{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T18:29:13Z","timestamp":1790101753252,"version":"4.0.1"},"reference-count":94,"publisher":"Akademiai Kiado Zrt.","issue":"2","license":[{"start":{"date-parts":[[2020,6,1]],"date-time":"2020-06-01T00:00:00Z","timestamp":1590969600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Ministry of Social Affairs and Health, Helsinki, Finland"}],"content-domain":{"domain":["akjournals.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2020,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p\/>\n                  <jats:sec>\n                    <jats:title>Background and aims<\/jats:title>\n                    <jats:p>The Prevention Paradox (PP) suggests that a large proportion of aggregate harm from gambling occurs to people who do not have a gambling disorder. However, it has not yet been tested using a population-representative sample. We aimed to test whether the PP applies to gambling in Finland. The prevalence rates of diverse harmful consequences from gambling were surveyed amongst a population-representative sample of past-year gamblers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      The study used first wave data (\n                      <jats:italic>N<\/jats:italic>\n                      = 7,186) of Finnish Gambling Harms survey, collected via online and postal surveys in 2017. A subset of 3,795 adults (\u226518 years), who had gambled at least monthly in 2016, were selected for analysis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements<\/jats:title>\n                    <jats:p>Gambling-related harms were evaluated with the 72-item Harms Checklist. Problem and Pathological Gambling Measure (PPGM) measured respondents\u2019 probable disordered gambling from the subset of items for impaired control (4 questions) and other issues (3 questions).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>Consistent with previous findings, the majority of harms were reported by those in the less severe PPGM categories (i.e. scoring &lt;5). However, considering each domain separately, this was true only for financial, emotional\/psychological, and work\/study harms. The PP was not supported for health, relationship, or social deviance harms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The population prevalence of the most serious harms (e.g. unsafe living conditions) is concentrated among those with severe impaired control issues. However, even excluding the \u223c15% of harms occurring to occasional gamblers, most financial, emotional and work\/study impacts occur to those with lower levels of control issues. Efforts at harm reduction should focus on the entire spectrum of issues that people experience from their gambling.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1556\/2006.2020.00018","type":"journal-article","created":{"date-parts":[[2020,7,24]],"date-time":"2020-07-24T15:50:08Z","timestamp":1595605808000},"page":"371-382","update-policy":"https:\/\/doi.org\/10.1556\/policypage.crossmark.crossref.1","source":"Crossref","is-referenced-by-count":35,"title":["The prevention paradox applies to some but not all gambling harms: Results from a Finnish population-representative survey"],"prefix":"10.1556","volume":"9","author":[{"given":"Matthew","family":"Browne","sequence":"first","affiliation":[{"name":"1Central Queensland University Bundaberg, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Volberg","sequence":"additional","affiliation":[{"name":"2School of Public Health and Health Sciences, University of Massachusetts Amherst, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Rockloff","sequence":"additional","affiliation":[{"name":"1Central Queensland University Bundaberg, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne H.","family":"Salonen","sequence":"additional","affiliation":[{"name":"3Finnish Institute for Health and Welfare, Department of Public Health Solutions, Helsinki, Finland"},{"name":"4University of Eastern Finland, Faculty of Health Sciences, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"425","reference":[{"key":"ref511","volume-title":"Measuring the burden of gambling harm in New Zealand","author":"Browne","year":"2017"},{"key":"ref571","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1556\/2006.6.2017.059","article-title":"The dangers of conflating gambling-related harm with disordered gambling: Commentary on: Prevention paradox logic and problem gambling (Delfabbro & King, 2017)","volume":"6","author":"Browne","year":"2017","journal-title":"Journal of Behavioral Addictions"},{"key":"ref161","article-title":"Prevention paradox logic and problem gambling: Does low-risk gambling impose a greater burden of harm than high-risk gambling?","volume":"1\u20135","author":"Delfabbro","year":"2017","journal-title":"Journal of Behavioral Addictions"},{"key":"ref411","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1370\/afm.243","article-title":"Alcohol-related injuries: Evidence for the prevention paradox","volume":"3","author":"Spurling","year":"2005","journal-title":"The Annals of Family Medicine"},{"key":"ref471","doi-asserted-by":"crossref","DOI":"10.33684\/CFHG3.en","volume-title":"Conceptual framework of harmful gambling: An international collaboration","author":"Abbott","year":"2018"},{"key":"ref91","doi-asserted-by":"crossref","DOI":"10.4309\/jgi.v0i36.3978","article-title":"What is the harm? Applying a public health methodology to measure the impact of gambling problems and harm on quality of life","author":"Browne","year":"2017","journal-title":"Journal of Gambling Issues"},{"key":"ref631","article-title":"Prevention paradox logic and problem gambling: Does low-risk gambling impose a greater burden of harm than high-risk gambling?","volume":"1\u20135","author":"Delfabbro","year":"2017","journal-title":"Journal of Behavioral Addictions"},{"key":"ref551","volume-title":"Assessing gambling-related harm in Victoria: A public health perspective","author":"Browne","year":"2016"},{"key":"ref781","doi-asserted-by":"crossref","first-page":"716","DOI":"10.1093\/eurpub\/cku210","article-title":"The extent and distribution of gambling harm in Finland as assessed by the Problem Gambling Severity Index","volume":"25","author":"Raisamo","year":"2015","journal-title":"The European Journal of Public Health"},{"key":"ref251","doi-asserted-by":"crossref","first-page":"1184","DOI":"10.1176\/ajp.144.9.1184","article-title":"The South Oaks gambling screen (SOGS): A new instrument for the identification of pathological gamblers","volume":"144","author":"Lesieur","year":"1987","journal-title":"American Journal of Psychiatry"},{"key":"ref61","volume-title":"The social cost of gambling to Victoria","author":"Browne","year":"2017"},{"key":"ref331","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1093\/eurpub\/ckr178","article-title":"Does the prevention paradox apply to various alcohol habits and problems among Swedish adolescents?","volume":"22","author":"Romelsj\u00f6","year":"2012","journal-title":"The European Journal of Public Health"},{"key":"ref851","author":"Salonen","year":"2015","journal-title":"Suomalaisten rahapelaaminen 2015. 