Gambling Disorder: Gambling, often seen as a recreational activity, is increasingly recognised as a substantial health concern, with new research showing its wide-ranging effects on both mental and physical health. A recent report from The Lancet Public Health has underscored that gambling disorder and other gambling-related harms are more widespread than previously understood, affecting millions globally.
What Is Gambling Disorder?
Gambling disorder, also referred to as problem or pathological gambling, is characterised by an inability to control one’s gambling habits despite negative consequences. This condition goes beyond recreational gambling, resulting in severe mental, financial, and social repercussions. Globally, an estimated 80 million adults are thought to experience gambling disorder, and over 448 million adults engage in “risk gambling” where gambling causes some form of adverse personal, social, or health consequence, according to the Lancet Public Health Commission, which presented the findings of the study to call for regulatory action.
Impact Of Gambling On Physical And Mental Health
The health implications of gambling disorder may extend beyond financial strain. Individuals with gambling disorder face heightened risks of depression, anxiety, mood disorder, hugh blood pressure, and substance abuse, the study found. Additionally, gambling-related stress has been linked to physical health problems, relationship breakdowns, and a worrying increase in the risk of suicide.
According to Professor Heather Wardle, co-chair of the Lancet commission that produced the report, gambling today is not confined to casinos or traditional lottery tickets. “Anyone with a mobile phone now has access to what is essentially a casino in their pocket, 24 hours a day,” Wardle explained. The rapid growth of digital gambling platforms and sophisticated marketing tactics are key factors making gambling more accessible and addictive.
Problematic gambling, the report said, can occur with mental health conditions that include anxiety and mood disorders, and also with physical health issues such as high blood pressure and headaches.
"Qualitative research evidence clearly links suicidal behaviour or suicidal ideation to gambling, suggesting that gambling might precede many comorbidities, such as depression. Furthermore, qualitative evidence shows that gambling contributes to suicidality through the mechanisms of indebtedness and shame," the report pointed out.
Gambling also has strong ties to criminal activity, the report said, adding that individuals experiencing gambling disorders often get involved in crimes. Gambling enterprises are seen to be tainted by corruption and criminal connections, serving as platforms for activities such as money laundering, match-fixing, and extortion. In 2021, the UN Office on Drugs and Crime reported that up to $1.7 trillion was wagered in illicit gambling markets controlled by organised crime globally. Specifically in Southeast Asia, the UN noted that "casinos and junkets represent a crucial piece of the underground banking and money laundering infrastructure", facilitating transnational organised crime in the region and beyond.
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Who Is Most Vulnerable To Gambling Disorder?
Certain groups are more susceptible to gambling harms than others. Adolescents and young adults are particularly vulnerable, as digital advertising and online gaming often promote gambling in ways that blur lines between games and gambling, the study points out. Socio-economically disadvantaged communities also face a higher risk of developing gambling problems, often due to the financial pressures that make the lure of easy money more enticing. Lower- and middle-income countries face additional challenges, as regulatory frameworks in these regions are often too weak to manage the rapidly growing industry and its impacts.
The digital transformation of the gambling industry has made gambling more pervasive. High-tech design features and persistent marketing strategies encourage repeated engagement, making it challenging for individuals to control their gambling habits. “The global growth trajectory of this industry is phenomenal; collectively we need to wake up and take action,” Wardle said.
The report also highlighted the rising popularity of online casino games and sports betting, both of which see high participation rates among adolescents. An estimated 26.4% of adolescents who engage with online slot games may be at risk of developing gambling-related health problems.
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The Call For Regulatory Reform
Commercial gambling is prevalent in over 80% of countries, but its expansion poses particular risks for lower-income nations. Communities already facing economic hardship bear the brunt of gambling-related health issues, which can exacerbate inequality and hinder progress toward global development goals, such as reducing poverty and improving overall well-being.
Dr. Charles Livingstone from Monash University highlighted Australia’s experience with gambling. Australians spend more on gambling per capita than any other nation, with both online betting and electronic gaming on the rise. “Both online betting, boosted by close connection with football and other sports, and electronic gaming machine gambling continue to grow at a rapid pace here, despite escalating concerns of ordinary people and the voice of those affected by gambling harms becoming more prominent,” Livingstone observed.
As gambling continues to evolve alongside digital technology, experts warn that inaction will make the consequences harder to manage. The Lancet Public Health Commission has emphasised the need for stronger global regulations to address gambling’s health impacts.
Dr. Kristiana Siste from Universitas Indonesia stressed the importance of shielding vulnerable groups from gambling harms. "We need to take action to protect children from the harms of gambling," Siste noted, explaining that early exposure to gambling can lead to higher risks of gambling disorders in adulthood.
The commission took note of the efforts made by the Indian state of Tamil Nadu to recognise the "links between gambling and financial distress and suicidality", referring to the Tamil Nadu Prohibition of Online Gambling and Regulation of Online Games Act, 2022.
To combat the negative impacts of gambling, the report called for comprehensive regulatory measures. These include limiting the promotion and accessibility of gambling products, raising awareness about gambling-related harms, and providing affordable treatment options for those affected. The commission also suggested that organisations like the World Health Organization (WHO) incorporate gambling harms into their health and wellness strategies.
The commission has recommended forming an international coalition to advocate for reduced gambling harms. This alliance would bring together experts, people with lived experiences of gambling disorder, and regulatory bodies to lead international policy efforts. A call for a resolution at the World Health Assembly further underscores the need to prioritise gambling as a public health challenge.