Cashless gambling: Qualitative analysis of consumer perspectives regarding the harm minimization potential of digital payment systems for electronic gaming machines.

OBJECTIVE: Land-based gambling venues remain predominantly cash-based despite broader consumer trends toward digital payments. Little prior literature directly investigates the role of payment methods in gambling; however, digital payment systems offer a key intervention point for gambling harm minimization. This study explores the perspectives of electronic gaming machine (EGM) gamblers regarding the concept of cashless gambling-the ability to gamble without using physical currency. METHOD: Twenty-six Australian EGM gamblers (10 females, 16 males; aged 24-76 years) participated in four online focus group discussions. Using content analysis and a pragmatic approach, data were organized thematically in relation to consumer perceptions about the benefits and risks of cashless gambling, factors potentially influencing uptake of cashless gambling, and recommendations about harm reduction features that could be incorporated into the system. RESULTS: Cashless gambling was perceived to present important opportunities for more useful and meaningful harm reduction measures based on the ability to track a user's complete gambling activity. However, participants reported reluctance toward adoption of cashless gambling, tending to perceive such systems as being overly restrictive and invasive, and potentially facilitating (over)spending, depending on design and implementation. Participants commonly perceived systems as offering little value to individuals who gamble without experiencing significant harms. CONCLUSIONS: Perceived irrelevance and privacy concerns appear to be major barriers to adoption of a cashless gambling system with strong harm reduction features. Our findings provide insights for policy makers considering the optimal design, implementation, and marketing of cashless gambling from a harm reduction perspective. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Problematic online behaviors and psychopathology in Australia.

This study aimed to ascertain frequency rates and predictors of six problematic online behaviors (POBs) in an Australian sample. Participants (N = 1626) completed instruments measuring problematic online gaming, cyberchondria, problematic cybersex, problematic online shopping, problematic use of social networking sites, problematic online gambling, anxiety, depression and attention deficit/hyperactivity disorder (ADHD). Each POB was presumed to be present based on the cut-off score on the corresponding instrument and at least one indicator of interference with functioning. Generalized linear model analyses were used to determine socio-demographic and psychopathological predictors of each POB. The most common POB was problematic online shopping (12.2%), followed by problematic online gambling (11.4%), problematic use of social networking sites (6.0%), problematic cybersex (5.3%), problematic online gaming (5.2%) and cyberchondria (4.6%). Age group 27-36 had the highest rates of POBs. The intensity of ADHD symptoms predicted all POBs, whereas younger age predicted all POBs except for problematic cybersex and online gambling. Female gender predicted lower scores on the measures of problematic online gaming and cybersex. These findings have implications for age- and gender-adapted education, prevention and treatment efforts and suggest that specific POBs should be investigated separately instead of lumping them together under the umbrella terms such as "Internet addiction".

Open Science Practices in Gambling Research Publications (2016-2019): A Scoping Review.

The replication crisis has stimulated researchers around the world to adopt open science research practices intended to reduce publication bias and improve research quality. Open science practices include study pre-registration, open data, open access, and avoiding methods that can lead to publication bias and low replication rates. Although gambling studies uses similar research methods as behavioral research fields that have struggled with replication, we know little about the uptake of open science research practices in gambling-focused research. We conducted a scoping review of 500 recent (1/1/2016-12/1/2019) studies focused on gambling and problem gambling to examine the use of open science and transparent research practices. Our results showed that a small percentage of studies used most practices: whereas 54.6% (95% CI: [50.2, 58.9]) of studies used at least one of nine open science practices, each practice's prevalence was: 1.6% for pre-registration (95% CI: [0.8, 3.1]), 3.2% for open data (95% CI: [2.0, 5.1]), 0% for open notebook, 35.2% for open access (95% CI: [31.1, 39.5]), 7.8% for open materials (95% CI: [5.8, 10.5]), 1.4% for open code (95% CI: [0.7, 2.9]), and 15.0% for preprint posting (95% CI: [12.1, 18.4]). In all, 6.4% (95% CI: [4.6, 8.9]) of the studies included a power analysis and 2.4% (95% CI: [1.4, 4.2]) were replication studies. Exploratory analyses showed that studies that used any open science practice, and open access in particular, had higher citation counts. We suggest several practical ways to enhance the uptake of open science principles and practices both within gambling studies and in science more generally.

