebe J.","year":"2001"},{"key":"e_1_2_9_14_1","volume-title":"Gambling and Problem Gambling in Ontario","author":"Williams R. 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