Booze, Bets and BMI

Overweight slots players Health and lifestyle trends based on casino game preference.

An Investigation into the Physical Fitness and Contributory Lifestyle Factors in Different Casino Players

Obesity is a growing problem. The rate at which our collective waistline is expanding is matched only by the growing list of associated diseases and the frequency of obesity-related press stories and government warnings. Despite being made well aware of the obesity epidemic in the UK, it appears we are doing little to fight back the fat.

It wouldn’t be a bold claim to assume that gamblers may be more susceptible to obesity given the associated lifestyle and low levels of activity required to play most casino games. However, gambling covers a wide variety of games and ways in which they are played. Could it be that different casino game players lead different lifestyles resulting in varying levels of physical fitness? Or indeed, is the assumption that gamblers are overweight and unhealthy incorrect?

These seemingly simple questions encouraged us to conduct this research and answer these queries.

We set about this task by surveying 2,131 active British gamblers. Armed with a set of testing questions on lifestyle, physical fitness, and gambling game preference, we collated and analysed the data and compiled results that have yielded some interesting results and appear in the following report.

Key Findings of our Survey

  1. Slots players are the unhealthiest of gamblers and are classed as ‘moderately obese’ with an average BMI of 31. Being moderately obese can reduce life expectancy by 3 years [1].
  2. Slots players who predominately play on desktop computers as opposed to mobile, tablets and land-based casinos, are the most likely subgroup to have higher than average BMI and associated health complications.
  3. Video poker players have the second highest BMI of 30 which is still significantly above the UK average of 27 and on the cusp of moderate obesity.
  4. Conversely pai gow poker players had the lowest BMI with an average of just 23.
  5. Roulette, blackjack and craps/dice players all had BMIs over that of the national average.
  6. 24% of slots players were regular smokers. The UK national average is 20% [2].
  7. Poker players have the joint second lowest BMI of 25 (along with baccarat) and were the youngest in our survey with an average age of 38.
  8. 73% of slots players and 72% of video poker players fail to meet the government’s recommended guidelines for physical activity.
  9. Slots, poker and baccarat had the biggest percentage of respondents who drank over the recommended weekly limits for alcohol consumption (24%, 23% and 20% respectively).
  10. Female slots and male poker players were the most likely to exceed the recommended weekly limit of alcohol units (26% and 25% respectively).
  11. Slots, video poker, dice and baccarat players all exercise less than the national average for physical activity requirements.
  12. Poker, roulette, blackjack and pai gow players all exceeded the national average for physical activity requirements.
  13. The average age of all respondents was 43. 58% were male, 42% female. The average BMI was 27.
Infographic Click here to see the infographic.

Detailed Results

The results section details findings on different groups of casino players, regarding the different lifestyle factors measured in our survey. The results are then discussed in the context of previous research and prevailing opinions on physical health.

BMI and Casino Games

Average BMI Categorised by Casino Game Preference

Figure 1

Slots

Slots was the most popular game in our survey, being selected as the most commonly played casino game by 51.3% of respondents.

With an average Body Mass Index (BMI) of 31, slots players had by far the largest average BMI of all the groups of casino players. A BMI of 31 is outside of what is considered to be healthy for a fully grown adult and is in the category of ‘Obese Class I’ (Moderately obese) [3]. According to the WHO, a BMI of 31 is well above the average in the UK which is currently 27 [4].

A study by Oxford University [5] found that the moderately obese can expect to have their life expectancy reduced by about 3 years. It is therefore fair to assume that on average, slots players are likely to die younger. A high BMI is linked with increased instances of heart disease [6], cancer [7] and diabetes [8]. Dr Vivienne Nathanson [9], Director of Professional Activities at the BMA, is quoted in a recent paper [10] as saying,

‘Obesity is linked to dozens of different diseases: not just heart disease and stroke, but cancers and many other things — infertility [for example]’.

Anthony Barnett, Emeritus Professor of Medicine and Consultant Physician at the University of Birmingham and Heart of England NHS Foundation Trust, had this to offer on the link between obesity and diabetes:

‘The biggest driver for the worldwide epidemic of Type 2 Diabetes is overweight/obesity coupled with a sedentary lifestyle. In the UK, obesity rates have quadrupled in a single generation. Any change in behaviour that encourages more physical activity and leads to a reduction in BMI has to be a positive thing.’

Video Poker

Following slots players, video poker players had the second highest BMI with an average BMI of 30. This finding puts video poker players on the cusp of moderate obesity (30+) and puts them well above the national average. The results suggest that both slots and video poker players are at a higher risk of a variety of diseases because of their large BMIs and are more likely to have a shorter life span as a result.

