Abstract
This paper summarizes the degree to which different forms of legal gambling contribute to Problem and Pathological Gambling (PPG) in Canada. Legal gambling activities were compared using meta-analysis of publicly available data concerning Canada’s legal gambling industry. The majority of revenues in the decade spanning 2002–2012 were drawn from Video Lottery Terminals and casino slot machines. Population surveys indicated that three quarters of Canadians reported some form of past-year gambling participation, but most did not play Electronic Gambling Machines. Annual revenues divided by estimated numbers of participants in various gambling activities showed that Video Lottery players spent more money on average than did participants in other forms of gambling. The relative risk of PPG was higher among Video Lottery players than it was for other common forms of gambling. Results from a community study of frequent Video Lottery players showed that the risk of frequent players reporting symptoms of PPG was elevated if they reported playing weekly, spending $50 or more per session, or playing for more than an hour per session. These studies provide converging evidence that Video Lottery is more hazardous to consumers than other forms of gambling that are commonly practised in Canada.
Similar content being viewed by others
References
Afifi, T. O., LaPlante, D. A., Taillieu, T. L., Dowd, D., & Shaffer, H. J. (2014). Gambling involvement: Considering frequency of play and the moderating effects of gender and age. International Journal of Mental Health and Addiction, 12, 283–294.
American Psychiatric Association. (2013). The diagnostic and statistical manual of mental disorders: DSM5. Washington, DC: Author.
Angus Reid Group. (1996). Problem gambling survey 1996: Final report. Submitted to the British Columbia Lottery Corporation. Vancouver, BC: Author.
Bagby, R. M., Quilty, L. C., & Watson, C. (2012). CPGI-Population harm: A supplement to the Canadian Problem Gambling Inventory. Toronto, ON: Canadian Consortium of Gambling Research. Available online at http://www.ccgr.ca/canadian-problem-gambling-index-cpgi/.
Baseline Market Research. (1996). Final Report: Prevalence Study: Problem Gambling: Wave 2. Prepared for Department of Finance. Fredericton, NB: New Brunswick Department of Finance.
Baseline Market Research. (1996). Final Report: 1996 Prevalence Study on Problem Gambling in Nova Scotia. Prepared for Nova Scotia Department of Health. Halifax, NS: Author.
Baseline Market Research Ltd. (1992). Final Report Prevalence Study Problem Gambling. Prepared for Department of Finance. Fredericton, NB: New Brunswick Department of Finance.
Black, D. W., Shaw, M. C., McCormick, B. A., & Alien, J. (2012). Marital status, childhood maltreatment, and family dysfunction: A controlled study of pathological gambling. Journal of Clinical Psychiatry, 73, 1293–1297.
Blaszczynski, A., & Nower, L. (2002). A pathways model of problem and pathological gambling. Addiction, 97, 487–499.
Borenstein, M., Hedges, L. V., Higgins, J. P. T., & Rothstein, H. R. (2009). Introduction to meta-analysis. New York: Wiley.
Butt, P., Beirness, D., Cesa, F., Gliksman, L., Paradis, C., & Stockwell, T. (2011). Alcohol and health in Canada: A summary of evidence and guidelines for low-risk drinking. Ottawa, ON: Canadian Centre on Substance Abuse.
Canadian Partnership for Responsible Gambling. (2003). Canadian gambling digest 2002–2003. Toronto, ON: Author.
Canadian Partnership for Responsible Gambling. (2004). Canadian gambling digest 2003–2004. Toronto, ON: Author.
Canadian Partnership for Responsible Gambling. (2005). Canadian gambling digest 2004–2005. Toronto, ON: Author.
Canadian Partnership for Responsible Gambling. (2006). Canadian gambling digest 2005–2006. Toronto, ON: Author.
Canadian Partnership for Responsible Gambling. (2007). Canadian gambling digest 2006–2007. Toronto, ON: Author.
Canadian Partnership for Responsible Gambling. (2008). Canadian gambling digest 2007–2008. Toronto, ON: Author.
Canadian Partnership for Responsible Gambling. (2009). Canadian gambling digest 2008–2009. Toronto, ON: Author.
Canadian Partnership for Responsible Gambling. (2010). Canadian gambling digest 2009–2010. Toronto, ON: Author.
Canadian Partnership for Responsible Gambling. (2011). Canadian gambling digest 2010–2011. Toronto, ON: Author.
