1 Lopez-Gonzalez, H., Griffiths, M.D., Jiminez-Murcia, S. & Estévez, A. (2019). The perceived influence of sports betting marketing techniques on disordered gamblers in treatment. European Sport Management Quarterly, in press. Abstract Research question: The proliferation of marketing stimuli to gamble on sports is a growing concern in many jurisdictions. However, little is known about the perceived influence of marketing among the most severe group of problem gamblers (i.e., those receiving treatment). This study aims to explore how problem sports bettors perceive gambling marketing is affecting them. Research methods: It examines the opinions of 43 sports bettors undergoing treatment for gambling disorder. Seven qualitative focus groups were carried out to understand their self-reported views on gambling marketing influence. Responses were analysed using a thematic analysis approach. Results and findings: The results showed three main marketing paths for impact: (i) mass-mediated marketing stimuli, (ii) personalised marketing, and (iii) stimuli inside betting shops. Price-related promotions (e.g., bonuses) were viewed as especially harmful. Also, the use of cognitive biases by bookmakers made it harder for sports bettors to stop gambling, and constantly facilitated their relapse. Implications: The paper provides evidence to substantiate regulatory action to restrict gambling promotions. In addition, it recommends gambling companies to develop responsible gambling measures to reduce the cognitive biases ingrained in their sports betting products. Keywords: Gambling; sports betting industry; gambling marketing; gambling disorder; sports betting 2 Introduction Individual, situational, and structural factors are often cited to explain the deleterious effects of gambling in specific subgroups of the population (Griffiths, 2005). Although much of the scholarly attention has centred upon individual vulnerability traits (Cassidy, 2014) – perhaps explained by the overrepresentation of psychologists among problem gambling scholars – sociological, situational and structural determinants of problem gambling have gained ground in recent years (McCormack & Griffiths, 2013). Among them, advertising-related factors have received growing attention, partly because of the liberalisation of online gambling regulations worldwide (Parke, Harris, Parke, Rigbye, & Blaszczynski, 2014). This has led to a proliferation of marketing stimuli to gamble, which has systematically raised growing concerns about the long-term effects that such proliferation might have on public health. In many European countries such as Spain (where the present study was conducted), media portrayals of advertising-induced problem gambling have proliferated, in particular those focusing on sports betting behaviour, the fastest-growing form of gambling (Directorate General for the Regulation of Gambling, 2017). In fact, amongst European online gamblers, sports betting represents 43% of the gambling market (European Gaming and Betting Association, 2018). As opposed to other gambling forms, sports betting capitalises on the popularity of elite sport, something that results in a permanent media exposure and a higher perception from consumers of the ubiquity of betting products (Lamont, Hing, & Vitartas, 2016). Consequently, bookmakers have increased steadily over the last few years the money devoted to marketing endeavours (Davies, 2016). 3 The public perception of the harmful effects of sports betting marketing strategies have provoked numerous calls to regulate the limits of gambling advertising more restrictively. In 2017, Italy passed a new law banning virtually all gambling advertising to be enforced in 2019 (Stradbrooke, 2018), Belgium has proposed a near-total ban, while other countries such as Ireland, Spain, and Romania have adopted more lenient approaches (Ewens, 2018). In the UK, the Gambling Commission has promised tougher fines to protect consumers from gambling advertising (Gambling Commission, 2018). Amongst the most prominent risk factors that these regulatory proposals emphasise is the vulnerability to gambling advertising of those already experiencing gambling disorder. Evidence from multiple jurisdictions has shown that excessive gamblers report higher levels of distress due to gambling advertising exposure, despite their perception that advertisements do not impact their gambling behaviour (Hanss, Mentzoni, Griffiths, & Pallesen, 2015; Hing, Lamont, Vitartas, & Fink, 2015), something also reported among adolescents (Derevensky et al., 2007). These studies typically rely on survey- based approaches with occasional and regular gamblers, while others recruit frequent gamblers for more in-depth qualitative studies (Thomas, Lewis, McLeod, & Haycock, 2012). With few exceptions (Binde, 2009; Grant & Kim, 2001), research has not gathered evidence of advertising impact from those likely to be suffering the most severe consequences (i.e., those diagnosed with gambling disorder). Furthermore, such studies have not specifically focused on sports betting. Therefore, the present study addresses this gap utilizing focus groups that explore the perception that problematic sports bettors have about how marketing techniques influence their gambling disorder. 