Gambling Harm Around the World: What the Data Shows and What South Africa Can Learn

This article is intended for informational and public-interest purposes. The prevalence figures discussed use different methodologies and are not directly comparable between countries.

Problem gambling exists in every country with a developed gambling market. It is not unique to South Africa. The United Kingdom, Australia, Sweden, the United States, Canada and many other countries have all identified gambling harm as a public health issue, and each one has built its own regulatory and treatment response over time.

What differs between countries is not whether gambling harm exists, but how it is measured, how it is funded, and how it is regulated.

This article looks at the most recent official prevalence data from six countries, including South Africa, and at how each country has responded. It is written for readers who want to understand where South Africa sits in the global picture, and what the international evidence tells us about gambling harm, regulation, and the responsibilities that come with operating in this space.

Why These Figures Cannot Be Directly Compared

Before reading any of the figures in this article, one point needs to be made clearly. Problem gambling prevalence rates cannot be directly compared between countries. The numbers in the table below are not a league table, and treating them as one would be misleading.

There are four main reasons for this.

Different countries use different measurement instruments. The UK and Sweden use the Problem Gambling Severity Index (PGSI). The United States uses indicators based on DSM-5 criteria. Australia combines PGSI with a broader gambling-related harm scale. Earlier South African studies have used a mix of PGSI and DSM-based criteria. Each instrument measures something slightly different, and the thresholds for what counts as problem gambling are not identical across them.

Different countries use different timeframes. Some studies measure past-year prevalence. Others measure lifetime prevalence. The two are not the same number and cannot be plotted on the same chart without distortion.

Different countries use different survey methods. The UK Gambling Commission moved to a push-to-web methodology in 2023, which produced significantly higher PGSI scores than the previous Health Survey for England methodology, which used face-to-face interviews. The Commission itself has cautioned that estimates from the new survey are not directly comparable with results from prior surveys, and such comparisons should not be used to assess trends over time. The numbers changed because the method changed, not because problem gambling tripled overnight.

Different countries have different gambling markets, regulatory frameworks and cultural contexts. A country with a heavily restricted gambling market and another country with widely available online betting are not measuring the same underlying behaviour, even if the instrument and timeframe are identical.

The figures in this article should be read as national snapshots, each shaped by its own methodology and context. They show that gambling harm is a real public health issue in every country with a developed gambling market. They do not show which country has it worst.

Problem Gambling Prevalence by Country

The table below sets out the most recent official prevalence figures from six countries, with the study name, year, instrument, sample size and source for each. The methodology column is the most important part of the table. It is what makes the figures meaningful and what stops them being misread.

A few points worth pulling out from the table.

The UK figure of 2.5 percent is not a sudden jump in problem gambling. It is the result of a new measurement methodology that reaches active online gamblers more effectively than the previous face-to-face survey did. The underlying behaviour did not change overnight. The way it was measured did.

The Australia figure of 15 percent measures gambling-related harm rather than problem gambling in the narrower clinical sense. It captures a wider population, including people affected by someone else’s gambling. The 15 percent and the UK 2.5 percent are not measuring the same thing. The Australian study separately classifies 2.6 percent of adults as being at high risk of gambling harm.

The US figure of 8 percent reports adults who experienced at least one indicator of problematic gambling many times in the past year. The National Council on Problem Gambling has been explicit that NGAGE 3.0 is not a clinical prevalence study. It is a behavioural indicator survey.

Sweden’s 0.6 percent comes from a longstanding longitudinal study using a consistent PGSI methodology, which makes it one of the most internally reliable data sets in the table, but only for comparison with itself over time.

Canada’s data is from 2018 and predates the legalisation of single-event sports betting in 2021. The current picture in Canada is almost certainly different, but the most recent national-level dataset is still the 2018 CCHS.

South Africa’s figures require particular attention. Historical National Responsible Gambling Programme studies put sub-threshold problem gambling at 4 to 7 percent and pathological gambling at around 1 percent of the adult population. The most recent National Gambling Board Annual Report for FY2024/25 records a sharp increase in problem gambling prevalence to 31 percent of participants, up from under 6 percent in 2017, and an increase in distressed calls to the SARGF helpline from approximately 140,000 in the previous year to over 1.1 million in FY2024/25. The methodology underlying the 31 percent figure differs from the historical national prevalence studies and reflects gambling participants rather than the general adult population.

