Online gambling as a public health and regulatory challenge: moving beyond individual responsibility.

Online gambling has expanded faster than the public health systems and regulatory frameworks designed to contain its harms. Unlike venue-based gambling, digital platforms combine constant accessibility, rapid betting cycles, frictionless payments, algorithmic personalization, and intensive marketing, features that may heighten risk and hinder early detection of problematic use. In this perspective, we argue that online gambling should be understood not only as an individual behavioral disorder, but also as a public health and regulatory challenge with broader social consequences. Recent evidence shows that online gambling is associated with gambling disorder, depression, anxiety, suicidality, financial distress, family conflict, and harms to affected others, although much of the current literature remains cross-sectional and heterogeneous. We further examine how vulnerabilities are unequally distributed across age, sex, socioeconomic position, and regional regulatory context. To move beyond a purely descriptive account, we compare recent policy responses across jurisdictions, including stake limits and a statutory levy in Great Britain, restrictive advertising rules in Belgium, and new federal controls in Brazil. These examples suggest that effective harm reduction requires more than self-regulation or individual responsibility messaging. A precautionary public health approach should include restrictions on advertising and inducements, binding deposit or loss limits, centralized exclusion systems, robust age verification, financial safeguards, and insulation of research and policymaking from industry influence.