Category: MIL-OSI

This research examines the recovery experiences of Asian individuals living in New Zealand with lived experience of gambling harm. Specifically, the study explores the factors influencing gambling initiation, the processes of change from harm to recovery, the barriers and facilitators to accessing support services, and the key determinants of successful recovery. 

The study used a qualitative inductive thematic research design. Participants included 28 recovered gamblers and 12 affected family members belonging to a range of Asian ethnic groups.

The research identifies important factors influencing harmful gambling and help-seeking behaviours amongst Asian people in New Zealand, as well as key cultural factors contributing to Asian people’s gambling addiction recovery.

The results show that Asian gamblers’ recovery journeys are highly personal and dynamic and can take many forms. Common strategies used to overcome addiction included setting limits or control over gambling behaviour, staying away from high-risk gambling settings, replacing gambling with alternative healthier activities, and practicing mindfulness and meditation. Family played an essential role in gambling recovery. Religion and faith-based support were also powerful sources of healing and support during their recovery process.

The results from family members show they also embark on their own path of recovery, focusing on prioritising their own and their family’s wellbeing while supporting their loved one’s recovery process.

The implications of these findings include the need for targeted health promotion to improve early help-seeking, community engagement and self-help resources to enhance access to early intervention, provision of culturally responsive gambling harm counselling services, support groups and strong support networks for long-term recovery maintenance, and cultural sensitivity in gambling harm recognition training to strengthen gambling host responsibility. 

This research explores the sociodemographic and behavioural characteristics of monetary engagement (eg, microtransactions) in Free-to Play (F2P) gaming and how this engagement relates to gambling risk and harm.

It includes surveys of 4,180 adults who were categorised into three groups:

1. those who gambled for money online but did not participate in F2P games (66.3% of the sample)
2. those who participated in F2P gaming and spent money on microtransactions but who did not gamble online (5.3% of the sample)
3. those who gambled for money online and played F2P games and spent money on microtransactions (28.4% of the sample).

Twenty-eight percent of the 4,180 participants were in the latter group (mixed gamblers/gamers). This group reported they participated in online gambling more than F2P gaming, suggesting that online gambling should remain the priority to reduce harm. However, the study shows that mixed gamblers/gamers exhibit behaviours that increase the risk of becoming a moderate risk/problem gambler/gamer with an increased risk of harm compared to those in groups 1 or 2.

Despite the increasing convergence between gambling and F2P gaming, major harm minimisation efforts have not included F2P gaming. This study has identified that harm minimisation and prevention efforts should be targeted not only to people who gamble but also focus on those gamblers who participate in F2P gaming and spend money in those games on generic microtransactions and, more specifically, on loot boxes given their potential relationship with a migration to gambling behaviours.

Furthermore, additional focus must remain on Māori, Pacific and Asian populations as well as younger adults who are disproportionately affected by F2P gaming harms as well as gambling harms.

This research presents a literature review on the convergence of simulated gambling, monetary gambling and gambling harm. It also reviews conceptual and empirical evidence for risk and protective factors for gambling harm that might arise from simulated gambling and suggests strategies to help reduce this harm. The study extracted data from academic and peer-reviewed grey literature sources. In total, 181 articles were included in the review.

The study provides a comprehensive synthesis of conceptual and empirical research on simulated gambling and its links with gambling harm. It confirms there is strong and consistent evidence about the concurrence of simulated gambling, monetary gambling and problem gambling, although more research is needed to assess migration pathways (eg, migrating from simulated gambling to monetary gambling).

The study also identifies numerous strategies that have the potential to drive and significantly strengthen public health approaches to mitigate gambling harm linked to simulated gambling. In turn, these strategies can help to address a public health issue that is growing, threatens the wellbeing of the next generation of gamblers, and increases health disparities for priority groups in Aotearoa New Zealand, including Māori, Pacific peoples, some Asian communities and young people/rangatahi.

Overall, the study concludes that research on simulated gambling is still in its infancy and that prevents firm conclusions to be drawn about its role in migration towards or away from monetary gambling and gambling harm. This limits the specificity of recommended strategies to advance protective strategies and reduce risk factors to help ameliorate this harm. 

Kids Online Aotearoa Gambling and High Stakes research investigated the extent and nature of children’s exposure to gambling activities and marketing, particularly online. It also gathered the views of children and key stakeholders on this exposure, effectiveness of current public health measures, and what new measures are required to better protect children. 

