A public-health crisis, fuelled by ads.

Gambling is a growing public-health crisis.

Public health

Public health is defined as the organized effort of society to keep people healthy and prevent injury, illness and premature death. It is a combination of programs, services and policies that protect and promote the health of all Canadians.¹

A public-health crisis is an occurrence or serious occurrences that harm the health, safety, and well-being of a community or a population.

Gambling as a public-health issue

The harmful effects of gambling are recognized as a health and well-being issue in the majority of the 33 countries that participated in a global review of the public-health approaches to gambling.²

An addictive behaviour

Gambling disorder has been recognized since 1977 as a health disorder within the World Health Organization’s International Classification of Diseases (currently the ICD-11)³, and in 1980, the American Psychiatric Association classified “problem gambling” as a non-substance-related addictive disorder.⁴ Since 2013, it has been considered an addictive disorder akin to “substance abuse disorders such as heroin and cocaine addiction.”⁵

The prevalence of gambling in Canada

A survey by the Canadian Centre on Substance Use and Addiction (CCSA), with Greo Evidence Insights and Mental Health Research Canada, found that the incidence of “problem gambling” has risen to 9.9% of the sampled population, the highest ever reported. Among young adults who gambled online, 69.4% met the criteria for problem gambling and 23.5% reported experiencing a high level of gambling-related harms.⁶

The Canadian Paediatric Society has found that underage gambling is common in Canada and can start as young as 9 or 10 years old.⁷

A study in the Canadian Medical Association Journal found that Ontario’s iGaming expansion drove a 198% increase in gambling-related help-seeking above what would have been expected without it. Among adolescent boys and men aged 15 to 24, the increase was 338%.⁸

Problem-gambling prevalence in Ontario has climbed from roughly 1.1% in 2018 to 11% by the end of 2024. Approximately 44% of Ontarians gambled online last year.⁹

Conclusion

The data are clear. This is not a negligible concern. It is a crisis touching close to half the population in Ontario.⁹

As the CCSA and its co-investigators note, there is a complete absence of a public-health strategy with respect to online gambling, compared to the well-established public-health strategies developed for alcohol, cannabis and tobacco.⁶

A way forward

The World Health Organization, the Canadian Medical Association, the Centre for Addiction and Mental Health, and similar bodies in other countries have recommended comprehensive and concerted action to address the crisis. For example, the WHO recommends:

• ending gambling advertising, promotion and sponsorship of sports and other cultural activities;
• reducing stigma and shame experienced by those harmed by gambling;
• universal account registration with binding pre-commitment and effective self-exclusion tools;
• product-safety measures including universal loss limits, maximum bet sizes and required breaks in gambling sessions;
• effective regulation of gambling providers, including well-resourced enforcement activities;
• addressing gambling-industry corporate political activity and influence on research; and
• counter-messaging that conveys warnings about harms associated with gambling products.

The federal and provincial/territorial governments should institute such protections as soon as possible.