A systematic literature review of studies on attitudes towards gambling using the Attitudes Towards Gambling Scale (ATGS)

Figures & data

Figure 1. PRISMA flow chart.

Table 1. Study characteristics and key findings by the target population.

Reference	N	Country	Target population^a	Mean age (SD)	% women	ATGS version	ATGS mean scores	Key reported findings
General population
Àndra et al. (2021)	704	Italy	General population	–	54.4	8	–	Problematic gamblers reported higher ATGS scores compared to non-/non-problematic gamblers. No gender difference on the ATGS was found. Level of education was inversely associated with ATGS scores.
Canale et al. (2016)	7746	United Kingdom	General population	46.4 (–)	52.0	8	–	ATGS scores were positively associated with gambling frequency. ATGS scores were positively associated with levels of gambling problems.
Donaldson et al. (2015)	1794	Australia	General population	55.4 (13.3)	52.8	14	32.5/18.6^b	ATGS scores were positively associated with gambling frequency, gambling product diversity, time last gambled (recency), and game intensity, and inversely related to attitudes toward harm reduction and gambling reform legislation. ATGS scores were inversely related to PGSI score, being a woman, full-time employment, and education.
Fiedor et al. (2018)	1076	Czech Republic	Inhabitants from a post-communist country/the general population of the Czech Republic	–	–	8	17.8	ATGS scores were positively related to gambling frequency. ‘Broader’ definition/conception of gambling was inversely associated with the ATGS. Younger age groups (except 20–29 years) reported more positive attitudes than compared to older age groups. Women reported more negative attitudes than men. Widows/widowers and married participants reported more negative attitudes than single/divorced.
McAllister (2013)	1213	Australia	General population	–	–	8	3.9 (out of 10)	Frequent gamblers reported more positive attitudes than less frequent gamblers. Frequency of general gambling was more strongly related to the ATGS than the frequency of scratch/lottery tickets. The ATGS was inversely related to stricter public attitudes toward gambling regulation and explained a large proportion of the variance in the multivariate model. Frequent church attendees had more negative attitudes on gambling than those less frequent or not attending church.
Orford et al. (2009, 2010)	8872	United Kingdom	General population	–	–	14	35.4/20.2^b	Scores on the ATGS were positively associated with gambling frequency, the amount lost, amount won, younger age first started to gamble, scores on DSM-IV problem gambling criteria/PGSI, and having a parent that gambles. Having a parent or close relative with problem gambling was inversely associated with the ATGS. Male sex, younger age, white/European ethnicity, lowest school qualification, lower-status occupations, higher household income, better self-reported health, smoking, and heavy drinking were all associated with less negative attitudes toward gambling.
Pallesen’s et al. (2020)	9037	Norway	General population	44.6 (16.4)	51.3	8	F: 20.7 M: 22.7	Gambling participation last 6 months was positively associated with ATGS scores. Those who did not gamble or were categorized as problem gamblers (according to the PGSI) reported lower scores on the ATGS than normal-, low-risk- and moderate-risk gamblers. Those being single, not having children, having a lower income, and full-time employment had higher scores on the ATGS than their counterparts. Female gender, lower age, and the highest educational level were inversely associated with ATGS scores.
Salonen et al. (2014)	3497	Finland	General population	48.2 (16.8)	52.8	8	22.7	Problem gambling severity (SOGS) and being a concerned other of a problem gambler were inversely associated with ATGS scores. Net wage >2000 euro, and risky alcohol consumption were positively associated with ATGS scores. Female gender, higher age, and less than 12 years of education were inversely related to ATGS scores.
Salonen et al. (2017)	S1: 4484 S2: 4515	Finland	General population	–	S1: 52.8 S2: 48.9	8	2011 F: 21.4 2011 M: 23.9 2015 F: 22.9 2015 M: 25.2	Participants reported overall higher ATGS scores in S2 compared to S1. Change in ATGS score was not significant among men aged 15-17- and 18-24-years, and women aged 15–17 years. Women generally reported lower ATGS scores than men.
Adolescents/young adults
