The rise of online betting has led the commercial gambling industry to balloon worldwide, posing a significant threat to public health, according to a new report.
The report, published Thursday, comes from a public health commission on gambling convened by the medical journal The Lancet. The commission’s 22 members — academic experts from a dozen countries — reviewed existing studies and surveys on gambling’s prevalence, impacts and harms and determined that on a global scale, current regulations do not go far enough to protect the public and need to be strengthened.
“We’re not talking about people playing a game with cards around the table anymore,” said the commission’s epidemiology lead, Louisa Degenhardt, a professor at the University of New South Wales in Sydney. “Many people might be really experiencing harms from gambling — we think that it’s probably around 72 million people globally. That number is likely to increase, as we are seeing the increase in commercial organizations targeting people to gamble more.”
Gambling is legal in some capacity in more than 80% of countries worldwide, according to the report. Based on their systematic review of research, the authors estimated that 16% of adults and 26% of adolescents who use online casino or slot products have gambling disorders and that 9% of adults and 16% of adolescents who use sports betting products have such disorders.
In the U.S., 38 states and Washington, D.C., have legalized sports betting since the Supreme Court struck down a ban in 2018, according to the American Gaming Association. Thirty states permit and regulate mobile sports betting. A 2022 Pew Research survey found that 19% of U.S. adults had placed sports bets either in person or online in the last year.
But he said he sees some of those regulations as “a misunderstanding of what responsible gaming is meant to be.”
“The individual has to accept some responsibility or treatment is not going to work,” said Feldman, who worked for MGM resorts for nearly 30 years and is chair emeritus of the industry-funded International Council for Responsible Gaming. “You have to let the decision to gamble rest with the customer. That said, everyone in the ecosystem shares a role in this — manufacturer of games, governments, jurisdictions, treatment providers.”
He added that much of the new report’s findings have “been long-known and often discussed.”
A review published last year found that people who engaged in online sports betting reported higher rates of substance use disorder and psychological distress. That study also suggested that advertisements for gambling can contribute to the development of gambling problems. A 2015 paper found that online gambling could lead to the emergence or aggravation of gambling problems.
In recent years, centers for problem gambling in some states have reported a rise in calls to their helplines. Feldman, however, said the uptick in gamblers seeking help in the U.S. could owe to mental health resources’ having become more accessible to them.
“We’re experiencing this change in attitude about mental health, in part driven by technology. Right now, you or I could get to a counselor in probably under 60 seconds for any number of things, including gambling,” he said.
But Wardle maintained that the expansion of commercial gambling poses a threat.
“We know that gambling can be associated with very severe harms to health, to individuals, and it can be an addictive behavior,” she said. “Our recommendations focus very much on that prioritization of protection of health and then the implementation of very strong regulatory systems to be able to protect public health while still permitting gambling to happen.