Growing Health Concern Regarding Gambling Addiction in the Age of Sportsbooks

Atharva Yeola; Matthew R Allen; Nimit Desai; Adam Poliak; Kevin H Yang; Davey M Smith; John W Ayers

doi:10.1001/jamainternmed.2024.8193

. 2025 Feb 17;185(4):382–389. doi: 10.1001/jamainternmed.2024.8193

Growing Health Concern Regarding Gambling Addiction in the Age of Sportsbooks

Atharva Yeola ^1,², Matthew R Allen ^3,⁴, Nimit Desai ^3,⁴, Adam Poliak ⁵, Kevin H Yang ⁶, Davey M Smith ^4,⁷, John W Ayers ^2,^4,^7,^✉

¹Department of Electrical and Computer Engineering, University of California, San Diego, La Jolla

²The Qualcomm Institute, University of California, San Diego, La Jolla

³School of Medicine, University of California, San Diego, La Jolla

⁴Altman Clinical Translational Research Institute, University of California, San Diego, La Jolla

⁵Department of Computer Science, Bryn Mawr College, Bryn Mawr, Pennsylvania

⁶Department of Psychiatry, University of California, San Diego, La Jolla

⁷Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, La Jolla

Accepted for Publication: November 29, 2024.

Published Online: February 17, 2025. doi:10.1001/jamainternmed.2024.8193

^✉

Corresponding Author: John W. Ayers, PhD, MA, Qualcomm Institute, 9500 Gilman Dr, 3014 Atkinson Hall, La Jolla, CA 92093 (ayers.john.w@gmail.com).

Author Contributions: Dr Ayers had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Yeola, Allen, Poliak, Smith, Ayers.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: Yeola, Allen, Desai, Yang, Smith, Ayers.

Critical review of the manuscript for important intellectual content: All authors.

Statistical analysis: Yeola, Ayers.

Obtained funding: Smith.

Administrative, technical, or material support: Allen, Poliak, Yang.

Supervision: Smith, Ayers.

Conflict of Interest Disclosures: Dr Smith reported grants from the National Institutes of Health during the conduct of the study as well as personal fees from Model Medicines (including stock options), Hyundai Biosciences, Red Queen Therapeutics, and Gilead and stock options in Lindear Therapies outside the submitted work. Dr Ayers reported equity in Health Watcher, Good Analytics, and Medeloop outside the submitted work. No other disclosures were reported.

Data Sharing Statement: See Supplement 2.

^✉

Corresponding author.

PMCID: PMC11833657 PMID: 39960737

Key Points

Question

How has sports betting in the US evolved since the Murphy v National Collegiate Athletic Association decision of the US Supreme Court, and what association has this had with gambling addiction help-seeking?

Findings

In this time series study of US states with legalized sports betting, it was found that sportsbooks (physical or online places where individuals can place wagers on the outcomes of sporting events) have expanded from a single state to 38 states, with wagers increasing from $4.9 billion in 2017 to $121.1 billion in 2023. Pre/post analyses revealed substantial national increases in online searches for gambling addiction after Murphy v National Collegiate Athletic Association, with pronounced increases in states that introduced online sportsbooks.

Meaning

These findings emphasize the need for public health efforts to study and address the potential harms associated with the rapid growth of sports betting.

Abstract

Importance

The US Supreme Court decision Murphy v National Collegiate Athletic Association allowed states beyond Nevada to legalize sports betting, including online wagers. How sports betting has evolved and its association with gambling harms has not been studied.

Objective

To describe how US sports betting evolved after Murphy v National Collegiate Athletic Association and offer insights into the potential health effects of sportsbooks, which are platforms for wagering on sporting events.

Exposure

Enactment of (1) Murphy v National Collegiate Athletic Association nationally and (2) the opening of retail or online sportsbooks in states.

Design, Setting, and Participants

In this longitudinal study, aggregate US internet search trends for gambling addiction and wagers on sports were described before and after the emergence of legalized sportsbooks.

Main Outcomes and Measures

Internet searches per 10 million queries that mentioned gambling and addiction, addict, anonymous, or hotline (such as gambling addiction hotline) made to Google from January 1, 2016, through June 30, 2024.

Results

The number of states with operational sportsbooks increased from 1 during 2017 to 38 during 2024. Total sports wagers increased from $4.9 billion during 2017 to $121.1 billion during 2023, with 94% of wagers during 2023 being placed online. There were 23% (95% CI, 15%-30%) more searches nationally for gambling addiction help-seeking after Murphy v National Collegiate Athletic Association. Massachusetts (47%; 95% CI, 21%-79%), New Jersey (34%; 95% CI, 21%-45%), New York (37%; 95% CI, 26%-50%), and Pennsylvania (50%; 95% CI, 35%-66%) each had more searches than expected after the opening of any sportsbooks in their state. Additional analyses suggest the opening of online, vs retail, sportsbooks corresponded with a larger increase in searches.

Conclusions and Relevance

The results of this time series study suggest that access to sportsbooks, sports wagers, and potential help-seeking for gambling addiction increased substantially and highlight the need to address the health implications of sportsbooks, including recognition and treatment of gambling problems and their broader societal implications.

This time series study examines the association between expanded legalization of sportsbooks in the US and gambling addiction help-seeking.

Introduction

Before the US Supreme Court Murphy v National Collegiate Athletic Association (NCAA) decision on May 14, 2018, gambling in the US was confined to locations like tribal lands; Las Vegas, Nevada; and Atlantic City, New Jersey. The decision to dismantle the 1992 Professional and Amateur Sports Protection Act allowed legal sports betting across the US.

The cultural normalization and rapid commercialization of sports betting since the decision has been striking. Sportsbooks, platforms for wagering on sporting events, have been heavily integrated into mainstream media, as exemplified by the creation of ESPN BET.¹ Partnerships between sports leagues and sportsbooks are now commonplace, as evidenced by the alliance between the New York Jets and BetMGM.^2,3 Sports betting is advertised on billboards, social media, and television.⁴ Major casino operators are rebranding to emphasize their sportsbook services, as seen with Caesars Entertainment’s rebranding to Caesars Sportsbook and Casino.⁵

Despite the rise of sportsbooks and the recognition within the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) that gambling can be an addiction,^6,7 research on the public health effects remains scarce.⁸ Since the legalization of sportsbooks in 2018, only 59 studies archived by PubMed mention gambling addiction in their titles.⁹ This inadequacy in research may stem from the exclusion of gambling-related outcomes in standard health surveillance mechanisms but may also reflect a general blind spot to gambling.¹⁰ For instance, the Pan American Health Organization has disregarded gambling as a mental health risk factor altogether.¹¹ Health care professionals also lack gambling-focused training, which likely affects their understanding of the prevalence of gambling disorders and the development of resources for patients with gambling addiction.¹² Furthermore, because sportsbooks are regulated outside public health frameworks, data on gambling behaviors are not routinely gathered or reported by health agencies.¹³ Consequently, as noted by the Lancet Public Health Commission, gambling is often overlooked in health research, clinical practice, and health policy development, with insufficient governmental efforts to prevent or mitigate harms.¹⁴

Our goal was to describe how sports betting in the US has evolved post Murphy v NCAA and offer data-driven insights into the potential public health effects of sportsbooks. Using aggregate internet search trends, which provide early detection for changes in population behavioral health,^15,16,17,18 we investigated the association between the rise of sportsbooks and searches for gambling addiction.

