Understanding the influence of gambling opportunities: expanding exposure models to include adaptation.

Many regions are considering expanding the various forms of gambling that are available to residents. The expansion of legalized gambling frequently is the topic of heated debate because of possible harmful ramifications on individuals' mental and physical health as well as the public's health in general. Conventional wisdom holds that the expansion of gambling relates to increases in gambling-related problems among the population (i.e., the exposure effect). A review of empirical evidence provides an opportunity to verify the accuracy of this wisdom. An evaluation of available research studies provides some support for the exposure effect, but also raises questions about the durability of that phenomenon across settings and time points. Some exposure studies indicate specific patterns of gambling activity and consequences that are inconsistent with the exposure effect. These studies suggest that some people and some places might have adapted to the risks and hazards of gambling (i.e., the adaptation effect). This evaluation suggests that social context is an important moderator of exposure processes.