A profile of gambling behaviour and impacts among Indigenous Australians attending a cultural event in New South Wales.

Hing, Nerilee ; Breen, Helen ; Buultjens, Jeremy 等

Abstract: This study examines gambling behaviour, gambling motivations, gambling-related problems, impacts of gambling and help-seeking among a sample of Indigenous Australians. The study is exploratory and cross sectional and represents the first quantitative analysis of Indigenous gambling in New South Wales since 1996. With the help of several Indigenous Australian research assistants, a survey was conducted at a 2011 Indigenous arts and cultural event, capturing responses from 277 Indigenous Australian adults. While about one-quarter of respondents gambled on card games in the previous 12 months, nearly three-quarters had gambled on commercial forms of gambling, especially poker machines. Participation rates and weekly gambling on poker machines, keno and wagering, and the proportions of problem and at-risk gamblers, were higher in the Indigenous sample than in the general New South Wales population. While the main reasons for gambling were reported as pleasure and fun, socialising, to relax and the chance to win money, several negative impacts were reported, including financial problems and subsequent reliance on relatives or friends. More than one in ten gamblers also reported gambling had led to household arguments, depression and violence. Distinctive barriers to seeking help for gambling problems included lack of knowledge and confidence about help services and lack of culturally appropriate help services. Although limited by a non-representative sample, this paper highlights some distinctive aspects of Indigenous gambling that warrant further research to inform appropriate public health and treatment measures to address problems associated with contemporary Indigenous gambling.

Introduction

There is a growing body of research into gambling in Australia, but little has focused on gambling by Indigenous Australians. Yet Indigenous Australians have been participating in gambling since before white settlement. The first forms of card gambling were introduced in the north by Macassan traders, while British colonists brought poker, dice games, and pitch and toss to the south (Breen 2008; O'Hara 1988). Today, Indigenous people in more regional and remote areas still gamble in card rings, while those in less remote areas are also likely to participate in commercial forms of gambling, such as gaming machines, casino games, sports betting and wagering (McMillen and Donnelly 2008). The availability of commercial gambling has broadened Indigenous participation in gambling generally (Breen et al. 2010; McMillen and Donnelly 2008).

However, little knowledge exists about contemporary Indigenous Australian gambling, in stark contrast to the now substantial research efforts directed towards non-Indigenous gambling. For example, most Australian state governments regularly commission gambling prevalence studies, which typically examine participation, frequency, duration and expenditure on the various forms of gambling, measure the prevalence of gambling-related problems, from low to severe, and analyse these data in relation to problem gambling severity and various socio-demographic variables. However, these surveys have captured minimal and unreliable data from Indigenous Australians, largely because of their relatively small proportions in most state populations and because of the telephone survey methodologies employed. For example, a state-wide telephone survey of gambling in the Northern Territory excluded the two-thirds of Indigenous residents without a home telephone, with the 126 responses representing only more affluent urban residents (Young et al. 2006). In the jurisdiction with the next highest proportion of Indigenous residents, Queensland, four prevalence surveys with samples ranging from approximately 13 000 to 30 000 adults have reported no Indigenous-specific data except that Indigenous people tend to be over-represented among at-risk and problem gamblers (Queensland Government 2002, 2005, 2008, 2010). In New South Wales (NSW), where the current study is based, the most recent gambling prevalence study involving more than 5000 respondents (AC Nielsen 2007-16) did not report Indigenous-specific results, noting that 'Indigenous ... communities are likely to have different views on gambling, as well as different gambling behaviour. For these reasons, these groups require a separate tailored approach from the general NSW population survey.'

This paper helps to address this void by reporting research into some aspects of gambling by Indigenous people who attended an Indigenous arts and cultural event, the Saltwater Freshwater Festival, in NSW in 2011. The study aimed to examine gambling behaviour, motivations for gambling, gambling-related problems, some impacts of gambling, and certain aspects of help-seeking among this cohort. Where possible, results are compared to those for the general NSW adult population as derived from secondary data. We cannot claim our sample is representative of the NSW Indigenous adult population; however, if important differences are found, the need for further Indigenous-focused research will be heightened. Thus, our study should be considered exploratory and an initial step towards gathering a more accurate and complete picture of Indigenous Australian gambling than currently exists.

Indigenous Australian gambling

Gambling among Indigenous Australians gained some early research interest, mainly from anthropologists and ethnographers, resulting in some community case studies of Indigenous card gambling in remote areas (e.g. Altman 1985; Goodale 1987; Hunter and Spargo 1988; Martin 1993; Paterson 2007). These studies revealed that card gambling, especially in remote communities, has been a widespread and acceptable social recreational practice within Aboriginal society. Busutill (2002) observed that Indigenous card gamblers played for social reasons and recirculated winnings by supporting losers with food, thereby minimising the harmful impacts of gambling. Indigenous law ensured the community supported problem gamblers even if this support created a negative domino effect with high rates of suffering and financial duress. However, some Indigenous card rings appear to be changing, with some games providing substantial prize pots and game organisers taking a share of profits (Breen 2010; Paterson 2007; Young et al. 2006). Being less social and more commercial in nature, and attracting participants from a wider geographic catchment, these games have less of a financial redistributive function, such that the negative impacts for losers and significant others may be heightened. Indigenous card games, both small social games and larger more commercial enterprises, continue today but appear to be declining overall, especially in urbanised areas (Breen et al. 2010). Increasing participation in commercial gambling may be one explanation for their declining popularity (Breen et al. 2010).

While most studies have tended to examine Indigenous card gambling as a cultural and leisure practice, research into Indigenous commercial gambling has predominantly taken a public health perspective and focused on gambling behaviours and problems. Attempts to measure problem gambling, defined in Australia as 'difficulties in limiting money and/or time spent on gambling which leads to adverse consequences for the gambler, others, or for the community' (Neal et al. 2005:i), have been minimal in Indigenous Australian populations, and no representative surveys have been published. Dickerson et al. (1996) surveyed a convenience sample of 222 Indigenous Australians in two NSW cities and three country towns; the Queensland Department of Families, Youth and Community Care (1996) surveyed 145 Indigenous Australians in licensed venues in North Queensland; the Queensland Department of Corrective Services (2005) surveyed 109 Indigenous Australians in the Queensland community corrections population; and Young et al. (2006) captured responses from 126 Indigenous Australians in the Northern Territory. Overall, these studies suggest that rates of gambling problems are higher among Indigenous than non-Indigenous populations. This over-representation is also supported by international evidence that suggests that higher proportions of Indigenous than non-Indigenous populations are problem and at-risk gamblers (e.g. Belanger 2011; Lin et al. 2011; Ministry of Health 2009; Raylu and Oei 2004; Westermeyer et al. 2008; Williams et al. 2011).

