Insights on Canadian Society
Who gambles and who experiences gambling problems in Canada

by Michelle Rotermann and Heather Gilmour

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Introduction

Gambling is common in Canada,^Note  as it is in many other countries.^Note  The majority of people who gamble do so without harm, but a minority will be adversely affected.^Note 

People gamble for many reasons—typically for social or recreational ones.^Note  At the same time, loneliness can be an important factor in the development of problem gambling.^Note  Most gamblers feel that it is beneficial, but problem gamblers are much more likely than non-problem gamblers to identify winning money as their main motivation.^Note 

When gambling becomes a problem, both the person who gambles and their family are negatively affected. Gambling problems can lead to marital breakdown, bankruptcy or financial hardship, suicide, crime, reduced health and increased use of alcohol and other substances.^Note 

Problem gambling (more recently referred to as a gambling disorder in the Diagnostic and Statistical Manual of Mental Disorders)^Note  is now recognized as a public health concern, which could help ensure that people who need treatment can get it. It has been estimated that the gambling-related burden of harm is similar in magnitude to the harm attributed to major depressive disorder, or alcohol misuse and dependence.^Note 

There has been an ongoing concern that the COVID-19 pandemic has negatively impacted the mental health of Canadians. Problem gambling is a form of addiction; the stress and disruption caused by the pandemic may influence gambling activities, along with alcohol and drug consumption. Although it is too early to determine, access to a wide range of gambling platforms and sites, in the context of increased amount of time spent online during the pandemic^Note  , could be associated with increased risks of problem gambling.   

Most information about gambling in Canada comes from provincial surveys. The national data available are very limited and not current (CCHS Mental Health 2002). In 2018, the CCHS-Gambling Module was collected to address this data gap.

A better understanding of the characteristics and factors associated with people who gamble—and the minority who experience gambling-related problems—could help with the development of more effective education, prevention and treatment strategies. This is especially important in the context of evolving gambling technologies and legislative framework. For example the Safe and Regulated Sports Betting Act^Note  legalized single-event sports betting in Canada in 2021 and led to the launch of Ontario’s iGaming market in April 2022.

Two-thirds of Canadians reported gambling in the past 12 months

Gambling can take many forms, such as buying instant lottery tickets, betting at a casino table, playing at electronic gambling machines or sports betting (see Data sources, methods and definitions for a complete list). In the 2018 Canadian Community Health Survey–Gambling Rapid Response (CCHS–GAM RR), respondents who reported any of these activities at least once in the past 12 months were considered to have gambled.

According to the 2018 CCHS–GAM RR, nearly two-thirds (64.5%) of Canadians aged 15 or older (18.9 million) reported gambling^Note  at least once in the past year.

People aged 45 to 64 were the most likely to have gambled in the past year (72.3%), while those aged 15 to 24 were the least likely (43.9%) (Table 1). In all age groups, males were more likely than females to report past-year gambling.

In 2018, nearly three-quarters (74.6%) of residents of Newfoundland and Labrador, and about 7 in 10 residents of New Brunswick (72.1%), Saskatchewan (70.9%) and Quebec (69.1%) reported having gambled in the past year. By contrast, residents of Ontario (62.2%) and British Columbia (59.0%) reported lower-than-average participation. It is likely that gambling rates across Canada reflect sociodemographic, cultural and interprovincial variation in access to casinos, race tracks, Video Lottery Terminals, and lotteries.

The percentage of Canadians who reported gambling in the past year differed by household income. Those with the highest income (top 20% of the income distribution) were more likely to have gambled than those with lower incomes (households in the three lowest income quintiles). Other studies have also found that gambling participation increases with income.^Note 

Immigrants may have different gambling behaviours than non-immigrants. For example, US research has shown that the prevalence of gambling and problem gambling is lower among first-generation immigrants than that of native-born Americans.^Note    Similar results were observed in Canada.

