{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T10:55:38Z","timestamp":1787914538428,"version":"build-2784847793"},"reference-count":51,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T00:00:00Z","timestamp":1771286400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T00:00:00Z","timestamp":1771286400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and aims<\/jats:title>\n                    <jats:p>Health economic models can be used to assess the effectiveness and cost\u2010effectiveness of public health policies for gambling. To develop such a model, we must understand how gambling behaviour is associated with risk of experiencing gambling\u2010related harms. This study aimed to: (1) assess the strength of association between gambling frequency and the risk of gambling\u2010related harm and to examine how these associations differ when lottery\u2010only players are excluded; (2) apply the study's findings in a hypothetical policy model aimed at reducing gambling frequency.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Observational study using six waves of cross\u2010sectional data from the Health Survey for England and the Scottish Health Survey.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Survey conducted in England in 2015, 2016 and 2018 and Scotland in 2015, 2016 and 2017.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>The sample included 16\u2009648 adults (aged 18 and over) who reported gambling in the past year, generally representative of the populations of England and Scotland.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements<\/jats:title>\n                    <jats:p>Gambling frequency was measured using 6 categories which indicated frequency in the past 12 months: (a) 2 or more times a week; (b) once a week; (c) less than once a week, more than once a month; (d) once a month; (e) every 2\u20133\u00a0months; (f) once or twice a year. Risk of gambling\u2010related harm was assessed using Problem Gambling Severity Index (PGSI) score (0\u201327) and its four categories: no\u2010risk (0), low\u2010risk (1\u20132), moderate\u2010risk (3\u20137) and high\u2010risk (\u22658). Control variables included age, sex, deprivation, social grade, presence of mental disorder and frequency of drinking alcohol.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>\n                      Using multinomial logistic regression and zero\u2010inflated negative binomial models we found that gambling at least twice weekly was associated with a statistically significantly higher PGSI score than gambling once or twice a year (incidence rate ratio\u2009=\u20093.528, 95% confidence interval = 2.040\u20136.103,\n                      <jats:italic>P<\/jats:italic>\n                      value &lt; 0.001). Reducing gambling to guideline levels for people gambling at least twice weekly moved 10% of the sub\u2010sample from higher PGSI categories (low, medium and high risk) to the no\u2010risk category and shifted the distribution of PGSI scores down.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>There appears to be a statistically significant association between gambling frequency and risk of gambling\u2010related harm. Data derived from this and similar analyses can be used to model gambling policies which impact gambling frequency.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/add.70344","type":"journal-article","created":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T11:17:27Z","timestamp":1771327047000},"page":"1594-1610","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The association between gambling frequency and risk of harm: Analysis using health survey data from England and Scotland"],"prefix":"10.1111","volume":"121","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8533-690X","authenticated-orcid":false,"given":"Esther","family":"Moore","sequence":"first","affiliation":[{"name":"Sheffield Centre for Health and Related Research (SCHARR) University of Sheffield  Sheffield UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4853-0719","authenticated-orcid":false,"given":"Robert","family":"Pryce","sequence":"additional","affiliation":[{"name":"Sheffield Centre for Health and Related Research (SCHARR) University of Sheffield  Sheffield UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2776-4014","authenticated-orcid":false,"given":"Hazel","family":"Squires","sequence":"additional","affiliation":[{"name":"Sheffield Centre for Health and Related Research (SCHARR) University of Sheffield  Sheffield UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Goyder","sequence":"additional","affiliation":[{"name":"Sheffield Centre for Health and Related Research (SCHARR) University of Sheffield  Sheffield UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,17]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"Office for Health Improvement and Disparities.2023.The economic cost of gambling\u2010related harm in England: evidence update 2023. 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