Methods

Using American Gaming Association reporting, we described the legal status of sportsbooks, including the date sportsbooks came to market, either retail or online, in each state.¹⁹ Annual trends in total sports wagers (the total amount of money staked on sports betting, both retail and online) from 2017 through 2023 were also described (eMethods in Supplement 1).

Using Google Trends, we retrieved monthly search volumes for queries originating from the US that mentioned gambling and addiction, addict, anonymous, or hotline (such as gambling addiction hotline or am I a gambling addict?) from January 1, 2016, through June 30, 2024. These terms were selected to capture interest in gambling addiction that may be associated with help-seeking by an affected person, their social network, or general curiosity about the subject. To enable temporal/geographic comparisons, the search engine normalized search volumes in which queries matching our search terms were divided by the total number of searches per 10 million made in a given place (the entire US or a specific state), reported as a query fraction (QF). Additionally, we used Comscore estimates of the search engine’s search traffic to estimate absolute search volume ranges from the observed QFs (eMethods in Supplement 1).

First, we studied national monthly search volumes before and after Murphy v NCAA. We used a pre/post observational time series design, leveraging autoregressive integrated moving average (ARIMA) modeling to project counterfactual trends based on historical projections in the absence of the policy changes that we describe as the observed and expected search volumes. This approach is widely used for analyses of time series data for policy evaluations.^20,21,22 Specifically, the percentage increase greater than the expected volume was calculated from the ratio of observed and expected volumes forecasted using an ARIMA of the form (3,1,1) applied to preperiod trends. Alternative selections of other common ARIMA forms were not associated with any changes in the main effect estimates. This method was selected vs a difference-in-differences approach due to the lack of a clear control group for comparison, as sports betting is already legal in other large English-speaking nations. Additionally, using a forecasted or synthetic counterfactual approach minimizes the risk of bias from improperly selected control groups and is considered the criterion standard for pre/post time series analyses.^23,24

Second, we replicated this analysis with before and after monthly periods for when sportsbooks opened in a given state. To be included in the analysis, states needed to meet the following criteria: sportsbooks had been introduced, at least 1 year of data were available following the most recent launch (whether retail or online), and sufficient search data were accessible, as the search engine excluded data for regions or periods with low search volume (eg, less populated states).²⁵ This approach systematically identified the 8 largest states with sportsbooks and no changes in operation for at least 12 months postlaunch. These states were Illinois, Massachusetts, Michigan, New Jersey, New York, Ohio, Pennsylvania, and Virginia. For each state, we used an ARIMA model of the same form as the national model (3,1,1) to estimate the ratio of observed to expected search volumes. The expected volumes were forecasted based on trends from periods before the introduction of sportsbooks, as reported by the American Gaming Association.¹⁹

Third, we distinguished between the potential association of retail vs online sportsbooks by estimating the change in searches after the opening of retail sportsbooks and online sportsbooks, as reported by the American Gaming Association.¹⁹ We focused on states where there was at least a 4-month gap between the opening of retail and online sportsbooks and where the timing of either retail or online sportsbook openings did not coincide with the COVID-19 pandemic peak, defined as February or March 2020. This resulted in analyses for New York and Pennsylvania, where we estimated increases in searches during the period when only retail sportsbooks were operational compared with the period when online sportsbooks were also operational using the same counterfactual projection from historical data before any sportsbooks opened carried forward. Analyses were conducted using Python, version 3.11, and were exempted from ethical review by University of California, San Diego because they relied on public, nonhuman research data.

Results

The number of states with legal and operational sportsbooks before Murphy v NCAA in 2017 was 1 (Nevada), increasing to 8 in 2018, 19 during 2019, 21 during 2020, 32 during 2021, 35 during 2022, and 37 during 2023 (Figure 1). Approximately 34 states (92%) with legal retail sportsbooks had also legalized online sportsbooks in 2023, with only Vermont allowing for online sportsbooks without any retail sportsbooks. During 2024, North Carolina became the 38th state to allow sportsbooks, bringing the total population with access to legal sportsbooks to 63% of people in the US.

Figure 1. — A, The bars indicating the number of states with legalized sportsbooks during the year. If sportsbooks were legalized at any point during the year they were counted in that year. The number of states with retail (brick-and-mortar) sportsbooks and online sportsbooks is separately reported. All states with online sportsbooks offered retail sportsbooks except Vermont, which only allows online wagers. During 2024, North Carolina became the 38th state to allow sportsbooks, including retail and online. B, The bars indicate the sum of sportsbook wagers, nationally, in billions of dollars. The results are reported in total and for online wagers alone.

National sports bet totals were $4.9 billion during 2017, $6.6 billion during 2018, $13.1 billion during 2019 (the first full year after Murphy v NCAA), $21.6 billion during 2020, $57.7 billion during 2021, $93.2 billion during 2022, and $121.1 billion during 2023. These wagers are increasingly occurring online, with online bets accounting for 94% (or $113.8 billion) of total sports wagers during 2023.

Nationally, gambling addiction help-seeking searches increased following Murphy v NCAA after declining or stabilizing during the COVID-19 pandemic (Figure 2). Searches have consistently increased year over year since 2021, when 32 states had sportsbooks, including 22% (95% CI, 21%-24%) during 2022, 25% (95% CI, 23%-27%) during 2023, and 31% (95% CI, 26%-36%) during the first half of 2024. There were cumulatively 23% (95% CI, 15%-30%) more searches nationally than expected since Murphy v NCAA, with searches higher than expected for 55 of the 73 months during the postperiod, including every month since September 2021. In the 73 months since Murphy v NCAA, there were approximately 6.5 to 7.3 million searches for gambling addiction help-seeking nationally, with 180 000 monthly searches at a peak during June 2023.

Figure 2. — The time trend shows the monthly rate (query fraction: searches per 10 million) for Google searches with the term *gambling* and *addiction*, *addict*, *anonymous*, or *hotline* (such as *gambling addiction hotline* or *am I a gambling addict?*), with the interruption showing the *Murphy v NCAA* US Supreme Court decision that overturned legislation that had banned sports betting.

Additional analyses demonstrated that Illinois (35%; 95% CI, 18%-53%), Massachusetts (47%; 95% CI, 21%-79%), Michigan (37%; 95% CI, 22%-53%), New Jersey (34%; 95% CI, 21%-45%), New York (37%; 95% CI, 26%-50%), Ohio (67%; 95% CI, 42%-98%), Pennsylvania (50%; 95% CI, 35%-66%), and Virginia (30%; 95% CI, 18%-44%) independently had statistically significantly more searches than expected after the opening of any sportsbooks in their state (Figure 3). The significantly higher search volumes observed in all 8 of the independent state evaluations suggest that these results are highly unlikely to be due to chance. Each state’s cumulative increase in searches was higher than the aggregate national model and their peak month typically occurred during 2024, suggesting that searches are continuing to rise following the opening of sportsbooks.