How Countries Respond to Gambling Harm

The regulatory response to gambling harm varies as widely as the data does.

The United Kingdom operates under the Gambling Commission, with a statutory framework that includes operator licensing, advertising rules, affordability checks, and a national self-exclusion register called GAMSTOP. Treatment is coordinated through GambleAware and funded historically through voluntary operator contributions, now moving to a statutory levy under recent reforms.

Australia regulates gambling at state level, with each state and territory operating its own licensing regime. National-level coordination exists through BetStop, the national self-exclusion register, and through the Australian Communications and Media Authority on advertising. Federal interventions tend to focus on advertising and protection measures rather than direct licensing.

Sweden reorganised its gambling market in 2019 under a licensing model administered by Spelinspektionen, replacing the older state monopoly. Self-exclusion is handled through Spelpaus, a single national system that operators are legally required to integrate with. Advertising standards are codified in law.

Norway and Finland continue to operate state monopoly models, where gambling is controlled by state-owned operators and private commercial operators are largely excluded from the legal market. These models concentrate revenue and treatment funding within the state, but do not eliminate gambling harm.

The United States regulates gambling at state level, with no unified federal licensing framework. The National Council on Problem Gambling coordinates research, advocacy and helpline services across jurisdictions, but the regulatory picture differs from one state to the next.

What unites these regulatory models is that all of them recognise gambling harm as a real public issue, and all of them require licensed operators to contribute to addressing it. None of them have solved the problem completely. Each one represents a different set of trade-offs between accessibility, revenue, consumer protection, and treatment funding.

Where South Africa Sits

South Africa has a regulatory framework built on the National Gambling Act 7 of 2004, administered through the National Gambling Board at national level and through nine provincial gambling boards at provincial level. Licensed operators contribute 0.1 percent of gross gambling revenue to the National Responsible Gambling Programme, which funds research, public education, and free treatment services through the South African Responsible Gambling Foundation.

In comparative terms, the South African framework holds up well on the fundamentals. The funding mechanism for the National Responsible Gambling Programme is closer in design to a statutory levy than to the voluntary contribution models that the UK is moving away from. The provincial regulatory structure produces a more devolved system than the UK or Sweden but operates on similar principles to Australia’s state-level model.

Where the South African framework is weaker is in areas the international comparison makes clear. The national self-exclusion infrastructure is less developed than the UK’s GAMSTOP, Sweden’s Spelpaus or Australia’s BetStop. Advertising standards are less codified than in the UK or Sweden. And affiliate websites that promote licensed operators, including comparison sites and review sites, operate outside the responsible gambling obligations that apply to the operators themselves. This is the same gap that exists in the UK, where the recent white paper has flagged affiliate oversight as an area requiring further work, but it is more pronounced in South Africa.

The FY2024/25 NGB figures suggest the gap is becoming material. A 623 percent increase in helpline calls in a single financial year is not a methodological artefact. It is a signal that the responsible gambling infrastructure is under significant pressure, and that the regulatory framework needs to evolve to match the scale of the current market.

What the International Evidence Tells Us

Three points come out of the international comparison clearly.

Gambling harm is not solved by any current regulatory model. Mature markets with sophisticated regulators, statutory funding and national self-exclusion registers still report meaningful prevalence figures. Restricting the market does not eliminate harm. Liberalising the market does not either. Both approaches require ongoing public health investment.

Measurement matters. The UK’s methodology shift is the clearest example of how much the measurement instrument shapes the reported figure. Without consistent measurement, the conversation about whether gambling harm is rising or falling cannot be had honestly.

Affiliate oversight is the next frontier in most regulated markets. The UK, the EU and Australia are all moving in the direction of bringing affiliates inside the responsible gambling framework rather than treating them as a marketing channel that sits outside it. South Africa will need to follow.

Where to Get Help

If you or someone you know is affected by gambling, free, confidential help is available in South Africa through the National Responsible Gambling Programme.

Call the toll-free helpline on 0800 006 008 or visit responsiblegambling.org.za. Treatment, counselling and self-exclusion services are available at no cost.

Most countries operate equivalent national services. In the UK, the National Gambling Helpline is run by GambleAware. In the US, the National Council on Problem Gambling operates a national helpline. In Australia, Gambling Help Online provides 24-hour support.

