Public health implications of the deregulation and privatization of online and sports gambling in Canada.

Λεπτομέρειες βιβλιογραφικής εγγραφής
Τίτλος: Public health implications of the deregulation and privatization of online and sports gambling in Canada.
Συγγραφείς: Forrest R; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada. r.forrest@mail.utoronto.ca.
Πηγή: Canadian journal of public health = Revue canadienne de sante publique [Can J Public Health] 2026 Jun; Vol. 117 (3), pp. 471-475. Date of Electronic Publication: 2025 Sep 15.
Τύπος έκδοσης: Journal Article
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: Springer Nature Country of Publication: Switzerland NLM ID: 0372714 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1920-7476 (Electronic) Linking ISSN: 00084263 NLM ISO Abbreviation: Can J Public Health Subsets: MEDLINE
Imprint Name(s): Publication: Switzerland : Springer Nature
Original Publication: Ottawa : Canadian Public Health Association
Ιατρικοί όροι (MeSH): Gambling*/prevention & control , Privatization*/legislation & jurisprudence , Public Health* , Internet* , Sports* , Government Regulation*, Humans ; Ontario ; Canada ; Public Policy
Περίληψη: Recent legislative changes have allowed the rapid expansion of online and sports gambling in Ontario. These changes include the privatization of the online and sports gambling market and the legalization of marketing practices for private operators, leading to an unprecedented growth in opportunities and inducements to gamble. While the stated objectives of these reforms centre on economic growth, consumer choice, and consumer protections, the potential public health implications of this policy shift demand urgent attention. This commentary argues for the necessity of applying a public health lens to understand the wide range of potential harms associated with Ontario's gambling policy changes, particularly as other jurisdictions in Canada and across the Americas consider adopting similar approaches. It advocates for targeted research that reframes policy debates around gambling, moving away from a narrow focus on individual responsibility and towards a broader understanding informed by environmental, social, and commercial determinants of health. The public health community must step up to provide the public and decision-makers with the evidence needed to mitigate harm, protect vulnerable populations, and advance equitable health outcomes.
(© 2025. The Author(s) under exclusive license to The Canadian Public Health Association.)
Competing Interests: Declarations. Ethics approval: N/a. Consent to participate: N/a. Consent for publication: N/a. Conflict of interest: The author declares no competing interests.
References: Baxter, D. G., Hilbrecht, M., & Wheaton, C. T. J. (2019). A mapping review of research on gambling harm in three regulatory environments. Harm Reduction Journal, 16(1), Article 12. https://doi.org/10.1186/s12954-018-0265-3. (PMID: 10.1186/s12954-018-0265-3307368176368783)
Browne, M., & Rockloff, M. J. (2018). Prevalence of gambling-related harm provides evidence for the prevention paradox. Journal of Behavioral Addictions. https://doi.org/10.1556/2006.7.2018.41. (PMID: 10.1556/2006.7.2018.41303525206376386)
Centre for Addiction and Mental Health. (2024). Gambling policy framework . https://www.camh.ca/-/media/driving-change-files/public-policy/camh-gambling-policy-framework-pdf.pdf . Accessed 09 Dec 2024.
Dowling, N. A., Merkouris, S. S., Greenwood, C. J., Oldenhof, E., Toumbourou, J. W., & Youssef, G. J. (2017). Early risk and protective factors for problem gambling: A systematic review and meta-analysis of longitudinal studies. Clinical Psychology Review, 51, 109. https://doi.org/10.1016/j.cpr.2016.10.008. (PMID: 10.1016/j.cpr.2016.10.00827855334)
Dryden, J. (2024). Alberta wagers allowing more online gambling operators will capture illicit market. CBC. https://www.cbc.ca/news/canada/calgary/alberta gambling-dale-nally-david-hodgins-nigel-turner 1.7308386#:~:text=But%20in%20May%2C%20the%20provincial,websites%20operated%20by%20private%20companies . Accessed 12 Dec 2024.
Government of Ontario. (2021). Discussion paper: A model for internet gaming in Ontario . https://www.ontario.ca/page/discussion-paper-model-internet-gaming-ontario.
iGaming Ontario (2023) iGaming Ontario’s FY 2022–23 Q3 market performance report. https://igamingontario.ca/en/igaming-ontarios-fy-2022-23-q3-market-performance-report.
iGaming Ontario. (2024). Operators: What sites are regulated? https://www.igamingontario.ca/en/operator/operators . Accessed 16 Dec 2024.
iGaming Ontario. (2025). iGaming Ontario's FY 2024-25 Q2 market performance report.  https://igamingontario.ca/en/news/marketperformance-report-fy-2024-25-q2 . Accessed 21 Mar 2025.