Figure 3. — Each panel shows a time trend with the monthly rate (query fraction: searches per 10 million) for Google searches with the term *gambling* and *addiction*, *addict*, *anonymous*, or *hotline* (such as *gambling addiction hotline* or *am I a gambling addict?*) occurring in the 8 states with available data that met eligible inclusion criteria (had operating sportsbooks and at least 1 year of observation after the most recent opening of retail or online sportsbooks). The interruption shows the month when sportsbooks opened in that state, including retail (eg, brick-and-mortar) and online providers. The cumulative estimated increase in searches greater than expected volumes after any sportsbooks operating in the state is shown in each plot.

In New York, the potential association of retail sportsbook operations was significantly less (−1.27%; 95% CI, −12% to 9%) during the 30-month period leading up to the opening of online sportsbooks, which corresponded with a 50% (95% CI, 41%-59%) increase in searches greater than expected for the remaining 29 months of observation. In Pennsylvania, the introduction of retail sportsbooks corresponded with 33% (95% CI, 21%-45%) more searches than expected during the 5-month period before online sportsbooks opened. When online sportsbooks were opened, searches were 61% (95% CI, 48%-74%) higher than expected and significantly higher than during the retail period for the remaining 61 months of observation. Additionally, for both states, their record highest monthly search volumes were observed after online sportsbooks began operations in their jurisdictions.

Discussion

The Murphy v NCAA decision expanded national access to sportsbooks and sports betting. Concurrently, potential gambling harms, as evidenced by our analysis of internet searches for gambling addiction searches, have markedly increased. Our results suggest that the association may be more acute with the availability of online than retail sportsbooks.

These findings highlight the need for health agencies to engage in sportsbook regulation. While gambling is extensively regulated,^26,27 these frameworks largely ignore public health considerations. However, our results suggest that sportsbooks pose a substantial health concern. A paradigm shift in how regulatory frameworks and health organizations collaborate to address the complexities of gambling harms is needed. We recommend that state legislatures work with health agencies to establish mandatory health effect assessments and prioritize public health when expanding sportsbooks.

Gambling disorder shares neurobiological similarities with substance use disorders and is associated with many mental health conditions,²⁸ including depression, bipolar disorder, and suicidality.^28,29 These comorbidities complicate treatment and are associated with more severe clinical presentations and worse outcomes, and a potential syndemic for people harmed by gambling.³⁰ Gambling addiction also poses several physical health consequences, including tachycardia, angina, and hypertension.²⁸ Many psychosocial consequences also stem from gambling, including higher rates of bankruptcy,²⁸ unemployment,^31,32 and homelessness.³³ Societal effects also include fractured social relationships.^34,35,36

Gambling treatment and/or prevention also incurs substantial costs. In 1999, pathological gambling cost US taxpayers $5 billion, decades before sportsbooks proliferated.³⁷ Yet, legislation that legalizes sportsbooks rarely includes funding for the health costs of gambling. For example, Wyoming allocated $300 000 in annual funding for gambling addiction services alongside legalizing sportsbooks.³⁸ More commonly, states appropriate sportsbook-related tax revenues to their general funds. In 2023, states allocated a mean of $3.1 million annually for gambling addiction services.³⁹ However, this figure is largely driven by Massachusetts, which allocated $22.6 million, while most states allocated less than $1 million and 20 states allocated less than $400 000,³⁹ despite ample tax revenues. For example, New Hampshire allocated approximately $100 000 to gambling prevention and/or treatment during 2023 while collecting $36.4 million in tax revenue from sports wagers.⁴⁰ The delayed regulation of the tobacco industry serves as a cautionary tale, with accountability for health research and damages only following advocacy and litigation after decades of harm.⁴¹

This study’s results also concern health care systems and their preparedness. Many practitioners report little to no training or experience with gambling disorders.⁴² This gap in clinical expertise is compounded by the lack of medications approved by the US Food and Drug Administration for gambling disorder treatment, with treatment limited to off-label medications or labor-intensive interventions, like cognitive behavioral therapy.^28,43 Furthermore, a lack of research funding may potentially limit the development of effective interventions.²⁸ These findings underscore the need for increased education and innovation in identifying and treating gambling disorders.

Our findings for online sportsbooks align with research showing that increased access to gambling is associated with raised gambling rates,⁴⁴ including higher rates of harmful gambling for online gamblers than retail gamblers.^45,46 Despite these findings, some states are expanding online wagers to include e-gaming (betting on video games), digital casinos, and poker.⁴⁷ We caution against such expansion before more research on the health implications of online gaming are available. Given the unique risks posed by online gambling,⁴⁶ technological safeguards, such as betting limits, enforcement of mandatory breaks, and credit card bans, may protect the health interests of gamblers.

Sports betting stands apart from other types of gambling. Sportsbooks offer unprecedented opportunities for continuous engagement through in-play bets, such as which player will next score. Australia has banned such bets to reduce wager opportunities, providing a model for the US.⁴⁸ People who bet on sports perceive their wagers as safer and skill-based,⁴⁹ potentially lowering their awareness of problem behaviors. Some even treat sports betting as an investment, swapping stock portfolios for wagers.⁵⁰ Unlike other gambling activities, sports betting is perceived positively by most of the public. About 63% of people in the US view sports betting favorably,⁵¹ complicating intervention efforts and underscoring the need to reshape social narratives to address potential harms.

In light of our findings, we propose several additional actions. First, we recommend the development and evaluation of preventive countermeasures, such as educational materials on gambling, similar to campaigns against tobacco.⁵² These should raise awareness about the risks of gambling, particularly among high-risk populations, such as young male individuals.^8,28,53

Second, advertising restrictions on sportsbooks, which reached $1.8 billion in the US during 2023,⁵⁴ should be considered. Nations, such as Spain, have banned sportsbook advertising as a precedent for US states.⁵⁵ Additionally, the association between advertisements and gambling problems should be studied.⁵⁶ While the American Gaming Association’s Responsible Marketing Code for Sports Wagering⁵⁷ encourages advertising that respects the legal gambling age and limits on college advertising, legal rules and penalties governing advertisements vary widely by state, creating a wild west of claims. DraftKing’s Risk-Free Bet campaign triggered a class action lawsuit for misleading consumers.⁵⁸ Moreover, existing code violations and industry responses have been largely unpublished, leaving the effectiveness of legal regulation in doubt.