Canadian Partnership for Responsible Gambling. (2012). Canadian gambling digest 2011–2012. Toronto, ON: Author.
Chase, H. W., & Clark, L. (2010). Gambling severity predicts midbrain response to near-miss outcomes. Journal of Neuroscience, 30, 6180–6187.
Clark, L. (2014). Disordered gambling: The evolving concept of behavioral addiction. Annals of the New York Academy of Sciences, 1327, 46–61.
Clark, L., Crooks, B., Clarke, R., Aitken, M. R. F., & Dunn, B. D. (2012). Physiological responses to near-miss outcomes and personal control during simulated gambling. Journal of Gambling Studies, 28, 123–137.
Clark, L., Liu, R., McKavanagh, R., Garrett, A., Dunn, B. D., & Aitken, M. R. F. (2013). Learning and affect following near-miss outcomes in simulated gambling. Journal of Behavioral Decision Making, 26, 442–450.
Criterion Research Corporation. (1993). Problem gambling study final report. Winnipeg, MB: Author.
Criterion Research Corporation. (1995). Problem gambling study final report. Winnipeg, MB: Author.
Currie, S. R., Casey, D. M., & Hodgins, D. C. (2010). Improving the psychometric properties of the problem gambling severity index. Canadian Consortium for Gambling Research. Available online at http://www.ccgr.ca/canadian-problem-gambling-index-cpgi.
Currie, S. R., Hodgins, D. C., Casey, D. M., el-Guebaly, N., Smith, G. J., Williams, R. J., et al. (2012). Examining the predictive validity of low-risk gambling limits with longitudinal data. Addiction, 107, 400–406.
Currie, S. R., Hodgins, D. C., Wang, J., el-Guebaly, N., & Wynne, H. (2008a). In pursuit of empirically based responsible gambling limits. International Gambling Studies, 8, 207–227.
Currie, S. R., Hodgins, D. C., Wang, J., el-Guebaly, N., Wynne, H., & Chen, S. (2006). Risk of harm among gamblers in the general population as a function of level of participation in gambling activities. Addiction, 101, 570–580.
Currie, S. R., Hodgins, D. C., Wang, J., el-Guebaly, N., Wynne, H., & Miller, N. V. (2008b). Replication of low-risk gambling limits using Canadian provincial gambling prevalence data. Journal of Gambling Studies, 24, 321–335.
Currie, S. R., Miller, N., Hodgins, D. C., & Wang, J. (2009). Defining a threshold of harm from gambling for population health surveillance research. International Gambling Studies, 9, 19–38.
Dixon, M. J., Collins, K., Harrigan, K. A., Graydon, C., & Fugelsang, J. (2015). Using sound to unmask losses disguised as wins in multiline slot machines. Journal of Gambling Studies, 31, 183–196.
Dixon, M. J., Fugelsang, J. A., MacLaren, V. V., & Harrigan, K. A. (2012). Gamblers can discriminate ‘tight’ from ‘loose’ electronic gambling machines. International Gambling Studies, 13, 98–111.
Dixon, M. J., Graydon, C., Harrigan, K. A., Wojtowicz, L., Siu, V., & Fugelsang, J. (2014a). The allure of multi-line games in modern slot machines. Addiction. doi:10.1111/add.12675.
Dixon, M. J., Harrigan, K. A., Sandhu, R., Collins, K., & Fugelsang, J. A. (2010). Losses disguised as wins in modern multi-line video slot machines. Addiction, 105, 1819–1824.
Dixon, M. J., Harrigan, K. A., Santesso, D. L., Graydon, C., Fugelsang, J., & Collins, K. (2014b). The impact of sound in video slot machine play. Journal of Gambling Studies, 30, 913–929.
Dixon, M. J., MacLaren, V. V., Jarick, M., Fugelsang, J. A., & Harrigan, K. A. (2013). The frustrating effects of just missing the jackpot: slot machine near-misses trigger large skin conductance responses, but no post-reinforcement pauses. Journal of Gambling Studies, 29, 661–674.
Doiron, J. (2006). Gambling and problem gambling in Prince Edward Island. Submitted to Prince Edward Island Department of Health.
Doiron, J., & Nicki, R. M. (1999). The prevalence of problem gambling in Prince Edward Island. Fredericton, NB: University of New Brunswick.