Poker

Interestingly, poker is the second most popular casino game with 313 respondents (15%) and is the joint second lowest average BMI (Average BMI of 25; tied with baccarat). A BMI of 25 is also categorised as ‘normal’ in adults. BMIs that fall into the ‘normal’ category (18.5-25) are considered to be healthy and are associated with reduced risk of obesity-related diseases. The average BMI of 25 found in poker players is also below the UK average of 27. Therefore, our survey suggests that poker players may run a lower risk of dying from high BMI related diseases. The same could be said for baccarat players, although the relatively small sample size (59 respondents) means that these results may be less reliable.

Pai Gow

At the other end of the scale, pai gow players had an average BMI of 23, which falls well within the ‘normal’ bracket and is considered to be healthy for fully grown adults.

Pai gow originated in China and was only introduced to the West in the 1980s. The game isn’t in great demand in most casinos in the UK (as reflected in our survey), but is popular with people of Asian origin/descent. Asian countries are known to have less instances of obesity compared to those in Europe and North America, so perhaps this is a possible explanation for pai gow players’ low BMIs. However, the small number of respondents in the pai gow category may make it tricky to make accurate assessments.

Baccarat

Similar to the poker and pai gow results, baccarat players also had a BMI which was lower than the national average. With an average BMI of 25, baccarat players (as well as poker players) would be classified in the ‘normal range’ but are on the edge of entering the ‘overweight range’. The fact that baccarat had the joint second lowest average BMI and is still on the verge of being classed as overweight says much about the prevalence of obesity in today’s society [11].

Baccarat is the same as pai gow in that it is also a popular game in Asian countries [12], so maybe they share a common explanation for their relatively low average BMIs. Although our survey didn’t ask for ethnicity and nationality, it may be the case that the baccarat players mainly consisted of people of Asian origin and that cultural differences account for the differences in average BMI.

Other Casino Games

Average BMIs for the other types of players were all above the national average; except from the ‘Other’ category which can be disregarded as there were only nine respondents. Roulette, blackjack and dice players all had average BMIs exceeding the national average, placing them firmly in the ‘overweight range’ (25-30).

The total average BMI across all casino players was 27.2, which falls in line with the national average. However, the fluctuations in average BMI which see some casino players rise well above the UK average (slots and video poker) and others fall well below (poker, pai gow and baccarat) indicate major lifestyle differences which will be explored in the following sections.

Casino Game Chosen as most commonly played game by (%) Average BMI
Slots 51.3% 31
Video Poker 10.4% 30
Blackjack 9.1% 28.5
Roulette 10.0% 28
Dice 0.7% 27.5
Other 0.4% 26.5
Poker 14.7% 25
Baccarat 2.8% 25
Pai Gow 0.6% 23
Table 1. Table showing casino games ranked by popularity in survey and average BMI.

Alcohol Consumption Results

Percentage of Respondents Exceeding the Recommended Weekly Alcohol Limit Categorised by Casino Game Preference and Gender.

Figure 2

Looking at the number of respondents who reported to regularly drink more than the recommended limit for weekly alcohol consumption, slots, poker and baccarat had the highest proportion of yes answers (24%, 23% and 20% respectively). It is advised by the Department of Health that men should not drink more than 21 units of alcohol per week and that women should drink no more than 14 units per week [13]. Exceeding these limits is classed as ‘hazardous drinking’ [14] and increases the risk of physical and psychological harm.

A study by UCL researchers [15] in the Department of Epidemiology and Public Health found that 44% of men and 31% of women exceeded the DoH’s guidelines for alcohol consumption. These figures dwarf the ones in our survey because they have been corrected for a self-reporting bias. In surveys people tend to underestimate how much alcohol they consume [16], so this was corrected for in the UCL study by adding 15 percentage points on for men and 11 for women. If we take the average of this (13%) and apply it to our results they roughly fall in line with that found in the UCL study. Indeed, the percentage of slots and poker players exceeding recommended weekly alcohol intake guidelines are more than that found in the general population.

Looking at the BMI, exercise and alcohol consumption data, slots players rank least favorably on all three. It seems that the high BMI found in slots players, in comparison to other types of casino player and the national average, is the result of an unhealthy lifestyle. Infrequent exercise and hazardous drinking are likely to be two factors contributing to the average slots player’s moderate obesity.

Poker players in the survey paint a more blurry picture as their alcohol consumption is comparable to that of our average slots player, but their average BMI is much less (25 compared to 31). More intriguing is that poker players were most likely to meet the recommended physical activity requirements with 58% engaging in physical activity for at least 30 minutes, 5 times per week. Conversely, a slots player was least likely to exercise with only 27% saying they met the government exercise recommendations.