An Empirical Study of the Pathway Model Link Between Cognitive Distortions and Gambling Problems.

This research empirically tests the relationship between gambling-related cognitive distortions and the development of gambling problems. In two separate studies using methodologies designed to support non-experimental causal inference, we demonstrate that holding false beliefs about gambling experiences is related to current and future risk of developing problems with gambling. In our first study, we use an instrumental variable estimation strategy on an internet sample (n = 184) and observe a statistically significant relationship between Gamblers' Belief Questionnaire scores and measures of loss chasing, overspending, and gambling problems. These findings were robust to linear and ordinal estimation strategies and multiple model specifications. In our second study, we examine five-year prospective longitudinal data (n = 1,431) to validate our initial findings and test whether irrational thoughts are also related to future problems with gambling. While controlling for current fallacies, we find that past Gambling Fallacies Measure scores are related to present gambling problems across two survey waves. The effect size of each of the past fallacy levels is roughly half of the effect size of present levels, suggesting meaningful impacts. Our findings support the Pathways Model of Problem and Pathological Gambling.

The directionality of anxiety and gaming disorder: An exploratory analysis of longitudinal data from an Australian youth population.

Gaming activities among adolescents have increased during the COVID-19 pandemic, bringing with it a growing concern for the potential harms of excessive gaming and its risk factors. Anxiety is frequently linked with gaming disorder, but studies investigating this association were mostly cross-sectional in design. Longitudinal studies that explore risk factors associated with gaming disorder are sparse and the trajectories of gaming disorder remain unclear. To address this paucity, the present study analyzed a large longitudinal dataset with a 12-month follow-up of 4,968 Australian adolescents (ages 13-14) during the pandemic. Logistic regression and multiple regression analyses were conducted to investigate the temporal relationships between anxiety, gaming frequency, the amount of money spent within video games, and gaming disorder. Prevalence rates for gaming disorder in adolescents aged 13 and 14 were 15 and 16%, respectively. The regression models indicated a bidirectional relationship between anxiety and gaming disorder symptoms, where higher levels of anxiety were associated with higher levels of gaming disorder 12 months later and vice versa. The study also found that the interaction between anxiety and higher gaming frequency could predict gaming disorder symptoms. Overall, the findings suggest that young adolescents may be more vulnerable to developing gaming disorder and highlight the importance of addressing the interactions between risk factors and gaming disorder in treatment approaches.

Short-term cognitive impacts of electronic gaming machines with and without a skill-based component: A comparative laboratory study.

This study aimed to compare how consumers understand the role of skill and chance, experience cognitive distortions, and experience immersion based on use of either electronic gaming machines (EGMs) or skill gambling machines (SGMs; EGMs with a skill-based component). Participants (N = 246, M age = 34 years, 56.91% female) in a laboratory experiment were randomly assigned to play a real EGM or SGM without funds and self-reported measures including intention to gamble, understanding of the role of skill and chance, erroneous gambling beliefs, previous gambling and gaming, and problem gambling severity. Participants demonstrated different deficits in understanding of the role of skill vs. chance in determining outcomes following play. SGM players were more likely to increase their belief that a skill impacts outcomes and focused more on the game play experience. EGM players focused more on wins and personal performance. Intention to play both machines was predicted in both groups by greater experience of immersion during play and breadth of previous gambling, but breadth of previous gaming experience only predicted intent to play SGMs. The results revealed that both EGM and SGM players fail to understand how outcomes are determined, which is likely more problematic for EGM players as this reflects clear cognitive distortions. Further real-world testing is required to understand the extent to which SGMs harms may be different than EGMs, however, these initial findings suggest that their risks appear comparable to EGMs while attracting individuals with more gaming experience.

Testing the spectrum hypothesis of problematic online behaviors: A network analysis approach.

