US gambling addiction is ‘out of control’ as betting markets boom, policy expert warns

The rapid expansion of online gambling, prediction markets and sports betting platforms, “demands a public health response”, according to Harry Levant, director of gambling policy at the Public Health Advocacy Institute (PHAI), urging policymakers to intervene.

“You regulate the distribution, the speed, the type, the access to the product, because the product is what’s dangerous,” he said, calling for gambling to be treated like alcohol or tobacco. “The problem is the product, not the people,” said Levant. “We have a crisis here.”

The warning comes as experts from around the world are set to gather in Boston today to push for more regulation of the industry. The conference has been organized by PHAI, a US-based non-profit led by Richard Daynard, who led litigation against big tobacco in the 1980s.

In an interview with the Guardian, Levant argued that issues sparked by the rapid proliferation of gambling are growing. “We’re seeing the evidence everywhere,” he said. “The harm that is taking place to people, young men, families, people of all ages, it is simply out of control.”

Friday’s event will bring together scholars, researchers, public health professionals and policymakers to discuss the surge in online gambling since the US supreme court lifted the federal sports betting ban in 2018, how it has hit public health and pathways to “meaningful” reform.

“We firmly believe gambling should be regulated like any other addictive product,” said Mark Gottlieb, executive director of PHAI. “We firmly believe gambling should be regulated like any other addictive product.”

Sports betting has been legalized in 39 states and Washington DC since the landmark 2018 supreme court ruling.

Prediction market platforms – where users can bet on everything fromaward winners and war developments, to what someone might wear, or what an artist will sing on stage – have meanwhile surged in popularity in the last few years, with more than $1bn traded on Kalshi during Super Bowl Sunday alone.

Prediction market platforms contend that they are not gambling platforms, but rather financial trading platforms. Critics argue they are gambling under another name.

‘A public health crisis’

As prediction market platforms classify their offerings as “event derivatives”, however, they are placed – unlike traditional sports books or casinos – under federal commodities regulation by the Commodity Futures Trading Commission (CFTC), rather than state gaming authorities. As a result, they are accessible across the country to users 18 and older.

But as more Americans wager on sports, stocks and events, public concern around the expansion of online gambling appears to be growing as clinicians and advocate for greater support and regulation warn of increased addiction levels. An Ipsos poll from November also found that about 40% of Americans said that they would support the federal government “doing more to regulate sports betting.”

Levant believes the US is at a critical juncture. “There’s a need to demonstrate – both to the people of America, and the political leaders in America – that there is a problem,” he said. “And we know what the cause of the problem is: the cause of the problem is the unregulated nature of a dangerously and effectively designed online gambling product.

“Once you know what the problem is, seems to me, you have a binary choice. You maintain the status quo and accept a harm, or you go back to honoring that vow to try and do something about it.”

The PHAI conference is designed to “bring to the United States the true experts” on gambling and public health “not only from this country, but from around the world”, Levant said. Speakers include Charles Livingstone, an associate professor at Monash University’s school of public health and preventive medicine in Australia, and Dr Matt Gaskell, the clinical lead and consultant psychologist at the UK’s National Health Service (NHS) Northern Gambling Service. US speakers include Richard Blumenthal, a Democratic senator of Connecticut, and Paul Tonko, a New York congressman, who have pushed for a legislative crackdown.

“This is not an anti-gambling conference,” Levant said. “This is a pro-public health symposium with real solutions.”

On both the federal level and in numerous states, legislation has been introduced to regulate online gambling. One of the bills that will be talked about on Friday is the Safe Bet Act, introduced in Congress by Tonko and Blumenthal, which seeks to establish “minimum federal standards” for legal sports betting and seeks to impose limits on marketing, introduce affordability checks and restrictions on apps using artificial intelligence to track players and create bets.

Prediction market platforms “sort of amplify the need for a public health approach”, said Levant, who noted they make betting “even more readily available by reaching down to people as young as 18”, whereas in most states that have legalized sports betting you have to be at least 21. Such platforms are “broadening the scope of what can be gambled on in a micro way”, he argued, and contributing to the “normalization process that is at the heart of the public health crisis” around online gambling.

Levant’s perspective is shaped by personal experience. He said Monday marked the 12th anniversary of his last bet.