Gambling and gambling-related problems in France.

AIMS To provide an overview of the gambling landscape and gambling-related problems in France, including the history, legislation, gambling policy and epidemiological data on excessive gambling. METHOD A literature review, using Medline, PsycInfo and Toxibase/OFDT databases, based on the systematic monitoring of scientific literature since 2008 (including French and international papers). RESULTS Since 1776 and the creation of the royal lottery, state monopoly has been the main pillar of gambling policy in France. Increases in gambling venues and opportunities, growing evidence of gambling-related problems, pressures from the European Commission and the growth of on-line gambling have led to major changes in this policy: while land-based gambling remains mainly in the form of a state monopoly, on-line gambling was partially liberalized in 2010, and regulation authorities were established. The first epidemiological survey was conducted in 2010. Rates of problematic gambling in France are within the average of other European countries. Treatment has begun to be made available within addiction centres. CONCLUSION A majority of on-line gamblers in France use legal websites, which was one of the initial goals of liberalization. Recent studies confirm that the prevalence of problem gambling in France is far higher among on-line gamblers than among land-based gamblers; however, this difference cannot be attributed only to greater addictiveness of on-line gambling.