The rise of online gambling and its impact on public health

In recent years, online gambling has surged in popularity, transforming from a niche activity into a global phenomenon. With the advent of smartphones and the internet, gambling is now accessible anytime, anywhere, bringing with it significant public health concerns. This article explores the rapid growth of online gambling, its societal and health implications, and the urgent need for effective regulation and intervention.

The Explosive Growth of Online Gambling

The global gambling industry has undergone a seismic shift, driven by technological advancements and widespread legalization. In 2024, the industry generated over 700 billion in revenue, with projections suggesting it could reach 700 billion in revenue,with projections suggesting it could reach 1 trillion by 2030. Online gambling, in particular, has become a dominant force, accounting for a significant portion of this growth.

The U.S. Supreme Court’s 2018 decision to lift the federal ban on sports betting paved the way for individual states to legalize the activity. As of 2025, 38 states, Washington D.C., and Puerto Rico have legalized sports wagering9. Similarly, Canada legalized single-event sports betting in 2021, and Ontario opened its doors to private online gambling operators in 2022.

This legalization has been accompanied by aggressive marketing campaigns, with gambling ads becoming ubiquitous during sports events. Jeremy Alleyne, a basketball coach near Toronto, noted, “Sports betting is now so intertwined with sports as a whole, you can’t watch an entire game without seeing an ad”.

The Public Health Crisis

While the gambling industry thrives, the public health consequences are becoming increasingly apparent. Gambling disorder, recognized as a behavioral addiction, affects approximately 1.2% of the global adult population, with millions more experiencing harm from gambling.

Mental and Physical Health Impacts

Problem gambling is associated with severe mental health issues, including anxiety, depression, and suicidality. A Swedish study found that individuals with gambling disorder were 15 times more likely to die by suicide than the general population10. In Victoria, Australia, at least 4.2% of suicides were linked to gambling.

Theodore Oliver, a 27-year-old from Saskatoon, shared his harrowing experience: “It consumed my life. I thought about it. I dreamt about it.” His addiction led to financial ruin, deteriorating health, and strained relationships before he sought help.

Social and Economic Harms

Gambling harms extend beyond the individual, affecting families and communities. For every person with a gambling disorder, an average of six others—often family members—are impacted. These harms include relationship breakdowns, domestic violence, and financial distress.

In low-income and middle-income countries, where regulatory infrastructure is often weak, gambling exacerbates poverty by diverting household spending from essential needs like food, healthcare, and education.

Vulnerable Populations at Risk

Young people are particularly susceptible to gambling addiction. In Massachusetts, 46% of middle and high school students reported gambling in the past year9. Early exposure to gambling promotions and the allure of “easy money” increase the risk of developing gambling problems later in life.

Additionally, individuals experiencing significant life stressors—such as unemployment, retirement, or the death of a loved one—are at heightened risk.

The Role of Technology and Marketing

The rise of online gambling has been fueled by technological innovations and sophisticated marketing strategies. Mobile apps and high-speed wagering platforms make gambling more accessible and immersive than ever before.

Shekhar Saxena, a professor of global health at Harvard, warned that online gambling is “up to 10 times more harmful” than traditional gambling due to its continuous and intense nature. The design of these platforms often exploits cognitive biases, encouraging prolonged use and increasing the risk of addiction.

Aggressive advertising further normalizes gambling, particularly among young people. In Australia, gambling ads saturate sports broadcasts, with children exposed to an average of gambling ads per year.

The Need for Regulation and Intervention

Addressing the public health crisis caused by online gambling requires a multifaceted approach. Experts advocate for stricter regulations, including limits on advertising, mandatory pre-commitment tools, and universal account registration with binding loss limits.

Advertising Restrictions

Many jurisdictions have begun to curb gambling advertising. Ontario, for example, banned celebrities from appearing in gambling commercials in 2024. However, experts argue that more comprehensive measures are needed to reduce the normalization of gambling.

Public Health Interventions

Universal, population-wide interventions are essential to prevent gambling harm. These include clear warning messages about the risks of gambling, effective self-exclusion tools, and restrictions on access and availability.

Treatment and Support

Treatment for gambling disorder often involves cognitive behavioral therapy, motivational interviewing, and pharmacological interventions. However, stigma and shame frequently prevent individuals from seeking help. Increasing awareness and reducing stigma are critical to improving treatment uptake.

A Call to Action

The rapid expansion of online gambling presents a significant public health challenge. Governments, policymakers, and public health experts must prioritize the protection of vulnerable populations over commercial interests. As Timothy Fong, co-director of the UCLA Problem Gambling Studies Program, emphasized, “Online gambling has to be regulated just like food safety, air quality, and water quality, because it is an issue of public health”9.

The stakes are high, but with coordinated efforts, it is possible to mitigate the harms of online gambling and create a safer, healthier society.