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A larger sample size would allow more definite
conclusions.
A structured interview format could better
elucidate the effect of establishing a casino on
problem gambling.
Within the 2 regions, there was no change from
pretest to posttest in the number of individuals
reporting gambling problems. This result is not
surprising since it is unlikely that an increase
in the number of probable pathological gamblers
would be observed only 1 year after the
establishment of a new casino (see 7). However,
following up on these respondents after a longer
period of time (a minimum of 3 years) should
allow us to observe an increase in the number of
pathological gamblers, especially following such
a significant reported increase of participation
in gambling activities among certain people.
Interestingly we found a statistically
significant increase in the number of people
with a gambling problem when using an indicator
of lifetime prevalence. This result confirms the
inexact nature of prevalence studies that use
lifetime prevalence to assess the evolution of a
problem; this estimate appears to overestimate
the problem and thus does not allow for a
sensitive assessment of the gambling situation
over time. Considering that respondents
accumulate indicators of the problem over a long
period of time, it may be misleading to speak of
probable pathological gamblers in this context.
In the 18 years since pathological gambling
became an ICD-9
disease code (1980-1997) in the United States,
no death certificate
has listed gambling as the underlying cause of
death. A search of
the Compressed Mortality dataset, which is
maintained by the
Centers for Disease Control on their CDC Wonder
site, found 0
deaths for 312.3, the ICD-9 code for
impulse-control disorder,
which includes pathological gambling (312.31)
[1]. However, there
have been many attempts in the literature to
establish gambling as
an indirect cause of death. Two notable attempts
have been
discussed in previous WAGERs, "Measuring
Suicide:
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