Not Too Much, Not Too Often, and Not Too Many: the Results of the First Large-Scale, International Project to Develop Lower-Risk Gambling Guidelines.

Until now, there has been no evidence-based, specific advice for people who gamble who want to reduce their risk of experiencing gambling harms. This paper presents the results from the first large-scale, comprehensive, international project to develop lower-risk gambling guidelines. Specifically, we calculated relative risk estimates to determine risk of harm across the range of possible limits for gambling frequency, expenditure, and number of types of gambling engaged in; conducted an online survey (n = 4583) of people who gamble to assess whether they understood and found credible the proposed quantitative limits; conducted a series of interviews and focus groups with people who gamble to assess self-control strategies and reactions to proposed quantitative limits; conducted a meta-analysis of problem gambling risk factors in the general population; and consulted with a pan-Canadian, multi-sectoral committee of stakeholders. Project outcomes were examined and deliberated by a working group of scientists who decided upon a set of recommendations for lower-risk gambling. This paper presents these recommendations.