Understanding and addressing the challenges of online gambling addiction in mainland China

Gambling in China has a long and evolving history, from ancient court cockfighting to preliberation casinos with games like baccarat.1 Over time, gambling in China has evolved to include a wide range of activities, including gaming machines, online gambling and commercial gambling. Despite being declared illegal and regulated after the establishment of the People’s Republic of China, gambling remains deeply ingrained in Chinese culture. While recreational gambling is widely accepted, it often leads to excessive time spent and an increased risk of problematic gambling behaviours. In recent years, the situation has been exacerbated due to the rise of online gambling, which is emerging as the predominant form of gambling in China.2 Online gambling platforms provide a virtual environment that offers short-term relief, excitement and distraction. Their clandestine nature makes them more appealing to vulnerable groups, including adolescents and problem gamblers. The diverse forms of online gambling increase the risk of excessive gambling and present greater challenges for regulation and management. Addressing the associated harms requires simultaneous attention from both regulatory and medical perspectives. Gambling in China has a complex landscape that includes various forms of recreational activities. While generally considered a major vice alongside pornography and drugs, certain forms of recreational gambling are widely accepted during social gatherings. Favourable attitudes towards gambling increase intention and the likelihood of engagement, as per expectancy-value models like the theory of planned behaviour.3 The perception that insignificant stakes mitigate potential consequences has led to widespread participation, excessive time spent and frequent engagement in gambling activities. However, these factors crucially contribute to the development of gambling disorder.4 In China, this has resulted in a distinct group of problem gamblers primarily experiencing negative consequences in terms of time loss rather than financial loss. Consequently, this outcome poses challenges to current screening and …