Dow Schull, N. (2012). Addiction by design: Machine gambling in Las Vegas. Princeton, NJ: Princeton University Press.
Dowling, N. A., Jackson, A. C., Suomi, A., Lavis, T., Thomas, S. A., Patford, J., et al. (2014). Problem gambling and family violence: Prevalence and patterns in treatment-seekers. Addictive Behaviors, 39, 1713–1717.
Dowling, N., Smith, D., & Thomas, T. (2005). Electronic gaming machines: Are they the ‘crack cocaine’ of gambling? Addiction, 100, 33–45.
el-Guebaly, N., Casey, D. M., Currie, S. R., Hodgins, D. C., Schopflocher, D. P., Smith, G. J., & Williams, R. J. (2015). The leisure, lifestyle, & lifecycle project (LLLP): A longitudinal study of gambling in Alberta. Final Report for the Alberta Gambling Research Institute.
Ferris, J., Stirpe, T., & Ialomiteanu, A. (1996). Gambling in Ontario: A report from a general population survey on gambling-related problems and opinions. Toronto, ON: Addiction Research Foundation.
Ferris, J., & Wynne, H. J. (2001). The Canadian problem gambling index. Ottawa: Canadian Centre on Substance Abuse.
Focal Research Consultants. (2001). 2001 survey of gambling and problem gambling in New Brunswick. Halifax, NS: Author.
Focal Research Consultants. (2004). 2003 Nova Scotia Gambling Prevalence Study. Commissioned by the Nova Scotia Office of Health Promotion.
Focal Research Consultants. (2008). 2007 adult gambling prevalence study. Halifax, NS: Nova Scotia Health Promotion and Protection.
Gemini Research & Angus Reid Group. (1994). Social gaming and problem gambling in British Columbia. Report to the British Columbia Lottery Corporation. Roaring Spring, PA: Gemini Research.
Goddard, M. J. (2014). Critical psychiatry, critical psychology, and the behaviorism of B. F. skinner. Review of General Psychology, 18, 208–215.
Goodie, A. S., & Fortune, E. E. (2013). Measuring cognitive distortions in pathological gambling; Review and meta-analyses. Psychology of Addictive Behaviors, 27, 730–743.
Grant, J. E., Schreiber, L., Odlaug, B. L., & Kim, S. W. (2010). Pathologic gambling and bankruptcy. Comprehensive Psychiatry, 51, 115–120.
Grant, V. V., Stewart, S. H., O’Connor, R. M., Blackwell, E., & Conrod, P. J. (2007). Psychometric evaluation of the five-factor modified drinking motives questionnaire-revised in undergraduates. Addictive Behaviors, 32, 2611–2632.
Griffiths, M. D. (1991). The psychobiology of the near miss in fruit machine gambling. Journal of Psychology, 125, 347–357.
Griffiths, M. D. (1993). Fruit machine gambling: The importance of structural characteristics. Journal of Gambling Studies, 9, 101–120.
Gruenewald, P. J., Johnson, F. W., Light, J. M., & Saltz, R. F. (2003). Drinking to extremes: Theoretical and empirical analyses of peak drinking levels among college students. Journal of Studies on Alcohol, 64, 817–824.
Gumbel, E. J. (1958). Statistics of extremes. New York: Columbia University Press.
Harrigan, K. H. (2007). Slot machines: Pursuing responsible gaming practices for virtual reels and near misses. International Journal of Mental Health and Addiction, 7, 68–83.
Harrigan, K. H. (2008). Slot machine structural characteristics: Creating near misses using high award symbol ratios. International Journal of Mental Health and Addiction, 6, 353–368.
Harrigan, K. A., Dixon, M. J., MacLaren, V. V., Collins, K., & Fugelsang, J. A. (2011). The maximum rewards at the minimum price: Reinforcement rates and payback percentages in multi-line slot machines. Journal of Gambling Issues, 26, 11–29.
Harrigan, K., MacLaren, V., Brown, D., Dixon, M., & Livingstone, C. (2014). Games of chance or masters of illusion: Multiline slots design may promote cognitive distortions. International Gambling Studies, 14, 301–317.
Haw, J. (2009). The multiplier potential of slot machines predicts bet size. Analysis of Gambling Behavior, 3, 1–6.
Hodgins, D. C., Schopflocher, D. P., Martin, C. R., el-Guebaly, N., Casey, D. M., Currie, S. R., et al. (2012). Disordered gambling among higher-frequency gamblers: Who is at risk? Psychological Medicine, 42, 2433–2444.