4 Literature review Overall, critical reviews have concluded that, if gambling advertising has any impact on the development of gambling problems, such impact must be relatively small, although higher amongst vulnerable groups (Binde, 2014; Planzer & Wardle, 2011). Generally speaking, gamblers do not agree that advertising transforms non-gamblers into gamblers but they are more receptive to the view that advertising is a mechanism to increase expenditure for those already gambling, or as a redistributor of market share between companies (Hing, Lamont, Vitartas, & Fink, 2015). Studies have consistently indicated that the majority of gamblers do not think that advertising has had any impact on their gambling behaviour (Binde & Romild, 2018; Pallesen, Molde, Mentzoni, Hanss, & Morken, 2016). Nevertheless, these and other studies (e.g., Hing, Lamont, Vitartas, & Fink, 2015) have found that problem gamblers are the most represented group of gamblers ─ as opposed to non-problem, low-risk and moderate-risk gamblers ─ in acknowledging advertising influence. An interview study with 25 treatment-seeking gamblers in Sweden reported that only 20% of them thought advertising had any influence on their disorder, with none thinking advertising was the main cause for their problems (Binde, 2009). Several studies have demonstrated that problem gamblers are more exposed to gambling advertising and marketing tactics than any other gambling group (e.g., Clemens, Hanewinkel, & Morgenstern, 2017; Derevensky, Sklar, Gupta, & Messerlian, 2010). A survey-based study with 1,148 Canadian adolescents concluded that those already experiencing gambling problems were more vulnerable to the inducement of gambling advertisements (Derevensky et al., 2010). Nonetheless, it is unclear whether advertising 5 exposure leads to greater problematic gambling, or vice versa. Participants in a study with a nationally representative sample of over 6,000 Norwegians gamblers reported that gambling advertising increased their knowledge of gambling brands, but did not have an impact on their gambling attitudes, interests, or behaviours. However, among problem gamblers, the same study noted that, after controlling for frequency of gambling advertising exposure, problem gamblers still experienced more advertising- derived impact than regular gamblers (Hanss et al., 2015). Bookmakers commercialise almost identical sports betting products, with similar multiplatform technological features, accessibility, availability, and sport markets coverage. This minimal product differentiation has shifted the attention to price, prompting gambling advertising to focus on price-related characteristics. A comprehensive review of Australian sports betting inducements reported that 47% of marketing inducements included some kind of refund, welcome bonus, stake back, reduced odds, or in general, any inducement that represented the idea of the operator giving away money or offering risk-free betting opportunities (Hing, Sproston, Brook, & Brading, 2017). These promotions are sometimes cited by bettors as ‘safe bets’ (Deans, Thomas, Derevensky, & Daube, 2017), and are generally ranked by problem gamblers as the most persuasive inducement methods (Hing, Vitartas, & Lamont, 2017). Nevertheless, alluding to specific price offers produces mixed effects among bettors. Explicit gambling advertising in sports has been found to evoke negative reactions in non- gamblers. However, engaged sports bettors viewed these adverts positively, especially if 6 they portrayed practical information about odds or bonuses perceived as attractive (Lamont, Hing, & Vitartas, 2016). Price-related enticements to bet on sports are exceptionally popular in many jurisdictions. A recent study combining ecological momentary assessment, and experimental methods demonstrated that betting inducements (i) encourage riskier bets, (ii) increase betting expenditure, and (iii) have a carryover effect due to prolonged aggregate exposure (Hing, Russell, Rockloff, et al., 2018). Very importantly, the same study found that while betting inducements encourage riskier bets, their promotion appears to lower the perceived risk of betting. Free-money-like inducements were also found to elicit the riskier bets among all gambling severity groups, something that had already been posited by research that examined the most prevalent marketing techniques among British bookmakers (Newall, 2018). At message level, some gambling advert narratives have been rapidly restricted – at least in Europe (European Commission, 2014). These include messages that depict gambling as (i) a legitimate source of wealth, (ii) an investment product, and (iii) an alternative to employment. This has paved the way for more fun-centred messages that introduce sports betting as a game of skill while reducing its chance components (Lopez-Gonzalez, Estévez, & Griffiths, 2018a; 2018b). Repeated exposure over time to sports betting advertising narratives depict normative representations, including how much money a ‘normal’ bettor stakes, in which location, accompanied by whom, and/or accepting which odds (Lopez-Gonzalez, Guerrero-Solé, & Griffiths, 2018). The long- term accumulation of marketing stimuli to gamble is considered to produce a 7 normalisation effect that naturalises gambling practices, most critically in emergent adults (McMullan, Miller, & Perrier, 2012; Milner & Nuske, 2012). One of the singularities of sports betting in contrast to other forms of gambling is that it builds on an existing socially valuable entity (i.e., sport), to draw upon its symbolism to sanitise gambling among sports fans. This symbolic overlap gets its strength from the supposedly shared values of competitiveness, fair game, analysis, preparation and training, and entertainment, to name but a few (Lopez-Gonzalez, Guerrero-Solé, Estévez, & Griffiths, 2018). Responsible gambling advocates have raised concerns about the use of celebrities in sports betting advert narratives, under the assumption that it might reduce the perceived risk of the advertised gambling product, increasing the likelihood of winning in the consumer’s mind (Lamont, Hing, & Gainsbury, 2011). However, and despite this context of sports betting advertising salience and penetration, to the best of our knowledge, no study to date has explored the influence that sports bettors experiencing gambling-related problems perceive from marketing and advertising stimuli. The current study, as stated before, seeks to address this deficiency by providing scientific