Gambling disorder: Gambling, often seen as a recreational activity, is increasingly recognized as a substantial health problem, with new research showing its wide-ranging effects on mental and physical health. A recent one report from The Lancet Public Health pointed out that gambling disorders and other gambling-related harms are more widespread than previously understood, affecting millions globally.

What is gambling disorder?

Gambling disorder, also called problem or pathological gambling, is characterized by an inability to control one’s gambling habits despite negative consequences. This condition goes beyond recreational gambling, resulting in serious mental, financial and social repercussions. Globally, an estimated 80 million adults have a gambling disorder and over 448 million adults engage in “risk gambling”, where gambling causes some form of consequence negative personal, social or health effects, according to the Lancet Public Health Commission, which presented the study’s findings to call for regulatory action.

The impact of gambling on physical and mental health

The health implications of gambling disorder can extend beyond financial strain. People with gambling disorder face increased risks of depression, anxiety, mood disorders, high blood pressure and substance abuse, the study found. In addition, gambling stress has been associated with 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 which produced the report, gambling today is not limited to traditional casinos or lottery tickets. “Anyone with a mobile phone now has access to what is essentially a casino in their pocket, 24 hours a day,” explained Wardle. The rapid growth of digital gambling platforms and sophisticated marketing tactics are key factors that make gambling more accessible and engaging.

Problem gambling, the report said, can occur with mental health conditions that include anxiety and mood disorders, as well as physical health problems such as high blood pressure and headaches.

“Evidence from qualitative research clearly links suicidal behavior or suicidal ideation with gambling, suggesting that gambling may precede many comorbidities such as depression.

Gambling also has strong links to criminal activity, the report said, adding that people with gambling disorders often become involved in crime. Gambling businesses are believed to be plagued 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 on illicit gambling markets controlled by organized crime globally. In Southeast Asia in particular, the UN noted that “casinos and junkets are a crucial part of the underground banking and money laundering infrastructure,” facilitating transnational organized crime in the region and beyond.

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Who is most vulnerable to gambling disorder?

Certain groups are more susceptible to gambling-related harm than others. Teens and young adults are particularly vulnerable because digital advertising and online gaming often promote gambling in ways that blur the lines between gaming and gambling, the study points out. Socio-economically disadvantaged communities also face a greater risk of developing problem gambling, often due to financial pressures that make the lure of easy money more appealing. Low- and middle-income countries face additional challenges, as regulatory frameworks in these regions are often too weak to manage the fast-growing industry and its impacts.

The digital transformation of the gambling industry has made gambling more widespread. High-tech design features and persistent marketing strategies encourage repeat engagement, making it difficult 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,” said Wardle.

The report also highlighted the growing popularity of online casino games and sports betting, both of which saw high participation rates among teenagers. It is estimated that 26.4% of teenagers who engage in 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 more than 80% of countries, but its expansion poses particular risks to lower-income countries. Communities already experiencing economic hardship bear the brunt of gambling-related health problems, which can exacerbate inequality and hinder progress towards global development goals such as reducing poverty and improving overall well-being.

Dr Charles Livingstone of 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 a close association with football and other sports, and electronic gambling continue to grow at a rapid pace here, despite the growing concerns of ordinary people and the voice of those affected by the harms of gambling becoming increasingly 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 highlighted the need for stronger global regulations to address the health impact of gambling.

Dr. Kristiana Siste from Universitas Indonesia emphasized the importance of protecting vulnerable groups from the harms of gambling. “We need to take steps to protect children from the harms of gambling,” Siste noted, explaining that early exposure to gambling can lead to higher risks of developing gambling disorders in adulthood.

The Commission took note of the efforts made by The Indian state of Tamil Nadu to recognize the “linkages between gambling and financial hardship and suicidality”, referring to the Tamil Nadu Online Gambling Prohibition and Regulation of Online Gaming Act, 2022.

To combat the negative impact of gambling, the report called for comprehensive regulatory measures. These include limiting the promotion and accessibility of gambling products, raising awareness of gambling-related harm and providing affordable treatment options for those affected. The commission also suggested that organizations such as the World Health Organization (WHO) include the harmful effects of gambling in their health and well-being strategies.

The commission recommended the formation of an international coalition to advocate for the reduction of gambling-related harm. This alliance would bring together experts, people with lived experience of gambling disorder and regulatory bodies to lead international policy efforts. A call for a resolution at the World Health Assembly further emphasizes the need to prioritize gambling as a public health challenge.

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