These surveys, along with some qualitative studies, have also illuminated other aspects of Indigenous gambling behaviour. In NSW, Dickerson et al. (1996) found that more than 50% of their Indigenous sample gambled weekly, while 15% did not gamble at all, with overall gambling participation and frequency significantly higher than for the non-Indigenous gamblers in their study. Poker machines were the most popular form of gambling. A consultative study by the Aboriginal Health and Medical Research Council (AHMRC) of NSW reported that gambling is a common and widely accepted activity for NSW Aboriginal people, and that women prefer poker machines, bingo and cards, while men prefer wagering (AHMRC 2007). Breen et al. (2010) interviewed 169 Indigenous people in northern NSW, and found that commercial gambling was more popular than card gambling, with most people preferring to gamble on products with low stakes and free offers and that were easy to play, notably poker machines. They also found that people typically spend between two to three hours gambling, usually with their social group, spending $5 to $300 in each gambling session. Major reported motivations to gamble were to win and to socialise. Others gambled to escape, reduce boredom and fill in time. The popularity of commercial gambling was facilitated by easily accessible venues that were perceived as comfortable, inclusive and affordable.

The impacts of gambling on Indigenous peoples and communities have also received some research attention, but their nature and extent have not been quantified, with related evidence described as sketchy, inconsistent and inconclusive (McMillen and Donnelly 2008). In the most comprehensive qualitative study in NSW (Breen at al. 2010), Indigenous participants reported that a positive consequence of gambling was socialising, but that negative impacts included financial hardship, family and relationship difficulties, the spread of negative impacts throughout the community and, to a lesser extent, mental health problems and crime. Similar impacts were reported in the consultative NSW study by the AHMRC (2007).

In summary, there are little definitive data regarding contemporary Indigenous gambling practices, their impacts and consequences, and the extent of gambling-related problems. This study hopes to add to this scant knowledge base through the first quantitative analysis of Indigenous gambling in NSW since 1996.

The Saltwater Freshwater Festival

The Saltwater Freshwater Festival is the largest regional Aboriginal cultural event on the NSW mid-north coast. It is held annually on Australia Day (26 January) and organised by the Saltwater Freshwater Arts Alliance Aboriginal Corporation, a peak body for Aboriginal arts and culture in this area. The Alliance aims 'to position Aboriginal art and culture as the foundation for the long-term social, economic and environmental development of the region's Aboriginal communities' (Saltwater Freshwater Arts Alliance 2011a). The festival showcases Indigenous design, art, music and cuisine, and attracts people from across NSW, uniting inland 'freshwater' and coastal 'saltwater' communities.

The inaugural event was held in 2010 in Coffs Harbour and reportedly attracted more than 12 000 people. In 2011 the event was held in Port Macquarie. Although it was reported that this event attracted more than 10 000 people, the research team's own estimate was less than half this number. The vast majority of attendees were Indigenous Australians.

The festival featured two stages of music, cultural workshops, a Speakers' Tent and an Aboriginal market from 11 am to 9 pm. Thirty-two Aboriginal stallholders sold bush tucker, clothing, arts and crafts, while 95 Aboriginal artists, presenters and performers were employed at the festival, with an additional 35 people performing on a voluntary basis to showcase their talents (Saltwater Freshwater Arts Alliance 2011b).

Method

Survey instrument

The survey instrument was based on a previous survey of Indigenous gambling in north Queensland (results remain confidential), which in turn was informed by a confidential survey conducted in an Indigenous community in south-east Queensland, the Queensland Household Gambling Survey 2006-07 (Queensland Government 2008), the Productivity Commission's (1999) national survey of problem gamblers, and a survey of more than 500 people on community correction orders of whom 109 were Indigenous Australians (Queensland Department of Corrective Services 2005).

The survey contained an information sheet followed by questions about the respondent's gambling relating to:

* participation, frequency, duration and expenditure on card gambling

* frequency of gambling on ten forms of legal commercial gambling

* duration, venue and expenditure for the respondent's most frequent commercial gambling activity

* reasons for gambling

* consequences of the respondent's gambling

* help-seeking for gambling-related problems

* erroneous beliefs about gambling

* demographic characteristics including Aboriginality, age, gender, marital status, employment status and source of income

* the Problem Gambling Severity Index (PGSI) (Ferris and Wynne 2001), the standard instrument used in Australia to measure the severity of gambling problems.

The PGSI contains nine items scored as 'never' = 0, 'sometimes' = 1, 'most of the time' = 2 and 'almost always' = 3. Scores are summed for a total between 0-27, with respondents classified as 0 = non-problem gambler; 1-2 = low risk gambler; 3-7 = moderate risk gambler, and 8+ = problem gambler. The PGSI was selected for several reasons. It has been used in major prevalence studies in most Australian jurisdictions, all Canadian provinces, and in Great Britain, Iceland and Norway. A comparative evaluation of three problem-gambling screens used in Australia, based on a population survey of 8479 adults, found that the PGSI demonstrated the best measurement properties when compared to South Oaks Gambling Screen and the Victorian Gambling Screen (McMillen and Wenzel 2006). A recent review of the PGSI's psychometric properties (Currie et al. 2010), based on a total sample of 21 374 adults derived from nine population studies, concluded that the instrument demonstrates strong internal validity and reliability, with its factor structure invariant across subgroups defined by age, gender, income level and game types. On development, the PGSI was validated with a general population sample, unlike other instruments that were constructed using clinical samples of problem gamblers. However, it has not been validated among an Indigenous population in Australia or elsewhere. Nevertheless, the Cronbach's alpha for the PGSI was 0.942 in this study, indicating high reliability of the scale. (1)

Survey administration

The survey was administered at the 2011 Saltwater Freshwater Festival and overseen by a research team of three--one Indigenous man who is a gambling community educator and qualified gambling counsellor, and two non-Indigenous women who specialise in gambling research. The research team had permission from the festival organisers to conduct the survey and to staff a stall with responsible gambling information and collateral. We also sponsored the Speakers' Tent, and arranged for the Indigenous member of the research team, Ashley Gordon, to conduct a community education workshop on gambling.

