Gambling During the COVID-19 Crisis - A Cause for Concern

The COVID-19 pandemic has the potential to worsen mental health problems in the general population, including increasing engagement in addictive behaviors. Here, we describe observations suggesting that the current crisis and its sequelae may worsen problem gambling. The current pandemic may impact financial and psychological well-being due to social isolation during spatial distancing, and these stressors in conjunction with substantial changes in gambling markets (land-based, online) during the pandemic may significantly influence gambling behaviors. This situation calls for rapid research initiatives in this area and preventive and regulatory measures by multiple stakeholders.Copyright © 2020 Lippincott Williams and Wilkins. All rights reserved.

Australia's gambling epidemic: The role of Covid-19 support payment

Covid-19 exposed the whole world to numerous challenges ranging from health to economic recession. Nevertheless, it also impeded gambling activities. Here, we consider the relationship between Covid-19 support payment and gambling. Gambling is considered leisure for many game players but leads to multiple social and economic harms. This has led to a growing body of literature examining the factors that influence gambling. This paper contributes to this strand of the literature by utilizing the ordinary least square and instrumental variable approach to investigate if Covid-19 support payment is a driver of gambling. We utilize a wide range of gambling measures and different forms of Covid-19 support payment. Our findings show that Covid-19 support payment is positively associated with gambling. Our results also suggest a stronger effect for male gamblers and online gamblers compared to female gamblers and gamblers who gambled at the venue. © 2023 The Authors. Australian Economic Papers published by John Wiley & Sons Australia, Ltd.

Gambling Despite Nationwide Self-Exclusion-A Survey in Online Gamblers in Sweden.

Background: Voluntary self-exclusion is a well-known harm reduction intervention in problem gambling, although primarily in operator-specific or venue-based systems. A nationwide overall self-exclusion system ("Spelpaus") for all licensed gambling was introduced in Sweden in 2019. However, gambling in overseas companies despite national exclusion may be a concern in online gamblers. The present web survey study aimed to study self-reported self-exclusion and gambling despite exclusion in a nationwide multi-operator land-based/online exclusion system. Methods: Web survey in web panel members of a market survey company, carried out in May, 2020 (co-occurring with the COVID-19 pandemic). Past-year online gamblers (n = 997) answered questions about gambling patterns, gambling problems, psychological distress, self-exclusion since "Spelpaus" introduction, and gambling despite self-exclusion. Results: Seven percent reported ever self-excluded at Spelpaus, and this was associated with younger age, female gender, gambling problems, and chance-based games and online poker. In logistic regression, Spelpaus remained strongly associated with past-year online casino gambling, gambling problems, and absence of past-year sports betting. Among those having self-excluded, 38 percent reported gambling despite self-exclusion, most commonly online casino. Conclusions: In online gamblers in a setting with a nationwide self-exclusion system, using this was associated with past-year online casino gambling and gambling problems. Gambling despite self-exclusion appears to be common, and more commonly involves online casino. Stakeholders should aim to increase rates of self-exclusion in high-risk online gamblers, both during and beyond the COVID-19 situation in which the study was carried out. Also, policy makers should use gambling regulation in order to decrease the risk of breaching self-exclusion online, such as through the prohibition of non-registered gambling operators. Further research should focus on in-depth analysis of the reasons for gamblers to enroll or not enroll in multi-operator self-exclusion.

Worsened Anxiety and Loneliness Influenced Gaming and Gambling during the COVID-19 Pandemic.