Third, pragmatic online interventions should be scaled to reach people who gamble who are seeking help online. Online interventions may rival in-person methods⁴¹ and can be promoted in online sportsbooks in lieu of generic warnings.⁵⁹

Fourth, while we cannot infer the demographic characteristics of those who searched for help, sportsbooks cater to young audiences.⁵³ Increasing the legal sports betting age from 18 years to 21 years (as New York proposed⁶⁰) aligns with the current understanding of addiction vulnerability in the developing mind.⁶¹

Finally, we must move beyond traditional responsible gambling approaches that focus on individual player responsibility toward a comprehensive public health framework that addresses sportsbook gambling through multiple intervention levels: universal (eg, restricting availability and marketing), selective (eg, limit setting and age restrictions), and indicated (eg, algorithmic detection of problematic patterns).⁶²

Limitations

This study had limitations. We did not measure clinical outcomes, such as gambling disorder. However, we directly observed instances of concern about gambling addiction as reflected by search behaviors, a marker that has been associated with population trends in numerous settings,¹⁷ including for mental health.⁶³ Moreover, research suggests that sports betting is significantly associated with being classified as a person who engages in moderate-risk or high-risk gambling.⁸ Our results may be confounded, as states with sportsbooks differ from states without sportsbooks. Yet, we were able to observe temporally specific increases in gambling addiction searches within communities after sportsbooks were allowed or came to market. The COVID-19 pandemic may have confounded our results, delaying the population effects of sportsbooks because professional sports teams played abbreviated seasons or did not play and pandemic concerns trumped interest in sports. The search queries in our model were not exclusively submitted by users experiencing gambling problems, and their associations with sportsbook policies are only meaningful across large populations. Some searches may be displaced by users turning to large language models, like online chatbots, resulting in an underestimate of the scope of gambling problems. Lastly, while states and sportsbooks have specific rules and procedures to prevent gambling across state lines,⁶⁴ inconsistent enforcement could result in some wagers being placed by residents of other states.

Conclusions

The results of this time series study suggest that there has been an increase in sportsbooks, sports wagers, and internet searches for gambling addiction, potentially serving as an early warning for public health. This underscores the need for swift action, including prioritizing research on sportsbooks, developing policies to address gambling-related health effects, and implementing a comprehensive health care response. Prompt measures are essential to prevent the escalation of gambling-related harm and its long-term consequences.

Supplement 1.

eMethods

jamainternmed-e248193-s001.pdf^{(117.2KB, pdf)}

Supplement 2.