Ayandele’s et al. (2021)	197	Nigeria	Youths	22.8 (3.2)	16.2	8	28.2	Higher gambling frequency was related to higher ATGS scores. Age was inversely associated with the ATGS scores.
Calado et al. (2017)	988	United Kingdom	Adolescents and young people	19.8 (–)	40.8	8	–	ATGS scores did not predict problem gambling status.
Calado et al. (2019)	111	Portugal	High school students	17.6 (1.6)	58.5	8	–	Participants in the intervention group reported reduced ATGS scores at the last session of intervention. Changes in ATGS scores were not associated with problem gambling status. The main effect was not significant at follow-up six weeks after the intervention.
Delfabbro et al. (2021,2021)	1787	Australia Croatia Israel Canada	University students	Australia: 19.6 (2.1) Israel: 23.3 (2.8) Croatia: 21.6 (2.5) Canada: 21.0 (2.4)	64.0	8	Australia: 19.8 Israel: 18.0 Croatia: 18.7 Canada: 21.4	Canadian respondents had the highest ATGS scores followed by Australia, Croatia and Israel. Participants who gambled regularly reported more positive attitudes toward gambling than those who were not regular gamblers. Women reported lower scores on the ATGS than men. Gambling attitudes correlated positively with social accessibility and positive attitudes toward (strict) gambling regulation. Gambling attitudes were inversely and weakly related to exposure to people with gambling problems. Gambling attitudes were inversely associated with stigma (ostracism and contempt).
Dowling et al. (2020)	499	Australia	–	23.2 (–)	56.1	8	26.7	Women reported higher ATGS scores than men ATGS scores were unrelated to problem gambling.
Hanss et al. (2014, 2014)	1977	Norway	Adolescents Norwegian 17-year-olds	17 (–)	52.9	14	37.7/21.5^b	Problematic gambling (PGSI) was inversely related to ATGS scores. Lifetime gambling and peer/family approval of gambling were positively associated with ATGS scores. ATGS scores were inversely associated with female gender, agreeableness, and positively associated with sensation seeking.
Kaakinen et al. (2019)	S1: 1200 S2: 230	Finland	Young people	S1: 21.3 S2: 24.4	S1: 50.0 S2: 53.0	8	S1: 23.4 S2: 24.0	Respondents with more positive gambling attitudes reported higher positive interest in pro-gambling messages in a vignette experiment.
Oksanen et al. (2019)	1200	Finland	Finnish young people	21.2 (2.8)	50.0	8	23.4	ATGS scores were positively associated with frequency of competent- and entertainment-type gambling.
Pallesen et al. (2016)	W1: 2055 W2: 1239	Norway	Adolescents	W1: 17.5 W2: 18.5	70.4	14	W1: 37.7/21.5^b W2: 38.7/22.1^b	Adolescent participants significantly had more positive attitudes toward gambling in W2 compared to W1. ATGS scores at W1, gambling only at W2, gambling both at W1 and W2, and family and friends’ approval of gambling positively predicted ATGS scores at W2. Female gender and neuroticism were inversely related to ATGS score.
Sanscartier et al. (2019)	1194	Canada	Young adults	19.1 (1.5)	68.0	14	35.1/20.1^b	Gambling frequency, family/peer approval of gambling, and more permissive drinking norms were positively related to ATGS scores. Problematic gambling in the family, higher perceived religious faith, higher age,
Zhou et al. (2018)	122	Canada	University undergraduate students	F: 23.4 (5.2) M: 23.4 (7.3)	75.4	8	22.6	ATGS scores correlated weakly with problem gambling severity (SOGS). Men reported higher ATGS scores than women.
Adults
Gavriel-Fried (2015)	1000	Israel	Jewish-Israeli adults	40.3 (14.1)	49.6	8	19.5	ATGS scores were positively associated with gambling frequency and the number of forms of gambling engaged in. PGSI score, female gender, and higher self-perceived religiosity were inversely related to the ATGS.
Other
Fiedor and Seidlova (2021)	171	Czech Republic	People from Vietnam and Ukraine living in the Czech Republic	–	–	8	Ukraine: 18.0 Vietnam: 18.3	Individuals who participated in more games in the past year reported higher ATGS scores than those who did not- or participated in fewer games per year. The Ukrainians and Vietnamese reported slightly more positive attitudes than the Czech majority (compared to the results from Fiedor et al., 2018).
Rosen et al. (2020)	126	USA	Ex-offenders	32.5 (7.3)	13.0	8	21.5	Ex-offenders with gambling disorder reported higher ATGS scores than ex-offenders without gambling disorder. ATGS score was inversely related to the likelihood to seek treatment for gambling problems. Individuals with gambling disorder reported lower ATGS scores after a brief intervention, but the interaction effect of time x condition (treatment and control) was not significant.

