Gambling addiction is soaring: The SAFE Bet Act can stop it getting worse

For sports lovers, the month of April is as exciting as it gets. Over a span of 30 days, fans will celebrate the NCAA college basketball championship, The Masters, home openers of Major League Baseball, and the start of the NHL Stanley Cup Playoffs.  

The anticipation of these games and come-from-behind triumphs will put millions on the edge of their seats. But for those who place bets on these events, many of them — especially young men — will put their financial and mental health at risk.  

Sports betting has exploded since the Supreme Court opened the door for states to legalize it in 2018. Once restricted to Nevada-based casino sportsbooks, betting apps now allow millions of users to place wagers on just about any form of competition.  

There is no federal age requirement for legal sports betting — it’s entirely up to the states. In places like Kentucky, kids as young as 18 can use their phones to place a bet as easily as they can order an Uber ride. Today, more than 20 percent of all Americans — and nearly half of all men between the ages of 18-49 — have at least one online betting account. The American Psychiatric Association estimates that more than a quarter of Americans gamble online every day.  

Before 2018, legal bets on sports totaled less than $5 billion. In just six years, it skyrocketed to $150 billion and sparked a 33 percent spike in gambling addiction.  

Online sports betting is a growing public health problem. Gambling addiction can cause depression, mood and anxiety disorders. It can promote feelings of low self-esteem, lead to poor work performance and foster feelings of guilt and shame. Gambling can be a gateway to other problems too, as the recent jump in sports betting has been linked to a 20 percent rise in binge drinking. 

Especially worrisome is the growth of betting among boys and young men. One study found an estimated two thirds of adults participated “in at least one form of gambling” prior to turning 21. Another alarming survey found 12 percent of boys actively participate in sports gambling today.

Stories of adolescents consumed with online betting — including Saul Malek, who accumulated $25,000 in online gaming debt as a teenager and considered suicide — are cautionary tales of how dangerous gambling addiction can be.

Two of the largest online sports betting companies — FanDuel and DraftKings — have spent considerable sums on state lobbying and advertising to expand their reach and engage new customers with their easy-to-use platforms. Both companies spent over $20 million from 2014 to 2024 advancing their business agendas with state legislatures. FanDuel has acknowledged spending $1 billion on advertising and promotions, and both operators are now investing millions more on the upcoming 2026 federal midterm elections.  

The fact that these companies are backing candidates for U.S. Congress when online sports gambling is decided by states is, in betting parlance, a “tell” — a sign online gaming operators see threats on the horizon at the federal level.

Introduced last year, the Supporting Affordability and Fairness with Every Bet Act, known as the SAFE Bet Act, sought to federally regulate online sports betting by banning gambling advertisements during live sporting events. It would have also barred sportsbook operators from enticing people to bet through the use of select promotions.

The legislation would have required the federal government to study the public health impact of online sports betting. Additionally, it would have compelled gambling operators to conduct “affordability checks” on those who place high-dollar bets, prohibited the use of AI to assess gambling behaviors and banned increasingly popular “prop bets” on amateur and college athletes — all in the name of protecting users of their platforms.

The bill stalled in the U.S. House, and its future is unclear. 

Lessons from the tobacco crisis are applicable here. Clever marketing by cigarette companies through advertising and branding campaigns led to an increase in child smoking. Congress must take action to prevent more people — especially young people — from getting hooked in a similar fashion to online sports betting. 

We need more research on gambling’s addictive qualities, with a special focus on its effects on young men. We need federal standards on betting platform advertising, and we must impose safeguards to limit spending and put restrictions on the number of bets users can place within a specified time period. We must also introduce gambling education, awareness and prevention in schools at an early age.  

Online sports gambling is a growing public health threat that demands attention. It is heading in a dangerous direction, and if Congress fails to act, more and more young people will be at higher risk of getting in way over their heads. Those are odds lawmakers can’t ignore.  

Lyndon Haviland, DrPH, MPH, is a distinguished scholar at the CUNY School of Public Health and Health Policy.

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