Editing Problem gambling (section)

==Prevalence==

===Europe===
In Europe, the rate of problem gambling is typically 0.5 to 3 percent.<ref>{{cite web |title=Problem Gaming |url=https://www.egba.eu/pdf/EGBA_FS_ProblemGaming.pdf |publisher=European Gaming and Betting Association |access-date=April 4, 2012}}</ref> The "British Gambling Prevalence Survey 2007", conducted by the United Kingdom Gambling Commission, found approximately 0.6 percent of the adult population had problem gambling issues—the same percentage as in 1999.<ref name="2007uksurveyp10">{{cite web |url=http://www.gamblingcommission.gov.uk/pdf/British%20Gambling%20Prevalence%20Survey%202007.pdf |author1=Wardle, Heather |author2=Sproston, Kerry |author3=Orford, Jim |author4=Erens, Bob |author5=Griffiths, Mark |author6=Constantine, Rebecca |author7=Pigott, Sarah |date=September 2007 |title=British Gambling Prevalence Survey 2007 |publisher=National Centre for Social Research |page=10 |url-status=dead |archive-url=https://web.archive.org/web/20091128000055/http://www.gamblingcommission.gov.uk/pdf/British%20Gambling%20Prevalence%20Survey%202007.pdf |archive-date=November 28, 2009}}</ref> The highest prevalence of problem gambling was found among those who participated in [[spread betting]] (14.7%), [[fixed odds betting terminal]]s (11.2%), and [[betting exchange]]s (9.8%).<ref name="2007uksurveyp10"/> In Norway, a December 2007 study showed the amount of current problem gamblers was 0.7 percent.<ref>{{cite report |title=Pengespill og Pengespillproblem i Norge 2007 |date=December 2007 |publisher=SINTEF |page=3}}</ref>

With gambling addiction on the rise worldwide and across Europe in particular, those calling gambling a disease have been gaining grounds. The UK Gambling Commission announced a significant shift in their approach to gambling{{When|date=July 2022}} through their reclassification of gambling as a disease, and therefore that it should be addressed adequately by the NHS.

The World Health Organization has also classified gambling a disease. In its 72nd World Health Assembly held on Saturday, May 25, 2019, ‘gaming disorder’ was recognized as an official illness. The 194-member meet added excessive gaming to a classified list of diseases as it revised its International Statistical Classification of Diseases and Related Health Problems (ICD-11).{{Citation needed|date=July 2022}}

===North America===
Lizbeth García Quevedo, director of the Coordination with Federal Entities (CONADIC), spoke of pathological gambling as a strong addiction in Mexico: "It has very similar behaviors, that is why some experts consider it an addiction because it is similar in the behaviors, in the origins, some risk factors that can trigger pathological gambling, it can also trigger drug consumption". In Mexico there could be between one and three million people addicted to gambling. "They should be aware of what their children are doing, and on the other hand, they should motivate pro-active gambling, healthy gambling", commented Lizbeth García Quevedo.  The Ministry of Health document highlights that a study on pathological gambling that analyzed 46 studies carried out in Canada, the United States, Australia, Sweden, Norway, England, Switzerland and Spain, revealed that the prevalence of pathological gambling is relatively higher among adolescents, which shows the continuity of the problem considering that many pathological gamblers state that they started their gambling behavior at an early age.<ref>{{Cite web |date=2016-09-11 |title=Ludopatía, comportamiento incontrolable por los juegos de azar {{!}} México {{!}} Noticieros Televisa |url=http://noticieros.televisa.com/mexico/1502/ludopatia-comportamiento-incontrolable-juegos-azar/ |access-date=2022-10-28 |archive-url=https://web.archive.org/web/20160911065048/http://noticieros.televisa.com/mexico/1502/ludopatia-comportamiento-incontrolable-juegos-azar/ |archive-date=September 11, 2016 }}</ref>

