Analysis & backgrounders

Public health resources.

A curated reading list: gambling as a recognized addictive disorder, and the peer-reviewed evidence that advertising exposure drives gambling harm — especially for children and young people.

Gambling — a recognized addictive disorder

1. Gambling disorder is classified as a non-substance-related addictive disorder.

Gambling disorder is classified as a non-substance-related disorder within “Substance-Related and Addictive Disorders” in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) (American Psychiatric Association, 2013). In the Manual, gambling as a mental illness is described as follows:

Gambling can cause low self-esteem, stress, anxiety and depression if gambling becomes a problem. Gambling can become an addiction, just like drugs or alcohol, if you use it compulsively or feel out of control. Gambling can affect the part of our brain that releases dopamine.

2. Gambling as a public health challenge.

This announcement from the University of Bath (July 3, 2020) explains how “the ‘gamblification’ of sports over recent years poses significant challenges for individuals, families and community wellbeing according to new research”.

The impact of advertising

1. What is the evidence that advertising policies could have an impact on gambling-related harms? A systematic umbrella review of the literature.

E. McGrane, H. Wardle, M. Clowes, L. Blank, R. Pryce, M. Field, C. Sharpe, E. Goyder — Public Health, Volume 215, February 2023 (ScienceDirect). In summarizing the results of their review, the authors state:

Included studies, using quantitative and qualitative methods, consistently support the existence of a causal relationship between exposure to advertising of gambling products/brands and more positive attitudes to gambling, greater intentions to gamble and increased gambling activity at both individual and population level. There is evidence of a ‘dose–response’ effect; greater advertising exposure increases participation which leads to a greater risk of harm.

The authors conclude:

Gambling advertising restrictions could reduce overall harm and mitigate the impact of advertising on gambling-related inequalities. Public health harm prevention strategies should include policies which limit exposure to advertising, particularly among children and vulnerable groups.

2. How EU countries are tightening restrictions on gambling ads.

This article in The Conversation (February 13, 2023), written by marketing experts at the University of Bristol, explains why a reform of gambling advertising is needed, addresses the research showing that certain types of advertising used by the sports betting companies are particularly appealing to children and young people, and summarizes the restrictions imposed in other countries — including a complete ban on all gambling advertising in Italy and an almost complete ban in Belgium. See also our International Comparison page.

3. Ipsos: nearly half of Canadians think gambling ads have gotten out of hand.

In a report published January 18, 2023, Ipsos polling finds that Canadians are experiencing fatigue from gambling advertising.

4. Protecting children and young people from contemporary marketing for gambling.

Samantha Thomas, May C I van Schalkwyk, Mike Daube, Hannah Pitt, Darragh McGee, Martin McKee — Health Promotion International, Volume 38, Issue 2, April 2023 (Oxford University Press). From the authors' lay summary:

Gambling marketing has become particularly pervasive and aligned with major cultural activities such as sport.
Evidence clearly shows the normalizing impact of marketing on children and young people's gambling attitudes and consumption intentions.
Current regulatory efforts are inadequate and have not protected children and young people from exposure to a range of different forms of marketing.
Young people and their parents support the implementation of significant restrictions on gambling marketing.
The array of marketing mechanisms used by the gambling industry should be addressed as part of a comprehensive public health policy approach to protect children from gambling harms.

The authors conclude by recommending government action:

…while recognizing that the industry will work hard to circumvent it, the evidence in this paper justifies suggesting a total ban on commercial advertising for gambling, as occurs with tobacco in many jurisdictions, and this should at least be discussed. Primary responsibility for action to protect children and young people rests with governments.

5. CAMH's submission to the Alcohol and Gaming Commission of Ontario.

On May 9, 2023, CAMH responded to the AGCO's proposal to restrict the participation of athletes and celebrities in gambling advertising. In its introduction, CAMH states:

A recent review of the scientific literature found that there is a causal relationship between people's exposure to gambling advertising and their intentions to gamble as well as increased gambling activity. Children and youth, as well as those already experiencing gambling problems, are especially susceptible to these effects.

Beyond the proposed restrictions, CAMH encouraged the province to enact a whistle-to-whistle advertising ban covering all gambling content, and summarized the sharp increase in calls to the Ontario Problem Gambling Hotline regarding online gambling since June 2021.

6. The Guardian bans all gambling advertising.

On June 15, 2023, The Guardian announced a global ban on gambling advertising across all of its outlets, arguing it is unethical to take money from services that can lead to “addiction and financial ruin”. The studies behind the decision are summarized by the University of Sheffield: exposure to gambling advertising is linked to attitudes, intentions and behaviours associated with greater risk of harm — with children, young people, and those already at risk most likely to be influenced.

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