Insight Canada Research (1993). Prevalence of problem & pathological gambling in Ontario using the South Oaks Gambling Screen. Prepared for Canadian Foundation on Compulsive Gambling. Yorkville, ON: Author.
Ipsos-Reid & Gemini Research. (2003). British Columbia problem gambling prevalence study. Victoria, BC: Ministry of Public Safety and Solicitor General.
Ipsos-Reid & Gemini Research. (2008). British Columbia problem gambling prevalence study. Victoria, BC: Ministry of Public Safety and Solicitor General.
Jensen, C., Dixon, M. J., Harrigan, K. A., Sheepy, E., Fugelsang, J. A., & Jarick, M. (2013). Misinterpreting ‘winning’ in multi-line slot machine games. International Gambling Studies, 13, 112–126.
Kairouz, S., Nadeau, L., & Paradis, C. (2011). Portrait of gambling in Quebec: Prevalence, incidence and trajectories over Four Years. Montreal, QC: Université Concordia.
Koob, G. F. (2013). Negative reinforcement in drug addiction: The darkness within. Current Opinion in Neurobiology, 23, 559–563.
Kotov, R., Gamez, W., Schmidt, F., & Watson, D. (2010). Linking “big” traits to anxiety, depressive, and substance use disorders: A meta-analysis. Psychological Bulletin, 136, 768–821.
Ladouceur, R. (1991). Prevalence estimates of pathological gamblers in Quebec. Canadian Journal of Psychiatry, 36, 732–734.
Ladouceur, R., Jacques, C., Chevalier, S., Sevigny, S., & Hamel, D. (2005). Prevalence of pathological gambling in Quebec in 2002. Canadian Journal of Psychiatry, 50, 451–456.
Ladouceur, R., & Walker, M. (1996). A cognitive perspective on gambling. In P. M. Salkovskis (Ed.), Trends in cognitive and behavioural therapies. Hoboken, NJ: Wiley-Blackwell.
Lambe, L., MacKinnon, S. P., & Stewart, S. H. (2014). Validation of the Gambling Motives Questionaire in Emerging Adults. Journal of Gambling Studies. doi:10.1007/s10899-014-9467-0.
Lemaire, J., MacKay, T., & Patton, D. (2008). Manitoba gambling and problem gambling 2006. Winnipeg, MB: Addictions Foundation of Manitoba.
Lesieur, H. R., & Blume, S. B. (1987). The South Oaks Gambling Screen (SOGS): A new instrument for the identification of pathological gamblers. American Journal of Psychiatry, 144, 1184–1188.
Liquor and Gaming Authority of Manitoba. (2014). Liquor and gambling in Manitoba. Winnipeg, MB: Author.
Lorains, F. K., Cowlishaw, S., & Thomas, S. A. (2011). Prevalence of comorbid disorders in problem and pathological gambling: Systematic review and meta-analysis of population surveys. Addiction, 106, 190–198.
MacLaren, V. V. (2014). Experienced EGM players know how to control the reinforcement rate and time on device. Journal of Gambling Studies. doi:10.1007/s10899-014-9498-6.
MacLaren, V. V. (2015). Behavioral indicators and player characteristics of frequent VLT players. Report to the Manitoba Gambling Research Program.
MacLaren, V. V., Ellery, M., & Knoll, T. (2015a). Personality, gambling motives and cognitive distortions in electronic gambling machine players. Personality and Individual Differences, 73, 24–28.
MacLaren, V. V., Fugelsang, J., Harrigan, K. A., & Dixon, M. J. (2011). The personality of pathological gamblers: A meta-analysis. Clinical Psychology Review, 31, 1057–1067.
MacLaren, V. V., Harrigan, K. A., & Dixon, M. (2012). Gambling motives and symptoms of problem gambling in frequent slots players. Journal of Gambling Issues, 27, 1–13.
MacLaren, V. V., Harrigan, K. H., & Dixon, M. J. (2015b). Meet the new game: An introduction to taptix instant ticket vending machines. Journal of Gambling Issues, 30, 22–34.
MarketQuest Research (2005). 2005 Newfoundland and Labrador Gambling Prevalence Study. Prepared for the Department of Health and Community Services, Government of Newfoundland and Labrador. St. John’s, NL: Department of Health and Community Services.
