Gambling is a global activity, involving wagering on events that involve chance. It can be conducted with real money, and also with materials that have value but are not monetary, such as marbles in a game of marbles or collectible card game pieces (pogs and Magic: The Gathering). There is a significant international trade in gambling products, and the overall volume of legally wagered money is estimated at $10 trillion per year. It is a major cause of harm and can erode public health, social, and economic well-being, contributing to substance use disorder, mental illness, and suicide.
There are many factors that increase the risk of developing a gambling problem. Men are more likely to develop a gambling problem than women, and people who have a family history of gambling problems are at greater risk of developing one themselves (1). People who play video games and mobile apps, which often require micro-transactions and payments, are at risk of becoming addicted to gambling (2). In addition, children as young as seven can become involved in gambling activities (3). Gambling harms can also occur among vulnerable populations, such as racial minorities and the elderly (4).
In developed countries, gambling is heavily regulated by governments, and the industry is subject to rigorous scrutiny of its product design and advertising practices. However, in many low- and middle-income countries gambling is not adequately regulated and it is rapidly becoming a major driver of public health harms. There is a need for strong international cooperation to ensure that gambling policies and practices do not impede progress toward the Sustainable Development Goals (SDGs) (5).
The proliferation of gambling products and their easy availability is driving the normalization of gambling, increasing the likelihood of harmful consumption. Easy accessibility is facilitated by the presence of gambling products in public spaces, including in social media, and through commercial associations with sporting or other popular events, such as football pools, and aggressive marketing in the media. It is also exacerbated by the use of so-called dark nudges, which exploit gamblers’ cognitive biases to promote extended gambling products (6).
While it is not possible to completely eliminate gambling-related harms, there are a number of effective measures that can be taken to reduce their impact on individuals and communities. This includes implementing universal pre-commitment systems that require people to set binding limits on the time and amount they spend gambling, as well as self-exclusion from gambling providers. These systems must be enforceable, as voluntary approaches are not effective and have poor uptake (7).
Another important step is to raise awareness of the harms of gambling and encourage people to seek help when needed. This can be done through education, advocacy, and community action. Those who have a gambling problem should be encouraged to seek support from their family and friends, health professionals, local services, and support groups. They should also be offered treatment options, such as brief interventions and/or pharmacological treatments. If they do not seek help, there is a risk that their gambling will continue to worsen and can lead to serious consequences, such as financial debt, legal disputes, family breakdown, addiction, and suicide (8).