evidence from disordered sports bettors. Methods Recruitment and procedure The research comprised focus group discussions with sports bettors currently undergoing treatment for gambling disorder. To recruit the participants, the research team contacted the Spanish Federation of Rehabilitated Gamblers (i.e., the Federacion Espanola de Jugadores de Azar Rehabilitados [FEJAR]), which is the largest organisation that helps people experiencing gambling problems in the country. FEJAR 8 sent out notifications to its member associations across Spain, informing them of the details of the study, its inclusion criteria, and requesting their participation. Five associations responded to the call and agreed to participate. Additionally, a sixth source of participants was identified in a community hospital in the greater area of Barcelona. Focus groups were arranged in the premises where gamblers received treatment in each association. This data collection method was favoured against one-on-one interviews because focus groups best capture the social nature of sports betting (especially in the first stages of the habit). Also, preserving the face-to-face interaction between bettors was thought to provide greater insight. These groups were conducted by the first author from April to June 2017. Each focus group discussion lasted approximately 90 minutes. In total, a sample of 43 participants was recruited for the present study. The inclusion criteria to participate in the study was to (i) be an adult (aged 18+ years), (ii) have sports betting as their most prevalent gambling type (although many participants reported gambling on multiple products), (iii) have been diagnosed with gambling disorder, and (iv) be currently undergoing treatment for gambling disorder. All the sports bettors that met the inclusion criteria and were willing to take part were included in the study. The diagnosis of gambling disorder was based on the scores of the National Opinion Research Center DSM Screen for Gambling Problems (NODS; National Opinion Research Center, 1999) for those recruited via FEJAR, and the Spanish adaptation of the DSM-IV criteria (Jiménez-Murcia et al., 2009) for those recruited in the Barcelona hospital. The scores from the screening tools were combined in both cases with individual assessments made by trained psychologist. Participants 9 The sample was entirely comprised of male participants since no female gambler met the inclusion criteria. Participants resided in six different Spanish cities. Altogether, seven focus groups were performed with the following characteristics: Focus Group 1 (location: Barakaldo; n=7; Mage=29.1 years, SD=8.13); Focus Group 2 (location: Vigo; n=5; Mage=31 years, SD=13.1); Focus Group 3 (location: A Coruña; n=12; Mage=34 years, SD=10.9); Focus Group 4 (location: Madrid; n=6; Mage=36.5 years, SD=9.1); Focus Group 5 (location: Madrid; n=3; Mage=31.6 years, SD=9.5); Focus Group 6 (location: Pamplona; n=6; Mage=33.6 years, SD=8.6); and, Focus Group 7 (location: Barcelona; n=4; Mage=36.7 years, SD=4.3). In total, participants had a mean age of 33.2 years (SD=9.3). Ethics The first author’s university research ethics committee approved the study according to the guidelines of the Declaration of Helsinki. Participants consented with their signature to be audiotaped. They were informed that participation in the study was entirely voluntary and were reassured of their rights to withdraw from the study at any time and the confidentiality of their data management. Participant’s names were not collected at any time during the research. All of the participants received a small gift (earphones or pen drives with an approximate value of €10) at the end of the session. Analytic strategy The discussion within the focus groups was articulated through a brief script that consisted of the following blocks: (i) personal relationship to sport (used as an icebreaker), which included questions about watching sport on television, and previous experience practicing sport; (ii) general betting patterns (e.g., what kind of markets do 10 you bet on? which odds do you find attractive? how do you navigate the odds? do you typycally gamble before the games or in-play?), and if they followed any professional tipster or forum to inform their betting decisions; (iii) betting promotions and advertisements, which included questions about promotions they could recall, the ones they find them most attractive, what were betting advertisements trying to communicate in their opinion, and their personal history with promotions, especially with bonuses and ‘safe bet’ inducements (e.g., do you receive emails from bookmakers and if so, what do they look like?); (iv) the atmosphere in betting shops (e.g., how do you socialise with other bettors? what marketing techniques do bookmakers use inside shops?); and (v) the attitudes towards sports betting advertising, which included questions about prohibition, regulation, minors, and responsible gambling messages. The research strategy was not guided by any a priori theoretical framework and the scripted questions to foster discussion were streamlined to a bare minimum to allow for distinct conversation in each focus group. Given the inductive nature of the analytic approach, a thematic analysis perspective was adopted to analyse the findings. Thematic analysis is a flexible qualitative method to capture into ‘themes’ or units of significance the underlying ideas that participants communicate in their discourse (Braun & Clarke, 2006). This research method has been previosly used in problem gambling contexts to extract information about the thinking of gamblers (Deans, Thomas, Daube & Derevensky, 2017; McLean & Griffiths, 2013). Because theory building was not within the scope of the current study, a thematic analysis approach was preferred to other qualitative methods such as grounded theory. 