– = did not report data on this variable, ATGS= Attitudes Towards Gambling Scale, ^a = The targeted population as reported by the individual manuscript, ^b = ATGS-14 score transformed to ATGS-8 score by the authors, W1 = first wave, W2 = second wave, S1 = first study, S2 = second study, PGSI = the Problem Gambling Severity Index, SOGS = the South Oaks gambling Screen.

Table 2. Results from the MMAT quality assessment.

Study	S1. Are there clear research questions?	S2. Do the collected data allow to address the research questions?	2.1. Is randomization appropriately performed?	2.2. Are the groups comparable at baseline?	2.3. Are there complete outcome data?	2.4. Are outcome assessors blinded to the intervention provided?	2.5. Did the participants adhere to the assigned intervention?	4.1. Is the sampling strategy relevant to address the research question?	4.2. Is the sample representative of the target population?	4.3. Are the measurements appropriate?	4.4. Is the risk of nonresponse bias low?	4.5. Is the statistical analysis appropriate to answer the research question?
Àndra et al. (2021)	Y	Y						Y	N	Y	C	C
Ayandele’s et al. (2021)	Y	Y						Y	N	Y	C	C
Calado et al. (2017)	Y	Y						Y	N	Y	C	C
Calado et al. (2019)	Y	Y	Y	Y	Y	C	Y
Canale et al. (2016)	Y	Y						Y	Y	Y	Y	Y
Delfabbro et al. (2021)	Y	N						N	N	Y	N	Y
Delfabbro et al. (2021)	Y	Y						Y	N	Y	C	C
Donaldson et al. (2015)	Y	Y						Y	C	Y	C	C
Dowling et al. (2020)	Y	C						C	C	Y	C	Y
Fiedor et al. (2018)	Y	Y						Y	N	Y	Y	Y
Fiedor and Seidlova (2021)	Y	Y						Y	N	Y	C	C
Gavriel-Fried (2015)	Y	Y						Y	Y	Y	Y	C
Hanss et al. (2014)	Y	Y						Y	Y	Y	N	Y
Hanss et al. (2014)	Y	Y						Y	Y	Y	Y	Y
Kaakinen et al. (2019)	Y	Y	C	Y	Y	C	C
McAllister (2013)	Y	Y						Y	Y	Y	N	Y
Oksanen et al. (2019)	Y	Y						Y	Y	Y	Y	Y
Orford et al. (2009)	Y	Y						Y	Y	C	Y	C
Orford et al. (2010)	Y	Y						Y	Y	Y	Y	Y
Pallesen et al. (2016)	Y	Y						Y	Y	Y	C	Y
Pallesen’s et al. (2020)	N	C						Y	Y	Y	Y	Y
Rosen et al. (2020)	Y	Y	Y	Y	Y	C	Y
Salonen et al. (2014)	Y	Y						Y	Y	Y	Y	Y
Salonen et al. (2017)	Y	Y						Y	Y	Y	Y	Y
Sanscartier et al. (2019)	Y	Y						Y	N	Y	C	Y
Zhou et al. (2018)	Y	Y	Y	Y	Y	C	Y

Y = Yes, N = No, C = Can’t tell.

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*Ayandele, O., Oguntayo, R., & Olapegba, P. O. (2021). Gambling characteristics and demographic differences as determinants of attitudes towards gambling among youths in Lagos, Nigeria. Journal of Gambling Issues, 47(47), 243–259. https://doi.org/10.4309/jgi.2021.47.10

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*Calado, F., Alexandre, J., & Griffiths, M. D. (2017). How coping styles, cognitive distortions, and attachment predict problem gambling among adolescents and young adults. Journal of Behavioral Addictions, 6(4), 648–657. https://doi.org/10.1556/2006.6.2017.068

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*Zhou, X. L., Goernert, P. N., & Corenblum, B. (2018). Examining the efficacy of the gamesense gambling prevention programme among university undergraduate students. International Gambling Studies, 19(2), 282–295. https://doi.org/10.1080/14459795.2018.1554083

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Data availability statement

The data that support the findings of this study are available on request from the corresponding author.