Have restrictions on alcohol advertising in Ireland affected awareness among adults? A comparative observational study using non-probability repeat cross-sectional surveys.

OBJECTIVE: Since November 2019, Ireland has restricted alcohol advertising at the cinema and outdoors (e.g., near schools), and banned alcohol advertising on public transport. Although awareness of such advertising had decreased one year after the restrictions, measures to limit COVID-19 transmission complicated interpretation. We examine: (1) changes in awareness two years post-restrictions, when COVID-19 mitigation measures had eased; and (2) how changes in Ireland compare to Northern Ireland, where the restrictions do not apply. METHOD: Repeat cross-sectional surveys of adults recruited from non-probability online panels, with three waves in Ireland (October 2019 [pre-restrictions] and October 2020/2021 [post-restrictions]; n=3,029) and two in Northern Ireland (October 2020/2021; n=1,011). Participants self-reported past-month awareness of 13 alcohol marketing activities, including public transport, cinema, and outdoor advertising (coded: Any past-month awareness/No awareness/Not sure). RESULTS: In Ireland, the odds of reporting no past-month awareness (vs. any) were higher in 2021 and 2020 versus 2019 for all restricted advertising activities (e.g., 2021 vs. 2019 for public transport: ORAdj=1.88, 95% CI: 1.53-2.32). Interactions between wave and jurisdiction indicated that in 2021, compared to 2020, the odds of reporting no past-month awareness of public transport and cinema advertising (vs. any) were higher in Ireland than Northern Ireland, despite increased opportunities for exposure in both jurisdictions through eased pandemic mitigation measures. There was no interaction for outdoor advertising, suggesting between-wave trends did not differ by jurisdiction. CONCLUSIONS: Ireland's restrictions have reduced past-month awareness of alcohol advertising at the cinema and on public transport, but not outdoors. Continued monitoring is required.

Expenditure on Paid-for Gambling Advertising During the National COVID-19 'Lockdowns': An Observational Study of Media Monitoring Data from the United Kingdom.

Changes in gambling advertising during national COVID-19 'lockdowns', when stay-at-home rules restricted participation in certain gambling activities, provides important context to variance in gambling behaviour during these periods. This study describes expenditure on paid-for gambling advertising during three national lockdowns, compares expenditure to pre-pandemic estimates, and compares changes in expenditure by subsector. Data come from an observational study of weekly expenditure on paid-for gambling advertising in the United Kingdom (n = 135 weeks; beginning 2019 to mid-2021), focusing on three COVID-19 lockdowns: (1) March-May 2020; (2) November-December 2020; and (3) January-March 2021. We descriptively analysed how total advertising expenditure in each lockdown (£GBP, inflation-adjusted) compared to the same time points in 2019, both overall and by subsector (bookmakers, lotteries, online bingo, online casino and poker, gaming, pools, mobile content). Gambling advertising expenditure during lockdown one was 38.5% lower than 2019 (£43.5 million[m] vs. £70.7 m, respectively), with decreases across all subsectors (range: -81.7% [bookmakers] to -2.8% [online bingo]). Total advertising expenditure in lockdown two was 49.3% higher than 2019 (£51.7 m vs. £34.6 m), with increases for 5/7 subsectors (range: -31.6% [mobile content] to + 103.8% [bookmakers]). In lockdown three, advertising expenditure was 5.9% higher than 2019 (£91.2 m vs. £86.1 m), with increases for 4/7 subsectors (range: -92.4% [pools] to + 49.2% [mobile content]). Reductions in advertising expenditure in lockdown one are congruent with self-reported reductions in overall gambling also observed during this period. Further research is needed to determine whether increased advertising expenditure in lockdowns two and three correlates with increased gambling, overall and for specific subsectors.

Awareness of alcohol marketing one year after initial implementation of Ireland's Public Health (Alcohol) Act and during the COVID-19 pandemic.

BACKGROUND: The Republic of Ireland is introducing new controls on alcohol marketing, starting in November 2019 with restrictions on some outdoor and cinema advertising, and a ban on public transport advertising. We examined changes in marketing awareness one year after initial implementation and during the COVID-19 pandemic. METHODS: Repeat online cross-sectional surveys with adults in Ireland conducted October 2019 (n = 1,007) and October 2020 (n = 1,020). Participants self-reported past-month awareness of alcohol marketing and completed the Alcohol Use Disorders Identification Test-Concise (AUDIT-C). Current drinkers were categorised as those reporting heavy episodic drinking at least monthly and higher-risk drinkers (≥5 AUDIT-C). RESULTS: In both waves, most participants recalled some marketing awareness (94.1% vs. 93.8%). For 9/13 activities measured in both waves, there were decreases in the proportion reporting any awareness and frequency of awareness, including for the newly restricted activities. For example, any awareness of public transport advertising decreased between waves (ORAdj = 0.66, 95%CI: 0.53-0.81). In both waves, higher past-month awareness was associated with at least monthly heavy episodic drinking and higher-risk consumption. CONCLUSION: We recommend a precautionary interpretation. It is plausible that both Ireland's initial controls and COVID-19 restrictions contributed to decreases in awareness, but longer-term evaluation is required to determine relative contribution.