11 Consecutive coding cycles were performed over the material following Saldaña’s recommendations (Saldaña, 2009). First, the holistic coding identified the main ‘themes’ (also termed ‘nodes’ by NVivo) of the conversations, with a structure resembling that of the researcher’s script that triggered those topics. To transcend these predetermined topics, a structural coding was performed. This coding type rearranged the data into categories not previously anticipated by the research team. Simultaneously, in vivo coding was performed to detect those instances of natural language where participants better illustrated the categories from the structural coding. The themes identified in the structural coding are reported, as well as their frequency in the focus group discussions. For clarity, but keeping in mind the qualitative approach of the study, the paper reports a raw estimation about how frequently the participants adhered to each themes or subtheme, using ‘most’ (80% of the participant adherence or higher); ‘many’ (50-79%); ‘some’ (20-49%), and ‘a few’ (19% or below). QSR NVivo 11 for Mac was utilised to assist in the data codification. The terms advertising and marketing are treated as near-synonyms in this paper, despite the fact that technically advertising is subsumed under marketing as one of its techniques. Results Overview The preliminary coding of the data identified 53 nodes across the seven focus groups. The frequency of each node varied greatly, from nodes with only one reference to others with 65 (see Appendix 1 for a comprehensive list of the initial nodes). Subsequent rounds of coding merged these nodes into 23 themes. The themes more closely associated with marketing and advertising techniques were structurally coded to reduce the number of themes to seven, which were used to generate the findings of this section. 12 Themes were, in order of frequency: (1) price-related gambling promotions; (2) mechanisms of influence in gambling advertising and narratives; (3) personalised marketing techniques; (4) marketing techniques in betting shops; (5) attitudes towards gambling advertising regulation; (6) advertising avoidance and gambling advert- induced relapse; and (7) celebrities and tipsters. Price-related gambling promotions Bonuses, enhanced odds, money backs, refunds, and in general every betting product associated with price dominated the discussion in many focus groups. Participants categorized such promotions in many ways such as ‘hooks’, ‘baits’, or ‘sweets’. One bettor called them ‘fictional money’ (Pamplona, 35 years). The mentioning of bonuses in conversation triggered in a few participants a memory of a slogan (e.g., ‘your loyalty bonus is awaiting you’), jingle, or price tag associated with it. Bonuses were perceived by far as the most persuasive marketing techniques that participants could think of. Price-related gambling promotions made bettors instinctively calculate the potential gains in accepting the offer being promoted. This was even true when bettors knew too well about the near-impossible withdrawal conditions of the bonuses. Viewing an advertisement or a personalised promotion offer of perceived good value was mentioned by some as the main factor contributing to continuing gambling after a period without gambling. Some bettors mentioned the word ‘reminder’ to conceptualise bonuses. The following excerpt captures the inner contradiction that bettors face when thinking about bonuses. In this conversation, bonuses are seen simultaneously by the same 13 participant (P2 in the excerpt) as deceptive because of their withdrawal conditions, and legitimate because they allow you to gamble more with the money they promised. P1: [Bonuses] are like sweets. Put sweets at school gates and see how long they last. P2: They’re not that bad. I always signed up for every bonus. Always. P1: Are [bonuses] for real? I honestly ask, are they for real? They give you free money? P3: Yes. I think Luckia used to give €200. P2: But when you read the fine print and realise… P3: Exactly. You need to bet x times, it’s basically impossible [to cash the bonus] P2: I did it not long ago. I got to have €1,700 but I had to bet 20 more times to withdraw it, and I ended up losing it (Barakaldo, P1=43 years, P2=24 years, P3=27 years) Price-related gambling promotions were seen by most respondents as irresponsible and needing stricter regulation. Two bettors explained in independent groups that gambling with bonuses made them behave more recklessly, knowing that it was not real money and that losing it would have no adverse consequences. A few bettors reported having contacted bookmakers to ask for free money, and in the majority of cases, they were awarded small €5-€10 bonuses to continue gambling. One bettor explained that bonuses should be considered a form of credit. According to his logic, gambling with money from bonuses equates to gambling with money that is not the gambler’s. Considering 14 that in most European jurisdictions, bookmakers are not allowed to concede credit to customers, offering bonuses could be constructed as an unlawful practice that needs to be banned. Finally, two other bettors recalled having struggled to avoid gambling when receiving alerts of missed bets. These alerts inform clients of betting opportunities they have missed (e.g., if they had bet €10 on the 0-0 score for this match, which was the result that actually occurred, they could have won €250). When adding the free money from bonuses, the potential gain advertised in these promotions, the original stake can be multiplied tenfold. This is further elaborated on in the next section. Mechanisms of influence in gambling advertising and narratives A fundamental debate with participants revolved around the definition of advertising. In the majority of cases, when participants felt reluctant to acknowledge the effects of advertising, they had primarily in mind the short-term effects of it. In general, when asked for the first time, most participants did not think gambling advertising influenced the following situations: (i) long-term effects of advertising exposure (e.g., normalisation), (ii) accepting offers from the same bookmaker but different from the ones explicitly promoted, and – for a few bettors – (iii) welcome bonuses and reduced odds not constituting marketing methods. A shared belief among many bettors in the study was that sports betting advertising came too late for them, meaning that they were already experiencing gambling-related problems before the proliferation of betting advertising started. This idea was also shared by individuals aged as young as 19 and 20 years. 