Aim: To study the prevalence and patterns of problematic gaming and gambling during the COVID-19 pandemic and the association with psychiatric traits and major types of anxiety categories. Method: 1067 young adults participated in both wave 3 (2018) and wave 4 (2021) of the SALVe Cohort. Associations with psychiatric symptoms and anxiety were examined using logistic regression and Chi-square tests. Results: Problematic gaming decreased by 1.3 percentage points to 23.2% since the start of the pandemic, while problematic gambling increased by 0.9 percentage points to 6.5% in w4. Average time spent playing video games/day decreased from 2.2 h (w3) to 1.7 h (w4), while increases in gaming activity were associated with worsened feelings of loneliness (p = 0.002), depression (p < 0.001), and anxiety (p < 0.01) during the pandemic. Predictors for problematic gaming at w4 were previous problematic gaming and social anxiety (p = < 0.001 and 0.01, respectively). Moreover, previous problem gambling also predicted problem gambling at w4 p < 0.001. All anxiety categories were associated with both problematic gaming and gambling when adjusted for age and sex. However, after adjusting for depression and insomnia, social anxiety was associated with problematic gaming (p < 0.001), while panic was associated with problem gambling (p < 0.001). Conclusion: Overall, problematic gaming has decreased since the start of the pandemic, while problem gambling has increased. Worsened feelings of loneliness, depression, and anxiety during the pandemic are associated with increased gaming. Moreover, the association between problematic gaming and gambling and anxiety is independent of depression and sleep problems.

Large-Scale Web Scraping for Problem Gambling Research: A Case Study of COVID-19 Lockdown Effects in Germany.

The COVID-19 pandemic and the measures to prevent its spread have had a negative impact on substance use behaviour. It is likely that social distancing and lockdown measures have also altered gambling behaviour, for instance shifting from land-based to online gambling. We used large-scale web scraping to analyse posting behaviour on a major German online gambling forum, gathering a database of more than 200k posts. We examined the usage of different subforums, i.e. terrestrial, online gambling and problem gambling sections, and changes in posting behaviour related to the casino closures that were part of the nationwide restrictions in Germany in 2020. There was a marked increase in newly registered users during the first lockdown compared to the preceding weeks, an increase in the number of posts in the online gambling subforum and concurrent decrease in the terrestrial gambling subforum. Further, the number of short-latency replies was higher during the first lockdown compared to the preceding weeks. Many users who posted in both the online and terrestrial forum contributed at least once to the problem gambling subforum, implying that the topic of problem gambling is widely discussed. Our findings may indicate a shift from terrestrial to online gambling during lockdown, and mirror the general increase in screen time and usage of online platforms after the onset of the COVID-19 pandemic. The analyses help to identify lockdown-related effects on gambling behaviour. These potentially detrimental effects pose a special threat for individuals at risk and may require monitoring and special public health measures.

Psychosocial Perspective on Problem Gambling: The role of Social Relationships, Resilience, and COVID-19 Worry.

The COVID-19 pandemic has amplified several psychosocial risks and problem behaviors among vulnerable individuals. Given that gambling has high addictive potential, it is important to consider the underlying mechanisms of problem gambling. This study examined psychosocial factors associated with pandemic-time problem gambling.Cross-sectional data were gathered via an online survey of 18-75-year-old Finnish, Swedish, and British respondents (n = 2,022) who reported having gambled at least occasionally during the pandemic. Measures included problem gambling, loneliness, COVID-19 worry, social support, and psychological resilience. Control variables included gender, age, and education. Structural equation modeling was used as an analytical technique.Loneliness was found to be associated with problem gambling. While COVID-19 worry was not directly associated with problem gambling, it predicted higher loneliness, which in turn was associated with problem gambling. Evidence was not found regarding the protective role of resilience or social support in problem gambling. However, social support was found to be associated with higher problem gambling severity. Male gender and younger age were associated with problem gambling.The results bring insight into underlying vulnerabilities regarding problem gambling during the pandemic. More focus should be placed on the quality and sources of social support, as well as on how psychosocial risk and protective factors might work differently among different populations of gamblers.

Prediction of problem gambling by demographics, gaming behavior and psychological correlates among gacha gamers: A cross-sectional online survey in Chinese young adults.