How the design and nature of gambling marketing affects consumers: findings from a content analysis of advertising and in-depth interviews with sports bettors and young people during the COVID-19 pandemic in the United Kingdom

BackgroundGambling advertising often contains a multitude of information about inducements and incentives, in addition to details of the specific gambling product marketed and other promotional features. Research suggests that consumers are more likely to misjudge the likelihood of winning or benefiting as the complexity of the gambling product offered increases. As part of a larger study concerning the impact of COVID-19 on gambling behaviours and marketing, we explored how gambling products and inducements are marketed in the United Kingdom (UK) and how inducements are received, and perceived, by gamblers.MethodsTwo data sources are synthesised from the ‘Betting and Gaming COVID-19 Impact Study’. An in-depth content analysis was conducted on a stratified random sample of gambling adverts (n=200) from seven media activities in UK (March-May 2020). Coding captured information about the gamble promoted (e.g. suggested odds and wagers), inducements (e.g. new customer offers, free bets), and how Terms and Conditions (T&Cs) were communicated. In-depth telephone interviews were conducted (July-November 2020) with sports bettors (n=16) and young adults (n=11) in the UK to explore experiences and practices related to gambling. Data were analysed thematically using the framework method.ResultsGambling adverts routinely featured complex information about the gambling products promoted and associated inducements. The design of adverts appeared carefully curated so that promotional and branding aspects had greater prominence than practical information about how inducements operated and eligibility to participate and benefit, if such T&Cs appeared at all. In the interviews, participants perceived gambling advertising to be ubiquitous. While several participants underplayed the influence that gambling advertising and marketing had on their gambling activity, some explicitly said that the content had a negative impact on their gambling, including the adoption of novel and potentially ‘riskier’ gambling behaviours (e.g. online casino games). A few highlighted a lack of transparency in relation to T&Cs underpinning inducements offered by gambling operators, which, in turn, compounded adverse gambling experiences.ConclusionThe way that gambling products and inducements are marketed in the UK is complex and likely to challenge comprehension by consumers. Bettors routinely recall awareness of, and engagement with, a variety of gambling marketing activities, and highlight concerns about the reach and impact that marketing may have, particularly on vulnerable groups such as young people and problem gamblers.

The impact of the initial Covid-19 lockdown upon regular sports bettors in Britain: Findings from a cross-sectional online study.

BACKGROUND: In Britain, unprecedented restrictions on daily life associated with the Covid-19 pandemic included the suspension of professional sports events during the initial 'lockdown'. This provides opportunities to observe changes in sports bettors' behaviour when their primary form of activity is removed and assess the impact of Covid-19 related circumstances upon gambling. METHODS: In July 2020, we conducted an online cross-sectional survey of people who bet regularly (at least monthly) on sports before Covid-19 (n = 3866). Bi-variate analyses compared changes in gambling behaviours before and during the initial lockdown. Multi-variate logistic regression models explored associations between problem gambling (men) and moderate risk or problem gambling (MRPG) (women) with changes in Covid-19 related circumstances and changing gambling behaviours during Britain's initial 'lockdown' (March-June 2020). RESULTS: 29.8% of male sports bettors and 33.4% of female sports bettors stopped gambling altogether during the initial Covid-19 lockdown, though 17.3% of men and 16.5% of women started a new form of gambling during lockdown. Among men, adjusted odds ratios of problem gambling were higher among those starting a new gambling activity during lockdown (OR = 2.50 [95% CI 1.38-4.53]). Among women, adjusted odds ratios of MRPG were higher among those whose frequency of gambling on any activity increased during lockdown (OR = 4.21 [1.99-8.92] and among those shielding for health reasons. Poorer wellbeing was associated with problem gambling for men and MRPG for women. CONCLUSIONS: Those changing gambling behaviours during the initial Covid-19 lockdown (e.g. increasing gambling frequency or starting a new gambling activity) are potentially vulnerable to gambling harms.

Protocol for a Mixed-Method Investigation of the Impact of the COVID-19 Pandemic and Gambling Practices, Experiences and Marketing in the UK: The "Betting and Gaming COVID-19 Impact Study".

The COVID-19 pandemic led to unprecedented restrictions on people's movements and interactions, as well as the cancellation of major sports events and social activities, directly altering the gambling landscape. There is urgent need to provide regulators, policy makers and treatment providers with evidence on the patterns and context of gambling during COVID-19 and its aftermath. This protocol describes a study addressing the following three questions: (1) How has COVID-19 changed gambling practices and the risk factors for, and experience of, gambling harms? (2) What is the effect of COVID-19 on gambling marketing? (3) How has COVID-19 changed high risk groups' gambling experiences and practices? This mixed-method study focuses on two groups, namely young adults and sports bettors. In workpackage-1, we will extend an existing longitudinal survey of gambling in young adults (aged 16-24 years) (first wave conducted June-August 2019), adding COVID-19-related questions to the second wave (July-August 2020) and extending to a third wave in 2021; and undertake a survey of sports bettors in the UK (baseline n = 4000, ~July-August 2020), with follow-ups in ~October-November 2020 and ~February-March 2021. In workpackage-2, we will examine changes in expenditure on paid-for gambling advertising from January 2019 to July 2021 and undertake a mixed-method content analysis of a random sample of paid-for gambling advertising (n ~ 200) and social media marketing (n ~ 100) during the initial COVID-19 "lockdown". Workpackage-3 will involve qualitative interviews with a purposive sample of (a) young adults (aged 18-24 years) and (b) sports bettors.