Gambling is betting something of value, with awareness of risk and hope for gain, on an uncertain event whose outcome may be determined by chance or accident. It includes traditional activities like casinos, lotteries, and betting on sports, but also online gambling, fantasy leagues, scratch tickets and DIY investing (e.g., in stock markets). Gambling is a major global industry that generates substantial harms. These include family stress, financial difficulty, mental illness and suicide, addiction, and a legacy of harm that can persist across generations. Harms can also undermine economic development by reducing household spending on essential goods and services.
Understanding what makes certain people vulnerable to developing gambling problems could help inform prevention and treatment. For example, research suggests that some people are attracted to the escapism of gambling and the potential for instant gratification, while others are more likely to be impulsive and less able to control their spending. These characteristics can be influenced by social and family environment as well as genetic factors.
In addition to these factors, it is important to consider the context in which gambling takes place. Many gambling products are highly accessible, especially in low- and middle-income countries, where access to the internet has enabled the proliferation of online and mobile gaming. This normalization of gambling increases the likelihood of problem development. It is also exacerbated by aggressive advertising and promotion of gambling products, including sponsorship of major sporting events and colocation of gambling products with retail and entertainment outlets.
Moreover, the psychological and social dimensions of gambling are complex. It is not easy to determine whether someone has a gambling disorder, and it is even more difficult to determine which treatments are effective. Some researchers believe that gambling disorders can be conceptualized as a continuum of severity, whereas others view them as a unidimensional construct.
In terms of the health impacts of gambling, the most serious problems are related to compulsive and pathological gambling. Compared to nonpathological gamblers, those who have pathological gambling are more likely to be at risk for heart disease and other medical problems, have higher unemployment rates, and have poorer work-related performance. Moreover, the effects of gambling on health are widespread and often cross socioeconomic lines. It is therefore important to understand the health impacts of gambling and the role that governments should play in addressing them. Efforts to reduce gambling harms should be undertaken at population-level and include ending advertising and promotions, centralized account registration that requires those who gamble to set binding loss limits, restrictions on availability of gambling products (e.g., hours, density), and the use of counter-messaging that communicates warnings about harms. These measures will help reduce the incidence of gambling-related harms and improve outcomes for those who already have gambling disorders. They will also be critical to reducing the economic impact of gambling in low- and middle-income countries. In the future, these efforts will need to be extended to broader interventions that address underlying drivers of harm.