A dramatic rise in online gambling is fueling an industry boom with significant consequences for public health, according to a new report published by The Lancet’s Public Health Commission on Gambling. The commission’s findings highlight how the 24/7 accessibility of online gambling platforms has rapidly expanded gambling participation worldwide, endangering millions and straining global health resources.
The report, released on Thursday, was compiled by 22 academic experts from 12 countries who analyzed data on gambling prevalence and its impacts across age groups and demographics. Their review reveals a troubling picture: an estimated 72 million people globally may suffer from gambling-related harm, a figure poised to rise as the industry grows. The commission’s lead epidemiologist, Professor Louisa Degenhardt of the University of New South Wales, emphasized that commercial gambling companies aggressively target users, increasing the likelihood of addiction and serious health consequences.
“We are seeing an industry shift that goes beyond casual games; it’s a 24/7 enterprise with millions being influenced to gamble more,” Degenhardt stated. “Our research shows an urgent need to address this shift through stronger regulatory frameworks that prioritize public health.”
The commission’s findings spotlight a surge in gambling disorder rates among online users, especially among youth. According to their review, 16% of adults and 26% of adolescents who engage in online casinos or slots experience gambling disorders, while similar patterns emerge for online sports betting. These findings align with trends in the U.S., where sports betting is legal in 38 states and continues to grow rapidly; a recent survey indicated that nearly 19% of U.S. adults placed sports bets in the past year.
“This access is all-encompassing,” said Professor Heather Wardle from the University of Glasgow. “Online platforms not only allow 24-hour gambling but also target specific ads based on user behavior, making it difficult for individuals to disengage.”
The report urges governments to pivot from permissive policies toward stronger health protections. Among the recommendations are limits on advertising, reduced accessibility to gambling sites, and heightened support for those affected by gambling-related harm. The commission also suggests establishing age requirements, betting limits, and public awareness campaigns on gambling’s impact.
Some countries are already adopting such measures: Belgium, the Netherlands, and Ontario, for instance, impose restrictions on gambling advertisements, while Spain and Norway enforce loss limits. U.S. states like Massachusetts and Pennsylvania earmark portions of gambling revenues for rehabilitation programs. However, commission members argue these steps only scratch the surface of what’s needed to safeguard public health.
“The primary responsibility shouldn’t fall on the individual,” Wardle added. “Gambling companies must be accountable for creating safer systems and limiting harmful exposures.”
Leading online gambling companies, such as FanDuel and DraftKings, have responded by implementing user controls like spending limits and self-exclusion tools. FanDuel’s representative reiterated their support for “regulated markets that protect customers and provide tax benefits for states,” while DraftKings has advised users to set personal limits and avoid gambling if in recovery. Yet, critics argue that self-regulation alone cannot address the health issues raised by widespread gambling accessibility.
According to Alan Feldman, director at the University of Nevada, Las Vegas’ International Gaming Institute, the solution also lies in individual accountability, alongside regulation. “While regulation is important, treatment and responsible gaming require that the decision to gamble lies with the consumer,” Feldman commented.
With gambling addiction often linked to financial distress, mental health issues, and increased risks of domestic violence, the report argues that a comprehensive approach is crucial. The commission’s recommendations aim to create safer gambling environments without removing access entirely, focusing on effective regulation to balance public health with industry growth.
As commercial gambling continues to expand globally, the commission’s call for decisive action underscores the need for health-centered policy reform. By strengthening regulations now, the commission hopes to mitigate gambling’s growing toll on individuals and societies alike.
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