The rise of online gambling has seen the commercial gambling industry explode around the world, posing a significant threat to public health, according to a new report.
The report, published this Thursday, comes from a public health commission on gambling convened by the medical journal The Lancet. The 22 members of the commission – academic experts from a dozen countries – reviewed existing studies and surveys on the prevalence, impacts and harms of gambling and determined that, on a global scale, current regulations are not sufficient to protect the public and should reinforce.
“We’re no longer talking about people playing a card game around the table,” said the commission’s head of epidemiology, Louisa Degenhardt, a professor at the University of New South Wales in Sydney. “A lot of people may actually be suffering from the harms of gambling – we think it’s probably around 72 million people worldwide. That number is likely to increase as we’re seeing more commercial organizations targeting people to play more.”
According to the report, gambling is legal in more than 80% of the countries in the world. Based on a systematic review of research, the authors estimated that 16% of adults and 26% of adolescents who use online casino or slot machine products suffer from gambling-related disorders, and that 9% of adults and 16% of adolescents who use sports betting products suffer from these disorders.
In the United States, 38 states and Washington DC They have legalized sports betting since the Supreme Court overturned a ban in 2018, according to the American Gaming Association. Thirty states allow and regulate mobile sports betting. A 2022 Pew Research survey found that 19% of American adults had placed sports bets in person or online in the past year.
Beyond economic losses, gambling can lead people to lose their jobs, relationships or health, and increase risks of suicide and domestic violence, the report said. According to the Commission, even people who do not have gambling-related disorders suffer from its harm, including casual gamblers and family members of those with gambling problems.
The report highlighted the role that internet gambling has played in the increasing availability of commercial gambling as a whole. The document mentioned legal sports betting apps such as DraftKings or FanDuel as examples in the United States, along with internet casinos and slot machines.
“Accessibility is now 24/7,” said Heather Wardle, a commission researcher and professor of Urban Studies, Social Policy and Health at the University of Glasgow, Scotland. “They can target advertising at you that they know you will respond to. It is incredibly difficult to disconnect (…) Any greater exposure to gambling is associated with greater harm.”
A FanDuel representative indicated that “fully supports a regulated market that protects customers and provide significant tax revenue to states” and that the platform is “helping lead ongoing industry-wide discussions that prioritize creating best practices to protect customers.”
The platform offers its users the possibility of setting limits on their deposits, bets and time spent in their applications, as well as the option to self-limit themselves when continuing to bet.
DraftKings, which declined to comment, offers similar protections. Its website advises users to “always set reasonable limits” and recommends “avoiding gambling if you are recovering from any (gambling) dependence.” Both companies follow state regulations.
In its report, The Lancet commission criticized governments around the world for paying too little attention to the harms of gambling and not enforcing sufficient gambling-related public health protections. The authors recommended that leaders adopt policy frameworks that place the responsibility for minimizing harm on gaming companies, rather than players.
Their suggestions include restricting access to gambling and advertising, launching marketing campaigns about the consequences of gambling, and providing stronger support for those who suffer harm. The authors also call on governments to implement and enforce minimum age requirements and betting limits.
The report noted that several states and countries already have measures of this type. Belgium, the Netherlands and Ontario, for example, apply various restrictions on gambling advertising, including internet gambling. Germany limits the operating hours of physical casinos. Spain, Sweden and Norway have mandatory loss limits for internet betting. And in Massachusetts, Illinois, Virginia and Pennsylvania, in the United States, a percentage of state operators’ income is allocated to gambling rehabilitation funds.
Alan Feldman, director of strategic initiatives at the International Gaming Institute at the University of Nevada, Las Vegas, who was not part of the commission, said many of the safeguards the report suggests already exist.
But he added that he sees some of those rules as “a misunderstanding of what responsible gaming should be.”
“The individual has to accept some responsibility or the treatment won’t work,” said Feldman, who worked for MGM resorts for nearly 30 years and is president emeritus of the industry-funded International Council for Responsible Gaming. “You have to let the decision to play rest with the customer. That said, everyone in the ecosystem has a role in this: game manufacturers, governments, jurisdictions, treatment providers.”
He added that many of the new report’s conclusions “have been known for a long time and are often debated“.
A review published last year found that people who participated in online sports betting reported higher rates of substance use disorders and psychological distress. That study also suggested that gambling advertisements may contribute to the development of gambling problems. Research from 2015 found that online gambling could lead to the onset or worsening of gambling problems.
In recent years, gambling centers in some states have reported an increase in calls to their help lines. Feldman, however, noted that the uptick in problem gamblers seeking help in the United States could be because mental health resources are now more accessible to them.
“We’re experiencing this shift in attitudes about mental health, partly driven by technology. Right now, you or I can see a counselor in less than 60 seconds for anything, including gaming,” he said.
But Wardle maintains that the expansion of commercial gambling poses a threat.
“We know that the game can be associated with very serious damage to healthfor people, and that can be an addictive behavior,” he said. “Our recommendations focus largely on that prioritization of health protection and then the implementation of very strong regulatory systems to be able to protect the public health while still allowing gambling.