MarketQuest Research (2008). Newfoundland and Labrador Targeted Gambling Prevalence Study. Prepared for Department of Health and Community Services, Government of Newfoundland and Labrador. St. John’s, NL: Department of Health and Community Services.
MarketQuest Research (2009). 2009 Newfoundland and Labrador Gambling Prevalence Study. Prepared for Department of Health and Community Services, Government of Newfoundland and Labrador. St. John’s, NL: Department of Health and Community Services.
MarketQuest Research. (2010). 2009 New Brunswick Gambling Prevalence Study. Prepared for Department of Health and New Brunswick Lotteries and Gaming Corporation, Government of New Brunswick. Fredericton, NB.
Meltzer, H., Bebbington, P., Brugha, T., Farrell, M., & Jenkins, R. (2012). The relationship between personal debt and specific common metal disorders. European Journal of Public Health, 23, 108–113.
Nehlin, C., Gronbladh, L., Fredericksson, A., & Jansson, L. (2013). Alcohol and drug use, smoking, and gambling among psychiatric outpatients: A 1-year prevalence study. Substance Abuse, 34, 162–168.
Omnifacts Research. (1993). An examination of the prevalence of gambling in Nova Scotia. Halifax, NS: Nova Scotia Department of Health, Drug Dependency Services.
Patton, D., Brown, D., Dhaliwal, J., Pankratz, C., & Broszeit, B. (2002). Gambling involvement and problem gambling in Manitoba. Winnipeg, MB: Addictions Foundation of Manitoba.
Penney, A., Mazmanian, D., Jamieson, J., & Black, N. (2012). Factors associated with recent suicide attempts in clients presenting for addiction treatment. International Journal of mental Health and Addiction, 10, 132–140.
Putt, S. N. H., Shaw, A. P. M., Woods, A. J., Tyler, L., & James, A. D. (1987). Veterinary epidemiology and economics in Africa: A manual for use in the design and appraisal of livestock health policy. Nairobi, Kenya: International Livestock Research Initiative. Available online at http://www.fao.org/wairdocs/ilri/x5436e/x5436e07.htm#5.2.4%20estimating%20a%20rate%20or%20proportion%20from%20a%20cluster%20sample.
Quilty, L. C., Avila Murati, D., & Bagby, R. M. (2014). Identifying indicators of harmful and problem gambling in a Canadian sample through receiver operating characteristics analysis. Psychology of Addictive Behaviors, 28, 229–237.
Raylu, N., & Oei, T. P. S. (2004). The gambling related cognitions scale (GRCS): Development, confirmatory factor validation and psychometric properties. Addiction, 99, 757–769.
Shao, R., Read, J., Behrens, T. E. J., & Rogers, R. D. (2013). Shifts in reinforcement signalling while playing slot-machines as a function of prior experience ad impulsivity. Translational Psychiatry, 3, 1–9.
Smith, G. J. (1992). The gambling attitudes and behavior of Albertans. Edmonton, AB: Population Research Laboratory, Department of Sociology, University of Alberta.
Smith, G. (2014). The nature and scope of gambling in Canada. Addiction, 109, 706–710.
Smith, G. J., & Wynne, H. J. (2002). Measuring gambling and problem gambling in Alberta using the Canadian Problem Gambling Index. Edmonton: Prepared for the Alberta Gaming Research Institute.
Stewart, S. H., & Zack, M. (2008). Development and psychometric evaluation of a three-dimensional gambling motives questionnaire. Addiction, 103, 1110–1117.
Templeton, J. A., Dixon, M. J., Harrigan, K. A., & Fugelsang, J. A. (2014). Upping the reinforcement rate by playing the maximum lines in multi-line slot machine play. Journal of Gambling Studies. doi:10.1007/s10899-014-9446-5.
Thomas, A. C., Allen, F. C., & Phillips, J. (2009). Electronic gaming machine gambling: Measuring motivation. Journal of Gambling Studies, 25, 343–355.
Vachon, D. D., & Bagby, R. M. (2009). Pathological gambling subtypes. Psychological Assessment, 21, 608–615.
Volberg, R. A. (1994). Gambling and problem gambling in Saskatchewan. Northampton, MA: Gemini Research.
Volberg, R. A., & Wray, M. (2007). Legal gambling and problem gambling as mechanisms of social domination? Some considerations for future research. American Behavioral Scientist, 51, 56–85.
