A recent Lancet Public Health Commission report on gambling says the rapidly expanding online gambling industry is projected to result in US$700 billion in losses to consumers by 2028.

The Commission says gambling is now legally allowed in more than 80 per cent of countries worldwide and the expansion is most notable in low-income and middle-income countries where regulatory infrastructure is usually weaker according to the Lancet.

The Lancet Commission says digitization has “transformed” the production and operation of online gambling and the effects of the shift have not yet been fully recognized.

The Lancet says online gambling products are designed to be “rapid and intensive,” characteristics often associated with higher risk of harm for consumers.

The gambling industry, according to the Lancet, has deployed a range of strategies similar to those used by other industries selling potentially addictive or health-harming products, downplaying the harms and stressing the economic benefits, including tax revenue.

Beyond the obvious danger of financial loss, gambling can also result in job loss, broken relationships, and health effects, including the risk of suicide and crime. The effects are felt not just by the gambler but by their family and friends as well.

The Commission estimates that 46 per cent of adults and close to 18 per cent of adolescents worldwide had engaged in gambling of some form in the previous year, with ten percent of teens gambling online.

It recommends that all countries implement greater prohibitions or restrictions to online gambling, its promotion, marketing and sponsorship. Minimum age requirements should be enforced, and mandatory identification is required. The Commission also recommends that United Nations entities and intergovernmental organizations incorporate a focus on gambling harms into their strategies to improve health and well-being.