It would seem that poker players engage in a more active lifestyle which is contributing to their lower average BMI. Another possible explanation could involve the ages of these two types of casino players. Poker players had an average age of 38, compared with 41 for slots players. There is an established link between BMI and age. There is a trend for BMI to increase, in both men and women, as they get older [17], so this could be a contributing factor to the differences in BMI between slots and poker players. The stereotypical poker player is often seen as a young (average age 28) affluent, college-educated male (60% male), a concept which in part is supported by our survey.

Gender differences

A deeper understanding can be gained from examining the gender differences evident in the alcohol consumption results. Slots players had the highest percentage of excessive drinkers, and the results show that it was females who were driving this finding. Of all the female slots players, more than a quarter regularly drank over recommended weekly limit compared to 21.5% of male slot players. With 26.4% drinking more than the 14 unit weekly limit, female slots players were the biggest drinking subgroup in the survey.

Not far behind female slots players, male poker players were the next subgroup most likely to exceed the recommended limits, with 24.9% normally drinking more than 21 units per week. This finding contrasts with female poker players, of whom only 20.2% drank over the recommended weekly limit.

A further gender difference of note is the finding that female video poker players were almost twice as likely to exceed the recommended weekly limit compared to male players. Only 10.8% of male video poker players regularly drank more than the 21 unit limit, compared to 19.3 of female video poker players. It is interesting that the female dominated games (slots and video poker) both had comparatively high levels of alcohol consumption compared to their male counterparts. We believe that the excessive drinking, found more commonly in females in these games, is a contributing factor to their high average BMIs.

Smoking Results

The data showed that with the exception of poker and other casino game players, UK casino players are nearly 4% more likely to smoke than the average UK citizen.

Pai gow players had by far the biggest proportion of smokers, with 46.2% admitting to smoking regularly. If we excluded the pai gow players, as the relatively small sample size may account for any anomalous results, slots (24%) and baccarat players (25%) were most likely to be smokers.

Dice players had a percentage of smokers equal to the national average, while poker players fell marginally beneath this average. Players categorised as ‘other’ had a percentage of smokers much lower than other games; however, this only accounts for nine respondents, so there is little insight to be made.

The results are visualised in the graph below. The yellow line in the graph represents the national average percentage of smokers in the UK [18] (20%), which is lower than the average number of smokers found in the survey (23.6%).

Percentage of Respondents who Smoke Regularly Categorised by Casino Game Preference

Figure 3

Exercise Results

Slots and video poker players were the least likely of all casino game players to meet the recommended levels of exercise. Only 27% of slots players and 28% of video poker players reported that they achieve the recommended 150 minutes (2 hours and 30 minutes) of physical activity [19] per week. Poker players were the most physically active in our survey with a significant 58% meeting the recommended levels.

After slots and video poker, dice and baccarat players were the next least physically active, with only 33% and 34% respectively being physically active for 150 minutes per week. According to the British Heart Foundation the national average for meeting physical activity requirements is 34% [20], so slots, video poker, dice and baccarat players all exercise less than the average person.

Little or no exercise is a contributory factor to having a higher than average BMI such as the ones found in the slots and video poker respondents. We can therefore confidently conclude that the lack of exercise displayed by slots and video poker players is yet another contributing factor to the high BMI in these two groups.

Percentage of Respondents who Meet Recommended Physical Activity Guidelines Categorised by Casino Game Preference

Figure 4

As with alcohol consumption, there are commonly found biases in self-report methods. People tend to overestimate the amount of physical activity that they engage in [21], so it is fair to assume that the actual percentage of people meeting physical activity guidelines is even lower than detailed.

Notwithstanding this, poker, roulette, black jack and pai gow players all exceeded the national average for physical activity requirements.

Why should this be that more poker players met the physical activity requirements? Well, assuming the poker players weren’t bluffing us and really exercised as much as they claimed, we know that poker players are actually mindful of the effect a sedentary lifestyle has on their mental and physical well-being [22].

With longer tournaments and longer sessions needed at the online and live tables to record a profit, poker is a mental and physical endurance game. Certainly more than slots and roulette.

Stuart Rutter, a leading British poker pro with hundreds of thousands of dollars in career earnings to his name, commented:

‘About two or three years ago, a new trend came almost out of nowhere amongst young UK poker players to become fit, go to the gym and lose weight,’ he says. ‘I think it suits poker players, as they naturally like a challenge and a goal. You just have to look at the more successful players around these days – they are the ones with a gym routine and a balanced lifestyle.’