Data sharing statement

jamainternmed-e248193-s002.pdf^{(13.9KB, pdf)}

References

1.Manzo JR. ESPN to launch ESPN BET in a new agreement with PENN Entertainment. Accessed August 16, 2024. https://espnpressroom.com/us/press-releases/2023/08/espn-to-launch-espn-bet-in-a-new-agreement-with-penn-entertainment/
2.Berkovits SA. Gambling on Las Vegas: bringing professional sports to Sin City. Gaming Law Review. 2005;9(3):1. doi: 10.1089/glr.2005.9.220 [DOI] [Google Scholar]
3.Adgate B. Las Vegas is quickly becoming the newest sports Mecca. Accessed November 26, 2024. https://www.forbes.com/sites/bradadgate/2023/11/07/las-vegas-is-quickly-becoming-the-newest-sports-mecca/
4.Hernandez J. Sports betting ads are everywhere: some worry gamblers will pay a steep price. Accessed November 26, 2024. https://www.npr.org/2022/06/18/1104952410/sports-betting-ads-sports-gambling
5.Lochhead C. Caesars Entertainment reveals sports betting rebranding move. Accessed August 16, 2024. https://www.reviewjournal.com/post/2412130
6.Weinstock J, Rash CJ. Clinical and research implications of gambling disorder in DSM-5. Curr Addict Rep. 2014;1(3):159-165. doi: 10.1007/s40429-014-0026-7 [DOI] [PMC free article] [PubMed] [Google Scholar]
7.Yau YH, Potenza MN. Gambling disorder and other behavioral addictions: recognition and treatment. Harv Rev Psychiatry. 2015;23(2):134-146. doi: 10.1097/HRP.0000000000000051 [DOI] [PMC free article] [PubMed] [Google Scholar]
8.Grubbs JB, Kraus SW. Symptoms of problem gambling among US adults who wager on sports. JAMA Netw Open. 2022;5(10):e2239670-e2239670. doi: 10.1001/jamanetworkopen.2022.39670 [DOI] [PMC free article] [PubMed] [Google Scholar]
9.PubMed . gambling addiction[Title]—search results. Accessed August 16, 2024. https://pubmed.ncbi.nlm.nih.gov/?term=gambling+addiction%5BTitle%5D&filter=years.2019-2024&sort=date
10.Etuk R, Xu T, Abarbanel B, Potenza MN, Kraus SW. Sports betting around the world: a systematic review. J Behav Addict. 2022;11(3):689-715. doi: 10.1556/2006.2022.00064 [DOI] [PMC free article] [PubMed] [Google Scholar]
11.Ukhova D, Marionneau V, Volberg R, Wardle H. The expansion of gambling across the Americas poses risks to mental health and wellbeing. Lancet Reg Health Am. 2024;37:100855. doi: 10.1016/j.lana.2024.100855 [DOI] [PMC free article] [PubMed] [Google Scholar]
12.Wyllie C, Killick E, Kallman A. A review of gambling harm training materials for healthcare professionals: tackling gambling stigma. Accessed February 22, 2023. https://tacklinggamblingstigma.com/wpcontent/uploads/2023/04/A-Review-of-GamblingHealthcare-Training-Tackling-Gambling-Stigma.pdf
13.van Schalkwyk MCI, Petticrew M, Cassidy R, et al. A public health approach to gambling regulation: countering powerful influences. Lancet Public Health. 2021;6(8):e614-e619. doi: 10.1016/S2468-2667(21)00098-0 [DOI] [PubMed] [Google Scholar]
14.Wardle H, Degenhardt L, Marionneau V, et al. The Lancet Public Health Commission on gambling. Lancet Public Health. 2024;9:e950-e994. doi: 10.1016/S2468-2667(24)00167-1 [DOI] [PubMed] [Google Scholar]
15.Ayers JW, Althouse BM, Dredze M, Leas EC, Noar SM. News and internet searches about human immunodeficiency virus after Charlie Sheen’s disclosure. JAMA Intern Med. 2016;176(4):552-554. doi: 10.1001/jamainternmed.2016.0003 [DOI] [PubMed] [Google Scholar]
16.Allem JP, Leas EC, Caputi TL, et al. The Charlie Sheen effect on rapid in-home human immunodeficiency virus test sales. Prev Sci. 2017;18(5):541-544. doi: 10.1007/s11121-017-0792-2 [DOI] [PubMed] [Google Scholar]
17.Goel S, Hofman JM, Lahaie S, Pennock DM, Watts DJ. Predicting consumer behavior with web search. Proc Natl Acad Sci U S A. 2010;107(41):17486-17490. doi: 10.1073/pnas.1005962107 [DOI] [PMC free article] [PubMed] [Google Scholar]
18.Ayers JW, Althouse BM, Dredze M. Could behavioral medicine lead the web data revolution? JAMA. 2014;311(14):1399-1400. doi: 10.1001/jama.2014.1505 [DOI] [PMC free article] [PubMed] [Google Scholar]
19.American Gaming Association . State of the states. Accessed August 16, 2024. https://www.americangaming.org/resources/state-of-the-states-2024/
20.Poliak A, Satybaldiyeva N, Strathdee SA, et al. Internet searches for abortion medications following the leaked Supreme Court of the United States draft ruling. JAMA Intern Med. 2022;182(9):1002-1004. doi: 10.1001/jamainternmed.2022.2998 [DOI] [PMC free article] [PubMed] [Google Scholar]
21.Ayers JW, Leas EC, Johnson DC, et al. Internet searches for acute anxiety during the early stages of the COVID-19 pandemic. JAMA Intern Med. 2020;180(12):1706-1707. doi: 10.1001/jamainternmed.2020.3305 [DOI] [PMC free article] [PubMed] [Google Scholar]
22.Ayers JW, Althouse BM, Leas EC, Dredze M, Allem JP. Internet searches for suicide following the release of 13 reasons why. JAMA Intern Med. 2017;177(10):1527-1529. doi: 10.1001/jamainternmed.2017.3333 [DOI] [PMC free article] [PubMed] [Google Scholar]
23.Hyndman RJ, Athanasopoulos G. Forecasting: Principles and Practice. OTexts; 2018. [Google Scholar]
24.Jebb AT, Tay L, Wang W, Huang Q. Time series analysis for psychological research: examining and forecasting change. Front Psychol. 2015;6:727. doi: 10.3389/fpsyg.2015.00727 [DOI] [PMC free article] [PubMed] [Google Scholar]
25.Google . Low search volume. Accessed November 26, 2024. https://support.google.com/google-ads/answer/2616014?hl=en
26.Cornell Law . Gambling law: an overview. Accessed August 16, 2024. https://www.law.cornell.edu/wex/gambling
27.Lynch T. Gambling regulation belongs to the states. Accessed August 16, 2024. https://www.cato.org/commentary/gambling-regulation-belongs-states
28.Potenza MN, Balodis IM, Derevensky J, et al. Gambling disorder. Nat Rev Dis Primers. 2019;5(1):51. doi: 10.1038/s41572-019-0099-7 [DOI] [PubMed] [Google Scholar]
29.Valenciano-Mendoza E, Mora-Maltas B, Mestre-Bach G, et al. Clinical correlates of sports betting: a systematic review. J Gambl Stud. 2023;39(2):579-624. doi: 10.1007/s10899-023-10196-0 [DOI] [PMC free article] [PubMed] [Google Scholar]
30.Rash CJ, Weinstock J, Van Patten R. A review of gambling disorder and substance use disorders. Subst Abuse Rehabil. 2016;7:3-13. doi: 10.2147/SAR.S83460 [DOI] [PMC free article] [PubMed] [Google Scholar]
31.Lerner D, Adler DA, Chang H, et al. Unemployment, job retention, and productivity loss among employees with depression. Psychiatr Serv. 2004;55(12):1371-1378. doi: 10.1176/appi.ps.55.12.1371 [DOI] [PMC free article] [PubMed] [Google Scholar]
32.Mental health and productivity at work: does what you do matter? Labour Econ. 2017;46:150-165. doi: 10.1016/j.labeco.2017.05.001 [DOI] [Google Scholar]
33.Willison C, Unwala N, Singer PM, Creedon TB, Mullin B, Cook BL. Persistent disparities: trends in rates of sheltered homelessness across demographic subgroups in the USA. J Racial Ethn Health Disparities. 2024;11(1):326-338. doi: 10.1007/s40615-023-01521-9 [DOI] [PMC free article] [PubMed] [Google Scholar]
34.Kendra Cherry M. The impact of social isolation on mental health. Accessed August 16, 2024. https://www.verywellmind.com/the-impact-of-social-isolation-on-mental-health-7185458
35.Tulane School of Public Health . Understanding the effects of social isolation on mental health. Accessed August 16, 2024. https://publichealth.tulane.edu/blog/effects-of-social-isolation-on-mental-health/
36.Lincoln KD. Social support, negative social interactions, and psychological well-being. Soc Serv Rev. 2000;74(2):231-252. doi: 10.1086/514478 [DOI] [PMC free article] [PubMed] [Google Scholar]
37.Georgia Department of Behavioral Health & Developmental Disabilities . Social costs of problem gambling. Accessed August 16, 2024. https://dbhdd.georgia.gov/sites/dbhdd.georgia.gov/files/imported/DBHDD/AD/Gambling/economic_09_11.pdf
38.American Gaming Association . Map: sports betting. Accessed August 16, 2024. https://www.americangaming.org/research/state-gaming-map/
39.National Association of Administrators for Disordered Gambling Services . 2023 Budget update of publicly funded problem gambling services in the United States. Accessed August 16, 2024. https://naadgs.org/wp-content/uploads/2024/06/2023-Budget-Update-of-Publicly-Funded-Problem-Gambling-Services-USA.pdf
40.Spaywall . News & research. Accessed August 16, 2024. https://www.spaywall.com/news/https://www.washingtonpost.com/business/2024/06/07/sports-betting-lottery-state-budgets/
41.Truth Tobacco Industry Documents . Tobacco litigation documents. Accessed January 15, 2025. https://www.industrydocuments.ucsf.edu/tobacco/research-tools/litigation-documents/
42.Drebing CE, Mello A, Penk W, et al. Clinical care of gambling disorders: training, experience, and competence among VHA psychologists. J Gambl Stud. 2001;17(2):117-136. doi: 10.1023/A:1016668429311 [DOI] [PubMed] [Google Scholar]
43.Rolvien L, Buddeberg L, Gehlenborg J, Borsutzky S, Moritz S. A self-guided internet-based intervention for the reduction of gambling symptoms: a randomized clinical trial. JAMA Netw Open. 2024;7(6):e2417282. doi: 10.1001/jamanetworkopen.2024.17282 [DOI] [PMC free article] [PubMed] [Google Scholar]
44.Welte JW, Barnes GM, Tidwell MO, Hoffman JH, Wieczorek WF. The relationship between distance from gambling venues and gambling participation and problem gambling among U.S. adults. J Gambl Stud. 2016;32(4):1055-1063. doi: 10.1007/s10899-015-9583-5 [DOI] [PubMed] [Google Scholar]
45.Gainsbury SM, Russell A, Hing N, Wood R, Lubman D, Blaszczynski A. How the internet is changing gambling: findings from an Australian Prevalence Survey. J Gambl Stud. 2015;31(1):1-15. doi: 10.1007/s10899-013-9404-7 [DOI] [PMC free article] [PubMed] [Google Scholar]
46.Tran LT, Wardle H, Colledge-Frisby S, et al. The prevalence of gambling and problematic gambling: a systematic review and meta-analysis. Lancet Public Health. 2024;9(8):e594-e613. doi: 10.1016/S2468-2667(24)00126-9 [DOI] [PubMed] [Google Scholar]
47.Frazzini K. Sports betting on the rise as states let gamblers wager online. Accessed August 16, 2024. https://www.ncsl.org/state-legislatures-news/details/sports-betting-on-the-rise-as-states-let-gamblers-wager-online
48.Belot H. Major gambling firms caught enabling illegal in-play sports bets in Australia. Accessed November 26, 2024. https://www.theguardian.com/australia-news/2023/dec/19/major-gambling-firms-caught-enabling-in-play-sports-bets-in-australia
49.Meyersohn N. The dark side of the sports betting boom. Accessed August 16, 2024. https://www.cnn.com/2023/02/10/business/online-sports-gambling-addiction/index.html
50.Bloomberg . Gamblers are dumping stocks to bet on sports, new study says. Accessed August 16, 2024. https://www.bloomberg.com/news/articles/2024-08-15/gamblers-are-dumping-stocks-to-bet-on-sports-new-study-says
51.Harris Poll . What’s the spread?—Americans’ changing attitudes towards sports betting. Accessed August 16, 2024. https://theharrispoll.com/briefs/whats-the-spread-americans-changing-attitudes-towards-sports-betting/
52.Farrelly MC, Nonnemaker J, Davis KC, Hussin A. The influence of the national truth campaign on smoking initiation. Am J Prev Med. 2009;36(5):379-384. doi: 10.1016/j.amepre.2009.01.019 [DOI] [PubMed] [Google Scholar]
53.Aragay N, Pijuan L, Cabestany À, et al. Current addiction in youth: online sports betting. Front Psychiatry. 2021;11:590554. doi: 10.3389/fpsyt.2020.590554 [DOI] [PMC free article] [PubMed] [Google Scholar]
54.BIA Advisory Services . Online gambling ad spend report 2023. Accessed August 16, 2024. https://shop.biakelsey.com/product/online-gambling-ad-spend-report
55.Strauss M. Belgium bans gambling advertising from July 1. Accessed November 26, 2024. https://www.reuters.com/world/europe/belgium-bans-gambling-advertising-july-1-2023-03-09/
56.Bowler H. Amid global crackdown, US advertisers spend 400% more on sports betting. Accessed August 16, 2024. https://www.thedrum.com/news/2023/06/27/amid-global-crackdown-us-advertisers-spend-400-more-sports-betting
57.American Gaming Association . AGA responsible marketing code for sports wagering. Accessed August 16, 2024. https://www.americangaming.org/marketingcode/
58.Covers . “Risk-free” bets trigger class-action lawsuit against DraftKings. Accessed August 16, 2024. https://www.covers.com/industry/risk-free-bets-trigger-class-action-lawsuit-against-draftkings-april-18-2024
59.Ginley MK, Whelan JP, Pfund RA, Peter SC, Meyers AW. Warning messages for electronic gambling machines: evidence for regulatory policies. Addict Res Theory. Published online November 2, 2017. doi: 10.1080/16066359.2017.1321740 [DOI] [Google Scholar]
60.Mazzeo M. NY senator looks to expand fantasy sports products, raise age limit. Accessed August 16, 2024. https://www.legalsportsreport.com/182491/ny-senator-looks-to-expand-fantasy-sports-products-raise-age-limit/
61.Blinn-Pike L, Worthy SL, Jonkman JN; Adolescent Gambling . Adolescent gambling: a review of an emerging field of research. J Adolesc Health. 2010;47(3):223-236. doi: 10.1016/j.jadohealth.2010.05.003 [DOI] [PubMed] [Google Scholar]
62.Marionneau V, Ruohio H, Karlsson N. Gambling harm prevention and harm reduction in online environments: a call for action. Harm Reduct J. 2023;20(1):92. doi: 10.1186/s12954-023-00828-4 [DOI] [PMC free article] [PubMed] [Google Scholar]
63.Leas EC, Dredze M, Ayers JW. Ignoring data delays our reaction to emerging public health tragedies like 13 Reasons Why. JAMA Psychiatry. 2020;77(1):102-103. doi: 10.1001/jamapsychiatry.2019.2755 [DOI] [PubMed] [Google Scholar]
64.Griffiths MD. Implications for regulation and potential threats to player protection. Gaming Law Rev. Published online May 22, 2019. doi: 10.1089/glr2.2019.2352 [DOI] [Google Scholar]