Wardell, J. D., Quilty, L. C., Hendershot, C. S., & Bagby, R. M. (2015). Motivational pathways from reward sensitivity and punishment sensitivity to gambling frequency ad gambling-related problems. Psychology of Addictive Behaviors. doi:10.1037/adb0000066.
Weinstock, J., Ledgerwood, D. M., & Petry, N. M. (2007). Association between posttreatment gambling behavior and harm in pathological gamblers. Psychology of Addictive Behaviors, 21, 185–193.
Weinstock, J., Whelan, J. P., & Meyers, A. (2008). College students’ gambling behavior: When does it become harmful? Journal of American College Health, 56, 513–521.
Wiebe, J., Mun, P., & Kauffman, N. (2006). Gambling and problem gambling in Ontario 2005. Toronto, ON: Responsible Gambling Council (Ontario).
Wiebe, J., Single, E., & Falkowski-Ham, A. (2001). Measuring gambling and problem gambling in Ontario. Toronto, ON: Canadian Centre on Substance Abuse and Responsible Gambling Council (Ontario).
Wilkes, B. L., Gonsalvez, C. J., & Blaszczynski, A. (2010). Capturing SCL and HR changes to win and loss events during gambling on electronic machines. International Journal of Psychophysiology, 78, 265–272.
Willem, L., Bijttebier, P., Claes, L., & Uytterhaegen, A. (2012). Temperament and problematic alcohol use in adolescence: A examination of drinking motives as mediators. Journal of Psychopathology and Behavioral Assessment, 34, 282–292.
Williams, R.J., Belanger, Y.D., & Arthur, J.N. (2011). Gambling in Alberta: History, current status, and socioeconomic impacts. Final Report to the Alberta Gaming Research Institute.
Williams, R. J., Hann, R. G., Schopflocher, D., West, B., McLaughlin, P., White, N., et al. (2015). Quinte longitudinal study of gambling and problem gambling. Guelph, Ontario: Report prepared for the Ontario Problem Gambling Research Centre.
Williams, R. J., & Volberg, R. A. (2013). Gambling and problem gambling in Ontario. Report Prepared for the Ontario Problem Gambling Research Centre and the Ontario Ministry of Health and Long Term Care.
Williams, R.J., Volberg, R.A. & Stevens, R.M.G. (2012). The population prevalence of problem gambling: Methodological influences, standardized rates, jurisdictional differences, and worldwide trends. Report prepared for the Ontario Problem Gambling Research Centre and the Ontario Ministry of Health and Long Term Care. Available online at https://www.uleth.ca/dspace/handle/10133/3068.
Williams, R. J., & Wood, R. T. (2004). The proportion of gaming revenue derived from problem gamblers: Examining the issue in a Canadian context. Analyses of Social Issues and Public Policy, 4, 33–45.
Williams, R. J., & Wood, R. T. (2007). The proportion of Ontario gambling revenue derived from problem gamblers. Canadian Public Policy - Analyse de Politiques, 33, 367–387.
Wynne, H. (2002). Gambling and Problem Gambling in Saskatchewan: Final Report. Ottawa, ON: Canadian Centre on Substance Abuse.
Wynne Resources Ltd. (1994). Gambling and problem gambling in Alberta. Edmonton, AB: Author.
Wynne Resources Ltd. (1998). Adult gambling and problem gambling in Alberta, 1998. Edmonton: Report to the Alberta Alcohol and Drug Abuse Commission.
Acknowledgments
Portions of this research were funded by the Manitoba Gambling Research Program of Manitoba Liquor & Lotteries; however, the findings and conclusions of this paper are those solely of the author and do not necessarily represent the views of Manitoba Liquor & Lotteries. Special thanks to Robert Williams and to staff at the Liquor and Gaming Authority of Manitoba for their help in providing information about their gambling surveys. The author reports no real or potential conflicts of interest. All procedures performed in the study involving human participants were in accordance with the ethical standards of Brandon University, with Canadian Tricouncil Policy, and with the 1964 Helsinki declaration and its later amendments. Formal consent is not required for the retrospective analyses of public data sources that are reported in this paper.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
MacLaren, V.V. Video Lottery is the Most Harmful Form of Gambling in Canada. J Gambl Stud 32, 459–485 (2016). https://doi.org/10.1007/s10899-015-9560-z
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10899-015-9560-z