Gambling Platform Results

We also asked our respondents about where they primarily play casino games. Regardless of what games our respondents played, the most popular way to play games was using a desktop computer. On average 65% of respondents played on their desktops; just over a fifth of the people in our survey played casino games on their mobile or tablet device; and just 14% of respondents frequent actual bricks and mortar casinos.

Where do our respondents play casino games?

Figure 5

Upon examining the percentage of desktop players for each game with the average BMI for those games, there seems to be a positive correlation between the two (see Figure 6 below). The higher the percentage of desktop players, the higher the average BMI.

The positive relationship between the two could be attributed to desktop players having generally unhealthier lifestyles compared to mobile and land-based players. This finding is strengthened by the fact that no such trend was observed when comparing the percentage of mobile and land-based players with average BMI.

A Graph to Show the Relationship Between Average BMI and Percentage of Respondents who Play Using a Desktop

Figure 6

A Graph to Show the Relationship Between Respondents Exceeding Recommended Weekly Drinking Limits and the Percentage Playing Using a Desktop

Figure 7

A similar positive relationship was found when comparing percentage of players drinking more than the recommended weekly limit and percentage of desktop players. This suggests that excessive drinking could be contributing to the higher average BMI in desktop players. Additionally, no relationship was found when the percentage of smokers and percentage of players who meet exercise requirements were compared with the percentage of desktop players. These findings indicate that excessive alcohol consumption is the largest contributing factor to the higher BMI found in desktop players.

Move to Mobile

In contrast to desktop players, games with higher percentages of mobile players did not positively correlate with higher average BMIs. In addition, games with more mobile players also didn’t positively correlate with higher rates of smoking, excessive drinking or lack of exercise. These results suggest that mobile play isn’t contributing to increased BMI.

20% of respondents primarily played using their mobiles but the uptake of mobile gambling is widely reported to be on the rise, with 164 million people estimated to be using mobiles for online gaming by 2018 [23]. The proliferation of smartphones (and tablets) and quicker internet speeds have triggered the growth of mobile casinos and risk resulting in a shift away from desktop use.

Perhaps the move to mobile casinos could have a knock-on effect of improving health and lowering BMI. People can access mobile casinos from anywhere and don’t have to be sat at a desktop to play. This could push people away from the sedentary lifestyle associated with desktop play and encourage people to integrate mobile gambling into an active lifestyle.

Tam Fry FRSA [24] is a spokesperson for the National Obesity Forum, and strengthened our assertion that the shift to mobile may result in health benefits.

‘A sedentary lifestyle is concurrent with a loss of physical activity. But that’s not all – it’s also associated with snacking on foods that are stuffed with sugar and calories,’ explained Mr. Fry. There may be a chink of light on the horizon in 5-10 years as we move around and use tablets and mobile devices on the move. Research actually shows that we are spending less time in front of the TV. ‘We may be becoming a more mobile society, but we might see some improvement in health in that timeframe. It’s a ‘might’ at this stage, however.’

Gender Differences

Percentage of Male and Female Respondents Categorised by Game Preference

Figure 8

The gender split across all casino games was 58%/42%, with a male majority. This male preponderance was evident in all casino games except for slots and video poker, which had a 53.2% and 53.8% female majority respectively.

Slots, along with bingo, are known for being popular with female [25] gamblers and have been at the centre of a recent feminisation of gambling [26]. The growing popularity of online gambling has seen more and more women start to play casino games, as they perceive it to be less stigmatising and intimidating than going to land-based casinos. Our results reflect this, as fewer slots players played in land-based casinos compared with all other groups of casino players (see graph below).

Percentage of Respondents who Play in Land-Based Casinos Categorised by Casino Game Preference

Figure 9

The female majority found in the slots players is also interesting because they were the group with the highest average BMI. Recent research featured in the Lancet Medical Journal [27] found that high BMI was associated with 17 types of cancer. There was also evidence to suggest that extra weight gained was linearly associated with an increased risk of six types of cancer. Two cancers affecting women were on this list, with uterine cancer found to have the highest increased risk and cervical cancer the fourth highest. There was also an increased risk of cancer of the gallbladder, kidney, thyroid and of leukaemia.

About Jackpot.co.uk

Jackpot.co.uk is owned and operated by Jackpot Gaming Ltd., a UK-based company with its head office in London. The Jackpot website was launched in 2002 and is an online casino and gambling information directory for UK online casinos and those that accept GBP wagers. Jackpot.co.uk was built by gaming enthusiasts for gaming enthusiasts and has continued in this vein ever since. While having previously been tailored to assist those new to the online casino world, Jackpot.co.uk now also has plenty of information for the online casino connoisseur.

