title: The extent and distribution of gambling harm in Finland as assessed by the Problem Gambling Severity Index.
abstract: BACKGROUND
  Preventing gambling harm has become a policy priority in many European countries. Adverse consequences related to problem gambling are well known, but few studies have analyzed gambling-related harm in detail in general population samples. We determined the extent and distribution of gambling harm in Finland, as assessed by the Problem Gambling Severity Index (PGSI), and analyzed gambling involvement, demographics and their association with various types of harm.
  
  
  METHODS
  A nationwide telephone survey was conducted among 4484 Finns aged 15-74 years in 2011-12. Gambling-related harms were based on the nine-item PGSI. Gambling involvement was measured by gambling frequency and weekly average gambling expenditure. Associations among harms, demographics and gambling involvement were examined in logistic regression.
  
  
  RESULTS
  During the previous year, 13% of respondents experienced at least one gambling-related harm (males 18.1%, females 7.2%). The four commonest harms were 'chasing losses' (8.6%), 'escalating gambling to maintain excitement' (3.1%), 'betting more than could afford to lose' (2.8%), and 'feeling guilty' (2.6%). The harm profile in descending order was the same for both genders but differed in prevalence. Young age (<25 years) was associated with increased likelihood of reporting harms. Both monthly and weekly gambling and spending over €21 per week on gambling were related to the harms.
  
  
  CONCLUSIONS
  Our results provide support for the public health approach to gambling: harms were reported even at low gambling frequency-expenditure levels. In addition to the high-risk approach, adopting a population-level approach to preventing gambling harm could shift the population distribution of harm in a lower direction.
authors.affiliation: 1 Department of Alcohol, Drugs and Addiction, National Institute for Health and Welfare, Helsinki, Finland susanna.raisamo@thl.fi.
authors.forename: Susanna U
authors.initials: SU
authors.lastname: Raisamo
authors.affiliation: 1 Department of Alcohol, Drugs and Addiction, National Institute for Health and Welfare, Helsinki, Finland.
authors.forename: Pia
authors.initials: P
authors.lastname: Mäkelä
authors.affiliation: 2 Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland.
authors.forename: Anne H
authors.initials: AH
authors.lastname: Salonen
authors.affiliation: 3 The Finnish Foundation for Alcohol Studies, Helsinki, Finland.
authors.forename: Tomi P
authors.initials: TP
authors.lastname: Lintonen
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D016739:Behavior, Addictive / Q000453:epidemiology; D005260:Female; D005387:Finland / Q000453:epidemiology; D005715:Gambling / Q000191:economics / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011634:Public Health; D012959:Socioeconomic Factors; D055815:Young Adult