A free ride? An analysis of the association of casino bus tours and problem gambling among older adults.

TOUR buses; COMPULSIVE gambling; OLDER people; CASINOS; COMPULSIVE gamblers; CUSTOMER relations; BUS occupants; SOCIODEMOGRAPHIC factors; ECONOMICS; 21ST century economics; GAMBLING; CONFIDENCE intervals; STATISTICAL correlation; MOTOR vehicles; PROBABILITY theory; TRAVEL; MULTIPLE regression analysis; ODDS ratio; MANN Whitney U Test

Background and aims Little research has examined the relationship between incentives used by gambling venues to attract customers and the experience of gambling-related harm. Organized and subsidized bus tours are a common example of such incentives. The aim of this study was to examine whether bus-tour patronage was associated with increased odds of problem gambling among older adults. This study also compared rates of bus-tour use by socio-demographic characteristics and gambling behaviours. Design Pearson's χ2 tests and Mann-Whitney U-tests were applied for bivariate analyses. Multivariate generalized mixed-effects regression modelling was used to examine the relationship between bus-tour patronage and problem gambling while controlling for possible confounding factors. Setting Seven gambling venues located in Central and Southwestern Ontario, Canada. Participants A total of 1978 gambling venue patrons over the age of 55 years. Measurements Problem gambling as indicated by the Problem Gambling Severity Index, bus-tour patronage in the 12 months prior to the survey, spending per gambling visit and past-month slot machine participation. Findings Regression analyses showed that bus-tour patronage was associated with higher odds of problem gambling [odds ratio (OR) = 1.71, confidence interval (CI) = 1.06, 2.76] after controlling for several demographic characteristics, type of gambling and gambling expenditures. Bivariate analyses showed past-year bus-tour patronage was associated with more frequent slot machine play (χ2 = 48.16, P < 0.001), more past-year gambling venue visits ( P < 0.001) and lower spending on gambling per casino visit ( P < 0.001). Compared with non-patrons, bus tour patrons were more likely to be female (χ2 = 21.92, P < 0.001), born outside Canada (χ2 = 113.18, P < 0.001), above the age of 75 (χ2 = 24.02, P < 0.001) and retired (χ2 = 16.60, P < 0.001). Conclusions When adjusting for potential confounders among older adults, using bus tours to access Canadian gambling venues is associated with increased risk of problem gambling. Bus-tour patrons are more likely to be female, born outside Canada and above the age of 75 years. [ABSTRACT FROM AUTHOR]