Twelve Indigenous Australian research assistants were recruited through the local Indigenous employment centre and trained in the survey protocols by the research team before the festival. They were given uniforms, satchels, water and all materials needed for data collection, and later certificates acknowledging their training and employment with the researchers' university. The research assistants were asked to approach festival attendees, introduce themselves and explain that they were conducting a gambling survey. If people agreed to participate, the research assistants also offered to help those who wanted assistance. When each survey was completed, they asked the respondent to put it into the confidential envelope provided and seal it. All sealed envelopes were then collected. The surveys were anonymous and participation was voluntary. Each participant could elect to enter into a draw to win a $200 shopping voucher.

Participants

In total, 277 completed surveys were collected. Approximately 56% of the respondents were female, a slight over-representation when compared to the 51.5% of Indigenous Australians across NSW who are female (ABS 2006). Nearly 27% of respondents were aged under 30 years, 21% were 30-39 years, 23% were 40-49 years, 20% were 50-59 years and 9% were 60 years or over. Nearly 46% of respondents were married or in a de facto relationship, a further 13 % were separated or divorced, 5% were widowed and the remaining 36% were single. More than one-half (54%) were either self-employed or in full or part-time employment, 18% were unemployed, while the remaining 27% received a pension or allowance as their main form of income.

Data analysis

Data were entered into the statistical analysis program SPSS v.19 to generate the descriptive statistics reported in this paper. These include primarily frequency distributions, with the number of respondents and valid percentages provided to account for missing data, and chi square analysis to test for significant differences at the 0.05 level. Given the exploratory nature of this study, no hypotheses were formulated for testing. Comparisons are also made with secondary data pertaining to the overall NSW adult population where possible, drawn from the Gambling Module of the NSW Population Health Survey 2008-09 (Centre for Epidemiology and Research 2009). That survey sampled 12 000 people using random digit dialling to all NSW households with a private telephone. One person per household was randomly selected for inclusion. Only those aged 18 years or over were included in results for the Gambling Module. However, this study asked only about gambling participation and administered the PGSI. Thus, comparisons are also drawn with the Prevalence of Gambling and Problem Gambling in NSW study (ACNielsen 2007), which telephone surveyed 5029 adults from households randomly selected in NSW.

Ethical considerations

The collection and use of data was guided by several ethical guidelines relevant for research undertaken with Indigenous people. The Australian Institute of Aboriginal and Torres Strait Islander Studies (AIATSIS) Guidelines for Ethical Research in Indigenous Studies (AIATSIS 2000) is primarily intended to guide research sponsored by AIATSIS, but has been widely adopted. The guidelines are underpinned by 11 principles relating to consultation, negotiation and mutual understanding, respect, recognition and involvement, and benefits, outcomes and agreement (AIATSIS 2000). Additionally, the National Health and Medical Research Council (NHMRC) Values and Ethics: Guidelines for ethical conduct in Aboriginal and Torres Strait Islander health research (NHMRC 2003) was utilised. Finally, the generic Australian guidelines for all research involving people--the National Statement on Ethical Conduct in Human Research, which stresses respect for human beings, research merit and integrity, justice and beneficence (NHMRC 2007:11)--also determined the approach taken.

Respect was demonstrated by consulting with, and being granted permission to conduct the research by, the AHMRC, the local Aboriginal Health Service, and the regional and local Aboriginal Land Councils, plus the Saltwater Freshwater Board made up of Elders and a wide variety of community members. Individual consent was negotiated with each participant and identities were protected. Research merit and integrity included taking a balanced public health approach by investigating positive and negative gambling motivations with no reinforcement of negative stereotypes. Our priority is to try to achieve better outcomes for gamblers based on independent evidence. Justice and beneficence meant that all people were treated equally. Input from everyone was welcomed and treated with respect. Reciprocal relationships were important. We were determined to adhere to these ethical guidelines in spirit and in practice by conducting the research equitably and as it was represented. The project was approved by the AHMRC (Approval number 760/10) and a university Human Research Ethics Committee (Approval number 10/178).

Results

Card gambling behaviour

About one-quarter (24%) of respondents, or 66 participants, indicated they had participated in community card games for money in the previous 12 months. Among these card gamblers, the vast majority (89%) had played cards games in their local areas, while 62% had gambled on cards outside their local areas.

As Table 1 indicates, more than one-third of the card gamblers played at least a few days per week (36%), while the same proportion (36%) played only a few times a year. More than one-half (53%) played at least once per week.

The 66 card gamblers were also asked how long they usually spent on each card gambling session (Table 2). About one-half of card gamblers (52%) usually spent three hours or less per card gambling session, while around 20% played for eight hours or more and 9% played for 12 hours or more.

In terms of card gambling expenditure (Table 3), nearly one-half (48%) of the card gamblers spent up to $50 each fortnight on cards, 29% spent $51-$100 and the remaining 20% spent more than $200. In addition to money, 27% also gambled on card games with other resources, including cigarettes (12%), alcohol (6%), favours (6%), food (5%) and other possessions (5%).

Respondents were also asked how much the winning pot or pool was worth in their last card game played in their local area. Responses ranged from $20-$2500, with a mean of $392.27 (std dev. $500.57).

No significant differences were observed between the male and female respondents for any aspect of card gambling reported above. When compared to results from the Gambling Module of the NSW Population Health Survey 200809, the participation rate for card gambling was substantially higher among the festival respondents (24%) than among the general NSW adult population for gambling on 'games like cards or mahjong, privately for money at home or at any place' (4%) (Centre for Epidemiology and Research 2009:7).