Objective: The objective of this study is to explore the association of problem gambling with demographics, psychological distress, and gaming behavior in young adult gacha gamers in Hong Kong. Materials and methods: Cross-sectional data was collected in the first and fifth waves of COVID-19 pandemic in Hong Kong online. Participants who aged 18-25 years and had been playing gacha games over the past 12 months were recruited. Stepwise multiple regression was used to explore the association among risk of problem gambling, gaming behavior, participation in gaming activities and psychological distress. A two-sided p-value <0.05 was considered as statistical significance. Results: Three hundred and thirty-seven completed questionnaires were received with no missing data. 34.7% (n = 117) of the participants had non/low-risk of problem gambling. About 40% (n = 136) of them had moderate-risk and the remaining 25% (n = 84) were at high risk of problem gambling. A higher proportion of female participants (78.6%) were found in high-risk group as compared to 39.7% and 55.6% only in the non/low-risk and moderate-risk groups, respectively. The regression model (R 2 = 0.513, F = 71.895, p < 0.001) showed that 51.3% of the variance of the total problem gambling score could be explained by stress, anxiety, monthly expenses on gacha purchases, number of motives for gacha purchase and number of gambling activities engaged. Conclusion: The present study provides empirical evidence to support the association between problem gambling and microtransaction especially for gacha which is the most popular type of video game microtransaction in Asia. The established regression model suggests that gacha gamers with higher risk of problem gambling tend to have greater stress, higher anxiety level, spend more on gacha purchase, have more motives for gacha purchases and engage in more gambling activities. In contrast to the extant literature, higher proportion of female participants in high-risk group indicates that female gacha gamers are also at very high risk of becoming problem gamblers.

Gambling in Canada During the Pandemic: 6 Months After the National COVID Lockdown

Objective: To investigate the impact of the coronavirus disease (COVID) pandemic on gambling and problem gambling in Canada. Method(s): A stratified national cohort of regular gamblers (n=2790) completed a comprehensive online questionnaire 6 months before the onset of the pandemic (baseline;August-November 2019), during the nation-wide lockdown (May-June 2020), and 6 months after the lockdown (December 2020). Result(s): Significant decreases in gambling frequency, time spent in gambling sessions, money spent, and the number of game types played occurred during lockdown followed by significant increases in all of these same measures postlockdown. However, the level of postlockdown gambling behavior was still significantly lower than prepandemic baseline levels. A significant shift to online gambling was also observed during the lockdown, which persisted postlockdown. Problem gambling scores also declined during the lockdown, with no significant change in these scores postlockdown. Consistent with previous literature, it was found that a higher level of gambling engagement, online gambling participation, and known biopsychosocial factors (family history of problem gambling, gambling fallacies, substance use, male sex, mood disorder) were predictors of problem gambling at postlockdown. COVID-specific factors predictive of problem gambling postlockdown were the presence of negative COVID-related health impacts and increased levels of social interaction and leisure time. Conclusion(s): The COVID-related lockdowns have resulted in lower levels of gambling and problem gambling symptomatology as well as increased online gambling in Canada that have persisted to some extent 6 months postlockdown. Future studies are necessary to ascertain whether these represent permanent or temporary changes. Copyright © 2022 Lippincott Williams and Wilkins. All rights reserved.

Multi-operator Self-exclusion as a Harm Reduction Measure in Problem Gambling: Retrospective Clinical Study on Gambling Relapse Despite Self-exclusion.

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.

An interrupted time series analysis of gambling behavior based on gambling operator revenue-based taxation during the COVID-19 pandemic in Sweden.

OBJECTIVES: The impact of COVID-19 on gambling behavior and the gambling industry itself has been widely speculated. Prior studies have shown how boredom, social isolation, poor mental health, and financial hardships, all of which have been associated with COVID-19, can aggravate problem gambling behaviors in patients with gambling disorders while also luring newcomers. Few studies have used methods other than self-report to assess longitudinal behavioral changes in gambling behavior before versus during the pandemic. STUDY DESIGN: The present study addresses this gap by using an interrupted time series approach on data obtained from the Swedish Gambling Authority measuring taxation on gambling vendors' revenue between January 2019 and November 2021. METHODS: March, June, and October 2020 were chosen as interruption points as they correspond to the pandemic's commencement, the return of elite sports, and the second wave of cases in Sweden, respectively. We hypothesized that the pandemic would be associated with both temporary changes for select gambling types and long-term increases in online gambling. RESULTS: Results revealed the pandemic's onset was associated with transient effects at each point of interruption, as well as long-term upward trends in total gambling and commercial online gambling, excluding horse betting and the state-owned operator for online casinos and betting. CONCLUSIONS: The present study's findings, although consistent with the theory that gambling activity could increase during the pandemic, contradict previous studies that found no changes or a decrease from pre-COVID-19 levels. Findings indicate that the pandemic and Sweden's reaction to it were associated with increased use of some gambling products.

