Editor
Europe’s most influential medical body is calling for sweeping reform of gambling legislation and declares the industry a public health crisis that needs immediate legislative action at both national and European Union (EU) levels.
The Standing Committee of European Doctors (CPME), which represents over 1.7 million doctors across 36 countries, published a wide-ranging policy paper in March and urges policymakers to treat gambling with the same urgency as they apply to tobacco and alcohol, before the levels of harm deepen further.
The organization sees current regulatory regimes across Europe as completely inadequate in dealing with the rapidly growing online industry that operators design to maximize user engagement for profit by exploiting psychological vulnerabilities.
A Public Health Crisis Hiding in Plain Sight
The CPME’s assessment of the scale of gambling harm in Europe presents a stark picture. The World Health Organization (WHO) estimates that 1.2% of the world’s adult population suffers from a gambling disorder. In addition, about 6% of women and 12% of men globally experience some degree of harm from gambling.
Financial losses drive harm, but risks also extend to elevated suicide rates, relationship breakdown, domestic violence, stress, and mental illness. The CPME notes that this damage persists across generations and impacts families and communities, not just the people who place the bets.
The CPME highlights easy access provided by online gambling operators, along with aggressive marketing and addictive design features, as key concerns.
Young People at the Center of Concern
A recurring theme throughout the CPME’s paper highlights the particular vulnerability of children and young people. The organization points to data showing a long-term decline in traditional substance use among 15 and 16-year-olds in Europe, while gambling continues to grow as a risk, notably among women.
The CPME states that gambling now embeds itself across various digital environments, including sports betting apps, video game loot boxes, and social media feeds that deliver algorithmic recommendations.
The CPME calls for a mandatory EU-wide age verification system, requiring platforms to restrict online gambling content to users aged 18 and over. It also calls for restrictions on influencer promotion and urges action on the well-documented link between alcohol and gambling.
The Advertising Reckoning
The CPME uses some of its most forceful language when addressing advertising. It calls for an outright ban on gambling advertising, promotions, and sponsorships, especially across sports and cultural events.
The proposal specifically references the Évin Law, which French authorities use to restrict alcohol and tobacco advertising and sponsorship, as a model for EU-level advertising rules.
The CPME notes that almost 300 top-flight soccer clubs in Europe hold deals with betting firms. It argues that self-regulation has failed. It also highlights that removing gambling logos from the front of English Premier League shirts will reduce the number of visible gambling logos by only around 7% during an average game.
What Reforms It Suggests
The CPME’s policy paper outlines a comprehensive reform framework. It calls for harmonizing national rules, as the current system undermines harm-reduction efforts in stricter jurisdictions by allowing users to easily move between regions when accessing online sites.
The CPME also urges regulators to act against addictive algorithms that gambling operators use to maximize engagement. It recommends real-time pop-up reminders of player time and spending, centralized account registration, and mandatory loss limits. These measures shift more responsibility from individuals to operators and regulators, which the CPME argues is necessary.
The paper directly criticizes the promotion of casino products alongside sports betting, which it identifies as a deliberate strategy to funnel users from lower-risk sports wagering into more addictive online casino formats. The CPME calls for a ban on this type of cross-selling.
Finally, the CPME argues that governments must not rely solely on voluntary industry initiatives or regulatory fines to address gambling harm. Instead, it calls for government-funded mechanisms dedicated to prevention, treatment, education, and research, rather than industry-led funding models.
Calling on Doctors
The CPME provides strict guidance to doctors and healthcare professionals on identifying and addressing gambling harm. The paper urges clinicians to regularly ask patients about gambling alongside other addictive behaviors like smoking and alcohol use, especially when patients present mental health concerns such as depression, suicide ideation, anxiety, and psychosis.
The CPME highlights stigma as a key barrier that prevents people from disclosing gambling problems and notes that many healthcare professionals lack the training to raise the issue themselves. It recommends training programs, clinical resources, and cultural shifts to treat gambling disorder with greater openness and compassion.
The Path Ahead
The CPME policy paper arrives as the European Commission advances the Digital Fairness Act, which targets addictive design in digital products, including loot boxes, and develops an EU-harmonized approach to age verification. The upcoming review of the Audiovisual Media Services Directive also presents an opportunity to tighten gambling advertising restrictions.
The CPME clearly states what it believes needs to happen, based on its view that gambling represents a public health emergency that authorities have not properly addressed. Whether lawmakers will act on these recommendations remains uncertain.