Commercial gambling behaviour

With 71% of respondents participating in the previous 12 months, commercial gambling was clearly more popular than card gambling (24%). By far the most popular form was poker machines, which were played by about 62% of respondents (Table 4). A substantial minority of the sample had gambled on keno, lottery-type games, scratch tickets, and horse or dog races. About one-tenth had gambled on bingo and sporting events, while very few had gambled on poker tournaments, casino table games or online casino games. More men (36%) than women (19%) had wagered on horse or dog races ([x.sup.2] = 10.633, df = 2, p = 0.005). (2) More men (19%) than women (4%) had also participated in sports betting ([x.sup.2] = 14.964, df = 2, p = 0.001). In contrast, more women (17%) than men (6%) had played bingo ([x.sup.2] = 13.863, df = 2, p = 0.001). These were the only significant differences between the sexes for participation in the different forms of gambling.

When compared to results for the general NSW adult population (Centre for Epidemiology and Research 2009), participation rates for the festival survey respondents were more than double for poker machines (62% for festival respondents, cf. 24% for NSW adults), triple for keno (35%, cf. 12%), and higher for wagering on races (26%, cf. 16%) and sports betting (11%, cf. 7%). It is difficult to compare results for lottery products because the NSW survey did not provide separate results for lottery-type games and instant scratch tickets, instead reporting that 51% of NSW adults purchased lottery products in the previous 12 months. Similar to the festival results, the NSW study found that 5% or fewer participated in casino table games and internet casino games.

The frequency that festival respondents reported gambling on the most popular types of commercial gambling is shown in Table 5. Approximately 38 % of poker machine players did so on at least a weekly basis. The next most popular weekly activities were wagering and playing keno.

Some comparisons can be drawn with the Prevalence of Gambling and Problem Gambling in NSW study (AC Nielsen 2007), which found that 16% of NSW adults who played poker machines in the previous 12 months played at least once per week, 14% of race bettors gambled on this form at least weekly and 10% of keno participants played at least weekly. These proportions are all much lower than among the festival respondents. Thus, not only do higher proportions of the festival respondents gamble on these forms of gambling, when compared to the general NSW adult population, their average frequency of play is also higher. However, frequency of weekly sports betting was lower among the festival respondents, being 13% compared to 20% for NSW sports bettors (AC Nielsen 2007).

More than 58% of the 182 respondents who reported participating in commercial gambling in the previous 12 months nominated poker machines as the form they spent the most money on. This was followed by 15% of commercial gamblers who spent most of their gambling money wagering on horses or dogs, 10% on lottery games, 5% on instant scratch tickets, 3% on keno, 3% on poker tournaments in a hotel, club or casino, and 1% on casino games on the internet for money. A small but significant difference was found between the male and female responses to this question ([x.sup.2] = 15.274, df = 8, p = 0.05), with a higher proportion of women (67%) than men (50%) nominating poker machines, while a higher proportion of men (26%) than women (6%) nominated wagering on races.

Additional questions were asked about the respondents' gambling on the activity that they spent most money on. Table 6 shows reported expenditure for the two most popular activities. About one-half (49%) of respondents who had nominated poker machines as the type of gambling they spent most money on reported spending $50 or less per fortnight on this activity. In contrast, 12.7% reported spending $300 or more per fortnight. Most respondents who favoured poker machines played them most often in a club (68%), with 32% playing them most often in a hotel. About one-third (35%) of these respondents reported usually playing poker machines for less than one hour, another one-third (30%) played for one to two hours, while the remainder played for longer. Six percent of these players reported usually playing for 8-12 hours in a typical poker machine session.

Among respondents who nominated wagering on horse or dog races as the gambling activity they spent most money on, about one-third (35%) reported spending $50 or less per fortnight on this activity, another one-third (35%) reported spending $50-$200 and the remainder spent more. Eight percent of these respondents reported they spent $301-$500 per fortnight on wagering (Table 6). The race bettors were most likely to place bets at a hotel (39%), followed by at a standalone off-course betting agency (22%), on the internet (22%) and in a club (17%). No one reported most often placing race bets by telephone.

Reasons for gambling

All gamblers were asked to nominate the main reasons they gamble, with multiple responses allowed. Table 7 shows the percentage of respondents who answered 'yes' to each reason for the whole sample of gamblers, for those who reported spending most on poker machines, for those who reported spending most on wagering, and for those reporting spending most on other forms of gambling.

Overall, clearly many people reported that gambling gives them pleasure and fun (73%), and helps them to socialise with family and friends (66%) and relax (61%). Nearly 70% gamble for the chance to win extra money and 21% gamble because they are reportedly addicted to gambling. However, these reasons varied somewhat for the different types of gambling that respondents spent most of their gambling money on. For those spending most on poker machines, motivations relating to escape through relaxing, taking the mind off worries, reducing boredom, and reducing negative emotions and addiction, and motivations relating to socialising with others who gamble in a safe and pleasant place are more prominent than for gamblers spending most on wagering or other forms of gambling. In contrast, those spending most of their gambling money on wagering appear more motivated than the poker machine or other gamblers by the pleasure and fun and the hobby and interest that wagering provides.

Gambling problems

All gamblers were administered the nine items that comprise the PGSI (Ferris and Wynne 2001). Table 8 contains the questions and frequency distributions of responses. On comparing the mean scores of the nine items (where 'never' = 0, 'sometimes' = 1, 'most of the time' = 2, 'almost always' = 3), the most highly endorsed were betting more than they could afford to lose, feeling guilty about gambling, feeling they might have a gambling problem and chasing losses by going back another day to try to win losses back.

PGSI scores were computed and ranged from 0-24, with a mean score of 3.71 (std dev. = 5.584). No significant differences were detected between the male and female respondents, among the various age groups or among those with differing marital status.

Using the cut-off scores and categories described earlier, Table 9 shows that more than one-quarter of the sample were non-gamblers, about one-fifth were non-problem gamblers and another one-fifth were problem gamblers, with the remainder falling into the low or moderate risk category. Among the gamblers who answered all nine items of the PGSI (n = 201), nearly one-third were classified as non-problem gamblers, with the remainder at some level of risk from their gambling, with 29% of the gamblers classified in the most severe category of problem gamblers. No significant differences were detected between the male and female respondents in their proportions in the various PGSI categories. Tests of significance were not conducted for the other demographic variables due to the low number of cases in some cells.

