What are the most harmful forms of gambling? Analyzing problem gambling prevalence surveys

Eighteen national prevalence surveys of problem gambling (PG), most of them from Europe, were analyzed to assess the relative harmfulness of various forms of gambling. It was found that interactive Internet gambling, casino gambling, electronic gaming machines, and high-stakes unregulated/illegal gambling are often relatively closely associated with PG, while lotteries and instant lotteries appear relatively harmless. Other forms of gambling—sports pools, bingo, horse betting, and sports betting—are typically relatively moderately associated with PG. This paper discusses the possibilities and limitations of assessing the harmfulness of various forms of gambling by analyzing prevalence survey data. It is concluded that although such analyses yield valuable insights, they should be complemented by other sources of information, such as statistics on the gambling activities of those seeking help for PG and qualitative studies of problem gambling.