• Mark van der Maas, Robert E Mann, Flora I Matheson, Nigel E Turner, Hayley A Hamilton, and John McCready.
• Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
• Addiction. 2017 Dec 1; 112 (12): 2217-2224.

Background And AimsLittle research has examined the relationship between incentives used by gambling venues to attract customers and the experience of gambling-related harm. Organized and subsidized bus tours are a common example of such incentives. The aim of this study was to examine whether bus-tour patronage was associated with increased odds of problem gambling among older adults. This study also compared rates of bus-tour use by socio-demographic characteristics and gambling behaviours.DesignPearson's χ2 tests and Mann-Whitney U-tests were applied for bivariate analyses. Multivariate generalized mixed-effects regression modelling was used to examine the relationship between bus-tour patronage and problem gambling while controlling for possible confounding factors.SettingSeven gambling venues located in Central and Southwestern Ontario, Canada.ParticipantsA total of 1978 gambling venue patrons over the age of 55 years.MeasurementsProblem gambling as indicated by the Problem Gambling Severity Index, bus-tour patronage in the 12 months prior to the survey, spending per gambling visit and past-month slot machine participation.FindingsRegression analyses showed that bus-tour patronage was associated with higher odds of problem gambling [odds ratio (OR) = 1.71, confidence interval (CI) = 1.06, 2.76] after controlling for several demographic characteristics, type of gambling and gambling expenditures. Bivariate analyses showed past-year bus-tour patronage was associated with more frequent slot machine play (χ2 = 48.16, P < 0.001), more past-year gambling venue visits (P < 0.001) and lower spending on gambling per casino visit (P < 0.001). Compared with non-patrons, bus tour patrons were more likely to be female (χ2 = 21.92, P < 0.001), born outside Canada (χ2 = 113.18, P < 0.001), above the age of 75 (χ2 = 24.02, P < 0.001) and retired (χ2 = 16.60, P < 0.001).ConclusionsWhen adjusting for potential confounders among older adults, using bus tours to access Canadian gambling venues is associated with increased risk of problem gambling. Bus-tour patrons are more likely to be female, born outside Canada and above the age of 75 years.© 2017 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.

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