15 Participants identified methods by which advertising conceals or minimises the dangers inherent to sports betting. One of the most cited examples of concealment concerned the keywords engrained in advert narratives. Participants cited ‘easy money’, ‘dream’, ‘illusion’, ‘enjoying sport’, and ‘free money’ as examples of harm concealment. One seasoned sports bettor complained about sports betting being presented as ‘playing Parcheesi’ (Vigo, 48 years). On the contrary, advertisements were seen to maximise the perceived benefits, with special emphasis on presenting betting in a way that parents would feel fine about betting with their children, or that lost money could be recovered. However, as ex-gamblers experiencing gambling-related problems, participants identified in detail two specific mechanism by which betting advertising might be effective. First, advertisements introduced new products that otherwise would remain unknown by gamblers. Some bettors mentioned new products or features such as ‘spin & go’, ‘edit your bets’, and accumulators that advertising facilitated them to try and use. In relation to this, one participant (from Barcelona, 41 years) thought the main effect of advertising was to make sports bettors transition to other forms of gambling such as poker and casino games. Given bookmakers often commercialise a range of gambling products, he thought the true persuasive mechanism of sports betting advertisements was to act as a kind of gateway drug for what he perceived to be more pernicious types of gambling. Second, advertisements, particularly those used in social media platforms, were also reminders of missed opportunities. One participant illustrated the interaction of bookmakers and media to advertise and naturalise sports betting by referring to the 2015-2016 English Premier League title unexpectedly won by rank outsiders Leicester 16 City. The team started the season with odds of 5,000 to 1 against, which was profusely covered by the media: [The media] frame everything as a bet. I remember when Leicester City won the league. They didn’t talk about football [soccer], they just talked about odds. And they were always trying to compare [Leicester winning the championship] with…I don’t remember…ah yes, with sighting the monster of Loch Ness. Sighting the monster was more unlikely than Leicester winning the league. These things captured your attention. Not like, I’m gonna get rich, but, thinking, there’s people out there who have become rich. (Madrid, 32 years) Participants identified three main sources of gambling stimuli from bookmakers. The most identifiable source of stimuli came from mass media, mainly in the form of advertisements. Almost all of the participants cited the saturation of sports betting advertising on radio, television, and social media, especially around sport events. However, besides mass-mediated marketing, participants appeared to consider two other forms of marketing as more influential to them. Most mentioned (i) the marketing stimuli they received while spending time in betting shops, and (ii) the personal messages bookmakers sent them (see next section as to how). Personalised marketing techniques Many participants mentioned receiving personalised communications as being very persuasive in the form of personal emails with enclosed bonuses, phone calls, text messages, and pop-ups during online gambling sessions. Bettors reported receiving personalised weekly emails from bookmakers before self-excluding (a prerequisite for 17 being admitted into treatment). These emails were generally seen neutrally, except in three situations. First, many participants felt they were being observed by the gambling operator when emails with attached free bonuses coincided with a negative financial balance in their accounts. Many believed bookmakers use behavioural tracking data to stimulate their gambling, which was viewed very negatively. Second, personalised emails were greeted positively when participants were heavily engaged in gambling because it allowed them to continue indefinitely. However, when emails with bonuses were sent after spending some weeks without gambling, just to remind them of the possibility of gambling, they were viewed as annoying and harmful. Third, some participants reported receiving personalised emails informing them that an unsolicited deposit had been transferred into their account. This typically happened after discontinuing gambling because of insufficient funds. All of the participants agreed that this was a dishonest way of facilitating excessive gambling. A few participants, who already bet during the pre-regulated period of online sports betting in Spain (prior to 2011) recalled much more aggressive personalised marketing techniques. One participant reported being invited to dinner to an upmarket restaurant by a bookmaker, and receiving regular phone calls offering him up to €500 every fortnight to continue gambling. A few bettors protested about the VIP treatment involved in personalised promotions they received from bookmakers. They felt this treatment exploited an inner contradiction. On the one hand, VIP treatment was found to be natural in some cases; something