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[ioi240097r1] 1.Manzo JR. ESPN to launch ESPN BET in a new agreement with PENN Entertainment. Accessed August 16, 2024. https://espnpressroom.com/us/press-releases/2023/08/espn-to-launch-espn-bet-in-a-new-agreement-with-penn-entertainment/

[ioi240097r2] 2.Berkovits SA. Gambling on Las Vegas: bringing professional sports to Sin City. Gaming Law Review. 2005;9(3):1. doi: 10.1089/glr.2005.9.220 [DOI] [Google Scholar]

[ioi240097r3] 3.Adgate B. Las Vegas is quickly becoming the newest sports Mecca. Accessed November 26, 2024. https://www.forbes.com/sites/bradadgate/2023/11/07/las-vegas-is-quickly-becoming-the-newest-sports-mecca/

[ioi240097r4] 4.Hernandez J. Sports betting ads are everywhere: some worry gamblers will pay a steep price. Accessed November 26, 2024. https://www.npr.org/2022/06/18/1104952410/sports-betting-ads-sports-gambling

[ioi240097r5] 5.Lochhead C. Caesars Entertainment reveals sports betting rebranding move. Accessed August 16, 2024. https://www.reviewjournal.com/post/2412130

[ioi240097r6] 6.Weinstock J, Rash CJ. Clinical and research implications of gambling disorder in DSM-5. Curr Addict Rep. 2014;1(3):159-165. doi: 10.1007/s40429-014-0026-7 [DOI] [PMC free article] [PubMed] [Google Scholar]

[ioi240097r7] 7.Yau YH, Potenza MN. Gambling disorder and other behavioral addictions: recognition and treatment. Harv Rev Psychiatry. 2015;23(2):134-146. doi: 10.1097/HRP.0000000000000051 [DOI] [PMC free article] [PubMed] [Google Scholar]

[ioi240097r8] 8.Grubbs JB, Kraus SW. Symptoms of problem gambling among US adults who wager on sports. JAMA Netw Open. 2022;5(10):e2239670-e2239670. doi: 10.1001/jamanetworkopen.2022.39670 [DOI] [PMC free article] [PubMed] [Google Scholar]

[ioi240097r9] 9.PubMed . gambling addiction[Title]—search results. Accessed August 16, 2024. https://pubmed.ncbi.nlm.nih.gov/?term=gambling+addiction%5BTitle%5D&filter=years.2019-2024&sort=date

[ioi240097r10] 10.Etuk R, Xu T, Abarbanel B, Potenza MN, Kraus SW. Sports betting around the world: a systematic review. J Behav Addict. 2022;11(3):689-715. doi: 10.1556/2006.2022.00064 [DOI] [PMC free article] [PubMed] [Google Scholar]

[ioi240097r11] 11.Ukhova D, Marionneau V, Volberg R, Wardle H. The expansion of gambling across the Americas poses risks to mental health and wellbeing. Lancet Reg Health Am. 2024;37:100855. doi: 10.1016/j.lana.2024.100855 [DOI] [PMC free article] [PubMed] [Google Scholar]

[ioi240097r12] 12.Wyllie C, Killick E, Kallman A. A review of gambling harm training materials for healthcare professionals: tackling gambling stigma. Accessed February 22, 2023. https://tacklinggamblingstigma.com/wpcontent/uploads/2023/04/A-Review-of-GamblingHealthcare-Training-Tackling-Gambling-Stigma.pdf

[ioi240097r13] 13.van Schalkwyk MCI, Petticrew M, Cassidy R, et al. A public health approach to gambling regulation: countering powerful influences. Lancet Public Health. 2021;6(8):e614-e619. doi: 10.1016/S2468-2667(21)00098-0 [DOI] [PubMed] [Google Scholar]