The most recent NSW survey to include the PGSI is the Gambling Module of the NSW Population Health Survey 2008-09 (Centre for Epidemiology and Research 2009). This survey found that 0.4% of the NSW adult population were problem gamblers, 1.3% were moderate risk gamblers and 2.4% were low risk gamblers. The study also established that 95.8% of the population were non-problem gamblers or did not gamble at all. Clearly, the results from the festival respondents indicate a much higher prevalence of gambling problems than found in the NSW adult population. This NSW study also found that young adult males were over-represented among all of the risk gambling groups, whereas no significant differences were found in PGSI categories among the male and female festival respondents nor among their mean PGSI scores by age category.

Impacts of gambling

The respondents were asked if, in the past 12 months, their gambling had caused any financial problems for themselves or their households. Of the 215 respondents to this question, the majority (66%) reported they had never had any problems, while 23% had experienced problems 'sometimes', 8% had experienced problems 'most of the time' and a further 2% 'almost always' experienced these problems.

The participants who responded in these last three categories (n = 72) were then asked what they did when the money ran out. Table 10 shows the frequency of 'yes' responses to a range of options to which they were asked to provide a 'yes' or 'no' response. The most common response (54%) was to rely on family, relatives or friends, followed by going without (47%) and not paying or putting off the payment of bills (43%). Substantial minorities reported obtaining emergency help, begging, getting an advance, selling possessions, borrowing money or obtaining money illegally.

The gamblers in the sample were asked whether gambling had ever led to a range of consequences, which related to their own health, employment, relationships, finances, housing and crime, with the frequency of 'yes' responses to each item shown in Table 11. These impacts were experienced by a minority of gamblers, with the most common being arguments in the household (14%), depression (13%) and violence (10%).

Help-seeking behaviour

The gamblers were asked if, in the previous 12 months, they had sought help for problems related to their gambling. Of the 200 who responded, 17% (n = 34) reported that they had sought help, with 10% reporting then receiving help and 7% reporting not receiving help.

As expected, the most cited reason for not seeking help (51%) was that the person did not have a problem with gambling (Table 12). Twenty-four percent of respondents did not seek help either because they thought they could resolve the problem themselves or they did not know where to seek help. Other reasons for not seeking help ranged from not wanting anyone to tell them to stop gambling, concerns about confidentiality, embarrassment and the lack of appropriate services, especially those with a cultural understanding.

The 34 respondents who had sought help were asked where they looked for help with their gambling-related problems. The most favoured source was family or friends (80%), followed by a respected member of the community (72%) and written information (58%). A smaller proportion sought help from a gambling counselling service (46%), Aboriginal community health service (44%), self-exclusion from one or more gambling venues (41%), Gamblers' Anonymous (39%), an online counselling service (37%) and a gambling help telephone hotline (25%).

All 277 respondents were asked what types of services would work best to help Indigenous people affected by gambling problems. The vast majority agreed that a local Aboriginal gambling liaison person to assist people to seek help (88%) and a local Aboriginal gambling counselling service (88%) would work best. Seventy percent supported a local money management and budgeting service, while 41% supported a local non-Aboriginal gambling counselling service.

Discussion

This paper has provided the first quantitative analysis of Indigenous gambling in NSW since the 1996 Dickerson et al. study of a convenience sample (N = 222). Indigenous Australian attendees at an Indigenous arts and cultural event were surveyed, yielding 277 responses. The survey gathered data about respondents' gambling behaviour, reasons for gambling, gambling-related problems, other impacts of gambling and gambling behaviour. The data are not intended to be representative of the broader Indigenous Australian population, but to provide a preliminary profile of Indigenous gambling to highlight aspects that appear distinctive and that might usefully be explored in further research.

One distinctive aspect of Indigenous gambling confirmed in this study is the popularity of card gambling, which 24% of respondents had participated in during the previous 12 months. Nearly one-half of the card gamblers typically gambled on cards in sessions of at least three hours duration, and more than one-half gambled on cards at least fortnightly, spending more than $50 per fortnight on this activity. This finding is consistent with earlier qualitative analyses of Indigenous Australian card gambling that have found it to be a historically popular activity (Berndt and Berndt 1977) because it is accessible, normalised, a pastime, encourages social interaction and redistributes resources (Altman 1985; Foote 1996; Hunter and Spargo 1988). In one of the few quantitative analyses including card gambling, the Queensland Department of Community Corrections (2005) found that the sampled Indigenous people on community corrections orders were significantly more likely to have played card games for money, gambled on card games as their most dominant gambling activity, and played cards as their first ever gambling activity compared to their non-Indigenous counterparts. There is little doubt that card gambling remains a popular social activity among some Indigenous Australians, but further research is needed to provide a more representative profile of this activity.

In the current study, some more intensive card gambling was found, with prize pools as high as $2500 reported, along with some people typically playing for between 8-24 hours and spending more than $300 per fortnight on this activity. The changing nature of Indigenous card gambling has been alluded to by some researchers, along with concerns that it is becoming more problematic, individuated and less redistributive in nature (Breen 2010; Paterson 2007; Young et al. 2006). Given the evidence of high stakes card games found in this study, the changing nature of contemporary Indigenous card gambling would be another fruitful avenue of inquiry.

While card gambling is popular, nearly three times as many survey respondents had participated in commercial gambling activities in the previous 12 months. Most respondents had gambled on poker machines, while between one-quarter and one-third of the sample had gambled on keno, lottery-type games, scratch tickets, and wagering on horse or dog races. Other forms of gambling were less popular. Further, participation rates among the Indigenous respondents were more than double for poker machines, triple for keno, and higher for wagering on races and sports betting than for the NSW adult population (Centre for Epidemiology and Research 2009), while roughly double the proportions of Indigenous respondents were weekly gamblers on most of these activities compared to the NSW adult population (AC Nielsen 2007). These findings are consistent with the only other quantitative study of Indigenous gambling in NSW (Dickerson et al. 1996), which found that gambling participation and frequency were significantly higher among Indigenous than non-Indigenous respondents. However, neither the Dickerson et al. (1996) nor the current study captured representative samples of Indigenous Australians, so this remains an area for further research. Research could also explore why these commercial forms of gambling are more popular among Indigenous than non-Indigenous Australians. The current study has illuminated key reported reasons for gambling, discussed below, but not compared to non-Indigenous Australians.