bookmakers have inherited from casino and poker practices and implemented in sports betting. Terminology such as platinum, silver, and gold membership, and 18 special promotions only for regular clients, appeared to have had an impact on them. For instance: Once, I gambled away €114,000 in one afternoon. I started with €10, reached €114,000, and gambled them back to lose them. [The bookmaker] sent me a Gucci watch worth €3,000, of course they did, I just lost €114,000! You climb a staircase: you spend €10,000, you’re bronze, you spend €20,000, you’re silver. (Madrid, 40 years) Especially meaningful in the sports betting context were the free tickets to attend soccer matches. Three (out of 43) participants reported having been invited to a luxury box in Real Madrid’s Santiago Bernabéu stadium. Another two participants were invited to other sporting stadia events. When asked about their feelings concerning those who had been invited (supposedly also heavy gamblers), participants did not think they were handed those tickets because they were gamblers with heavy losses. In contrast, they thought they were being rewarded for their loyalty. Marketing techniques in betting shops Marketing techniques used inside betting shops were cited by many participants. In particular, three main tactics were cited. The first technique was receipts or lists of winners displayed on message boards. Some participants mentioned having seen these on betting shop announcement boards (or less frequently, as pop-ups when starting a session in a betting terminal inside a shop) comprising lists of usernames with big winnings. A participant recalled having seen one individual customer of a shop singled out accompanied by a statement similar to ‘a guy bet €1 and won €500 this week’ (from 19 Barcelona, 41 years). This was generally believed to have a lasting impact on them. A few of them acknowledged that, despite the harm this message board might cause, they would have felt proud of seeing their name on it. The second technique was that most bettors reported having been invited to complimentary things (mainly meals) by shop managers. Kebabs, pizzas, tapas, and burgers were cited as the most frequent meals offered to them (as well as free beer and soft drinks). Participants felt ambivalent about the fairness of this practice. A few bettors thought many bars in Spain offer free tapas to increase beverage consumption, which they considered to be a fair and widespread marketing tool. Some others described it as deception. One participant used the term ‘red carpet’ to describe how committed to his wellbeing the manager of the betting shop was every time he entered the premises (A Coruña, 39 years). For many other participants, betting shops were a safe place wherein they feel protected and taken care of. One participant remembered one time in which his betting shop saved his day: Last year I was awarded a roscón de reyes [in Spain, traditional oval cake to celebrate the arrival of the three Magi to Bethlehem] in the shop. I had gambled away €20 that day, the ones I had to use to buy it. I was in the roulette and they brought me a roscón. [Researcher: Was it given to you or was it like a lottery?] I can’t remember. I think they just gave it to me. I was desperate, I had to go back home without it. This way I didn’t have to lie. (Madrid, 34 years) 20 In hindsight, the participant thought the shop manager might have identified the situation and provided him with the cake so he could avoid being caught in a lie at home. The third technique that some participants questioned concerned the role of employees in betting shops. One participant felt angry about employees emphasising winnings when they approached the counter to cash them, but ignored losses (in Spanish betting shops, counters are not secured and customer and employees have direct access to each other). Another participant (A Coruña, 39 years) recalled one time where the girl behind the counter asked him to bet on her behalf because he was on such a lucky streak. Stemming from this anecdote, the participant raised two issues: (i) whether the employee was actually aware that he was indeed a net loser in that establishment, and (ii) whether employees were instructed to potentiate the winning sensation of bettors in order to increase their gambling. Attitudes towards gambling advertising regulation Almost all participants agreed that gambling advertising should be better regulated, with more restrictive conditions to broadcast gambling advertisements, and a tighter observance of watershed limits and protection towards minors. Beyond this common ground, participants disagreed on the specific measures to be taken. A few participants were in favour of a total ban of sports betting advertising. This view required other bettors to try and harmonise their views on problem gambling (leading them to support the ban) and freedom of the market (advocating for regulation rather than prohibition). 21 For the majority of bettors, who supported regulation without prohibition, there were four main positions: (i) introducing tobacco-like regulation for gambling products, which would result in the prohibition of advertising gambling concerning sport events, (ii) introducing tobacco-like messages when acquiring gambling products to alert consumers of their pernicious effects, (iii) banning the use of celebrities, and (iv) reducing price-related inducements. Advertising avoidance and gambling advert-induced relapse Almost all bettors agreed that avoiding sports betting advertising in Spain was impossible. Participants alluded to the growing penetration of gambling advertising in every sphere of daily life. Talking about it, one bettor illustrated the impossibility of avoiding it by referring to one of the supposedly safest places on earth, a hospital: It’s unavoidable […] Look, my sister was in hospital and we ordered some pizzas