Exploring the Users' Perspective of the Nationwide Self-Exclusion Service for Gambling Disorder, "Spelpaus": Qualitative Interview Study.

Background: Problem gambling and gambling disorder cause severe social, psychiatric, and financial consequences, and voluntary self-exclusion is a common harm reduction tool used by individuals with gambling problems.

Objective: The aim of this study was to explore users' experience of a novel nationwide, multioperator gambling self-exclusion service, "Spelpaus," in Sweden and to inform stakeholders and policy makers in order to improve harm reduction tools against gambling problems.

Methods: Semistructured interviews were conducted with 15 individuals who reported self-perceived gambling problems and who had experience of having used the self-exclusion service Spelpaus in Sweden. Interviews were transcribed and analyzed through qualitative content analysis.

Results: We identified 3 categories and 8 subcategories. The categories were (1) reasons for the decision to self-exclude, (2) positive experiences, and (3) suggestions for improvement. The subcategories identified a number of reasons for self-exclusion, such as financial reasons and family reasons, and positive experiences described as a relief from gambling; in addition, important suggestions for improvement were cited, such as a more gradual return to gambling post-self-exclusion, better ways to address loopholes in the system, and transfer from self-exclusion to treatment.

Conclusions: Voluntary self-exclusion from gambling, using a nationwide multioperator service, remains an appreciated harm-reducing tool. However, transfer from self-exclusion to treatment should be facilitated by policy making, and loopholes allowing for breaching of the self-exclusion need to be counteracted.