When reasons for gambling were explored among the Indigenous respondents, pleasure and fun, socialising with family and friends, to relax and the chance to win extra money were all nominated by most gamblers. These remained the top four motivations among those who spent most of their gambling money on poker machines, although more than one-half of these respondents also cited 'takes my mind off things that worry me' and 'makes me feel less bored'. These additional motivations reflect the well-known escape attraction and arousal-reducing qualities of poker machine gambling (Delfabbro 2009; Productivity Commission 2010). The majority of those who spent most of their gambling money on wagering added 'hobby and interest' to the top four reasons for gambling, reflecting the opportunity to apply knowledge, judgment and skill to this form of gambling. These findings generally align with those of previous studies. For example, a review of Australasian gambling research (Delfabbro 2009) concluded that most people report that they gamble for enjoyment, in order to socialise and because they want to win money. For poker machines, people are more likely to report that they gamble to achieve relaxation and as an escape from boredom, whereas racing and casino table games are reportedly chosen because of the thrill or excitement involved. However, the similar types of motivations between the Indigenous survey respondents and the general population studies reviewed by Delfabbro (2009) do not explain the higher gambling participation and frequency among the Indigenous respondents. Instead, the strength of motivation might be the more salient factor, with some studies finding that this increases with the regularity of gambling (Abbott and Volberg 2000; Roy Morgan Research 1999).

An important finding in this study is that problem gambling is much more extensive among the Indigenous survey respondents than among the general adult population of NSW; in fact, more than 50 times more extensive. The problem gambling prevalence of 22% found in this study is also double the Dickerson et al. (1996) estimate of 11% based on their 1996 survey of Indigenous people in NSW. Clearly, there is an urgent need for a representative survey that accurately measures the prevalence of gambling problems among Indigenous Australians. The vastly elevated rates found in this and other studies of Indigenous people in Australia (Dickerson et al. 1996; Queensland Department of Corrective Services 2005) and overseas (e.g. Belanger 2011; Ministry of Health 2009; Raylu and Oei 2004; Westermeyer et al. 2008; Williams et al. 2011) might be an artefact of the measurement instrument or survey administration methods, which may not be culturally aligned with capturing valid data. However, the higher gambling participation and frequency and the popularity of the most risky forms of gambling among the Indigenous respondents in the current study suggest it is likely that gambling problems really are more pervasive. There is a pressing need for the PGSI to be validated for Indigenous populations and for survey methodologies to be tailored to best capture accurate and representative data from Indigenous peoples.

Another interesting finding in relation to gambling problems is that no significant differences in mean PGSI scores were found between male and female Indigenous respondents, or among the different age groups or those of different marital status. This contrasts with non-Indigenous studies reviewed by Delfabbro (2009), who notes that by far the most consistent finding from Australian surveys is that problem gambling rates are negatively associated with age and higher among males. These previous surveys have found that problem gambling rates in the 18-30 age range tend to be almost double those in older age groups, and male prevalence rates tend to be one-and-a-half to two times higher than for females (Delfabbro 2009). Clearly, the apparently more pervasive nature of gambling problems among the Indigenous respondents requires further investigation, which the authors will do in a subsequent manuscript presenting an analysis of risk factors for gambling problems among these Indigenous respondents. However, this type of analysis is also needed, based on a representative sample, to help ascertain which particular subgroups are most affected by gambling problems and at whom appropriate public health and treatment measures might be directed.

Gambling problems are of concern mainly because of the impacts that arise from them. In the current study, about one-third of respondents had at least sometimes experienced financial problems due to gambling, with the most common response being to then rely on family, relatives or friends. This emphasises the ripple effects that gambling problems have and which are thought to be more extensive in Indigenous communities due to the typically larger families and Indigenous cultural obligations for reciprocity (Breen et al. 2010). Other common responses to financial shortfalls caused by gambling were reported as going without, and delaying or not paying bills. Some people sold personal property, begged, or obtained loans, advances and emergency help, and some stole money. Clearly, financial stress from gambling can lead to or exacerbate poverty, and is often the most immediate consequence of problem gambling (Thomas and Jackson 2004).

Other impacts of gambling were found in this study. Those reportedly affecting more than one in ten gamblers were arguments within the household, depression and incidents of violence. Separation, divorce, eviction, contact with police, theft and other criminal activity, bankruptcy, losing contact with children and children not attending school were impacts reported by a smaller minority. As noted by the Productivity Commission (2010), harms associated with gambling include those associated with people's health, jobs, finances, emotional states and relationships, even if some of these problems are experienced by people who are not problem gamblers. Thus, these harms are relevant from a public health perspective that aims to prevent and ameliorate the detriment people face when they or others gamble (Productivity Commission 2010). Thus, if rates of problem gambling are higher among Indigenous populations, the detriments associated with gambling are likely to also be more extensive. Other studies of Indigenous gambling have noted similar impacts of gambling that affect gamblers and others across several life domains (AHMRC 2007; Breen 2010; Breen et al. 2010), but their qualitative approach precluded quantification of these impacts. Although the current study has been able to quantify the extent of these impacts within this sample, further research is recommended to gain a more accurate picture of both the extent and severity of gambling impacts on Indigenous Australians.

A few aspects of help-seeking for gambling problems were investigated in this study. Apart from the gamblers who felt they did not have a gambling problem, the most commonly reported barrier to help-seeking was not knowing where to seek help. Several studies of help-seeking for gambling problems have been conducted in Australia and elsewhere (e.g. Bellringer et al. 2008; Evans and Delfabbro 2005; Hing et al. 2012; Lin et al. 2011; McMillen et al. 2004; Rockloff and Schofield 2004; Suurvali et al. 2008). In contrast to the current findings, these studies have generally found that the main obstacles to help-seeking are shame and embarrassment and a false hope in the ability to regain control or win back losses. While these barriers were also salient for some of the Indigenous gamblers, additional and distinctive barriers appear to be lack of knowledge about help services, lack of confidence in help services and lack of culturally appropriate help services, with widespread support for the need for Aboriginal liaison and gambling counselling services. These barriers have been identified in previous studies of Indigenous gambling (AHMRC 2007; Breen et al. 2010) and point to the need for consultation with Indigenous people and communities to inform the establishment and resourcing of more culturally appropriate sources of gambling help.