[ioi240097r14] 14.Wardle H, Degenhardt L, Marionneau V, et al. The Lancet Public Health Commission on gambling. Lancet Public Health. 2024;9:e950-e994. doi: 10.1016/S2468-2667(24)00167-1 [DOI] [PubMed] [Google Scholar]

[ioi240097r15] 15.Ayers JW, Althouse BM, Dredze M, Leas EC, Noar SM. News and internet searches about human immunodeficiency virus after Charlie Sheen’s disclosure. JAMA Intern Med. 2016;176(4):552-554. doi: 10.1001/jamainternmed.2016.0003 [DOI] [PubMed] [Google Scholar]

[ioi240097r16] 16.Allem JP, Leas EC, Caputi TL, et al. The Charlie Sheen effect on rapid in-home human immunodeficiency virus test sales. Prev Sci. 2017;18(5):541-544. doi: 10.1007/s11121-017-0792-2 [DOI] [PubMed] [Google Scholar]

[ioi240097r17] 17.Goel S, Hofman JM, Lahaie S, Pennock DM, Watts DJ. Predicting consumer behavior with web search. Proc Natl Acad Sci U S A. 2010;107(41):17486-17490. doi: 10.1073/pnas.1005962107 [DOI] [PMC free article] [PubMed] [Google Scholar]

[ioi240097r18] 18.Ayers JW, Althouse BM, Dredze M. Could behavioral medicine lead the web data revolution? JAMA. 2014;311(14):1399-1400. doi: 10.1001/jama.2014.1505 [DOI] [PMC free article] [PubMed] [Google Scholar]

[ioi240097r19] 19.American Gaming Association . State of the states. Accessed August 16, 2024. https://www.americangaming.org/resources/state-of-the-states-2024/

[ioi240097r20] 20.Poliak A, Satybaldiyeva N, Strathdee SA, et al. Internet searches for abortion medications following the leaked Supreme Court of the United States draft ruling. JAMA Intern Med. 2022;182(9):1002-1004. doi: 10.1001/jamainternmed.2022.2998 [DOI] [PMC free article] [PubMed] [Google Scholar]

[ioi240097r21] 21.Ayers JW, Leas EC, Johnson DC, et al. Internet searches for acute anxiety during the early stages of the COVID-19 pandemic. JAMA Intern Med. 2020;180(12):1706-1707. doi: 10.1001/jamainternmed.2020.3305 [DOI] [PMC free article] [PubMed] [Google Scholar]

[ioi240097r22] 22.Ayers JW, Althouse BM, Leas EC, Dredze M, Allem JP. Internet searches for suicide following the release of 13 reasons why. JAMA Intern Med. 2017;177(10):1527-1529. doi: 10.1001/jamainternmed.2017.3333 [DOI] [PMC free article] [PubMed] [Google Scholar]

[ioi240097r23] 23.Hyndman RJ, Athanasopoulos G. Forecasting: Principles and Practice. OTexts; 2018. [Google Scholar]

[ioi240097r24] 24.Jebb AT, Tay L, Wang W, Huang Q. Time series analysis for psychological research: examining and forecasting change. Front Psychol. 2015;6:727. doi: 10.3389/fpsyg.2015.00727 [DOI] [PMC free article] [PubMed] [Google Scholar]

[ioi240097r25] 25.Google . Low search volume. Accessed November 26, 2024. https://support.google.com/google-ads/answer/2616014?hl=en

[ioi240097r26] 26.Cornell Law . Gambling law: an overview. Accessed August 16, 2024. https://www.law.cornell.edu/wex/gambling

[ioi240097r27] 27.Lynch T. Gambling regulation belongs to the states. Accessed August 16, 2024. https://www.cato.org/commentary/gambling-regulation-belongs-states

[ioi240097r28] 28.Potenza MN, Balodis IM, Derevensky J, et al. Gambling disorder. Nat Rev Dis Primers. 2019;5(1):51. doi: 10.1038/s41572-019-0099-7 [DOI] [PubMed] [Google Scholar]

[ioi240097r29] 29.Valenciano-Mendoza E, Mora-Maltas B, Mestre-Bach G, et al. Clinical correlates of sports betting: a systematic review. J Gambl Stud. 2023;39(2):579-624. doi: 10.1007/s10899-023-10196-0 [DOI] [PMC free article] [PubMed] [Google Scholar]

[ioi240097r30] 30.Rash CJ, Weinstock J, Van Patten R. A review of gambling disorder and substance use disorders. Subst Abuse Rehabil. 2016;7:3-13. doi: 10.2147/SAR.S83460 [DOI] [PMC free article] [PubMed] [Google Scholar]

[ioi240097r31] 31.Lerner D, Adler DA, Chang H, et al. Unemployment, job retention, and productivity loss among employees with depression. Psychiatr Serv. 2004;55(12):1371-1378. doi: 10.1176/appi.ps.55.12.1371 [DOI] [PMC free article] [PubMed] [Google Scholar]

[ioi240097r32] 32.Mental health and productivity at work: does what you do matter? Labour Econ. 2017;46:150-165. doi: 10.1016/j.labeco.2017.05.001 [DOI] [Google Scholar]

[ioi240097r33] 33.Willison C, Unwala N, Singer PM, Creedon TB, Mullin B, Cook BL. Persistent disparities: trends in rates of sheltered homelessness across demographic subgroups in the USA. J Racial Ethn Health Disparities. 2024;11(1):326-338. doi: 10.1007/s40615-023-01521-9 [DOI] [PMC free article] [PubMed] [Google Scholar]

[ioi240097r34] 34.Kendra Cherry M. The impact of social isolation on mental health. Accessed August 16, 2024. https://www.verywellmind.com/the-impact-of-social-isolation-on-mental-health-7185458

[ioi240097r35] 35.Tulane School of Public Health . Understanding the effects of social isolation on mental health. Accessed August 16, 2024. https://publichealth.tulane.edu/blog/effects-of-social-isolation-on-mental-health/

[ioi240097r36] 36.Lincoln KD. Social support, negative social interactions, and psychological well-being. Soc Serv Rev. 2000;74(2):231-252. doi: 10.1086/514478 [DOI] [PMC free article] [PubMed] [Google Scholar]

[ioi240097r37] 37.Georgia Department of Behavioral Health & Developmental Disabilities . Social costs of problem gambling. Accessed August 16, 2024. https://dbhdd.georgia.gov/sites/dbhdd.georgia.gov/files/imported/DBHDD/AD/Gambling/economic_09_11.pdf

[ioi240097r38] 38.American Gaming Association . Map: sports betting. Accessed August 16, 2024. https://www.americangaming.org/research/state-gaming-map/

[ioi240097r39] 39.National Association of Administrators for Disordered Gambling Services . 2023 Budget update of publicly funded problem gambling services in the United States. Accessed August 16, 2024. https://naadgs.org/wp-content/uploads/2024/06/2023-Budget-Update-of-Publicly-Funded-Problem-Gambling-Services-USA.pdf

