Aug 4, 2026 | RESEARCH
Read the original article on The BASIS.
By Kira Landauer, MPH
Gambling operators are increasingly using proactive approaches to identify customers who may be at-risk for gambling-related harm, to offer them support. One such approach is the use of care calls, where trained staff contact customers who show indicators of risky gambling behaviors. During these calls, staff talk with customers about their gambling, provide personalized feedback, and introduce responsible gambling tools such as limit setting. This week, The WAGER reviews a study by Jakob Jonsson and colleagues that examined changes in gambling behavior following care calls provided to customers of a large Norwegian gambling operator who were identified as at risk for gambling-related harm.
What was the research question?
How does the gambling behavior of at-risk customers change following care calls provided by a gambling operator?
What did the researchers do?
The researchers analyzed Norsk Tipping data from 4,752 customers who received a care call between 2022–2024. They grouped customers based on why they received a call, such as high gambling losses, high-risk classification through a player tracking system, or self-initiated contact through customer service or Norsk Tipping’s Spillepuls intervention.1 The researchers compared customers’ gambling outcomes2 during the 12 weeks before and the 12 weeks after the call. They also looked at responsible gambling actions taken during calls, such as reducing loss limits, and compared changes in gambling outcomes between customers who did and did not reduce their loss limit.
What did they find?
Fifty-seven percent of the 4,752 customers contacted completed a care call. In the 12 weeks after the call, the researchers observed small-to-medium decreases for each gambling outcome examined (see Figure, final column). Overall, the largest reductions were in the number of days they gambled and net losses. When considering all gambling outcomes together (i.e., final row of the Figure), customers who self-initiated contact through Spillepuls, new customers with high losses, and customers recently escalated to high-risk classification had the largest overall decreases. Customers over age 30 with high losses and those with a long-term high-risk classification had the smallest overall changes. Nearly 44% of customers reduced their loss limits during the call. Customers who reduced their limit had greater reductions in gambling frequency, net losses, amount wagered, and number of deposits in the following 12 weeks compared with customers who did not reduce their limit.
Figure. Heatmap of Cohen’s D effect sizes of care calls on gambling outcomes across groups of Norsk Tipping customers, grouped by the reason for the care call. A small positive number indicates a smaller decrease in gambling behavior; a larger positive number indicates a larger decrease in gambling behavior. A negative number indicates an increase in gambling behavior. Adapted from Jonsson et al. (2026). Click image to enlarge.
Why do these findings matter?
These findings suggest that care calls may be a useful way to engage customers, encourage the use of responsible gambling tools, and support harm reduction in gambling behavior. The timing and type of outreach may matter, as newer customers, younger customers, and those who self-initiated contact showed some of the largest changes following calls. Alternative approaches may be needed to engage customers with longer-term high-risk gambling. These findings support the role of proactive strategies as part of a duty of care approach, where gambling operators play an active role in identifying risk and offering support to customers who may be at risk for gambling harm.
Every study has limitations. What are the limitations in this study?
This study only examined the gambling outcomes of people who completed a care call. Those who completed a call (57% of all calls) may differ in important ways from people who did not answer or complete a call, introducing the potential for sampling bias. Additionally, the study only captured gambling activity with Norsk Tipping. As a result, researchers could not determine whether customers reduced their overall gambling or instead shifted some of their gambling to other operators.
— Kira Landauer, MPH
1. Customers were categorized into eight groups based on the reason for the care call: high gambling losses among customers ages 18–25, ages 26–30, and ages 30+; high gambling losses among new customers; long-term or recent high-risk classification related to gambling behavior according to a player tracking system; and self-initiated contact with customer service or with Norsk Tipping’s Spillepuls intervention indicating potential gambling problems.
2. Gambling outcomes included days gambled, number of wagers, amount wagered, net loss (money lost after accounting for winnings), theoretical loss (an estimate of expected losses based on the amount wagered and the expected payout of games), and number of deposits made to gambling accounts.
Apr 10, 2026 | ADVOCACY, RESEARCH
For the first time, federal research funding will be available to study gambling addiction. The fiscal year 2026 defense appropriations package includes language allowing gambling disorder to be researched through the Department of Defense’s Peer Reviewed Medical Research Program (PRMRP).
The Senate report clarifies that gambling addiction is an eligible research topic under the program. While the funding is limited to military and veteran populations, the change represents the first time a federal medical research program has explicitly supported peer-reviewed research on gambling addiction, reflecting growing recognition of the issue as a public health concern.
The inclusion is especially relevant for servicemembers and veterans, who face elevated risk for gambling-related harm. Research has found strong links between gambling disorder and suicide risk; among veterans seeking treatment for a gambling problem, nearly 40 percent report a suicide attempt. Military populations may also experience higher exposure to risk factors such as stress, trauma and ready access to high-risk gambling environments.