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Gambling, gambling problems, and attitudes and opinions on gambling among Finns aged 15\u201374]"},{"key":"ref181","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1007\/s11469-007-9126-0","article-title":"The family functioning of female pathological gamblers","volume":"7","author":"Dowling","year":"2009","journal-title":"International Journal of Mental Health and Addiction"},{"key":"ref581","doi-asserted-by":"crossref","first-page":"410","DOI":"10.1556\/2006.7.2018.41","article-title":"Prevalence of gambling-related harm provides evidence for the prevention paradox","volume":"7","author":"Browne","year":"2018","journal-title":"Journal of Behavioral Addictions"},{"key":"ref801","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1093\/eurpub\/ckr178","article-title":"Does the prevention paradox apply to various alcohol habits and problems among Swedish adolescents?","volume":"22","author":"Romelsj\u00f6","year":"2012","journal-title":"The European Journal of Public Health"},{"key":"ref871","author":"Silvennoinen","year":"2019","journal-title":"Peluurin vuosiraportti 2018. 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Overview","volume":"2","author":"Salonen","year":"2018","journal-title":"Nordic Studies on Alcohol and Drugs"},{"key":"ref101","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1556\/2006.6.2017.059","article-title":"The dangers of conflating gambling-related harm with disordered gambling: Commentary on: Prevention paradox logic and problem gambling (Delfabbro & King, 2017)","volume":"6","author":"Browne","year":"2017","journal-title":"Journal of Behavioral Addictions"},{"key":"ref651","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1007\/s11469-007-9126-0","article-title":"The family functioning of female pathological gamblers","volume":"7","author":"Dowling","year":"2009","journal-title":"International Journal of Mental Health and Addiction"},{"key":"ref441","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1080\/14459795.2013.839731","article-title":"The classification accuracy of four problem gambling assessment instrument in population research","volume":"14","author":"Williams","year":"2014","journal-title":"International Gambling Studies"},{"key":"ref691","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1111\/j.1360-0443.1986.tb00342.x","article-title":"Alcohol consumption and the preventive paradox","volume":"81","author":"Kreitman","year":"1986","journal-title":"British Journal of Addiction"},{"key":"ref431","volume-title":"Best practices in the population assessment of problem gambling","author":"Williams","year":"2010"},{"key":"ref231","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1186\/s12889-016-2747-0","article-title":"Understanding gambling related harm: A proposed definition, conceptual framework, and taxonomy of harms","volume":"16","author":"Langham","year":"2016","journal-title":"BMC Public Health"},{"key":"ref281","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1016\/j.addbeh.2018.11.048","article-title":"Effects of prevention and harm reduction interventions on gambling behaviours and gambling related harm: An umbrella review","volume":"90","author":"McMahon","year":"2019","journal-title":"Addictive Behaviors"},{"key":"ref291","doi-asserted-by":"crossref","first-page":"1323","DOI":"10.1186\/s12889-019-7666-4","article-title":"Drinking patterns and the distribution of alcohol-related harms in Ireland: Evidence for the prevention paradox","volume":"19","author":"O\u2019Dwyer","year":"2019","journal-title":"BMC Public Health"},{"key":"ref391","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1080\/14459795.2017.1333131","article-title":"Mapping the proportional distribution of gambling-related harms in a clinical and community sample","volume":"17","author":"Shannon","year":"2017","journal-title":"International Gambling Studies"},{"key":"ref261","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1007\/BF01015919","article-title":"Revising the South Oaks gambling screen in different settings","volume":"9","author":"Lesieur","year":"1993","journal-title":"Journal of Gambling Studies"},{"key":"ref71","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1080\/14459795.2017.1304973","article-title":"A population-level metric for gambling-related harm","volume":"17","author":"Browne","year":"2017","journal-title":"International Gambling Studies"},{"key":"ref731","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1007\/BF01015919","article-title":"Revising the South Oaks gambling screen in different settings","volume":"9","author":"Lesieur","year":"1993","journal-title":"Journal of Gambling Studies"},{"key":"ref911","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1080\/14459795.2013.839731","article-title":"The classification accuracy of four problem gambling assessment instrument in population research","volume":"14","author":"Williams","year":"2014","journal-title":"International Gambling Studies"},{"key":"ref811","author":"Salonen","year":"2017","journal-title":"Rahapelikysely 2016: Rahapelaaminen, rahapelihaitat jarahapelien markkinointiin liittyv\u00e4t mielipiteet rahapeliongelmaan apua hakevien Peliklinikan asiakkaiden n\u00e4k\u00f6kulmasta"},{"key":"ref821","first-page":"1","article-title":"Gambling participation, gambling habits, gambling-related harm, and opinions on gambling advertising in Finland in 2016. 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