[ioi240097r40] 40.Spaywall . News & research. Accessed August 16, 2024. https://www.spaywall.com/news/https://www.washingtonpost.com/business/2024/06/07/sports-betting-lottery-state-budgets/

[ioi240097r41] 41.Truth Tobacco Industry Documents . Tobacco litigation documents. Accessed January 15, 2025. https://www.industrydocuments.ucsf.edu/tobacco/research-tools/litigation-documents/

[ioi240097r42] 42.Drebing CE, Mello A, Penk W, et al. Clinical care of gambling disorders: training, experience, and competence among VHA psychologists. J Gambl Stud. 2001;17(2):117-136. doi: 10.1023/A:1016668429311 [DOI] [PubMed] [Google Scholar]

[ioi240097r43] 43.Rolvien L, Buddeberg L, Gehlenborg J, Borsutzky S, Moritz S. A self-guided internet-based intervention for the reduction of gambling symptoms: a randomized clinical trial. JAMA Netw Open. 2024;7(6):e2417282. doi: 10.1001/jamanetworkopen.2024.17282 [DOI] [PMC free article] [PubMed] [Google Scholar]

[ioi240097r44] 44.Welte JW, Barnes GM, Tidwell MO, Hoffman JH, Wieczorek WF. The relationship between distance from gambling venues and gambling participation and problem gambling among U.S. adults. J Gambl Stud. 2016;32(4):1055-1063. doi: 10.1007/s10899-015-9583-5 [DOI] [PubMed] [Google Scholar]

[ioi240097r45] 45.Gainsbury SM, Russell A, Hing N, Wood R, Lubman D, Blaszczynski A. How the internet is changing gambling: findings from an Australian Prevalence Survey. J Gambl Stud. 2015;31(1):1-15. doi: 10.1007/s10899-013-9404-7 [DOI] [PMC free article] [PubMed] [Google Scholar]

[ioi240097r46] 46.Tran LT, Wardle H, Colledge-Frisby S, et al. The prevalence of gambling and problematic gambling: a systematic review and meta-analysis. Lancet Public Health. 2024;9(8):e594-e613. doi: 10.1016/S2468-2667(24)00126-9 [DOI] [PubMed] [Google Scholar]

[ioi240097r47] 47.Frazzini K. Sports betting on the rise as states let gamblers wager online. Accessed August 16, 2024. https://www.ncsl.org/state-legislatures-news/details/sports-betting-on-the-rise-as-states-let-gamblers-wager-online

[ioi240097r48] 48.Belot H. Major gambling firms caught enabling illegal in-play sports bets in Australia. Accessed November 26, 2024. https://www.theguardian.com/australia-news/2023/dec/19/major-gambling-firms-caught-enabling-in-play-sports-bets-in-australia

[ioi240097r49] 49.Meyersohn N. The dark side of the sports betting boom. Accessed August 16, 2024. https://www.cnn.com/2023/02/10/business/online-sports-gambling-addiction/index.html

[ioi240097r50] 50.Bloomberg . Gamblers are dumping stocks to bet on sports, new study says. Accessed August 16, 2024. https://www.bloomberg.com/news/articles/2024-08-15/gamblers-are-dumping-stocks-to-bet-on-sports-new-study-says

[ioi240097r51] 51.Harris Poll . What’s the spread?—Americans’ changing attitudes towards sports betting. Accessed August 16, 2024. https://theharrispoll.com/briefs/whats-the-spread-americans-changing-attitudes-towards-sports-betting/

[ioi240097r52] 52.Farrelly MC, Nonnemaker J, Davis KC, Hussin A. The influence of the national truth campaign on smoking initiation. Am J Prev Med. 2009;36(5):379-384. doi: 10.1016/j.amepre.2009.01.019 [DOI] [PubMed] [Google Scholar]

[ioi240097r53] 53.Aragay N, Pijuan L, Cabestany À, et al. Current addiction in youth: online sports betting. Front Psychiatry. 2021;11:590554. doi: 10.3389/fpsyt.2020.590554 [DOI] [PMC free article] [PubMed] [Google Scholar]

[ioi240097r54] 54.BIA Advisory Services . Online gambling ad spend report 2023. Accessed August 16, 2024. https://shop.biakelsey.com/product/online-gambling-ad-spend-report

[ioi240097r55] 55.Strauss M. Belgium bans gambling advertising from July 1. Accessed November 26, 2024. https://www.reuters.com/world/europe/belgium-bans-gambling-advertising-july-1-2023-03-09/

[ioi240097r56] 56.Bowler H. Amid global crackdown, US advertisers spend 400% more on sports betting. Accessed August 16, 2024. https://www.thedrum.com/news/2023/06/27/amid-global-crackdown-us-advertisers-spend-400-more-sports-betting

[ioi240097r57] 57.American Gaming Association . AGA responsible marketing code for sports wagering. Accessed August 16, 2024. https://www.americangaming.org/marketingcode/

[ioi240097r58] 58.Covers . “Risk-free” bets trigger class-action lawsuit against DraftKings. Accessed August 16, 2024. https://www.covers.com/industry/risk-free-bets-trigger-class-action-lawsuit-against-draftkings-april-18-2024

[ioi240097r59] 59.Ginley MK, Whelan JP, Pfund RA, Peter SC, Meyers AW. Warning messages for electronic gambling machines: evidence for regulatory policies. Addict Res Theory. Published online November 2, 2017. doi: 10.1080/16066359.2017.1321740 [DOI] [Google Scholar]

[ioi240097r60] 60.Mazzeo M. NY senator looks to expand fantasy sports products, raise age limit. Accessed August 16, 2024. https://www.legalsportsreport.com/182491/ny-senator-looks-to-expand-fantasy-sports-products-raise-age-limit/

[ioi240097r61] 61.Blinn-Pike L, Worthy SL, Jonkman JN; Adolescent Gambling . Adolescent gambling: a review of an emerging field of research. J Adolesc Health. 2010;47(3):223-236. doi: 10.1016/j.jadohealth.2010.05.003 [DOI] [PubMed] [Google Scholar]

[ioi240097r62] 62.Marionneau V, Ruohio H, Karlsson N. Gambling harm prevention and harm reduction in online environments: a call for action. Harm Reduct J. 2023;20(1):92. doi: 10.1186/s12954-023-00828-4 [DOI] [PMC free article] [PubMed] [Google Scholar]

[ioi240097r63] 63.Leas EC, Dredze M, Ayers JW. Ignoring data delays our reaction to emerging public health tragedies like 13 Reasons Why. JAMA Psychiatry. 2020;77(1):102-103. doi: 10.1001/jamapsychiatry.2019.2755 [DOI] [PubMed] [Google Scholar]

[ioi240097r64] 64.Griffiths MD. Implications for regulation and potential threats to player protection. Gaming Law Rev. Published online May 22, 2019. doi: 10.1089/glr2.2019.2352 [DOI] [Google Scholar]

PERMALINK

Growing Health Concern Regarding Gambling Addiction in the Age of Sportsbooks

Atharva Yeola, BS

Matthew R Allen, BS

Nimit Desai, BS

Adam Poliak, PhD

Kevin H Yang, MD

Davey M Smith, MD, MAS

John W Ayers, PhD, MA