A Longitudinal Study of Gambling Behaviors During the COVID-19 Pandemic in Sweden.

This study aimed to investigate changes in gambling behaviors during the first and second waves of the COVID-19 pandemic in Sweden. Participants who had gambled within the past year were recruited from social media and the Swedish National Helpline (n = 325, mean age 39.8 years, 64.8% males, 31.3% with problem gambling) and completed an online survey measuring gambling behaviors, consequences of the pandemic in general and worries related to the pandemic. A sub-sample (n = 139) completed a follow-up survey, during the second wave. The results showed no significant associations between COVID-19 consequences (financial or increased isolation) and increased monthly gambling behavior. No major migrations were observed between game types. However, gambling on a high-risk game (OR = 7.44, p < 0.001) and worrying about mental health due to the pandemic (OR = 2.85, p < 0.001) were significantly associated with past year gambling problems and increased monthly gambling problems from the first to the second wave. More longitudinal research is needed in vulnerable populations, to fully understand the long-term consequences of the pandemic.

Effects of a National Preventive Intervention Against Potential COVID-19-Related Gambling Problems in Online Gamblers: Self-Report Survey Study.

BACKGROUND: The COVID-19 pandemic has been suspected to increase gambling problems in the population. Several governments introduced COVID-19-specific interventions early with the aim to prevent gambling problems, but their effects have not been evaluated. OBJECTIVE: This study aimed to evaluate a Swedish COVID-19-related temporary legislation imposing an automated weekly deposit limit for online casino gambling. METHODS: The study was an anonymous survey sent by a state-owned gambling operator to online gamblers (N=619), among whom 54.0% (n=334) were moderate-risk/problem gamblers who reached the weekly limit on online gambling during the summer of 2020. RESULTS: Overall, 60.1% (372/619) were aware of having been limited by the COVID-19-related deposit limit, and a minority (145/619, 23.4%) perceived the intervention as fairly bad or very bad. Among those aware of the intervention, 38.7% (144/372) believed the intervention decreased their overall gambling, whereas 7.8% (29/372) believed it rather increased it. However, 82.5% (307/372) reported having gambled at more than one operator after the limit, and the most common gambling type reported to have increased at another operator was online casino (42% among moderate-risk/problem gamblers and 19% among others; P<.001). An increase in gambling following the intervention was associated with being a moderate-risk/problem gambler and having negative attitudes toward the intervention. CONCLUSIONS: The weekly deposit limit had relatively high acceptability, but the study highlights the limitations of a single-operator deposit limit, given the high number of gamblers also reporting gambling at other operators and the lower effect in clients with gambling problems.

Match-Fixing Causing Harm to Athletes on a COVID-19-Influenced Gambling Market: A Call for Research During the Pandemic and Beyond.

Match-fixing, although not a new problem, has received growing attention during the COVID-19 pandemic, which has been reported in the media to have increased the risk of match-fixing events. Gambling is a well-documented addictive behavior, and gambling-related fraud, match-fixing, is a challenge to the world of sports. Most research on match-fixing has a judicial or institutional perspective, and few studies focus on its individual consequences. Nevertheless, athletes may be at particular risk of mental health consequences from the exposure to or involvement in match-fixing. The COVID-19 crisis puts a spotlight on match-fixing, as the world of competitive sports shut down or changed substantially due to pandemic-related restrictions. We call for research addressing individual mental health and psycho-social correlates of match-fixing, and their integration into research addressing problem gambling, related to the pandemic and beyond.

Gambling in Canada During the COVID Lockdown: Prospective National Survey.