Kesaite, V., Wardle, H., & Rossow, I. (2024). Gambling consumption and harm: A systematic review of the evidence. Addiction Research & Theory. https://doi.org/10.1080/16066359.2023.2238608. (PMID: 10.1080/16066359.2023.2238608)
Korn, D., Gibbins, R., & Azmier, J. (2003). Framing public policy towards a public health paradigm for gambling. Journal of Gambling Studies, 19(2), 235. https://doi.org/10.1023/A:1023685416816. (PMID: 10.1023/A:102368541681612766471)
Marionneau, V., Egerer, M., & Raisamo, S. (2023). Frameworks of gambling harms: A comparative review and synthesis. Addiction Research & Theory. https://doi.org/10.1080/16066359.2022.2113071. (PMID: 10.1080/16066359.2022.2113071)
McGrane, E., Wardle, H., Clowes, M., Blank, L., Pryce, R., Field, M., Sharpe, C., & Goyder, E. (2023). What is the evidence that advertising policies could have an impact on gambling-related harms? A systematic umbrella review of the literature. Public Health. https://doi.org/10.1016/j.puhe.2022.11.019. (PMID: 10.1016/j.puhe.2022.11.01936725155)
Safe and Regulated Sports Betting Act, Pub. L. No. S.C. 2021 (2021). https://laws-lois.justice.gc.ca/eng/annualstatutes/2021_20/ . Accessed 09 Dec 2024.
Parke, A., & Parke, J. (2019). Transformation of sports betting into a rapid and continuous gambling activity: A grounded theoretical investigation of problem sports betting in online settings. International Journal of Mental Health and Addiction. https://doi.org/10.1007/s11469-018-0049-8. (PMID: 10.1007/s11469-018-0049-8)
Raybould, J. N., Larkin, M., & Tunney, R. J. (2021). Is there a health inequality in gambling related harms? A systematic review. BMC Public Health. https://doi.org/10.1186/s12889-021-10337-3. (PMID: 10.1186/s12889-021-10337-3335490827866763)
Rotermann, M., & Gilmour, H. (2022). Who gambles and who experiences gambling problems in Canada?   https://www150.statcan.gc.ca/n1/pub/75-006-x/2022001/article/00006-eng.htm . Accessed 06 Dec 2024.
Storer, J., Abbott, M., & Stubbs, J. (2009). Access or adaptation? A meta-analysis of surveys of problem gambling prevalence in Australia and New Zealand with respect to concentration of electronic gaming machines. International Gambling Studies. https://doi.org/10.1080/14459790903257981. (PMID: 10.1080/14459790903257981)
Suurvali, H., Hodgins, D. C., Toneatto, T., & Cunningham, J. A. (2012). Hesitation to seek gambling-related treatment among Ontario problem gamblers. Journal of Addiction Medicine. https://doi.org/10.1097/ADM.0b013e3182307dbb. (PMID: 10.1097/ADM.0b013e3182307dbb21979819)
Tran, L. T., Wardle, H., Colledge-Frisby, S., Taylor, S., Lynch, M., Rehm, J., Volberg, R., Marionneau, V., Saxena, S., Bunn, C., Farrell, M., & Degenhardt, L. (2024). The prevalence of gambling and problematic gambling: A systematic review and meta-analysis. The Lancet Public Health, 9(8), e594–e613. https://doi.org/10.1016/S2468-2667(24)00126-9. (PMID: 10.1016/S2468-2667(24)00126-939025095)
Turner, N. E., Sinclair, L., & Matheson, F. I. (2024). Brief report: The rise of online betting in Ontario. Journal of Gambling Studies, 40(2). https://doi.org/10.1007/s10899-023-10268-1.