This research comprised three studies: an analysis of gambling-related data from Kids Online Aotearoa, focus groups with children, and workshops with key stakeholders.

Findings show that children are frequently exposed to gambling and gambling marketing, both online and in the physical world, with substantial exposure occurring during online games. Online, children are exposed to gambling and gambling marketing 1.3 times per hour on average (New Zealand children spend 42h/week or 6h/day online), and the highest proportion of exposures occurred when children were playing games (44.4%).

Of all gambling content online, simulated gambling accounted for the most exposures (loot boxes and microtransactions, 45.0%; social casino games, 10.9%). Nearly one-third of children’s exposures to gambling and gambling marketing online were on social media. Exposures were generated equally between companies/organisations and users.

Boys were exposed to simulated gambling content significantly more than girls. The majority (71.7%) of exposures contained interactive elements, although children rarely engaged with it (6.9%).

The research highlights the social inequities in New Zealand affecting children’s experiences with gambling, the manipulative nature of gambling marketing, and the insufficiency of current public health measures. Stronger and comprehensive government regulations, better monitoring, improved information for parents and children, as well as the involvement of children in decision-making processes are recommended to ensure children’s rights are upheld and that they are protected from gambling harm.

This research aimed to empirically test factors relating to New Zealand (NZ) Asian migrants’ experiences with gambling and mental health, as identified in the Integrated Tree Model, supporting its use as a holistic approach to addressing gambling harm.

The study employed a three-phase, mixed-methods design consisting of: a literature review of peer reviewed and grey literature from 2000 to 2024, focusing on Asian migrants in Western contexts, qualitative interviews with 25 people from Asian migrant communities with an experience of gambling harm through their own or a family member’s gambling, and a quantitative nationally representative survey of Asian adults living in NZ.

The Integrated Tree Model has the following elements:

• roots – cognitive factors
• trunk – demographic and personality influences
• branches, leaves – experiences and acculturative stressors
• flowers, fruits – comorbid mental health and other issues
• soil and water – microsystem (eg, family and close friends)
• air, moisture and ventilation – mesosystem (eg, accessibility of gambling opportunities, media and marketing messaging)
• sunlight, temperature, climate – macrosystem (eg, regulatory environment in New Zealand compared with most Asian countries)
• tree variations – cultural influences on personal and experiential risk factors.

The research showed that Asians living in New Zealand with lived experience of gambling harm face multifaceted drivers that align with the factors identified in the Integrated Tree Model. The model illuminates the interconnected factors that increase vulnerability to harm, from deeply rooted cultural beliefs about luck and fate, to personal experiences like migration recency and socioeconomic status, to environmental pressures such as pervasive gambling advertising and venue accessibility.

This research examines how gambling help-seeking is defined, measured and enacted across a wide range if behaviours and supports. It captures how people experiencing gambling harm and professionals conceptualise help-seeking. Brief and comprehensive measures of help-seeking were developed and tested, and the full range of services, supports and strategies that people use were documented.

A panel of 514 adults in New Zealand and Australia tested a new Gambling Help-Seeking Assessment Tool (GHAT). The quota approach ensured that 75% of respondents had a self-reported previous or current issue with gambling, and 25% self-reported they had gambled in the past 12 months but did not have a previous or current issue with their gambling. All participants had gambled in the previous year.

Age quotas specified that at least 10% of respondents were aged 18–34 years and at least 10% were aged 65 years or older. Ethnicity quotas were set to ensure at least 10% of participants identified as Māori, 10% as Pacific, and 10% as Asian.

The results showed that people identified many different forms of help for gambling harm. These included professional care from health practitioners, crisis lines, mental health and addiction services, medical providers, and practical supports such as financial counselling and workplace assistance.

Community, cultural, and peer connections were also named, spanning family, friends, peers with lived experience, church leaders, marae, iwi, and online networks. Others used self-directed help, such as information-based resources like websites and apps, and personal strategies such as mindfulness, exercise, stress management, and self-exclusion.

Overall, the study found that 97.1% of participants reported at least one help-seeking action in the past year, showing that help-seeking is widespread, multifaceted, and often informal or self-directed.

The findings also suggest value in testing a brief version of GHAT (two questions) in routine care across primary care, mental health, allied health, and alcohol and other drug services. Incorporating the GHAT at service entry could provide a consistent way to start conversations about gambling, enabling services to learn what types of support people have already tried and what might be helpful next. 