The current study investigated the impact of the COVID pandemic lockdown on gambling and problem gambling in Canada. The AGRI National Project's online panel participants (N = 3449) provided baseline gambling data 6 months prior to the pandemic. Re-surveying this sample during the lockdown provided an opportunity to make quantitative comparisons of the changes. Nearly one-third of gamblers reported ceasing gambling altogether during the lockdown. For the continuing gamblers, quantitative data indicated significant decreases in gambling frequency, time spent in gambling sessions, money spent, and the number of game types played. Qualitative perceptions of changes in gambling were examined and the accuracy of these reports were not closely aligned with actual changes in gambling. Gambling platform was the only gambling engagement metric where increases were found with ~ 17% of the gambling sample migrating to online gambling during the lockdown. Although problem gambling within the sample generally declined, consistent with previous literature, it was also found that gambling online-among other biopsychosocial factors-was a significant predictor for classification as a problem gambler during the lockdown. COVID-specific influences on health, employment, leisure time and social isolation were moderately associated with problem gambling scores but were not independent predictors of changes in gambling engagement during lockdown. Future studies are required to assess if the pandemic related changes in gambling evidenced in this study remain stable, or if engagement reverts to pre-pandemic levels when the pandemic response allows for the re-opening of land-based gambling venues.

Gambling behaviors during COVID-19: a narrative review.

The COVID-19 pandemic has ushered the world into unforeseen circumstances, prompting the authorities to impose restrictions and cut back various events including many gambling avenues. Professional sports have been postponed, land casinos are closed, and social distancing has shut home games down. The present narrative overview has addressed the following changes in gambling behavior since the start of the pandemic: - a) Change in the number of gamblers and intensity of gambling b) differences among various types of gambling modalities (land-based, horse betting, casino, online). and transitioning between them. c) Psychosocial effects on gamblers owing to the shutdown of gambling avenues in the early phase of COVID-19 lockdown. It alludes to several survey studies conducted so far in Northern Europe (Sweden, UK, Italy), North America (Canada, USA), and Australia on the potential impact of the SARS-Cov2 pandemic on gambling figures. Problem Gambling Severity Index (PGSI) scale is used by most of the studies to demonstrate the severity among gamblers i.e., low-risk, high-risk, and problem gamblers respectively. The majority of studies are based on self-reported questionnaires, few tracked data from online gambling operators, and one study used revenue-based taxation of land-based and online gambling as its information source. The decline in the overall gambling activity attributable to the situational changes was predominant in a majority of surveys. The impact of the COVID-19 pandemic on gambling is diverse - possibly causing a reduction in current or future problems in some, but also promoting increased problematic gambling in others.

Impact of Gambling Supply Reduction During COVID-19 Shutdowns on Gambling Problems and Gambling Behaviour in Australia: A National Longitudinal Study.

Restricting access to gambling products is one possible harm reduction strategy. We examined whether land-based gambling product supply restrictions during the COVID-19 pandemic impacted gambling problems and gambling engagement. In a three-wave, online, longitudinal study, 462 Australian adults (Mage = 44.94; 87% male) who gambled completed survey measures of demographics, gambling engagement (land-based and online), gambling problems, and psychological distress. Analyses were pre-registered and examined the impacts of restrictions on gambling problems and engagement. During the period of restrictions, there were no significant differences in gambling problems (OR = 0.88 [95%CI 0.55-1.42], p = .610) nor online gambling (B = 4.48 [95%CI-0.40-9.35], p = .071) between states experiencing and not experiencing restrictions. There was a small overall reduction in gambling engagement at 2-(t = 2.03, p = .043) and 5-months (t = 2.37, p = .019) post-restrictions, but no change in gambling problems (t = 1.25, p = .211; t = 1.50, p = .134). Amongst those at moderate-to-high risk of problems at baseline, there were no significant reductions in gambling engagement (t = 0.58, p = .564; t = 1.20, p = .232) or problems (t = 0.92, p = .359; t = 1.53, p = .126) at 2- and 5-months post-restrictions. Findings show only a modest impact of COVID-related supply restrictions on gambling engagement and no impact on gambling problems up to 5 months follow-up. The wide-ranging psychosocial and financial impacts of the pandemic may have overshadowed any potential beneficial effects of the supply restrictions on problem gambling levels. Policies to promote and improve access to problem gambling treatment services are needed even following periods of reduced availability of gambling products.

Gambling-Like Day Trading During the COVID-19 Pandemic - Need for Research on a Pandemic-Related Risk of Indebtedness and Mental Health Impact.