Conclusion

This exploratory study has provided descriptive data on an under-researched aspect of contemporary Indigenous life in Australia--gambling. Although Indigenous Australians have been gambling for more than 300 years, the recent expansion of commercial forms of gambling appears to have broadened Indigenous gambling participation. However, research efforts have not kept pace, and this study represents the first quantitative study of Indigenous gambling in NSW since the one previous study in 1996. While limited by a convenience, non-representative sample, this study has been able to highlight some aspects of Indigenous gambling that appear distinctive and warrant further research.

These aspects include card gambling, about which little is known despite its long history and continuing popularity and its apparent changing nature, which may be heightening its potential for harm. Research is also needed to explain the higher participation and frequency of gambling on commercial forms, particularly poker machines, as found in this and other studies. Deeper investigation of the types and strengths of motivations for gambling is warranted, especially interstate and international comparative studies with Indigenous populations. Most critically, an accurate picture of the extent of gambling problems among the Indigenous Australian population is needed, along with an analysis of associated risk factors and impacts.

While this study has provided only a small insight into gambling among a group of Indigenous Australians, it is hoped that its findings will prompt further research to inform appropriate public health and responsible gambling measures and the provision of culturally appropriate help services to address the extensive problems that appear to be associated with contemporary Indigenous gambling.

Acknowledgments

This research was funded by an Australian Research Council Discovery Grant. We also thank all Indigenous organisations and individuals who contributed to this study.

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Suurvali, Helen, David Hodgins, Tony Toneatto and John Cunningham 2008 'Treatment seeking among Ontario problem gamblers: Results of a population survey', Psychiatric Services 59(11):1343-6.

Thomas, Shane and Alun Jackson 2004 'Influences on gambling behaviours and outcomes: A model for the design of effective interventions', Gambling Research 16(2):40-51.

Westermeyer, Joseph, Jose Canive, Paul Thuras, James Thompson, Suk Kim, Ross Crosby and Judith Garrard 2008 'Mental health of non-gamblers versus "normal" gamblers among American Indian veterans: A community survey', Journal of Gambling Studies 24:193-205.

Williams, Robert, Rhys Stevens and Gary Nixon 2011 'Gambling and problem gambling in North American Aboriginal people' in Yale Belanger (ed.), First Nations Gaming in Canada: Current trends and issues, University of Manitoba Press, Winnipeg, MB, pp.166-94.

Young, Martin, Ibtisam Abu-Duhou, Tony Barnes, Elizabeth Creed, Mary Morris, Matthew Stevens and Bill Tyler 2006 An Overview of Gambling in the Northern Territory, Charles Darwin University, Darwin.

Nerilee Hing, Helen Breen, Jeremy Buultjens and Ashley Gordon

Centre for Gambling Education and Research, Southern Cross University

NOTES

(1.) In statistics, Cronhbach's alpha is a coefficient of reliability. It is commonly used as a measure of the internal consistency or reliability of a psychometric scale for a sample of respondents.

(2.) [x.sup.2] refers to the chi-square statistic, df refers to degrees of freedom, p refers to significance level.

Nerilee Hing, PhD, is a Professor at the School of Tourism and Hospitality Management at Southern Cross University, and the Director of the Centre for Gambling Education and Research, Southern Cross University, New South Wales.

<nerilee.hing@scu.edu.au>

Helen M Breen, PhD, is a Senior Lecturer at the School of Tourism and Hospitality Management, Southern Cross University, and an Australian Research Council Postdoctoral Research Fellow at the Centre for Gambling Education and Research.

<Helen.breen@scu.edu.au>

Jeremy Buultjens, PhD, is an Associate Professor at Southern Cross University's School of Business and a researcher with the Centre for Gambling Education and Research.

<Jeremy.buultjens@scu.edu.au>

Ashley Gordon, BEd, is an Indigenous researcher, a gambling counsellor and gambling community educator with lengthy experience in Indigenous community engagement.

<agconsultant@optusnet.com.au>

Table 1: Frequency that card gamblers played card games for money in
the previous 12 months (N = 66)

 Frequency Valid % Cumulative

Nearly every day 11 17.2 17.2
A few days per week 12 18.8 35.9
Once a week 11 17.2 53.1
Once a fortnight 4 6.3 59.4
Once a month 3 4.7 64.1
A few times per year 23 35.9 100

Total 64 100
Missing data 2

Table 2: Amount of time card gamblers usually spent each time they
played card games for money (N = 66)

 Frequency Valid % Cumulative

Less than an hour 8 12.5 12.5
1-2 hours 13 20.3 32.8
2-3 hours 12 18.8 51.6
3-4 hours 14 21.9 73.4
4-8 hours 4 6.3 79.7
8-12 hours 7 10.9 90.6
12-24 hours 6 9.4 100

Total 64 100
Missing data 2

Table 3: Amount of money card gamblers usually spent per fortnight
playing card games for money (N = 66)

 Frequency Valid % Cumulative

$1-$10 10 15.4 15.4
$11-$20 7 10.8 26.2
$21-$50 14 21.5 47.7
$51-$100 19 29.2 76.9
$201-$300 8 12.3 89.2
$301-$500 5 7.7 96.9
More than $500 2 3.1 100

Total 65 100
Missing data 1

Table 4: Participation in commercial gambling
activities in the previous 12 months (N = 277)

Type of commercial
gambling Frequency Valid

Poker machines 172 62.1
Keno 98 35.4
Lotto or lottery-type games 80 28.9
Instant scratch tickets 77 27.8
Horses or dogs 71 25.6
Bingo 32 11.6
Sporting events 29 10.5
Poker tournaments in a 17 6.1
 hotel, club or casino
Table games at a casino 8 2.9
Casino games on the 8 2.9
internet for money

Table 5: Frequency of gambling on the most popular commercial gambling
activities in the previous 12 months

 Poker Sports
 machines Keno Wagering betting

 N=209 N=172 N=168 N=162
 Valid % Valid % Valid % Valid %

Nearly every day 7.7 2.3 6.0 2.5
A few days per week 13.9 9.9 12.5 4.9
Once a week 16.7 10.5 7.7 5.6
Once a fortnight 13.9 8.7 0.6 0.6
Once a month 11.5 11.0 4.8 3.7
A few times per year 20.6 22.7 22.0 9.3
Never 15.8 34.9 46.4 73.5

