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Full citation
Tran, A. L., Hall, L., Hides, L., & Hodgins, D. C. (2024). The prevalence of gambling and problematic gambling: A systematic review and meta-analysis of representative survey studies. The Lancet Public Health, 9(9), e594–e613. https://doi.org/10.1016/S2468-2667(24)00126-9
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Region & Target Population
- Region: Global, covering 68 countries.
- Target population: Adults (≥18) and adolescents (typically 12–17/18) in representative population surveys (national or regional).
Study Design
Systematic review and meta-analysis of population-based surveys using validated measures of gambling and problem gambling.
Sample Characteristics
- 380 representative research surveys focused on gambling and problematic gambling identified; 366 included in meta-analyses.
- Surveys drawn from 68 countries across multiple WHO regions.
- Populations: adults and youth; combined N in the millions across all surveys.
Data Coverage & Timeframe
- Databases searched for studies published between Jan 1, 2010, and March 4, 2024.
- Surveys span from 2010–2023, providing the most up-to-date global synthesis of gambling participation and harm.
Measures Used
- Validated instruments (e.g., Problem Gambling Severity Index, South Oaks Gambling Screen, DSM-based screens).
- Outcomes meta-analysis included:
- Past-year gambling participation.
- Any-risk gambling (low-risk + moderate-risk + problem).
- Problem gambling (typically moderate/high-risk or clinical range).
- Analyses stratified by age group (adults vs adolescents) and region.
Research Question
What are the global and regional prevalence rates of gambling participation, at-risk gambling, and problem gambling, and how do these differ between adults and adolescents?
Key Findings
- Estimated past-year gambling participation (pooled):
- Adults: 46% worldwide.
- Adolescents: 18%.
- Any-risk gambling among adults: roughly 9%.
- Problem gambling among adults: around 1–2% (1.4% pooled estimate).
- Among those who use high-intensity formats (e.g., online casino/slots), the prevalence of problem gambling is much higher (15–16% among users of these forms).
- Substantial regional divergence in both participation and harm, reflecting differences in availability, regulation, and survey practices.
Study Conclusion
This meta-analysis establishes that gambling is a highly common behavior worldwide, with roughly half of adults and a sizeable minority of adolescents gambling in the past year. Although the percentage who meet criteria for problem gambling appears small in absolute terms (1–2%), at the global scale this translates into millions of affected individuals, and many more experiencing low- to moderate-risk gambling.
Crucially, risk is not evenly distributed: users of rapid, high-intensity products, especially online casino and slot-style games show markedly elevated problem-gambling rates, indicating that product design and structural characteristics are central determinants of harm. The authors argue that these results should serve as benchmark estimates for countries and regions, and they call for product-specific regulation (particularly online), improved surveillance in under-studied regions, and prevention strategies that target both youth and high-risk product environments.