In the United States, the percentage of pathological gamblers was 0.6 percent, and the percentage of problem gamblers was 2.3 percent in 2008.<ref>{{cite web |url=http://www.americangaming.org/industry-resources/research/fact-sheets/history-problem-gambling-prevalence-rates |title=History of Problem Gambling Prevalence Rates |publisher=[[American Gaming Association]] |access-date=April 4, 2012 |archive-url=https://web.archive.org/web/20121116160632/http://www.americangaming.org/industry-resources/research/fact-sheets/history-problem-gambling-prevalence-rates |archive-date=November 16, 2012 |url-status=dead }}</ref> Studies commissioned by the [[National Gambling Impact Study Commission Act]] has shown the prevalence rate ranges from 0.1 percent to 0.6 percent.<ref>{{cite book |author=National Opinion Research Center |date=April 1, 1999 |title=Gambling Impact and Behavior Study |chapter=The Prevalence and Correlates of Gambling Problems Among Adults |publisher=National Gambling Impact Study Commission |page=25}}</ref> Nevada has the highest percentage of pathological gambling; a 2002 report estimated 2.2 to 3.6 percent of Nevada residents over the age of 18 could be called problem gamblers. Also, 2.7 to 4.3 percent could be called probable pathological gamblers.<ref>{{cite report |last=Voberg |first=Rachel |date=March 22, 2002 |url=http://www.austgamingcouncil.org.au/images/pdf/eLibrary/911.pdf |title=Gambling and Problem Gambling in Nevada |publisher=Nevada Department of Human Resources |access-date=April 8, 2012 |archive-url=https://web.archive.org/web/20120318161756/http://www.austgamingcouncil.org.au/images/pdf/eLibrary/911.pdf |archive-date=March 18, 2012 |url-status=dead }}</ref>

According to a 1997 meta-analysis by [[Harvard Medical School]]'s division on addictions, 1.1 percent of the adult population of the United States and Canada could be called pathological gamblers.<ref>{{cite journal |last1=Shaffer |first1=Howard |last2=Hall |first2=Mathew |last3=Vander Bilt |first3=Joni |date=September 1999 |title=Estimating the Prevalence of Disordered Gambling Behavior in the United States and Canada: A Research Synthesis |journal=American Journal of Public Health |volume=89 |issue=9 |pages=1369–1377 |doi=10.2105/AJPH.89.9.1369 |pmid=10474555 |pmc=1508762}}</ref> A 1996 study estimated 1.2 to 1.9 percent of adults in Canada were pathological.<ref>{{cite journal |last=Ladouceur |first=Robert |date=June 1996 |title=The Prevalence of Pathological Gambling in Canada |journal=Journal of Gambling Studies |volume=12 |issue=2 |pages=129–142 |doi=10.1007/BF01539170 |pmid=24233912|s2cid=32686402 }}</ref> In Ontario, a 2006 report showed 2.6 percent of residents experienced "moderate gambling problems" and 0.8 percent had "severe gambling problems".<ref>{{cite report |last1=Weibe |first1=Jamie |last2=Mun |first2=Phil |last3=Kauffman |first3=Nadine |date=September 2006 |url=https://prism.ucalgary.ca/handle/1880/48245 |title=Gambling and Problem Gambling in Ontario |publisher=Responsible Gambling Council |hdl=1880/48245}}</ref> In Quebec, an estimated 0.8 percent of the adult population were pathological gamblers in 2002.<ref>{{cite journal |last1=Ladouceur |first1=Robert |last2=Jacques |first2=Christian |last3=Chevalier |first3=Serge |last4=Sévigny |first4=Serge |last5=Hamel |first5=Denis |date=July 2005 |url=http://ww1.cpa-apc.org:8080/publications/archives/cjp/2005/july/cjp-july-05-Ladouceur-OR.pdf |title=Prevalence of Pathological Gambling in Quebec in 2002 |journal=The Canadian Journal of Psychiatry |volume=50 |issue=8 |pages=451–456 |doi=10.1177/070674370505000804 |pmid=16127962|s2cid=2096562 |doi-access=free }}</ref> Although most who gamble do so without harm, approximately 6 million American adults are addicted to gambling.<ref name=NCGP>{{cite press release |url=http://www.ncpgambling.org/files/Press/Super%20Bowl%20XLVII%20Release%202013.pdf |title=Don't Let Betting on the Super Bowl Take Control: The National Council on Problem Gambling Offers Help and Hope to Gambling Addicts |date=31 January 2013 |publisher=National Council on Problem Gambling (US)}}</ref>

According to a survey of 11th and 12th graders in [[Wood County, Ohio]] found that the percentage who reported being unable to control their gambling rose to 8.3 percent in 2022, up from just 4.2 percent in 2018. The reasons for the increase cited, are the time spent online during the [[COVID-19 pandemic]], gambling-like elements put into video games, and the increased legalization of [[sports betting]] in a number of U.S. states.<ref>{{cite news |last=Ansberry |first=Clare |url=https://www.wsj.com/articles/problem-gambling-is-on-the-rise-among-young-men-11671388600 |title=Problem Gambling Is on the Rise Among Young Men |work=[[The Wall Street Journal]] |date=2022-12-18 |accessdate=2022-12-19 }}</ref>