for dinner. And the pizza box read: ‘Come to Codere and for having bought this pizza, get €20 […] I can’t imagine seeing vodka bottles for free in a pizza box’. (from Madrid, 31 years). Some bettors reported experiencing anticipatory anxiety in contexts where they knew they would encounter betting advertisements (e.g., sport stadia). Among the reported mechanisms to avoid betting advertising media exposure were: (i) watching sports with no gambling advertising (e.g., padel or badminton), (ii) switching channels during half- time breaks, (iii) turning down the television volume during game breaks, and (iv) leaving the room during game breaks (i.e., to smoke or to go to the bathroom). As to the reasons to avoid advertising, most bettors reported two: avoiding the temptation of 22 seeing odds or bonuses displayed to them on screen, and avoiding the irritation it produced while watching them. Two bettors specifically linked being exposed to gambling marketing stimuli and relapsing. One bettor (Vigo, 18 years), who presented a very aggressive and quick development of gambling disorder symptoms, said that after a few weeks without gambling, he went to a restaurant for lunch with his family, and was sat next to a betting terminal. This (he claimed) made him relapse. Another bettor (A Coruña, 23 years), after having not gambled for a few months after starting his treatment for gambling disorder, received an email. It contained a €50 free bonus, which he used, causing him to spiral out of control into disordered gambling. Apparently, as he recalled, his self- exclusion period had just expired and he was again eligible to receive gambling promotions. Similarly, another bettor (Barcelona, 41 years) acknowledged that due to voluntary self-exclusion time limits (where gamblers themselves set their exclusion duration), he was worried about receiving new promotions in the future, especially odds and bonuses, which were seen by him as the most powerful triggers to gamble. Celebrities and tipsters When the impact of celebrity endorsement was raised in some focus groups, a few participants confused them with tipsters (i.e., individuals who provide a subscription- based service bettors with recommendations and tips on what to bet on). This confusion was considered extremely telling, and led to further questions. A few bettors thought that before realisation of their gambling problem, they could have become professional bettors. These bettors, more than by non-gambling-related famous faces, felt attracted by bettors with a proven record of wins who were more similar to them (than compared 23 to [say] sporting celebrities). Two bettors remembered recommending tipsters to other co-workers. There was also some confusion between tipsters who published their recommendations before the events took place, and other tipsters who published winning receipts after the event was over. A few bettors acknowledged the persuasive component of seeing receipts of winning bets on social media. Two bettors recalled with precision the amount of money displayed in receipts seen on Twitter. In contrast, celebrity endorsers with no connection to gambling were considered less persuasive than tipsters by problem bettors. However, many bettors thought celebrities could have an impact on younger bettors and that their endorsements should be better regulated. Some bettors tried to minimise their contradictory feelings towards celebrities advertising gambling products. On the one hand, a few bettors defended celebrities like Rafael Nadal, Neymar Jr, or Cristiano Ronaldo on the basis that they are unaware of the deleterious consequences of their actions for problem gamblers. This group thought that, if given the chance to know the reality of problem gambling, they would stop endorsing gambling products. Some other bettors minimised the reward for celebrities, claiming that endorsements of gambling represent a marginal portion of their income. Finally, a few bettors did not find any problems with celebrity endorsement of gambling, and justified it by saying that they would also endorse it if paid to do. Discussion The present study examined how sports bettors undergoing treatment for gambling disorder perceived advertising and marketing techniques influenced them. The qualitative evidence gathered from participants across different gambling treatment centres in Spain highlighted a number of techniques with perceived negative impact on 24 them. Once all the themes that emerged from the analysis were outlined, they were integrated into a coherent structure that linked each theme with an overarching narrative. Figure 1 synthesizes the resulting model of how sports bettors perceive gambling advertising might be influencing their gambling behaviour. The figure describes three main marketing paths for impact: mass-mediated marketing stimuli, personalised marketing, and in-venue marketing. At a perceptual level, bettors recognised that betting marketing has both concealed harms and enhanced benefits. Among the benefits, the most persuasive ones were found to be the narratives envisioned by betting promotions, and the illustration of success in betting by influential examples such as tipsters and celebrities. At a behavioural level, marketing stimuli facilitated bettors to initiate gambling on new products, increase their gambling, and most notably, prevent them from discontinuing gambling (e.g., by presenting missed opportunities that made bettors regret that they had not wagered money on a particular sporting event). The most influential mechanisms for all these behaviours were price- related gambling promotions. Finally, bettors identified three main paths for effects. In general, bettors did not think marketing stimuli had any impact on them, and in the cases where it might have, they resisted those effects by avoiding the stimuli. However, and especially when undergoing treatment