The Bottom Line

Problem gambling exists in every country where gambling exists. The differences in measurement, regulation and treatment between countries do not change that underlying reality, but they do shape how the problem is identified and addressed.

South Africa is not uniquely affected and is not uniquely failing. It sits within a global picture in which gambling harm is a recognised public health issue, regulatory responses are still developing, and the work of reducing harm is ongoing.

The international evidence does not produce a ranked list of countries. It produces a clear set of principles. Licensed operators carry responsibilities. Treatment must be funded. Self-exclusion must be accessible. Advertising must be controlled. And the parts of the ecosystem that have historically sat outside the regulatory framework, including affiliates, are increasingly being brought inside it.

That direction of travel is the same in every developed gambling market. South Africa is not the exception to it. It is part of it.

References and Sources

United Kingdom

1. UK Gambling Commission. Gambling Survey for Great Britain, Annual Report 2024: Problem Gambling Severity Index. Available at: https://www.gamblingcommission.gov.uk/report/gambling-survey-for-great-britain-annual-report-2024-official-statistics/gsgb-annual-report-2024-problem-gambling-severity-index
2. UK Gambling Commission. Gambling Survey for Great Britain, Annual Report 2024: Headline Statistics. Available at: https://www.gamblingcommission.gov.uk/report/gambling-survey-for-great-britain-annual-report-2024-official-statistics/gsgb-annual-report-2024-headline-statistics
3. UK Gambling Commission. Gambling Survey for Great Britain, Annual Report 2023: Executive Summary. Available at: https://www.gamblingcommission.gov.uk/report/gambling-survey-for-great-britain-annual-report-2023-official-statistics/gsgb-annual-report-executive-summary

Australia

4. Australian Institute of Family Studies. National Gambling Prevalence Study Pilot 2024. Australian Gambling Research Centre. Available at: https://aifs.gov.au/research/research-snapshots/national-gambling-prevalence-study-pilot-2024
5. Australian Institute of Family Studies. National Gambling Study Finds More Australians Harmed Amid Rising Participation. Media release, September 2025. Available at: https://aifs.gov.au/media/national-gambling-study-finds-more-australians-harmed-amid-rising-participation
6. Australian Gambling Research Centre. National Gambling Trends Study. Available at: https://aifs.gov.au/research_programs/australian-gambling-research-centre/gambling-trends-study

Sweden

7. Public Health Agency of Sweden (Folkhalsomyndigheten). Swelogs (Swedish Longitudinal Gambling Study). Available at: https://www.folkhalsomyndigheten.se/the-public-health-agency-of-sweden/living-conditions-and-lifestyle/andtg/gambling/swelogs/

United States

8. National Council on Problem Gambling. National Survey on Gambling Attitudes and Gambling Experiences (NGAGE 3.0). Available at: https://www.ncpgambling.org/programs-resources/research/ngage/

Canada

9. Statistics Canada. Who Gambles and Who Experiences Gambling Problems in Canada. August 2022. Available at: https://www150.statcan.gc.ca/n1/daily-quotidien/220809/dq220809b-eng.htm

South Africa

10. National Gambling Board of South Africa. Annual Report FY2024/25. Available at: https://www.ngb.org.za/
11. South African Responsible Gambling Foundation. Research Reports. Available at: https://responsiblegambling.org.za/research-reports-2/
12. Collins, P., Stein, D. J., Pretorius, A., Sinclair, H., Ross, D., Hofmeyr, A., Sharp, C., Spurrett, D., Rousseau, J., Ross, D. P., Schuhr, A. Addressing Problem Gambling: South Africa’s National Responsible Gambling Programme. South African Medical Journal, 2011. Available at: https://scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742011001000022
13. Sinclair, H., Pretorius, A., Stein, D. J. A Counselling Line for Problem and Pathological Gambling in South Africa: Preliminary Data Analysis. Journal of Behavioral Addictions, 2014. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC4189313/
14. National Gambling Board of South Africa. The Social Impact of Gambling in South Africa. Available at: https://www.ngb.org.za/wp-content/uploads/2020/06/Social-impact-of-gambling-qualitative-perspective-2013.pdf

South African Regulatory Framework

15. Republic of South Africa. National Gambling Act 7 of 2004. Available at: https://www.gov.za/documents/national-gambling-act
16. South African Responsible Gambling Foundation. National Responsible Gambling Programme. Available at: https://responsiblegambling.org.za/