Total 100.0 100.0 100.0 100.0

 Scratch
 Bingo tickets Lotteries

 N=164 N=172 N=178
 Valid % Valid % Valid

Nearly every day 0.0 1.2 0.6
A few days per week 4.3 5.8 4.5
Once a week 6.1 9.9 11.8
Once a fortnight 2.4 4.7 6.7
Once a month 4.9 7.0 11.2
A few times per year 12.2 31.4 27.0
Never 70.1 40.1 38.2

Total 100.0 100.0 100.0

Table 6: Fortnightly expenditure on poker machines and wagering

 Poker machines Wagering
Expenditure Frequency Valid % Frequency Valid

$1-$10 9 8.8 3 11.5
$11-$20 10 9.8 3 11.5
$21-$50 31 30.4 3 11.5
$51-$100 19 18.6 6 23.1
$101-$200 9 8.8 3 11.5
$201-$300 11 10.8 6 23.1
$301-$500 8 7.8 2 7.7
More than $500 5 4.9 0 0.0
Total 102 100.0 26 100.0
Missing data 4 1

Table 7: Main reasons for qambling

 Spend
 Spend most on
 most on Spend other
 All poker most on forms of
Reason gamblers machines wagering gambling

 N=182 N=106 N=27 N=49
 Valid % Valid % Valid % Valid

Gives me pleasure and fun 73.0 77.6 87.5 61.1
It gives me a chance to 69.6 67.1 72.7 80.6
 win extra money
It helps me socialise 66.3 76.3 66.7 56.3
 with family & friends
Helps me relax 61.3 65.9 66.7 52.9
It takes my mind off 44.3 53.9 35.0 37.9
 things that worry me
I enjoy the challenge of 42.8 47.9 36.8 32.1
 trying to beat the odds
It makes me feel less 41.7 52.8 21.1 32.1
 bored
It is a hobby & interest 41.6 38.4 68.2 35.7
It helps reduce stress, 39.9 45.5 33.3 29.6
 depression or anger
Because most of my 38.4 47.3 22.2 24.1
 friends & family gamble
It helps me get out to a 35.3 43.5 21.1 21.4
 safe & pleasant place
I gamble because I think 33.6 33.8 17.6 38.7
 I am lucky
It is a cultural tradition 21.7 20.6 29.4 26.7
I am addicted to gambling 21.2 30.3 10.5 11.1

Table 8: Frequency distribution of responses to the PGSI

Item Never
In the past 12 months... N Mean Valid %

Have you bet more money than you
 could really afford to lose? 204 0.76 42.2
Have you needed to gamble with larger
 amounts of money to get the same
 feeling of excitement? 204 0.59 57.8
When you gambled, did you go back
 another day to try to win back the
 money you lost? 204 0.64 52.9
Have you borrowed money or sold
 anything to get money to gamble? 203 0.44 69.0
Have you felt you might have a
 problem with gambling? 204 0.67 56.4
Have other people criticised your
gambling--or told you that you have a
 gambling problem? 204 0.59 58.3
Have you felt guilty about the way
 you gamble or what happens when
 you gamble? 205 0.74 47.8
Has your gambling caused you any
 health problems, including stress
 or anxiety? 201 0.45 69.7
Has your gambling caused any
 financial problems for you or your
 household? 204 0.49 64.7

 Some-, Most of Almost
Item times the time always
In the past 12 months... Valid % Valid % Valid

Have you bet more money than you
 could really afford to lose? 42.6 11.8 3.4
Have you needed to gamble with larger
 amounts of money to get the same
 feeling of excitement? 27.9 11.3 2.9
When you gambled, did you go back
 another day to try to win back the
 money you lost? 33.3 10.3 3.4
Have you borrowed money or sold
 anything to get money to gamble? 20.2 8.9 2.0
Have you felt you might have a
 problem with gambling? 27.9 7.8 7.8
Have other people criticised your
gambling--or told you that you have a
 gambling problem? 27.9 9.8 3.9
Have you felt guilty about the way
 you gamble or what happens when
 you gamble? 35.6 11.7 4.9
Has your gambling caused you any
 health problems, including stress
 or anxiety? 17.9 10.0 2.5
Has your gambling caused any
 financial problems for you or your
 household? 24.5 8.3 2.5

Table 9: PGSI categories of respondents (N = 277)

 Valid % Valid %
PGSI category Frequency of sample of gamblers

Non-gambler 56 21.7 --
Non-problem gambler 63 24.5 31.3
Low risk gambler 33 12.8 16.4
Moderate risk gambler 47 18.4 23.4
Problem gambler 58 22.6 28.9

Total 257 100.0 100.0
Missing data 20

Table 10: What respondents who had experienced financial problems from
gambling did when money ran out (N = 72)

Item Frequency Valid

I relied on family, relatives or friends 39 54.2
I went without 34 47.2
I did not pay or I put off urgent bills
 (phone, rent) 31 43.1
I obtained emergency help 16 22.2
I sold personal property & assets 13 18.1
I humbugged or begged 13 18.1
I obtained advance money from social security 13 18.1
I obtained money illegally (lies, crime, fraud) 11 15.3
I got a loan from a bank, money lender or other
 institution 9 12.5

Table 11: Other impacts of gambling reported by respondents

Item N Frequency Valid %

Arguments within your household 187 40 14.4
You suffering from depression 192 35 12.6
Incidents of violence with family,
 friends, others 189 28 10.1
You separating or divorcing your
 partner 187 22 7.9
You being evicted from your house 186 20 7.2
You having problems with police or
 committing a crime 183 16 5.8
You losing a job 183 15 5.4
You being declared bankrupt 182 14 5.1
You losing contact with your children 180 12 4.3
You borrowing without permission/
 illegally 181 10 3.6
Your children not attending school 180 9 3.2

Table 12: Reasons for not seeking help for gambling-related problems

Reason for not seeking help Frequency Valid

I don't have a gambling problem 85 50.9
I didn't know where to seek help 35 24.1
I thought I could beat the problem on my own 36 24.0
I didn't want anyone to tell me to stop gambling 26 17.9
I was concerned about confidentiality 23 16.0
I was too embarrassed to seek help 22 14.8
I didn't think a help service would understand
 my cultural background 21 14.6
The kind of help I wanted wasn't available
 locally 19 13.3