Acknowledgements

Jackpot.co.uk would like to thank all those who completed the survey and we would like to give special thanks to all who contributed to the report.

Methodology

What did we do?

On the Jackpot.co.uk website and its associated network of gaming sites, we ran a questionnaire asking casino players a series of health-related questions. Out of the 3,000 respondents, 869 were removed due to respondent error or incomplete responses.

The remaining 2,131 clean responses were divided into 9 categories based on the casino game type the respondent played most often (e.g. poker, slots, roulette, blackjack, dice etc). We then tabulated all health and casino activity under each corresponding casino game.

Questions

Qualification Question

In order to target only those that play casino games we asked a simple qualification question. Answering this question negatively excluded them from participating in the survey.

Have you played any of these games in the last 30 days? (baccarat, blackjack, dice, pai gow, poker, roulette, slots, video poker, other casino games (excluding betting, lottery, bingo and spread betting))

Health Questions

We took an objective measurement of physical condition by asking each respondent their height in centimetres and their weight in kilograms. The BMI calculation was carried out by ourselves by dividing the respondents’ weight (kg) by height (m) and dividing by height again (e.g. for someone who is 80kg and 180cm, (80/1.80)/1.80=24.1.

We then asked health and lifestyle questions:

  • Do you normally drink more than the recommended limit for weekly alcohol consumption (21 units of alcohol for men and 14 for women)? (Yes/No)
  • Do you smoke regularly? (Yes/No)
  • Do you normally engage in at least 30 minutes of physical activity, 5 times per week? (Yes/No)

Demographical Questions

  • Age
  • Sex

Casino Activity Questions

We also asked the respondents about their casino game activity:

  • Which casino game do you play most often? (baccarat, blackjack, dice, pai gow, poker, roulette, slots, video poker, other casino game)
  • Where do you most commonly play this casino game? (Real land-based casino, mobile phone or tablet, desktop computer)

Infographic

Click here to see the infographic.

References

  1. http://www.ox.ac.uk/media/news_stories/2009/090317.html
  2. http://ash.org.uk/files/documents/ASH_106.pdf
  3. http://apps.who.int/bmi/index.jsp?introPage=intro_3.html
  4. http://gamapserver.who.int/gho/interactive_charts/ncd/risk_factors/bmi/atlas.html
  5. http://www.ox.ac.uk/media/news_stories/2009/090317.html
  6. http://atvb.ahajournals.org/content/16/12/1509.short
  7. http://www.cancer.gov/cancertopics/factsheet/Risk/obesity
  8. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1890993/
  9. http://bma.org.uk/about-the-bma/who-we-are/biography-vivienne-nathanson
  10. http://bma.org.uk/news-views-analysis/news/2012/may/obesity-engulfs-the-nation
  11. http://www.telegraph.co.uk/news/10566705/Britains-obesity-epidemic-worse-than-feared.html
  12. http://www.stuff.co.nz/world/asia/8771019/Baccarat-a-booming-business
  13. https://www.gov.uk/government/policies/reducing-harmful-drinking
  14. http://www.ias.org.uk/Alcohol-knowledge-centre/Consumption/Factsheets/A-good-measure-Units-and-drinking-guidelines.aspx
  15. http://eurpub.oxfordjournals.org/content/early/2013/02/25/eurpub.ckt016.full.pdf+html?sid=0c0e0829-a291-4096-8e51-873c1179778b
  16. http://alcoholresearchuk.org/downloads/finalReports/AERC_FinalReport_0009.pdf
  17. http://www.biomedcentral.com/1471-2458/7/269
  18. http://ash.org.uk/files/documents/ASH_106.pdf
  19. http://www.nhs.uk/Livewell/fitness/Pages/physical-activity-guidelines-for-adults.aspx
  20. http://www.bhf.org.uk/plugins/PublicationsSearchResults/DownloadFile.aspx?docid=e9994c21-ec6c-4fad-b741-ad96bacd69ed&version=-1&title=Physical+Activity+Statistics+2012&resource=M130
  21. http://europepmc.org/abstract/MED/17805081
  22. http://www.poker.co.uk/importance-physical-fitness-good-diet/
  23. http://www.mirror.co.uk/features/gambling-go-grows-popularity-3942363
  24. http://www.healthy-public.co.uk/?option=com_gtdisplay&view=gtspeakers&speakerid=32304
  25. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2790932/#jaba-42-04-21-Mok1
  26. http://drmarkgriffiths.wordpress.com/2012/01/23/the-gender-agenda-and-the-feminization-of-gambling/
  27. http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)60892-8/abstract

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