The validity of the constructs of problematic Internet or smartphone use and Internet or smartphone addiction has been extensively debated. The spectrum hypothesis posits that problematic online behaviors (POBs) may be conceptualized within a spectrum of related yet distinct entities. To date, the hypothesis has received preliminary support, and further robust empirical studies are still needed. The present study tested the spectrum hypothesis of POBs in an Australian community sample (n = 1,617) using a network analysis approach. Psychometrically validated self-report instruments were used to assess six types of POBs: problematic online gaming, cyberchondria, problematic cybersex, problematic online shopping, problematic use of social networking sites, and problematic online gambling. A tetrachoric correlation matrix was computed to explore relationships between online activities and a network analysis was used to analyze relationships between POBs. Correlations between online activities were positive and significant, but of small magnitude (0.051 ≤ r ≤ 0.236). The community detection analysis identified six distinct communities, corresponding to each POB, with strong relationships between items within each POB and weaker relationships between POBs. These findings provide further empirical support for the spectrum hypothesis, suggesting that POBs occur as distinct entities and with little overlap.

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.

Accuracy of self-reported gambling frequency and outcomes: Comparisons with account data.

Objectives: The ability to accurately recall past gambling behavior and outcomes is essential for making informed decisions about future gambling. We aimed to determine whether online gambling customers can accurately recall their recent gambling outcomes and betting frequency. Method: An online survey was distributed to 40,000 customers of an Australian sports and race wagering website which asked participants to recall their past 30-day net outcome (i.e., total amount won or lost) and number of bets. We compared responses to these questions with participants' actual outcomes as provided by the online site. Results: Among the 514 participants who reported their net outcome, only 21 (4.09%) were accurate within a 10% margin of their actual outcome. Participants were most likely to underestimate their losses (N = 333, 64.79%). Lower actual net losses were associated with greater underestimation and overestimation of losses. Of the 652 participants who reported their gambling frequency, 48 (7.36%) were accurate within a 10% margin of their actual frequency. Most participants underestimated their number of bets (N = 454, 69.63%). Higher actual betting frequencies were associated with underestimating betting and lower actual frequencies with overestimating betting. Conclusions: The poor recall accuracy we observed suggests public health approaches to gambling harm minimization that assume people make informed decisions about their future bets based on past outcomes and available funds should be reconsidered. Findings also question the reliability of research outcomes predicated on self-reported gambling behavior. Research is needed to determine the best methods of increasing people's awareness of their actual expenditure and outcomes. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Patterns and correlates of consumer protection tool use by Australian online gambling customers.

OBJECTIVE: Consumer Protection Tools (CPTs; e.g., deposit limits, timeouts) are provided by gambling sites to assist customers to gamble without harms. We aimed to understand how CPTs are used, and by which customers, which is essential to determine their effectiveness. METHOD: We examined the account data of 39,853 customers (median age = 33 years; 84% male) across six Australian wagering sites over 1 year (2018/07/01-2019/06/30). RESULTS: Most (83%) customers did not use any CPTs, with low rates of use for deposit limits (15.8%), timeouts (0.55%-1.57%), and self-exclusion tools (0.16%-0.57%) observed. Requiring customers to set a deposit limit or opt-out of setting one led to substantial increases in limit setting. Many customers who used limits later changed them, typically by increasing or removing them. Non-CPT users and deposit limit users were similar in their demographic and gambling characteristics, while comparatively, timeout and/or self-exclusion users were younger and displayed more risky gambling behaviors (e.g., higher net loss and betting frequency). CONCLUSIONS: Our findings suggest that voluntary deposit limits have inherent limitations in addressing harmful behaviors if consumers can easily increase or remove limits. The study suggests that greater efforts are needed to encourage CPT use among a broad customer base, including default limits requiring opt-out, greater restrictions on increasing or remove limits, and more persuasive communication of the benefits of timeouts. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Encouraging and evaluating limit-setting among on-line gamblers: a naturalistic randomized controlled trial.