Ukhova, D., Marionneau, V., Nikkinen, J., & Wardle, H. (2024). Public health approaches to gambling: A global review of legislative trends. The Lancet Public Health. https://doi.org/10.1016/S2468-2667(23)00221-9. (PMID: 10.1016/S2468-2667(23)00221-939491880)
Ukhova, D., Marionneau, V., Volberg, R., & Wardle, H. (2024). The expansion of gambling across the Americas poses risks to mental health and wellbeing. The Lancet Regional Health - Americas, 37, Article 100855. https://doi.org/10.1016/j.lana.2024.100855. (PMID: 10.1016/j.lana.2024.1008553917637611339040)
van der Maas, M. (2016). Problem gambling, anxiety and poverty: An examination of the relationship between poor mental health and gambling problems across socio-economic status. International Gambling Studies, 16(2), 281. https://doi.org/10.1080/14459795.2016.1172651. (PMID: 10.1080/14459795.2016.1172651)
Vieira, J. L., Coelho, S. G., Snaychuk, L. A., Parmar, P. K., Keough, M. T., & Kim, H. S. (2023). Who makes in-play bets? Investigating the demographics, psychological characteristics, and gambling-related harms of in-play sports bettors. Journal of Behavioral Addictions. https://doi.org/10.1556/2006.2023.00030. (PMID: 10.1556/2006.2023.000303733577610316160)
Wardle, H., Degenhardt, L., Marionneau, V., Reith, G., Livingstone, C., Sparrow, M., Tran, L. T., Biggar, B., Bunn, C., Farrell, M., Kesaite, V., Poznyak, V., Quan, J., Rehm, J., Rintoul, A., Sharma, M., Shiffman, J., Siste, K., Ukhova, D., … Saxena, S. (2024). The Lancet Public Health Commission on gambling. The Lancet Public Health, 9(11), e950–e994. https://doi.org/10.1016/S2468-2667(24)00167-1. (PMID: 10.1016/S2468-2667(24)00167-1)
Wheaton, J., Rossi, R., Moxley, M., Tozzi, E., & Moradipour, S. (2024). Exploring the prevalence of gambling marketing | An analysis of the prevalence of marketing across televised and social media coverage of NBA and NHL in Ontario. https://www.bristol.ac.uk/media-library/sites/business-school/documents/Exploring_the_Prevelance_of_Gambling_Marketing_UoB_CBCNews.pdf . Accessed 10 Dec 2024.
Yeola, A., Allen, M. R., Desai, N., Poliak, A., Yang, K. H., Smith, D. M., & Ayers, J. W. (2025). Growing health concern regarding gambling addiction in the age of sportsbooks. JAMA Internal Medicine, 185(4), 382. https://doi.org/10.1001/jamainternmed.2024.8193. (PMID: 10.1001/jamainternmed.2024.81933996073711833657)
Young, M. M., McKnight, S., Kalbfleisch, L., Leon, L., Lusk, E., Smit Quosai, T., & Stark, S. (2024). Gambling availability and advertising in Canada-A call to action. Canadian Centre on Substance Use and Addiction. https://www.ccsa.ca/sites/default/files/2024-06/Gambling-Availability-and-Advertising-in-Canada-en.pdf . Accessed 09 Dec 2024.
Contributed Indexing: Keywords: Addiction; Commercial determinants of health; Gambling; Gambling policy; Public health
Local Abstract: [Publisher, French] RéSUMé: De récentes modifications législatives ont ouvert la voie à l’expansion rapide du jeu en ligne et des paris sportifs en Ontario. La privatisation du marché du jeu en ligne et des paris sportifs et la légalisation des pratiques de marketing pour les entreprises privées ont en effet mené à une croissance sans précédent des possibilités de jouer et des incitations au jeu. Les objectifs déclarés de ces réformes sont axés sur la croissance économique, mais le choix et la protection des consommateurs et les conséquences possibles pour la santé publique de ce changement d’orientation exigent une attention urgente. Nous faisons valoir la nécessité d’appliquer un prisme de santé publique pour comprendre le vaste éventail de méfaits possibles associés au changement de cap de l’Ontario en matière de jeu, surtout que d’autres sphères de compétence au Canada et sur le continent américain songent à adopter des approches semblables. Nous préconisons des études ciblées qui reformulent le débat sur le jeu et qui, au lieu de se focaliser étroitement sur la responsabilité individuelle, visent une compréhension plus large, éclairée par les déterminants environnementaux, sociaux et commerciaux de la santé. La communauté de la santé publique doit se mobiliser pour fournir au grand public et aux décideurs les données probantes nécessaires pour atténuer les méfaits du jeu, protéger les populations vulnérables et favoriser des résultats de santé équitables.
Entry Date(s): Date Created: 20250915 Date Completed: 20260706 Latest Revision: 20260726
Update Code: 20260726
PubMed Central ID: PMC13345661
DOI: 10.17269/s41997-025-01108-3
PMID: 40954442
Βάση Δεδομένων: MEDLINE
Περιγραφή
ISSN:1920-7476
DOI:10.17269/s41997-025-01108-3