Global legislative trends in gambling policy

Gambling is increasingly framed as a public health issue with a public health approach advocated to tackle growing gambling harms. As commercial gambling provision grows worldwide, the extent to which the protection of public health is prioritised in legislation is unclear and if and how this competes with other priorities.
The authors conducted a systematic review of major gambling legislative change globally between 2018 and 2023, analysing primary legislation to uncover the motivations driving policy change. Overall, 80 jurisdictions worldwide have implemented major legislative change for gambling (that is they have either expanded or restricted gambling). Results show the primary global trend is for legalising commercial gambling, mainly for reasons relating to promoting revenue generation for states or protecting the transparency and integrity of gambling provision. Revenue generation was a substantially stronger motivation in North America, whereas protection of public health was more common in Europe.

The global implications of these trends will be discussed, with reference to the legal determinants of health. What is enshrined in legislation now sets the agenda for how gambling is regulated and provided over the next decade. It is therefore vital to understand and explore how legislative framing sets this agenda and to identify major gaps and challenges going forward.