AIMS: We tested the effectiveness of three different messages designed to increase limit-setting on gambling sites and sent these via e-mail or in-account notification to compare delivery modes. As a secondary aim, we examined the effects of limit-setting on gambling behaviour. DESIGN: A pre-registered, naturalistic randomized control trial using a 3 × 2 plus control design. SETTING: Four on-line Australian sports and racing wagering websites. PARTICIPANTS: A total of 31 989 wagering customers (reduced to 26,560 after eligibility screening) who had placed bets on at least 5 days in the past 30 [mean age = 41.4, standard deviation (SD) = 14.3; 79% male]. INTERVENTIONS AND COMPARATORS: Messages were sent via e-mail or in-account notification by on-line gambling operators and were designed to either: (1) be informative, describing the availability and purpose of the tool (informative messages), (2) highlight the benefits other people receive from using the tool (social messages) or (3) promote the benefit individuals could receive from using the tool (personal messages). A control group who did not receive messages was monitored for comparison. MEASUREMENTS: Our primary outcome was the number of customers who set a deposit limit within 5 days of receiving messages and secondary outcomes included pre- and post-message betting behaviour (e.g. average daily wager). FINDINGS: One hundred and sixty-one (0.71%) customers sent messages set limits compared to three (0.08%) controls [adjusted odds ratio (aOR) = 8.17, 95% confidence interval (CI) = 2.99, 33.76)]. Social and personal messages were no more effective than informative messages (aOR = 0.98, 95% CI = 0.65, 1.48; aOR = 0.93, 95% CI = 0.60, 1.44) and in-account messages were no more effective than e-mails (aOR = 1.02, 95% CI = 0.71, 1.49). Customers who set limits significantly decreased their average daily wager, the SD of daily wager, net loss and betting intensity compared with non-limit-setters. CONCLUSIONS: Messages to on-line gambling website customers are inexpensive, and may lead to small but impactful increases in setting deposit limits. Limit-setting may be an effective strategy for reducing gambling expenditure and intensity.

Impacts of the COVID-19 Shutdown on Gambling Patterns in Australia: Consideration of Problem Gambling and Psychological Distress.

OBJECTIVES: The COVID-19 pandemic reduced access to gambling and contributed to widespread psychological distress. Psychological distress is a known risk factor for problem gambling as it can motivate excessive gambling as a coping response. The availability of gambling is considered a factor in maintaining problems. This paper aimed to investigate the impact of the shutdown of gambling venues on Australians, particularly among those vulnerable to mental health problems and gambling disorder. METHODS: Australian adults who had gambled at least once in the past 12 months (N = 764, 85.2% male) completed an online cross-sectional survey. Self-report measures retrospectively assessed typical monthly gambling frequency and expenditure before and after the COVID-19 venue shutdown, problem gambling, and psychological distress. RESULTS: Significant median decreases in gambling frequency were observed, both online and overall. No relationship was found between psychological distress and baseline or increases in gambling. Greater problem gambling severity was related to higher baseline gambling, but not to increases in gambling. Exploratory analysis showed that individuals engaged in moderate-risk gambling, but not problem gambling, were more likely to report increased gambling frequency compared to nonproblem and low-risk gamblers combined. CONCLUSIONS: Findings provide important insights into how changes in availability influence gambling participation, and for understanding the effectiveness of forced restrictions and venue exclusion strategies. Most people moderated their gambling when venue-based gambling was unavailable and opportunities for sports betting were limited. However, harms experienced by individuals with some gambling problems may have been exacerbated during the period of limited access. Policies to enhance prevention and treatment of gambling problems are necessary even when availability is reduced.

Problematic risk-taking involving emerging technologies: A stakeholder framework to minimize harms.

