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Across 270 studies, there is a significant causal relationship between increasing prevalence of certain gaming behaviors and further risk of gambling addiction. Loot boxes are found within certain games, and they consist of lottery-like in-game merchandising where players can unlock certain items by chance. Among those who live in poverty and experience homelessness, 43.7% of individuals reported as lifetime gamblers. According to a 1997 meta-analysis by Harvard Medical School’s division on addictions, 1.1 percent of the adult population of the United States and Canada could be called pathological gamblers. Nevada has the highest percentage of pathological gambling; a 2002 report estimated 2.2 to 3.6 percent of Nevada residents over the age of 18 could be called problem gamblers.

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The “British Gambling Prevalence Survey 2007”, conducted by the British Gambling Commission, found approximately 0.6 percent of the adult population had problem gambling issues—the same percentage as in 1999. Nicki A. Dowling, Alun C. Jackson and Shane A. Thomas, a survey done from 1994 to 2008 in Tasmania gave results that gambling participation rates have risen rather than fallen over this period. A survey conducted in 2008 found that the most common motivation for fraud was problem gambling, with each incident averaging a loss of $1.1 million. Some of the harms resulting from problem gambling include depression, suicide, lower work productivity, job loss, relationship breakdown, crime and bankruptcy. According to the Productivity Commission’s 2010 final report into gambling, the social cost of problem gambling is close to 4.7 billion dollars a year. There is also a question as to the effectiveness of such programs, which can be difficult to enforce.

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In East African countries like Kenya and Uganda, more than a majority of youths surveyed reported gambling behaviors in the last 12 months. Similar to other parts of the world, Africa’s gambling rates are increasing, especially among youths. According to a survey of 11th and 12th graders in Wood County, Ohio found that the percentage who reported being unable to control their gambling rose to 8.3 percent in 2022, up from just 4.2 percent in 2018. Although most who gamble do so without harm, approximately 6 million American adults are addicted to gambling.