Taking a public health approach, this study examines the economic and social costs associated with gambling harm in New Zealand. The purpose is to provide a foundation and evidence base of the impact of gambling harm to inform targeted policy development and harm minimisation interventions and to support further refined and revised costings.

The costing framework integrated tangible costs (eg, healthcare and justice systems) with intangible costs, which are not easily monetised but represent significant impacts. The intangible costs are determined using the health-related quality of life measure (HRQoL). The study drew on the New Zealand Gambling Survey, previous New Zealand-specific research on gambling harm, and other relevant national statistics and literature. The quantitative analysis was further informed by community consultation.

Total social cost

The study found that the total estimated social cost of gambling problems in New Zealand for the 2023/24 period was $4.219 billion ($3.72 – $4.73 billion, 90% confidence interval). This represented the economic burden arising from gambling-related harm across individuals, whānau, and society. The total estimated social cost was primarily driven by health (physical and psychological) and financial impacts. Offshore online gambling imposed a substantial and disproportionate burden.

Addressing risky gambling forms, particularly offshore online gambling, is necessary to address harm

The riskier forms of gambling (particularly pokie machines and equivalent games online) are major drivers in the total social cost. These types of games present a critical challenge and highlight the importance of effective regulation and enforcement.

Significant costs are borne by affected others

Policy work and the funding of support services have not always recognised the need to provide dedicated support for families, whānau and friends, despite the significant costs borne by these groups.

Substantial reductions in social costs are possible

The report’s economic modelling suggests that structural changes aimed at the highest-harm products offer significant potential for harm reduction. Targeted interventions, such as ones focused on land-based pokie machines, could potentially deliver disproportionately large benefits to Māori and Pacific communities.

This research explores definitions, estimates, predictors, reasons, consequences, and potential solutions related to pulling out of formal psychological gambling treatment.

The research was co-designed with a panel of people with lived experience of gambling harm, and synthesises findings from a scoping review, service data, and practitioner and client perspectives to better understand the issue of clients pulling out of formal psychological gambling treatment.

The research found that pulling out of formal psychological gambling treatment is common (one in three clients), it typically occurs early, and it is influenced by a mix of individual and treatment-related factors rather than any single predictor. Reasons for this early withdrawal include practical barriers, low motivation or readiness, lack of support, concerns about treatment, treatment not fit for purpose, or early goal attainment.

Practical implications and solutions are provided including:

• use of client-centred, culturally appropriate terminology
• improving service data systems
• providing flexible and accessible service options
• prioritising early engagement
• tailoring support for Māori, Pacific, and younger clients
• investing in the workforce.

While gambling has been identified as impacting mental health, recent studies have examined the effects of gambling on a broader range of health and wellbeing issues. This study profiles the health and wellbeing of people experiencing gambling harm in New Zealand and presents findings of research into evidence-based complementary and alternative interventions that may be effective to improve health and wellbeing. The report also provides suggestions for how these interventions could be implemented.

The study includes three methods: A literature review covering over 275 scholarly papers, consultations with experts in the treatment of gambling harm (28 staff), and an online panel survey (n=1000 of the New Zealand adult population).

Key findings

The health of people experiencing gambling harm

Literature review highlighted evidence that people experiencing gambling harm show a range of health inequalities that extend to not only poor mental health, but also poor physical health and disability. The online survey of New Zealand adults identified some health inequalities associated with problem gambling and gambling harm.

Evidence supporting the use of complementary and alternative therapies and interventions for gambling harm and its comorbidities

There were indicative benefits identified in the literature for physical activity and nature-based interventions on elements of mental health (such as depression and anxiety) and on gambling cravings and behaviour.  Online survey results suggested that, if offered in gambling harm treatment services, people would be interested in interventions related to improving their overall wellbeing. Inclusion of complementary interventions could also increase the likelihood of attending counselling for gambling harm.

Complementary and alternative therapies and interventions used in gambling harm treatment services

Services involved in this research across New Zealand shared the importance of complementary and alternative interventions in the treatment of gambling harm. However, treatment funding was mainly for the provision of psychotherapeutic services. There is a need to develop treatment resources to support clinicians and workers to work with lifestyle interventions. This view was shared by Māori, Pacific, Asian, and mainstream service providers.

Study documents

Integrated findings of literature, sector consultations, and a survey

A literature review

Detailed results for reference