Gambling is easier than ever. Report warns it’s a global ‘threat to public health.’

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It’s everywhere.

Celebrities like Drake post on Instagram about their winnings from online casinos. Podcast ads plug sports betting. Friends casually work “parlay” into group texts.

Gambling has reached new levels worldwide. 

A new report by an international commission of 22 health and policy experts warns of gambling’s risks in the era of easy online access.

“Our conclusion is clear: gambling poses a threat to public health,” said the report published Thursday in the Lancet Public Health journal. Researchers from the World Health Organization and other institutions across five continents said controlling this growing problem requires “a substantial expansion and tightening of gambling industry regulation.”

Gambling disorder, or addiction, has been widely studied for decades. The factors are different than with other forms of addiction: With gambling, people don’t hit a wall − the way people overdose on drugs − unless they run out of money. 

And Las Vegas-style slot machines and game-day wagers are easier to access than ever.

“Anyone with a mobile phone now has access to what is essentially a casino in their pocket, 24 hours a day,” Heather Wardle, the commission’s co-chair and a professor of gambling research and policy at the University of Glasgow, in Scotland, said in a statement. “Highly sophisticated marketing and technology make it easier to start, and harder to stop gambling,” and users are encouraged to have “repeated and longer engagement.”

Worldwide, nearly 450 million adults participate in what’s called “risk gambling,” which can impact finances, mental health, relationships and work, according to the report, which was based on a review and analysis of prior gambling studies. Risk gambling leads to behavioral changes that impact a person’s life and or health, the report says. Around 80 million people arrive at a more severe form, called gambling disorder or problematic gambling.

However, the researchers said that number is likely an undercount.

Gambling disorder affects nearly 16% of adults and more than 26% of adolescents who use online casinos or slot machine games, the report estimated. Addiction is estimated to affect almost 9% of adults and more than 16% of teens who engage in sports betting.

In addition to causing significant financial losses, gambling can increase a person’s risk for suicide and domestic violence, the report noted.

The report examined new gambling laws between 2018 and 2023 across 80 jurisdictions, including most U.S. states. It also examined gambling in countries where it is banned but online access allows it to thrive.

Safe, responsible gaming?

In 2018, the U.S. Supreme Court overturned a prior ban on sports betting. Since then, 38 states have permitted gambling and its popularity has increased exponentially.

Joe Maloney, senior vice president of strategic communications at the American Gaming Association, an industry group, said the gambling industry has worked diligently with state regulators to foster a safe and responsible environment.

Since the 2018 ruling, Maloney said in a statement, “the industry has made significant investments towards advancing responsible gaming initiatives, expanding available consumer resources, and developing tools to promote safer gambling.”

“We firmly support ongoing discussions and the adoption of best practices to ensure the continued implementation of effective safeguards,” he said.

According to the gaming association, the industry has invested hundreds of millions of dollars to promote responsible gaming and it added more than 5,000 regulators across states where gambling is legal. The group materials cite several studies that suggest increased exposure to gambling has not resulted in more cases of addiction.

Among that evidence was the 2023 Massachusetts report by Rachel Volberg, the Lancet’s public health commissioner. Its statewide population surveys, from 2013 to 2021, showed declines in problem gambling as gambling declined overall. The report surveyed people before sports people became legalized in Massachusetts in 2023.

Volberg’s 2024 report released in August suggests there may have been a reversal in these declines. The report used online surveys among monthly gamblers, who are considered a “canary in the coal mine” group for the rise of gambling, according to Volberg, a research professor of epidemiology at the University of Massachusetts Amherst who studies gambling and problem gambling. Those recent results suggest increases in gambling prevalence and harm to people who gamble monthly, including to their financial, social and psychological well-being.

She noted, however, that the effect of easy access to online gambling hasn’t been studied fully.

“Monitoring is needed,” she told USA TODAY. “There is really very, very little done to monitor the impacts of gambling expansion.”

Rationale behind gambling laws

The Lancet report looked at the rationale behind gambling laws. The U.S. laws tend to focus on possible benefits to revenue, whereas European laws focus on dangers to public health.

The U.S. also differs in that it has a patchwork of regulations that differs from state to state, said Lia Nower, director of Rutgers University’s Center for Gambling Studies, in New Jersey. There is no federal regulator that sets overarching standards.

Nower said more young people are turning to betting, which they often access through video games. This is particularly concerning since youth who are exposed are likelier to continue gambling later in life. 

Researchers recommended governments prioritize health when they craft laws about gambling rather than the tax money the businesses could bring. The commission narrowed in on policy solutions, such as reducing the marketing and availability of gambling, curbing government influence on gambling and avoiding research funded by the gambling industry. The report also called for increased oversight to protect children and consumers, nationally and internationally, from the dangerous impact of gambling.

If you or someone you know is struggling with gambling, call or text 1-800-GAMBLER, operated by the National Council on Problem Gambling.

(This story was updated with new information.)

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