BACKGROUND AND AIMS: Despite the many benefits of technological advancements, problematic use of emerging technologies may lead to consumers experiencing harms. Substantial problems and behavioral addictions, such as gambling and gaming disorders, are recognized to be related to Internet-based technologies, including the myriad of new devices and platforms available. This review paper seeks to explore problematic risk-taking behaviors involving emerging technologies (e.g., online gambling and gaming, online sexual behaviors, and oversharing of personal information via social networking sites) that have the potential to lead to problematic outcomes for individuals. RESULTS AND DISCUSSION: Previous research has focused on policy frameworks for responding to specific issues (e.g., online gambling), but a broader framework is needed to address issues as they emerge, given lags in governments and regulators responding to dynamically evolving technological environments. In this paper, key terms and issues involved are identified and discussed. We propose an initial framework for the relative roles and responsibilities of key stakeholder groups involved in addressing these issues (e.g., industry operators, governments and regulators, community groups, researchers, treatment providers, and individual consumers/end users). CONCLUSION: Multidisciplinary collaboration can facilitate a comprehensive, unified response from all stakeholders that balances individual civil liberties with societal responsibilities and institutional duty of care.

Development and psychometric evaluation of the Recovery Index for Gambling Disorder (RIGD).

Objective: Recovery from Gambling Disorder lacks established operational criteria and a dedicated outcome measure. Cross-study comparisons and treatment efficacy determinants are difficult without a valid and widely used tool to assess recovery. The current article describes the development and psychometric evaluation of the Recovery Index for Gambling Disorder (RIGD). Method: Item development was based on an integration of academic, clinical, and consumer perspectives of recovery. Expert feedback and cognitive interview techniques were employed to review and refine the initial item pool. An empirical evaluation of the RIGD was conducted using 204 adult participants (63.7% male) with experience of seeking formal help for gambling problems. Results: Partial-least squares structural equation modeling resulted in a 32-item solution across 6 recovery dimensions: gambling reduction, urge coping, recovery wisdom, life functioning, interpersonal relationships, and mental health. The RIGD structural model explained 71.9% of variance in an external self-report global measure of recovery. Convergent validity was evidenced by significant correlations between all RIGD dimensions and other related measures, with the exception of recovery wisdom. Criterion-related validity was demonstrated as RIGD composite scores accurately classified nonproblem from problem gamblers, with a conservative cut-off score of 45. Test-retest reliability was established over a 2-week interval. Conclusions: The RIGD is an empirically supported instrument designed to broadly measure recovery from Gambling Disorder. Valid and uniform measurement of recovery is important given its central role in advancing effective treatments and shaping gambling help service policy internationally. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Reducing Internet Gambling Harms Using Behavioral Science: A Stakeholder Framework.

Internet gambling provides a unique environment with design mechanics and data-driven opportunities that can impact gambling-related harms. Some elements of Internet gambling including isolation, lack of interruption, and constant, easy access have been argued to pose specific risks. However, identifiable player accounts enable identification of behavioral risk markers and personalized private interfaces to push customized messages and interventions. The structural design of the Internet gambling environment (website or app) can have a strong influence on individual behavior. However, unlike land-based venues, Internet gambling has few specific policies outlining acceptable and unacceptable design practices. Harm minimization including responsible gambling frameworks typically include roles and responsibilities for multiple stakeholders including individual users, industry operators, government regulators, and community organizations. This paper presents a framework for how behavioral science principles can inform appropriate stakeholder actions to minimize Internet gambling-related harms. A customer journey through internet gambling demonstrates how a multidisciplinary nexus of collaborative effort may facilitate a reduction in harms associated with Internet gambling for consumers at all stages of risk. Collaborative efforts between stakeholders could result in the implementation of appropriate design strategies to assist individuals to make decisions and engage in healthy, sustainable behaviors.

Debt stress partly explains the relationship between problem gambling and comorbid mental health problems.

