Gambling involves risking something of value (typically money) on an event that has an element of chance, such as a football match or a scratchcard. There are a variety of ways that people gamble, including lotteries, casino games, online gambling, cards, dice, bingo and races. Some gambling is legal and some is not. Gambling can be a serious problem and it is important to understand the risks.
A rough estimate of the amount of money legally wagered annually is $10 trillion. The vast majority of this is on lotteries. State-licensed lotteries can be found throughout the world, with organized football pools being especially common in Europe and the United States. Many countries also offer state-organized or state-licensed wagering on other sporting events, including horse racing, basketball and cricket.
Most adults and adolescents have placed some kind of bet. While most do this without problems, a subset develops a gambling disorder as defined by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. This includes more than 2.5 million U.S. adults (1%) who meet the criteria for a severe gambling disorder. Other estimates suggest that 5-8 million Americans (2-3%) have milder forms of the disorder.
The reasons why some people develop gambling problems are complex and vary between individuals. Some people gamble to relieve stress, change their moods or socialize with friends. In addition, some gambling activities may be rewarded with a release of dopamine, the feel-good neurotransmitter. These brain responses can lead to a feeling of euphoria that makes it hard to stop gambling, even when the chances of winning are low.
Those who have lower incomes may be more vulnerable to developing a gambling disorder, as they might have more to gain from a big win than those with greater wealth. Young people, particularly boys and men, can also be more susceptible to gambling disorders, as can those who start gambling at an early age or play video or mobile games that demand micro-transactions and payments.
The proliferation of gambling products and advertising, including ‘dark nudges’ that exploit cognitive biases, can increase the uptake and harms associated with these activities. Strong regulation of gambling products, combined with clear health promotion messages about harms, can reduce these effects. The disproportionate availability of gambling in areas of high disadvantage and the colocation of products with other activities like sports leagues, can increase uptake. This is often augmented by aggressive promotion in popular media. This can lead to the ‘normalization’ of gambling, making it seem acceptable and desirable in some contexts. A well-designed regulatory framework that includes a definition of harmful gambling is needed to counter these influences. This should include a prohibition on the promotion of gambling products that are likely to cause harm. It should also ensure that warning messages about harmful gambling are effective in communicating their meaning to those at risk. In addition, it should ensure that there are adequate resources to support those who seek help for a gambling disorder.