The world-wide growth of the gambling industry should worry public health authorities, says The Lancet. Taking advantage of the celebration of Safer Gambling Week in Ireland and the UK earlier this month, The Lancet says that “The health harms of gambling are not a matter for individuals’ willpower and control, but the result of relentless profit-driven tactics. This requires robust wide-reaching regulation and legislation in response, based on the approaches used for tobacco and alcohol control.”

The problem varies quite a bit between countries. However, some research has suggested that problem gambling affects 0·1–5·8% of adults globally.

“When measured in quality-adjusted life-years, the burden of harm from gambling in some countries is similar to that of depression and alcohol, mostly resulting from financial loss, damage to relationships and health, mental distress, and adverse effects on work and education, disproportionately affecting individuals already in poor health and deepening societal and health inequities.”

However, options for dealing with the gambling industry are limited, as it has a powerful hold on society. More than 80% of jurisdictions permit gambling; internet gambling is growing rapidly; and governments depend on gambling taxes for revenue. “The inclusion of the gambling industry in the co-creation and implementation of solutions to problems it has created is morally dubious and doomed to failure,” says The Lancet acidly.