According to Jennifer Trimpey, as the legality of online sport betting and online casino gambling increase across the United States, almost all governments of states with legal online gambling offer state-run self-exclusion programs, and most major online betting operators provide their own self-exclusion programs as well.<ref>{{cite web |last1=Trimpey |first1=Jennifer |title=Self-exclusion for problem gamblers: A comprehensive overview of self-exclusion programs and efficacy in the US |url=https://www.syracuse.com/betting/responsible-gambling/self-exclusion/ |website=Syracuse.com |date=September 25, 2023 |access-date=9 October 2023}}</ref>

Signs of a gambling problem include:<ref name=NCGP/>{{medical citation needed|date=June 2015}}
* Using income or savings to gamble while letting bills go unpaid
* Repeated unsuccessful attempts to stop gambling
* Chasing losses
* Losing sleep over thoughts of gambling
* Arguing with friends or family about gambling behavior
* Feeling depressed or suicidal because of gambling losses

=== South America ===
For Isabel Sánchez Sosa, coordinator of the Compulsive Gamblers Association of Argentina, "gambling addiction is growing a lot in the country because the offer is impressive" and in this sense she asserted that the presence of bingos is a common issue in all neighborhoods. In the province of Buenos Aires there are 46 bingos.<ref>{{Cite web |last=Clarín.com |date=2010-05-19 |title=Cada vez son más los jugadores compulsivos en la Argentina |url=https://www.clarin.com/salud/adiccion-juego-ludopatia-jugador-compulsivo_0_B1FDNycPmg.html |access-date=2022-10-28 |website=Clarín |language=es}}</ref>

=== Africa ===
Similar to other parts of the world, Africa's gambling rates are increasing, especially among youths. In East African countries like Kenya and Uganda, more than a majority of youths surveyed reported gambling behaviors in the last 12 months.<ref name=":10">{{Cite journal |last1=Bitanihirwe |first1=Byron K. Y. |last2=Ssewanyana |first2=Derrick |date=September 2021 |title=Gambling Patterns and Problem Gambling Among Youth in Sub-Saharan Africa: A Systematic Review |url=https://pubmed.ncbi.nlm.nih.gov/33484393 |journal=Journal of Gambling Studies |volume=37 |issue=3 |pages=723–745 |doi=10.1007/s10899-021-10001-w |issn=1573-3602 |pmid=33484393}}</ref> Additionally, many youths begin gambling before the age of 18, which correlates with the psychological etiologies of risk-taking and low self-control. Gambling in East Africa is correlated with substance use, risky sexual behaviors such as unprotected sex and frequent sexual encounters, and risks of crime.<ref name=":10" /> Regarding youths who gamble, almost 50% of them report some form of gambling severe enough to be classified as problematic by the DSM.<ref name=":10" /> 

In Western Africa, such as countries like Nigeria and Ghana, these trends are mirrored. A majority of youths participate in lifetime gambling behaviors, and of those who gamble, over 70% reported consistent gambling within the last year.<ref name=":10" /> Gambling in West Africa is linked with problems with law enforcement and other authorities, substance use, and reckless financial spending.<ref name=":10" /> Across all areas of Africa, sports betting and card-games serve to be the most prevalent forms of gambling; a supermajority of individuals gamble on weekends in particular. Sports betting is incredibly common among high-schoolers and college-aged individuals and can be seen most often among young men.<ref name=":10" /> 

=== Asia ===
Gambling in Asia is particularly challenging to study because it is prohibited in a majority of countries. In countries such as China and Japan, the only way to gamble legally is through government-ran lotteries or casinos.<ref name=":11">{{Cite journal |last=Das |first=Muralee |date=2021-09-01 |title=Fantasy sports and gambling regulation in the Asia-Pacific |journal=The International Sports Law Journal |language=en |volume=21 |issue=3 |pages=166–179 |doi=10.1007/s40318-021-00198-8 |issn=2213-5154 |pmc=8380019}}</ref> Regardless of its legality, gambling still occurs in underground networks and through legal loopholes, such as pachinko in Japan. Gambling behaviors are closely connected with homelessness, especially in places such as Osaka City.<ref name=":12">{{Cite journal |last1=Hwang |first1=Chiyoung |last2=Takano |first2=Taichi |last3=So |first3=Ryuhei |last4=Sahker |first4=Ethan |last5=Kawakami |first5=Sho |last6=Livingstone |first6=Charles |last7=Takiguchi |first7=Naoko |last8=Ono-Kihara |first8=Masako |last9=Kihara |first9=Masahiro |last10=Furukawa |first10=Toshi A. |date=September 2023 |title=Prevalence of gambling disorder and its correlates among homeless men in Osaka city, Japan |journal=Journal of Gambling Studies |volume=39 |issue=3 |pages=1059–1076 |doi=10.1007/s10899-022-10121-x |issn=1573-3602 |pmc=10397130 |pmid=35704251}}</ref> Among those who live in poverty and experience homelessness, 43.7% of individuals reported as lifetime gamblers.<ref name=":12" /> There are a number of risk factors associated with this link; primarily, a long duration of homelessness throughout the life-course and repeated instances of homelessness increase risks of gambling behavior.<ref name=":11" /> 

