Gambling among adolescents: an emerging public health problem

While gambling among adults has been rightly identified as an urgent, understudied, and neglected public health issue, child health and wellbeing can also be harmed by this behaviour. In 2019, 11% of 11–16 year olds in the UK said they had spent money on gambling activities in the previous 7 days, and 36% reported doing so in the preceding 12 months. While these figures have remained static over recent years, two deeply concerning trends are beginning to emerge. The first trend is online gambling. The prevalence of 11–16 year olds exposed to online gambling adverts, sponsorships, and direct marketing continues to rise and drives increasing participation in gambling activities (in 2019, 7% of children in this age group reported ever having gambled online).2Gambling CommissionGambling Commission publishes the 2019 young people and gambling report.https://www.gamblingcommission.gov.uk/news-action-and-statistics/News/gambling-commission-publishes-the-2019-young-people-and-gambling-reportDate: Oct 23, 2019Date accessed: January 22, 2021Google Scholar Almost half of online gambling activity in this age group now takes places through mobile apps, made possible by the widespread uptake of smartphones among young people. In-game gambling, such as playing casino games and opening loot boxes, is becoming increasingly common in apps, online videogames, and unlicensed third party websites, and some children receive money from their parents to be spent specifically on these gambling games.2Gambling CommissionGambling Commission publishes the 2019 young people and gambling report.https://www.gamblingcommission.gov.uk/news-action-and-statistics/News/gambling-commission-publishes-the-2019-young-people-and-gambling-reportDate: Oct 23, 2019Date accessed: January 22, 2021Google Scholar The impact of COVID-19, which has reduced physical access to commercial gambling venues, might further increase the prevalence of such online behaviours. The second concerning trend is problem gambling. Using the youth-adapted DSM-IV-MR-J screen, 1·7% of 11–16 year olds in the UK were classified as “problem gamblers” (a proxy measure for gambling disorder) in 2019,2Gambling CommissionGambling Commission publishes the 2019 young people and gambling report.https://www.gamblingcommission.gov.uk/news-action-and-statistics/News/gambling-commission-publishes-the-2019-young-people-and-gambling-reportDate: Oct 23, 2019Date accessed: January 22, 2021Google Scholar a 4-times increase from 2016,3Gambling CommissionYoung people and gambling 2016.http://www.gamblingcommission.gov.uk/PDF/survey-data/Young-people-and-gambling-2016.pdfDate: November, 2016Date accessed: January 22, 2021Google Scholar while the prevalence of at-risk child gamblers increased from 1·6% to 2·2% in the same period. Worryingly, 40% of participants did not feel well informed about the risks of gambling, and only 59% agreed that gambling is potentially dangerous. Although the health impacts of gambling among adults are increasingly recognised, it is much less the case among children. Problem gambling in the early years of life is likely to be profoundly detrimental to the mental, emotional, and social health of children, to negatively impact on development and school performance, and to increase the risk of acquiring other addictions. These consequences might extend well beyond childhood and cause adverse health, social, and economic outcomes in adult life. Further research is urgently required to clarify the harms that gambling among children and adolescents can cause, including those exacerbated by the ongoing pandemic. To adequately respond to this emerging public health problem, research should inform policy making on industry regulation (of exposure and access to gambling), education (of children, parents, and teachers), and evidence-based health care. I declare no competing interests. The Lancet Public Health Commission on gamblingGambling is pervasive in society and is provided by increasingly powerful supra-national corporations, whose reach transcends national boundaries. The development of commercial gambling practices is deeply tied to technological development, and leaps in communication technologies have resulted in the expansion of commercial gambling.1 This pattern is also evident with online infrastructure, where the development of smart phone technology and increased accessibility and speed of access to the internet has generated new gambling products that were previously unavailable (eg, in-play betting).