Gambling addiction has historically received little attention in federal research portfolios, leaving gaps in evidence to guide prevention, early intervention and treatment. Advocates say expanding research access is an important step toward improving understanding and care for affected populations.
This funding must be appropriated each year. NCPG will be closely monitoring and working with their lobbyists to support funding renewal.
Feb 21, 2026 | RESEARCH, YOUTH GAMBLING
Read the original article on The BASIS.
By John Slabczynski
Gambling can create financial, social, psychological, and physical harms. Of particular concern is suicidality, which recent research has identified as a potential gambling harm. As we undergo worldwide gambling expansion, it is imperative that public health experts and the gamblers themselves know more about this link, including whether problem gambling predicts future suicidality. This week The WAGER reviews a study by Oliver Bastiani and colleagues that explored the relationship between problem gambling and suicidality among the same participants over time. What were the research questions? Do gambling problems predict future suicidality? What did the researchers do? The researchers used data from the Avon Longitudinal Study of Parents and Children, a United Kingdom-based birth cohort study. They limited their analysis to data collected from 2,801 participants who completed assessments between the ages of 16 and 25. During these years, participants provided information on their suicidality and gambling problems. The researchers used logistic regression to examine whether having gambling problems at age 20 or 24 increased the odds of reporting past-year suicide attempts at age 24 or 25, controlling for some known risk factors such as sex, alcohol consumption/harms, and previous suicide attempts. What did they find? Most participants reported no problem gambling at both age 20 (70.4%) and age 24 (76.5%). Approximately 2.6% reported a past-year suicide attempt at age 24 and 1.9% did so at age 251. Problem gambling severity at age 24 was associated with increased odds of past-year suicide attempt at the same age. Longitudinal analyses revealed that problem gambling at age 20 was predictive of past-year suicide attempts at age 24 but not at age 25. On a shorter timespan, problem gambling at age 24 predicted past-year suicide attempts at age 25. (See Figure.) 
Figure. Displays the odds of reporting past year suicidality at ages 24 and 25 by problem gambling severity at ages 20 and 24. Odds ratios can be interpreted as having X times higher odds of reporting an event. For example, a one-point increase in problem gambling severity (e.g., answering “most of the time” instead of “sometimes” on one question) at age 24 was associated with having 1.13 times higher odds of reporting past year suicidality at age 24. Why do these findings matter? These findings provide more support for the idea that problem gambling contributes to future suicidality, because in this study, problem gambling preceded suicide attempts. Because problem gambling can be detected and managed at an early stage, it is essential to spread the word about brief gambling screening to healthcare providers and anyone else in a position to intervene, such as college health services staff and debt counselors. Furthermore, public health advocates can use this information to more effectively advocate for preventive tools like mandatory cool-off periods, which can disrupt gambling flow states and discourage long sessions, or tighter regulations on gambling and gambling advertising. Every study has limitations. What are the limitations in this study? The relationship between problem gambling and suicidality is probably more complicated than a single study can reveal. For instance, this study did not explore the possibility that suicidality predicted future problem gambling (i.e., reverse causality), which might happen if people develop gambling problems while trying to escape from painful suicidal thoughts. Another complication is that problem gambling tends to occur alongside depression, anxiety, and illicit drug use, which the researchers were unable to control for, and which might have partly accounted for the relationships with suicide attempts.
Jan 29, 2026 | PROBLEM GAMBLING, RESEARCH, SPORTS BETTING, YOUTH GAMBLING
Read the original article on The BASIS here.
By John Slabczynski
As legalized sports betting grows in popularity, public health experts have raised concerns about its potential harms. As advertisers and sports leagues continue to make gambling a key part of spectatorship, this could normalize betting as a natural part of sports fandom. Previous research suggests that these practices are contributing to an increase in gambling problems, particularly among young adults. To better address these concerns, public health advocates need to understand the specific problems associated with young adult sports betting. This week, The WAGER reviews a study by Nerilee Hing and colleagues that explored young adult sports bettors’ experiences of gambling harm and their perspectives on changing their gambling behavior.
What were the research questions?
(1) How do young adult sports bettors experience gambling harms? (2) How do they conceptualize and engage in changing harmful gambling?
What did the researchers do?
The researchers recruited 50 Australians between the ages of 18 and 25 who reported experiencing moderate or severe harm from sports betting in the past year. Participants completed interviews with the research team that asked about the nature of sports betting-related harms they experienced, perceived barriers and facilitators of gambling behavior change, and strategies they used to change their gambling. The researchers then coded the transcribed interviews to identify relevant themes.
What did they find?