RATIONALE: Easy access to consumer credit products, such as credit cards, overdrafts, and personal loans, may facilitate gambling beyond affordable levels, which can result in debt problems. Debt and mental health problems are both potential motivators and core consequences of problem gambling. Debt stress (i.e., worry regarding ability to repay debts) is one potential psychological mechanism underlying the relationship between debt and mental health problems. Few previous studies have investigated debt stress among gamblers. OBJECTIVE: This cross-sectional study aimed to investigate the mediating effect of debt stress between gambling frequency and mental health and wellbeing. METHODS & RESULTS: A sample of 309 Australian past-month gamblers (83.8% male; mean age 41.5 years) completed an online survey. There was no evidence for the preregistered association between gambling frequency and debt stress, ruling out a predicted mediating effect for debt stress between gambling frequency and mental health and wellbeing. However, exploratory path analysis showed debt stress has statistically significant mediating effects between problem gambling and psychological distress, depression, wellbeing, and gambling-related family impacts, after controlling for sociodemographic factors and psychiatric history. CONCLUSIONS & IMPLICATIONS: Debt stress is a robust indicator of financial problems and may indicate underlying problem gambling and mental health issues, making debt stress a useful risk indicator. Clinical services should conduct screening for debt stress and address subjective worry about debts as a standard part of treatment plans as this may help to mitigate some of the impact of gambling and/or financial problems on poor mental health. Health practitioners should develop strong referral networks with gambling and financial counselling services. Government investment in making gambling and financial counselling services freely available and easily accessible is recommended to ensure appropriate support is received via effective care pathways.

Overconfidence in Understanding of How Electronic Gaming Machines Work Is Related to Positive Attitudes.

Previous research has demonstrated that attitudes are a primary determinant of intention to gamble on electronic gaming machines (EGMs) consistent with the Theory of Reasoned Action. This paper aims to address how biases in judgment can contribute to attitudes and subsequently behavior, including maladaptive problematic gambling behavior. We take a novel approach by viewing overconfidence in one's understanding of how outcomes are determined on EGMs as an indication of cognitive distortions. The novelty of this paper is further increased as we compare attitudes to existing EGMs with novel EGMs which include a skill component, referred to as skill-based gaming machines (SGMs), which enables a better controlled comparison between actual and perceived skill. In Study 1, 232 US-based participants were recruited online who were shown various slot machines and SGMs and asked a series of questions about perceived skill and chance in determining outcomes to assess their understanding, then were asked their confidence in their understanding, attitudes toward the machines and they completed the Problem Gambling Severity Index. In Study 2, 246 Australian participants were recruited through community and university student samples; they attended a laboratory where they were randomly allocated to play a real EGM or SGM without money and completed the same measures as in Study 1. In Study 2, participants were randomly told that the outcomes on the machine they would play were determined entirely by chance, skill, or a mixture of both. In both studies, our findings suggest that there are more extreme values in overconfidence in how EGMs work, whereas individuals are more similar in their confidence in understanding SGMs. We also find a relationship between overconfidence in EGM understanding and positive attitudes toward EGMs, but no such relationship with SGMs. There was no impact from controlling for demographics, problem gambling severity, or labeling of machines on these relationships.

Use of Consumer Protection Tools on Internet Gambling Sites: Customer Perceptions, Motivators, and Barriers to Use.

Internet gambling has been widely legalised in recognition of its capacity to, and the importance of, providing consumer protection tools to prevent and minimise gambling-related harms. Most licensed Internet gambling sites are required to provide consumer protection tools, including activity statements, deposit limits, and time-outs (temporary self-exclusion). However, few Internet gambling customers engage with the tools. An online survey of 564 customers of Australian Internet gambling sites aimed to understand the extent to which consumer protection tools are used, characteristics of those using these tools, and the perceptions and attitudes towards tool use, including barriers to use. Most participants were aware of the tools and had accessed activity statements; few had used deposit limits (24.5%) or time-outs (8.1%) but use of these restrictive tools was higher among those at-risk of gambling problems. Satisfaction with tools was generally high among users and tools were mostly used as intended; however, only moderate changes in behaviour were reported. Participants predominately did not use the restrictive tools as they did not see these as relevant for them, and they were perceived to be intended for people with gambling problems. The findings are important to drive necessary improvements to consumer protection efforts including efforts to encourage perception that tools are relevant for all customers. Changes to current practice, including terminology and promotion of tools, are needed by Internet gambling operators and policy makers to improve the utilisation and effectiveness of consumer protection tools to enable sustainable gambling among the broader cohort of Internet gamblers.