Simulated Gambling Games: an Integrative Review of Links with Monetary Gambling and Harmful Gambling in Adolescents and Adults

Purpose of Review Simulated gambling games (SGGs) combine features of gaming and gambling in social casino games, practice games, and games with mini gambling components. SGGs may act as a gateway to monetary gambling and gambling harm through a stimulus exposure effect. Alternatively, people with certain psychological or other characteristics may tend to use both activities, reflecting a selection effect. SGGs might also help to suppress the allure of gambling and satisfy gambling urges, reducing gambling harm for some people. This review aims to help clarify these relationships by synthesising empirical evidence on the co-occurrence and migration between SGGs and monetary gambling, including harmful gambling. Recent Findings All cross-sectional studies of adolescents and adults have found positive relationships between engagement in SGGs and monetary gambling, and increased risk of harmful gambling. Longitudinal and experimental studies support a stimulus effect of SGGs on monetary gambling, with little evidence of a suppression effect. The most compelling evidence is from a 24-week randomised controlled trial where the number of simulated slots sessions played per week reliably predicted increases in slots expenditure in real gambling venues the following week. Minimal research exists on migration pathways between SGGs and harmful gambling. Summary SGGs are most likely to stimulate monetary gambling; by contrast, evidence for any suppression effect is limited. While causal relationships are unclear, people already experiencing gambling harm are particularly attracted to SGGs, which expose them to additional gambling stimuli. Strengthening consumer protections in SGGs and restricting underage access may help reduce these risks.