Gambling is a form of risk-taking that involves betting on events with uncertain outcomes. These events can be anything from a football match to a scratchcard. The first part of gambling involves choosing a wager, which is then matched to ‘odds’ set by the betting company. These odds are the probability that an event will happen – in other words, how likely it is that you will win.

Once upon a time, pathological gambling was thought of as a character flaw or a sign of mental illness but now it is regarded as an addiction similar to substance abuse and recognised in the Diagnostic and Statistical Manual of Mental Disorders. However, many people who have problem gambling may not recognise it as an addiction, and this can be due to a number of factors.

For some, gambling is a fun and social activity they enjoy doing with friends. It can also be a way of relieving boredom, loneliness or stress. For others, it’s a means to escape from reality and the everyday pressures of life, such as financial problems, unemployment or family issues. People who have a mental health problem can be more at risk of problematic gambling and may use it to relieve symptoms of depression or anxiety or as a distraction from painful feelings.

Research has shown that gambling can stimulate the brain by triggering the release of dopamine, the feel-good neurotransmitter. This change in brain chemistry can make you want to gamble more, especially when you lose. Some individuals may be genetically predisposed to thrill-seeking behaviours and impulsivity, and this can be amplified by the environment they are in, which can lead to a vicious cycle of losing money and gambling more.

Some people start to gamble when they are feeling depressed, anxious or stressed because it distracts them from their problems and makes them feel a rush of pleasure. This is not always a good idea and can have serious consequences for your mental and physical health.

The costs of problem gambling can be significant and can affect the lives of both the gamblers and those close to them. Impacts can be observed on a personal, interpersonal and community/society level (Fig 1). Personal impacts influence gamblers themselves while interpersonal impacts affect the people who are close to them. These can include their friends and family members. Community/society impacts can involve the wider community, such as businesses and local government.

Problem gambling can cause a lot of stress and anxiety, which can lead to other health problems. For example, excessive gambling can lead to a sedentary lifestyle, leading to weight gain, muscle weakness and poor cardiovascular health. It can also result in missing work and social events. It can also lead to neglect of basic self-care, such as eating and sleeping well. This can put people at risk of a variety of mental and physical health conditions, including depression, anxiety, heart disease and dementia.