Health Experts Sound the Alarm: Addressing Gambling Harms in the Digital Age

A global coalition of over 300 health and addiction experts has issued a unified call, urging national governments, regulatory bodies, and international organizations to confront what they describe as a growing public health crisis: gambling addiction. This appeal, prominently featured in the Journal of Behavioral Addictions, highlights a notable rise in addiction rates across populations worldwide, largely attributed to the widespread availability of online gambling and sports betting.

Leading this significant initiative is Professor Zsolt Demetrovics of Flinders University, whose work underscores the urgent need for a coordinated, evidence-based approach to address gambling harm. The experts from across 35 countries recognize that the proliferation of accessible digital gambling platforms has led to more individuals meeting the diagnostic criteria for “gambling disorders.” This isn’t merely an academic concern; it’s a call to action for a problem that is increasingly affecting communities globally.

The Shifting Landscape of Gambling: Online Growth and Accessibility

The gambling industry has undergone a profound transformation, moving from traditional brick-and-mortar establishments to a vast, interconnected online ecosystem. This shift is primarily driven by advancements in technology and ubiquitous internet access, coupled with the increasing penetration of smartphones globally. The numbers tell a compelling story: the global online gambling market was valued at an estimated USD 95.5 billion in 2024 and is projected to surge to approximately USD 257 billion by 2034, reflecting a compound annual growth rate (CAGR) of 10.5%. Other estimates place the 2024 market size at around USD 78.66 billion, with projections reaching USD 153.57 billion by 2030, growing at an 11.9% CAGR. Regardless of the exact figures, the trend points to substantial and sustained expansion.

A significant part of this growth comes from sports betting. In the United States, for instance, the number of states where sportsbooks operate expanded from just one in 2017 to 38 by 2024. This legalization surge saw total sports wagers skyrocket from $4.9 billion in 2017 to $121.1 billion in 2023, with a staggering 94% of these bets placed online. The convenience and privacy offered by online platforms, especially mobile applications, have made gambling more accessible than ever before, contributing to higher rates of problematic behavior. Live “in-play” betting, which allows wagers on specific events as a game unfolds, has further shortened the interval between placing a bet and receiving a reward, intensifying the gambling experience and increasing risk.

Technological Innovations Fueling Engagement and Risk

Beyond simple accessibility, sophisticated technologies are enhancing user engagement in online gambling. Artificial intelligence (AI), for example, is revolutionizing the industry by offering personalized gaming experiences, optimizing marketing strategies, and improving platform security. AI algorithms analyze player behavior and preferences, suggesting tailored games and optimizing loyalty programs. They can also be instrumental in real-time odds adjustments and advanced fraud detection systems. Virtual Reality (VR) casinos are also emerging, promising immersive experiences that replicate physical casinos within players’ homes.

However, these innovations, while boosting the industry’s bottom line, also heighten the risks for individuals. The constant availability, personalized prompts, and rapid feedback loops can accelerate the development of gambling disorders. Even within these innovations, there is a parallel universe of crypto gambling, which offers anonymity and fast blockchain transactions, further expanding the reach and complexity of the online betting landscape. The global crypto gambling market, estimated at USD 6.6 billion in 2024, is projected to reach USD 17.1 billion by 2031 with a CAGR of 15.1%. Information on crypto casinos can be found at InsideBitcoins.com/crypto-casinos.

The Human Cost: A Growing Public Health Concern

The rise of online gambling platforms has unfortunately coincided with a concerning increase in problem gambling behaviors. Estimates suggest that between 1% and 3% of online gamblers exhibit problematic behaviors, though the actual prevalence is likely higher as these figures often only account for those seeking professional help. The World Health Organization (WHO) estimates that approximately 1.2% of the global adult population has a gambling disorder. Moreover, problem gambling significantly impacts individuals beyond direct financial losses, leading to severe emotional and psychological suffering, including guilt, shame, difficulty sleeping, low self-esteem, anxiety, depression, and even suicidal thoughts. A 2025 study from the University of California, Los Angeles, for example, found a link between the spread of legal sports betting and increased problematic debt and bankruptcies.