for their gambling problems, being exposed to gambling marketing stimuli might lead to relapse, which is the case where bettors asserted there should be stricter regulation. INSERT FIGURE 1 ABOUT HERE 25 Figure 1. Flowchart of perceived gambling advertising impact on disordered gamblers Price-related gambling promotions (particularly bonuses) were the most cited marketing stimuli. According to official data, the gambling industry in Spain spent €86 million on bonuses in 2017, which represented 39% of their advertising costs. For 2018, it is expected to increase to €110 million, which will almost quadruple the spend of 2013 (DGOJ, 2017b). Bettors with gambling disorder find it very challenging to avoid speculating about the possibilities behind the large numbers of betting propositions (essentially enhanced odds and free bonuses) when they see them promoted. The findings in the present study strongly align with the most recent evidence about the impact of price-related gambling promotions in sports betting. Bonuses, especially when they are promoted as risk-free, are the most attractive bet stimuli for gamblers (Hing, Vitartas, et al., 2017). Also, bonuses and enhanced odds promoted during live sports events are very effective facilitating impulse in-play betting, especially among those experiencing problem gambling (Killick & Griffiths, 2018). In addition, it has been estimated that approximately 60% of bettors underestimate how difficult it is to cash the money promised by bonuses (Hing, Browne, Russell, et al., 2018). Despite bettors in the present study knowing the terms and conditions applied to bonuses made it practically impossible to cash out, that did not deter their uptake of using the bonuses. This appears to indicate that regulations stipulating a more transparent disclosure of bonuses’ terms and conditions might not be enough to guarantee responsible gambling 26 among problem gamblers. Hence, it is advisable, given the evidence presented here, that disordered gamblers do not find themselves exposed to price-related gambling offers. The findings here also raise the question of ‘the right to stop gambling’. Bettors in the present study reported numerous techniques employed by bookmakers either to remind them of betting, of allowing them to continue doing so when they had run out of funds, to encourage them to bet when they were actively trying to stop, and to reinitiate gambling after voluntary self-exclusion periods. It is a particularly problematic path comprising the use of behavioural data tracking, followed by personalised messages shaped using behavioural tracking data, and ending with personalized price-related gambling inducements (sometimes in the form of unsolicited deposits). This combination of personal marketing strategies seriously disincentivize those who wish to stop gambling, and its legitimacy should be carefully reconsidered, at least among most frequent gamblers. However, direct and personal messages in the context of sports betting promotions have been found to be persuasive both for problem and non-problem gamblers (Russell, Hing, Browne, & Rawat, 2018). Sports bettors in the present study mentioned marketing and advertising techniques that evoke well-known cognitive biases and heuristics. First, the emphasis on winnings that bettors sensed from betting shop employees and managers could be generating confirmatory and representativeness biases in their gambling (Griffiths, 1994), by emphasizing winning bets and minimizing losing ones. Second, the association between big rewards and ‘fairy tale’ stories (e.g., Leicester City’s winning of the English Soccer Premier League with sightings of the Loch Ness monster), and repeated exposure over time to winners’ receipts both in gambling venues and on social media might be 27 reinforcing the availability bias (Tversky & Kahneman, 1974) in bettors. The combination of memorable stories, which are easier to remember, and repetition, arguably makes it easier to retrieve winning sports betting narratives from memory. Third, the emphasis on missed opportunities (e.g., personalised messages with potential gains had bettors placed the bet) appear to be a type of retrospective or hindsight bias (Fischhoff & Beyth, 1975; Griffiths, 1994). Once the match has finished, bettors are more vulnerable to imagining that the outcome was predictable. Here winners’ receipts on social media reiterate the missed opportunity thinking, fuelling hindsight bias. The strategy of hindsight bias was also found in an analysis of sports betting advertisements from Spain and the UK (Lopez-Gonzalez, Estévez, & Griffiths, 2018a). A responsible marketing approach would minimise the use of cognitive biases. However, on the contrary, bookmakers are more likely to promote betting options with higher expected losses that capitalise on irrational choices (Newall, 2018). When interpreting the findings, the present study has a number of limitations. First, the study discusses a very specific reality, that of Spanish sports bettors undergoing treatment for gambling disorder. This means the results cannot be directly generalised to other individuals and contexts with very different regulations or gambling cultures. Second, the study builds its argument based on the self-reported and self-perceived influence of advertising and marketing stimuli. Bettors in the context of gambling therapies, and in addition interviewed in groups, might be more likely to adapt their discourse to the perceived views of the majority of the group, introducing social desirability biases. 28 Conclusion Despite these limitations, the study here provides one of the few examples of gambling advertising impact examination among a population of disordered gamblers undergoing treatment, and the first to the best of our knowledge, to specifically examine this group on this topic. 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