Stock exchange trading increasingly has been highlighted as a possible cause of gambling disorder, typically in rapid and excessive "day trading" which may cause over-indebtedness and mental health problems. The COVID-19 pandemic has been suspected to increase online gambling and gambling problems. In a number of recent media reports, day trading has been reported to increase during COVID-19, possibly in relation to changes in everyday life, financial problems and job insecurity during the pandemic. Increasing day trading has thereby been suspected to cause addictive behavior, financial difficulties, and poor mental health. However, there is hitherto a lack of research in the area. The present paper addresses the potential for day trading to cause problem gambling, debts and mental health problems, and calls for research and clinical guidelines in problem gambling related to stock market behavior as a problematic gambling behavior. Screening tools, awareness among clinicians, and longitudinal research studies may be warranted, both during the COVID-19 pandemic and beyond.

Self-Exclusion from Gambling-A Measure of COVID-19 Impact on Gambling in a Highly Online-Based Gambling Market?

The COVID-19 pandemic, and related changes of the gambling market, have been suspected to affect the risk of problem gambling. Despite media attention and political concern with this risk, study findings hitherto have been mixed. Voluntary self-exclusion from gambling was introduced on a national level in Sweden as a harm reduction tool in 2019, and this self-exclusion service in Sweden is a rare example of such an official, nationwide, multi-operator system. The present study aimed to evaluate whether short-term self-exclusion patterns were affected by different phases of COVID-19-related impacts on gambling markets in 2020. During the lock-down of sports in the spring months of 2020, three-month self-exclusion was unaffected, and one-month self-exclusion appeared to increase, though not more than in a recent period prior to COVID-19. Despite large differences in sports betting practices between women and men, self-exclusion patterns during COVID-19 were not apparently gender-specific. Altogether, self-exclusion from gambling, to date, does not appear to be affected by COVID-19-related changes in society, in contrast with beliefs about such changes producing greater help-seeking behavior in gamblers. Limitations are discussed, including the fact that in a recently introduced system, seasonality aspects and the autocorrelated nature of the data made substantial statistical measures unfeasible.

Gambling and self-reported changes in gambling during COVID-19 in web survey respondents in Denmark.

Problem gambling is among the public health hazards which may increase due to the COVID-19 pandemic and its consequences on society. Results from a few countries have hitherto been diverse with respect to gambling during the pandemic. The present study aimed to study gambling behaviors during COVID-19 in Denmark, with the same methodology as previously used in Sweden, and also to provide a comparison to previously published Swedish data. A web survey was answered by 2,012 individuals, from December 2, to December 10, 2020. Four percent reported increased gambling habits, and three percent reported decreased gambling, during COVID-19. Self-reported increase in gambling was associated with spending more time at home, mental distress, and higher gambling severity. Prevalence of self-reported, increased gaming during COVID-19 was significantly lower in Denmark than in Sweden. Although the overall changes in gambling patterns during COVID-19 may be limited, people who increase their gambling during the pandemic may be at particular risk. Stakeholders should pay attention to individuals who report altered gambling habits during the pandemic.

Emerging lessons from the commissioning and delivery of a gambling treatment service.

OBJECTIVES: Gambling is a public health concern, given the multiplicity of harms for individuals, families and communities. This article reports on the commissioning and delivery of a problem gambling treatment service in a metropolitan area in England, where the concentration of problem gambling is often higher than the national average. STUDY DESIGN: This is a cross-sectional study, using purposively sampled 'experts' and stakeholders involved in the conception and set-up of the service. METHODS: Individual semistructured interviews were used to ascertain the depth of information required to fully appreciate the nuances and complexities of the service. Eight participants took part in the interviews, with an additional respondent providing written comments in relation to the interview schedule as a workaround to accommodate the organisational impacts of COVID-19. RESULTS: The article identifies several factors contributing to the successful delivery of the service. Well-managed collaborative provision with expertise from across sectors is critical, but this needs to be balanced against the challenges faced by bridging cultural variances in practice and language. Adopting evidence-based models of delivery was central to practice, and moreover, geographical location is a key consideration to encourage access for those facing gambling problems and discourage feelings of stigma. CONCLUSIONS: This article offers a unique contribution to understanding more about the provision of gambling treatment services. This is crucial, given that a greater number of people face challenges as a consequence of gambling harms, and such services should be seen part of forming a coherent public health response.