Patrons sit for lunch as baseball plays on TVs in a downtown Toronto bar.Cole Burston/The Canadian Press
Ontario’s addictions and mental health helpline saw “substantial increases” in people seeking help with gambling problems after online gambling became legal, a new study has found – especially contacts from boys and men aged 15 to 24, which grew by more than 300 per cent.
The paper, published in the Canadian Medical Association Journal on Monday, is one of few to investigate the public health harms of the practice in the decade since Ontario introduced regulated online gambling. The study authors did so by analyzing data from a 24-hour help service called ConnexOntario. Other studies have shown that helplines are the most used resource for gambling problems.
To better understand the findings, The Globe and Mail spoke with two of the study’s co-authors: Ryan Forrest, a doctoral student at the University of Toronto’s Dalla Lana School of Public Health, and Daniel Myran, an associate professor with U of T, who is the Gordon F. Cheesbrough Research Chair in Family and Community Medicine at North York General Hospital.
Editorial: Ontario’s addiction to online gambling revenue
Why did you want to look into this issue?
Ms. Forrest: Like many people in Ontario, I noticed an enormous increase in gambling advertising, and that shift was something that felt really rapid and visible. As a public health researcher, it made me curious: When access and promotion of gambling expands this quickly, do we see any measurable changes in health-related outcomes? This study was an attempt to answer that.
So what is the story that was revealed by your study and its findings?
Dr. Myran: There have been quite large increases in contacts to the mental health hotline for gambling concerns. They’ve gone up by 96 per cent overall after the opening up of the market and the legalization of single-event sports gambling.
But the changes have occurred almost exclusively in young men. They go up by 317 per cent in boys and men aged 15 to 24, and by around 115 per cent in men aged 25 to 44. And you don’t see changes in women.
Ms. Forrest: The scale of these increases, their concentration in young men, is really, really troubling. Gambling harms can accrue to anybody who gambles, as well as their families, communities and society at large. So these signs of an uptick of population-level harms are concerning because of these widespread spillover effects.
Dr. Myran: You really worry that for every person who’s contacting the helpline, there are far more who are having problems – who are suffering silently – and haven’t.
Legislators take aim at sports-betting ads as concern grows over gambling’s risks
You modelled some alternate-reality scenarios, including one where the Ontario government never got into the online gambling business or opened the doors for private companies to operate. What did that analysis reveal?
Dr. Myran: At a high level, what we found was that the launch of the government-run gambling platform PlayOLG in 2015 actually led to increases in gambling contacts in some groups of men. But the further expansion of the market, with the single-event sports gambling and privatization – that’s actually when you see the real takeoff in young men. It really accelerates.
Why do you think that is?
Dr. Myran: I think it’s related to the product availability and the marketing. During that initial period between 2015 and 2022, it’s only PlayOLG; there’s no single-event sports gambling, and it’s more classical gambling activities like online slots or blackjack. Now, there are 80 different websites, heavy advertisements and new types of gambling.
Ms. Forrest: The new types of gambling are important. With the legalization of single-event sports betting, you get things like in-play betting, which is a uniquely harmful form of betting. It allows wagers after a game has started – sometimes even every few seconds.
That’s different because it allows really rapid, continuous betting during sports events. And research suggests that the fast betting cycle, the constant opportunities to wager and real-time emotional engagement can really increase people’s impulsive decision making.
Opinion: Why Canada needs to tackle the scourge of sports betting
What do we know about the health harms of gambling, particularly among this younger cohort?
Dr. Myran: It’s very strongly associated with adverse mental health problems and suicide, and also with substance use. And it can cause substantial social, educational and occupational problems. Someone who’s losing huge amounts to gambling and is getting into debt – that can have major implications for their life.
Alberta is also opening its doors to private online gambling companies. What should other provinces take away from your Ontario study?
Ms. Forrest: So much of the conversation around this policy change in Ontario has really focused on revenue generation and expanding consumer choice. And what our study brings to the table is that there may be negative impacts for people’s health and well-being, and that should be taken seriously.
There are clear policy implications for this in my mind. An obvious first move is to restrict gambling advertising. And I think it’s worth having a broader societal conversation about what forms of gambling are acceptable to us as a society and whether certain forms, like in-play betting, aligns with our public health objectives.
Opinion: Gambling addiction is afflicting our athletes – and sports at large
How urgent is this issue? What are the stakes?
Dr. Myran: Gambling disorders and gambling harms are relatively rare. But I think the amount of discussion and attention that we’ve placed on gambling as an issue is not meeting the scale of the harms and problems that it causes. I really worry that gambling can become increasingly common as the access to it grows.
Gambling disorders or patterns of gambling that get established early in life can continue. And if you’re seeing a big uptick in young people, you really worry about this having a lasting, lifelong impact on them.
This interview has been edited and condensed.