Vulnerable Populations at Elevated Risk

The call from health experts specifically emphasizes the need to focus on vulnerable and minority groups, including young people, who are disproportionately affected by gambling related harm. Research consistently shows that young adults, particularly those aged 18 to 24, face a heightened risk of developing gambling problems. Their brains are still developing, with decision-making abilities and impulse control not yet fully matured, making them more susceptible to risky behaviors. Gambling disorders can even begin in children as young as 10 years old, with problem gambling impacting 4-8% of youths, a significantly higher rate than the 1% observed in adults. Adolescents and young people are increasingly drawn into gambling through innovative advertising, new technologies, and gambling-like elements embedded in video games and esports. Men also statistically show higher rates of gambling problems, although this gap is narrowing as more women engage in online gambling. Furthermore, individuals with pre-existing mental health conditions like depression and anxiety are at increased risk, often using gambling as a coping mechanism, which can exacerbate their existing issues.

A Global Regulatory Patchwork and Industry Landscape

The regulatory landscape for online gambling is a complex tapestry, varying significantly across countries and regions. While gambling is now legal in approximately 80% of countries globally, the approaches to regulation differ widely.

Consider the contrasting models of the United States and the United Kingdom. The U.S. employs a decentralized, state-by-state approach, resulting in a complex and often inconsistent legal framework. Each state crafts its own laws and regulations, leading to a patchwork of permissible activities and consumer protections. This fragmented system means operators must navigate varied legal requirements, and players face inconsistent protections depending on their location. For instance, while sports betting has expanded rapidly, casino-style online gambling remains highly restricted in many U.S. states. This overview of US and UK regulations provides more detail.

In contrast, the UK operates under a centralized system governed by the UK Gambling Commission (UKGC), which oversees all forms of gambling with a uniform set of rules since the Gambling Act 2005. This approach provides a clear framework for licensing and robust consumer protection measures, such as mandatory self-exclusion schemes and age verification processes. A notable distinction is that UK players are generally not taxed on their winnings, unlike in the U.S. where winnings can be taxed at varying rates.

Other regions present their own legislative nuances. Germany, for example, fully legalized online sports betting and casino games in 2021 with the Interstate Treaty on Gambling (GlüNeuRStV), attracting more legal operators, though challenges like strict deposit limits and advertising restrictions remain. Despite stringent regulations in some areas, the existence of offshore betting sites and underground online casinos, often circumventing bans using VPNs and cryptocurrencies, highlights persistent challenges in enforcement.

The industry itself is dominated by major players such as Bet365, Flutter Entertainment, Entain plc, and 888 Holdings. Other significant operators include William Hill, Betsson AB, Ladbrokes Coral Group PLC, The Stars Group Inc., and Kindred Group PLC. In the U.S., major sports betting apps like DraftKings Sportsbook, BetMGM Sportsbook, and Caesars Sportsbook have become household names.

Cultivating Responsible Gambling through Technology and Collaboration

The experts’ appeal is not merely about identifying the problem; it is a profound call for practical, evidence-based solutions. Professor Demetrovics and his colleagues emphasize that while gambling is a growing public health concern, there is a lack of clear guidance to prioritize research. They argue for effective early prevention, robust evidence-based policy, and tailored treatment programs as key priorities. The team plans to identify core research priorities to make the most of limited financial and human resources in this area.

Responsible gambling initiatives are crucial here. These include widely implemented self-exclusion programs, both state-run and offered by individual operators, which allow individuals to voluntarily ban themselves from gambling platforms. Age verification, deposit limits, and strict advertising regulations are also essential safeguards. Organizations like the Responsible Gambling Council (RGC) and the National Council on Problem Gambling (NCPG) work to promote safer gambling practices through education, prevention, and support services.

Intriguingly, technology itself offers tools to mitigate harm. AI algorithms, while contributing to personalized engagement, can also monitor player activity for patterns indicative of problem gambling. If such patterns are detected, the system can trigger intervention measures, such as prompting players to set limits or providing access to addiction support resources. This dual role of technology highlights the ongoing challenge and opportunity in regulating a digitally driven industry.

Charting a Path Forward

The medical community is advocating for a universally applicable framework for preventing gambling related harm, one that is flexible enough to be tailored to specific geographic and demographic contexts. This involves not only prevention but also comprehensive treatment programs. The goal is to move beyond reacting to addiction and instead build proactive systems that protect individuals and communities. The World Health Organization emphasizes population-wide public health approaches, including ending gambling advertising, reducing stigma, implementing universal account registration with binding pre-commitment, and establishing product safety measures like loss limits and maximum bet sizes.

The collective voice of these hundreds of experts underscores a shared conviction: addressing gambling addiction requires a united front from governments, regulators, and the industry itself, all working to prioritize public health and well-being. By focusing on evidence, supporting research, and implementing thoughtful, comprehensive policies, we can strive to mitigate the harms of gambling in our increasingly digitized world. Further details on specific interventions and research needs can be found via the Journal of Behavioral Addictions.