The report from the Lancet Commission examines the widespread impact of gambling, particularly through mobile technology that allows people to access gambling platforms at any time. With around 450 million people engaged in high-risk gambling globally, this activity affects personal finances, mental health, and social relationships.
Gambling disorder, a severe form of gambling addiction, impacts approximately 80 million people, with rates especially high among users of online casinos and sports betting. The report notes that sophisticated marketing tactics and ease of access to gambling contribute to prolonged engagement, making it difficult for users to stop, and placing adolescents especially at risk.
The social effects of gambling are profound, contributing to increased rates of suicide, domestic violence, and economic hardship for those affected. The commission reviewed global gambling laws implemented from 2018 to 2023 across 80 regions, including many U.S. states and territories where gambling is banned yet still accessible online.
Following the 2018 U.S. Supreme Court decision to lift a federal sports betting ban, 38 states now permit gambling, leading to a sharp rise in its popularity. The American Gaming Association, an industry group, emphasizes its commitment to responsible gaming, investing millions in resources to encourage safe gambling practices in states where it is legal.
Evidence of gambling harm varies. A 2023 Massachusetts study initially indicated a decrease in problem gambling from 2013 to 2021, but a 2024 follow-up showed an uptick in gambling-related harm among monthly gamblers.
This reversal is thought to reflect increased access to online gambling, although further study is needed to fully understand its effects. Rachel Volberg, a public health commissioner, points out that the impact of online gambling is under-researched, highlighting a lack of consistent data on its social and health consequences.
The rationale behind gambling regulations varies, with U.S. laws generally emphasizing revenue benefits, while European regulations prioritize public health concerns. This regulatory diversity in the U.S. results in varying standards across states, as there is no federal body to set unified regulations.
Lia Nower, a gambling expert at Rutgers University, warns that more young people are introduced to gambling through video games, increasing their likelihood of gambling into adulthood. This exposure, especially among youth, highlights the need for consistent guidelines on online gambling to reduce its health risks.
The Lancet Commission urges a health-focused approach to gambling laws, recommending that governments emphasize harm prevention rather than revenue generation.
Key policy suggestions include limiting gambling accessibility, curbing advertising, reducing government reliance on gambling revenue, and increasing regulatory oversight to protect consumers. Additionally, the report calls for policies to protect vulnerable groups, particularly children and adolescents, by prioritizing public health and consumer safety over industry profits.