The interviews revealed five distinct types of sports betting-related harm: 1) financial harm, 2) harm to mental health, 3) harm to work or study, 4) relationship harm, and 5) harm to physical health. Participants reported that many of these harms built up over time and intersected with one another. For example, several participants indicated that financial harms grew over time, and that these harms worsened their mental health. At the time of interviews, some participants were unwilling to change their gambling behavior. Others, however, pointed to improved knowledge of gambling disorder and an awareness of gambling harms as key factors in choosing to change their harmful behavior (see Figure).
Figure. Displays participant quotes representing each theme identified through thematic analysis. Click image to enlarge.
Why do these findings matter?
Information on the types of harm experienced by young adult sports gamblers can help public health practitioners identify potential gambling problems quickly and accurately, allowing for timely intervention and support before more significant harms happen. This study’s findings on behavior change are especially important. Many participants emphasized the value of awareness of gambling as an addiction as a catalyst for behavior change. Initiatives such as The Faces of Gambling that highlight how gambling problems develop from the perspective of people with lived experience may be especially effective in reducing the prevalence of gambling harms.
Every study has limitations. What are the limitations in this study?
This study screened participants for a history of experiencing gambling harms using a list of previously researched harms, which may have primed the sample to report these very same types of harm. Similarly, because the study focused on moderate to severe cases of gambling disorder among young adults, the results of this study may not be generalizable to those who experience less severe forms of the condition, or the wider gambling population.
Dec 17, 2025 | RESEARCH, RESOURCES
The National Council on Problem Gambling (NCPG) has released new findings from its National Survey on Gambling Attitudes and Gambling Experiences (NGAGE 3.0), offering an updated picture of how Americans are gambling—and what they believe about gambling.
The first NGAGE survey was conducted in 2018, just as states began legalizing sports betting following a landmark Supreme Court decision that opened the door for rapid expansion across the country. A follow-up survey in 2021 revealed a sharp increase in risky gambling behavior. At the time, researchers weren’t sure whether the spike reflected the spread of sports betting or the stress and isolation from the COVID-19 pandemic.
The 2024 survey, conducted after pandemic restrictions had largely lifted, shows that gambling-related risks have stabilized. About 8% of U.S. adults—nearly 20 million people—reported experiencing at least one sign of potentially problematic gambling “many times” in the past year. That number is down from 11% in 2021 but still higher than the 7% reported before sports betting became widely available.
“While it’s reassuring that the increases in problematic gambling behavior we saw in the 2021 survey seem to have abated along with the easing of the COVID-19 pandemic, maladaptive gambling remains a significant public health problem,” says Don Feeney, who helped design the NGAGE surveys. “Increased efforts at prevention and education are essential if we are to reduce gambling-related harm.”
The survey also sheds light on who is most at risk. Younger adults, men, online gamblers and sports bettors were among the groups most likely to report signs of risky play. Those who gamble frequently or participate in many different gambling activities are especially vulnerable.
“The best predictors of a gambling problem aren’t participation in any particular form of gambling,” explains Don. “Instead, the best predictors are the intensity of gambling involvement—how frequently someone is gambling—and the breadth of involvement—how many different forms of gambling someone is involved with.”
Even as legalized sports betting has expanded to 39 states, Washington, D.C. and Puerto Rico, the overall share of Americans placing sports bets has remained steady at about 23%. However, the ways people are betting are changing. The number of sports bettors making parlay bets—wagers that combine multiple outcomes for the chance of a large payout—has nearly doubled since 2018. Researchers note that these types of bets can be especially appealing to those trying to “win back” losses quickly, a pattern often associated with risky play.
Another key finding involves public attitudes toward gambling addiction. While nearly three in four adults agree that gambling addiction is similar to drug or alcohol addiction, fewer than 40% consider its consequences “very severe.” Many still believe gambling problems stem from a lack of willpower or moral weakness rather than recognizing them as treatable health conditions.
There is, however, some encouraging progress. Awareness of problem gambling helplines has increased, and most people understand that helplines exist to help people struggling with gambling problems.
“We’ve learned that we can improve awareness that there’s help for a gambling problem, and that awareness is greatest among those most in need of receiving services,” says Don. “However, these are the same people who are most skeptical that treatment works. We need to make the effectiveness of treatment an integral part of our message.”
Despite the progress, challenges remain. Public funding for problem gambling services has increased—from about $80 million in 2018 to $134 million in 2023—but seven states still provide no funding at all. On average, states spend just 35 cents per resident on prevention, education and treatment programs.
Continued investment and public awareness are critical to preventing gambling-related harm. Prevention and education work, but more people need to understand that help works too—and that recovery from gambling problems is possible.
The survey underscores that even as gambling becomes more common, many people still misunderstand the risks. Open discussion about gambling addiction, promoting the effectiveness of treatment and making help easy to find is necessary to keep gambling a form of entertainment rather than a source of harm.