Gambling is also closely associated with gaming behaviors, specifically the prevalence of loot boxes.<ref name=":13">{{Cite journal |last1=Siste |first1=Kristiana |last2=King |first2=Daniel L. |last3=Hanafi |first3=Enjeline |last4=Sen |first4=Lee Thung |last5=Adrian |first5=Adrian |last6=Murtani |first6=Belinda Julivia |date=2025-01-15 |title=Scrutinizing the Gateway Relationship Between Gaming and Gambling Disorder: Scoping Review With a Focus on the Southeast Asian Region |journal=JMIR Serious Games |language=EN |volume=13 |issue=1 |pages=e59740 |doi=10.2196/59740|doi-access=free |pmid=39819569 |pmc=11753718 }}</ref> Loot boxes are found within certain games, and they consist of lottery-like in-game merchandising where players can unlock certain items by chance. Loot boxes contain items which are graded by rarity, from common to legendary, and this relationship of rarity to unlock chances closely resembles payouts in certain gambling machines, such as jackpots in slot machines. Jackpots are very high rewards, but the chances of achieving them are very rare; this mimics the rarity of unlocking a legendary item through a loot box. Across 270 studies, there is a significant causal relationship between increasing prevalence of certain gaming behaviors and further risk of gambling addiction.<ref name=":13" />

===Oceania (Australia)===
Casinos and poker machines in pubs and clubs facilitate problem gambling in Australia. The building of new hotels and casinos has been described as "one of the most active construction markets in Australia"; for example, AUD$860 million was allocated to rebuild and expand the Star Complex in Sydney.<ref>{{cite web|title=Hotel refurbishment market continues boom phase|url=https://www.hotelmanagement.com.au/2012/01/11/hotel-refurbishment-market-continues-boom-phase/|work=Hotel Management|publisher=HM – The business of Accommodation|access-date=December 15, 2013|date=11 January 2012}}</ref>

A 2010 study, conducted in the Northern Territory by researchers from the [[Australian National University]] (ANU) and [[Southern Cross University]] (SCU), found that the proximity of a person's residence to a gambling venue is significant in terms of prevalence. Harmful gambling in the study was prevalent among those living within 100 metres of any gambling venue, and was over 50% higher than among those living ten kilometres from a venue. The study's data stated:

<blockquote>
Specifically, people who lived 100 metres from their favourite venue visited an estimated average of 3.4 times per month. This compared to an average of 2.8 times per month for people living one kilometre away, and 2.2 times per month for people living ten kilometres away.<ref>{{cite news|title=Too close to home: people who live near pokie venues at risk|url=http://theconversation.com/too-close-to-home-people-who-live-near-pokie-venues-at-risk-20771|access-date=December 15, 2013|newspaper=The Conversation Australia|date=6 December 2013|author1=Martin Young, Bruce Doran |author2=Francis Markham |name-list-style=amp}}</ref></blockquote>

According to the Productivity Commission's 2016 report into gambling, 0.5% to 1% (80,000 to 160,000)<ref>{{cite web|url=http://nafgah.org/statistics-gambling-addiction-2016/|title=Statistics of Gambling Addiction 2016|website=North American Foundation for Gambling Addiction Help }}</ref> of the Australian adult population had significant problems resulting from gambling. A further 1.4% to 2.1% (230,000 to 350,000) of the Australian adult population experienced moderate risks making them likely to be vulnerable to problem gambling.<ref name= pcgovau203/> Estimates show that problem gamblers account for an average of 41% of the total gaming machine spending.<ref name= pcgovau203>[http://www.pc.gov.au/inquiries/completed/gambling-2009/report/gambling-report-volume1.pdf#page=203 Productivity Commission Inquiry Report, Gambling, Vol 1, 2010, p. 203]</ref>