1. Expanding Gaming Opportunities in
New Hampshire: What Social Science
Does (and Doesn’t) Have to Say
Heather Gray, Ph.D.
Harvard Medical School
Division on Addictions, Cambridge Health Alliance

2. “Gambling has a long past…

3. Expanded Gambling: Considerations
 Potential to generate state revenues and jobs
 Public safety considerations
 Potential social costs

4. Expanded Gambling: Considerations
 Potential to generate state revenues and jobs
 Public safety considerations
 Potential social costs

5. Expanded Gambling: Considerations
 Potential to generate state revenues and jobs
 Public safety considerations
 Potential social costs
1. Are any groups of people particularly vulnerable to
disordered gambling?
2. Are certain types of games more “addictive”?
3. How does access to gambling opportunities impact
rates of disordered gambling?

6. What is Disordered Gambling?
1. Preoccupation
2. Tolerance
3. Withdrawal
4. Escape
5. Chasing
6. Lying
7. Loss of control
8. Illegal acts
9. Risked significant relationship
10. Bailout

7. Expanded Gambling: Considerations
 Potential to generate state revenues and jobs
 Public safety considerations
 Potential social costs
1. Are any groups of people particularly vulnerable to
disordered gambling?
2. Are certain types of games more “addictive”?
3. How does access to gambling opportunities impact
rates of disordered gambling?

8. Who’s More Vulnerable?
 People with certain brain abnormalities
 Young people
 People who are impulsive and make risky
decisions
Same time
 People who have a
mental-health disorder Disordered
gambling first
Mental health
disorder first

9. Who’s More Vulnerable?
 People experiencing other addictions
 73% have had an alcohol use disorder
 38% have had a drug use disorder
 60% have had nicotine dependence
 Why? Shared risk factors
 Mental health disorders
 Impulsivity, risky decision making
 Shared social experiences

10. Expanded Gambling: Considerations
 Potential to generate state revenues and jobs
 Public safety considerations
 Potential social costs
1. Are any groups of people particularly vulnerable to
disordered gambling?
2. Are certain types of games more “addictive”?
3. How does access to gambling opportunities impact
rates of disordered gambling?

11. Expanded Gambling: Considerations
 Potential to generate state revenues and jobs
 Public safety considerations
 Potential social costs
1. Are any groups of people particularly vulnerable to
disordered gambling?
2. Are certain types of games more “addictive”?
3. How does access to gambling opportunities impact
rates of disordered gambling?

12. Different Games: VLTs
 “….in view of the especially addictive aspects of
VLT/slot machines, this Commission finds that the
state should consider regulating – through licensing
standards and enforcement – methods and
technologies that have been identified as
exacerbating addictive behaviors in the use of VLT
machines.”
-New Hampshire Gaming Study Commission, May 2010

13. Different Games: VLTs
 “….in view of the especially addictive aspects of
VLT/slot machines, this Commission finds that the
state should consider regulating – through licensing
standards and enforcement – methods and
technologies that have been identified as
exacerbating addictive behaviors in the use of VLT
machines.”
-New Hampshire Gaming Study Commission, May 2010

14. Different Games: VLTs
 Rapid playing speed
 Rapid payout intervals
 Credited wins
 “Near-miss technology”
 Simulated control
 Audiovisual features

15. Different Games: VLTs
 Time to progress from recreational
gambling to disordered gambling
 Differences in players?
 Retrospective reports
 National surveys of US adults
 18-29: Casino gambling & cards
 30+: Casino, lottery, gambling
machines not in a casino

16. Expanded Gambling: Considerations
 Potential to generate state revenues and jobs
 Public safety considerations
 Potential social costs
1. Are any groups of people particularly vulnerable to
disordered gambling?
2. Are certain types of games more “addictive”?
3. How does access to gambling opportunities impact
rates of disordered gambling?

17. Expanded Gambling: Considerations
 Potential to generate state revenues and jobs
 Public safety considerations
 Potential social costs
1. Are any groups of people particularly vulnerable to
disordered gambling?
2. Are certain types of games more “addictive”?
3. How does access to gambling opportunities impact
rates of disordered gambling?

18. Access to Gambling Opportunities
 Proximity to a casino

19. Expanded Gambling: Considerations
 Potential to generate state revenues and jobs
 Public safety considerations
 Potential social costs
1. Are any groups of people particularly vulnerable to
disordered gambling?
2. Are certain types of games more “addictive”?
3. How does access to gambling opportunities impact
rates of disordered gambling?

20. Identifying Disordered Gambling
During the past 12 months, have you become restless, irritable, or anxious when
trying to stop and (or) cut down on gambling?
Yes: Potential PG No
During the past 12 months, have you tried to keep your family or friends from
knowing how much you gambled?
Yes: Potential PG No
During the past 12 months, did you have such financial trouble as a
result of gambling that you had to get help with living expenses from
family, friends, or welfare?
Yes: Potential PG No: Not a PG

21. What is Disordered Gambling?
1. Preoccupation
2. Tolerance
3. Withdrawal
4. Escape
5. Chasing
6. Lying
7. Loss of control
8. Illegal acts
9. Risked significant relationship
10. Bailout