In 2018, higher percentages of non-immigrants (69.7%) reported gambling in the past year compared with recent immigrants, who landed 10 years ago or less (43.1%) and longer-term immigrants, who arrived more than a decade ago (58.5%).

White people (69.1%) were more likely to have reported gambling in the past year than South Asian (39.8%), Chinese (45.6%) and Black (56.6%) people. This association remained largely the same when income level was taken into account. For example, among individuals with the highest income (top 40% of the income distribution), White people (71.8%) were more likely to have gambled in the past year than those who were South Asian (53.9%), Chinese (57.2%) and members of “Other” (60.9%) populations.^Note  Black Canadians (71.5%) were as likely to have gambled in the past year as White Canadians (data not shown).

Several studies in Canada, the United States and New Zealand have previously found that Indigenous populations were more likely to gamble than non-Indigenous people.^Note  Reasons have been proposed for this difference, including cultural beliefs, increased exposure to gambling, and gambling as a temporary way to escape from or cope with the effects of racism and trauma.^Note  Poverty and neighbourhood disadvantage are additional factors related to problem gambling.^Note 

Data from the CCHS–GAM RR is largely consistent and finds that a greater proportion of Indigenous people overall (72.4%) reported gambling in the past year, compared with their non-Indigenous counterparts (64.2%). There were also differences between identity groups. For example, gambling rates among First Nations males (78.6%) and females (73.6%) were higher than those reported by the non-Indigenous population.

Gambling was also more common among those who smoked daily and who reported heavy drinking. Specifically, over three-quarters of people who reported smoking cigarettes daily (76.8%) or drinking alcohol excessively (77.2%) also reported gambling. The corresponding estimates for non-daily smokers (62.9%) and less frequent drinkers (61.4%) were lower.

By contrast, rates of past-year gambling did not differ by sexual orientation or by self-perceived mental health status.

Just over half of Canadians bought a lottery or raffle ticket in the past year  

Some gambling activities were more popular than others. In 2018, over half of Canadians had bought a lottery or raffle ticket (51.8%) in the past year, and one-third (33.0%) reported buying or playing instant lottery tickets or instant online games (Table 2). About 1 in 10 (12.6%) reported using electronic gambling machines, also known as Video Lottery Terminals, while 1 in 13 reported placing bets at casino tables (7.5%) or on sports (7.9%). Bingo and speculative financial market activities were considerably less common, at less than 4% each.

According to the 2018 CCHS-GAM RR, more than one-quarter of Canadians (27.3%) reported participation in only one of these gambling activities in the past 12 months (Table 2). Another 23.2% reported two activities, 8.7% reported three, and the remaining 5.2% reported four or more. The number of gambling activities played can increase one’s risk for gambling-related problems. This relationship, known as dose-response, has been observed between the number of gambling activities, as well as frequency of play and problem gambling.^Note 

There were substantial differences between the genders in terms of gambling activity preference. For example, men were nearly four times as likely as women to have put money into speculative markets (5.7% versus 1.5%), over three times as likely to have bet on sports (12.1% versus 3.9%), twice as likely to have bet at a casino table (any location, online or anywhere else) (10.2% versus 4.8%) and were more likely to have bought a lottery or raffle ticket (55.4% versus 48.4%). By contrast, higher proportions of females reported having played bingo (5.7% versus 2.1%) and instant lottery tickets or instant online games (34.8% versus 31.1%) than men. Only electronic gambling machines (in person or online) were played by comparable numbers of women and men (12.3% and 12.9%, respectively).

Given recent developments in the gambling industry, it will remain important to keep track of these trends in the near future. For example, certain activities that are becoming easier to access, such as sports gambling, may become more popular. If that is the case, a priority for both research and policy will be determining if greater popularity for such activities is associated with an increase in the prevalence in gambling problems.

Lottery or raffle tickets are not only the most popular form of gambling, but also the most frequently played

Lottery or raffle tickets are not only the most popular form of gambling in Canada, but also the activity played most often (Table 3). Among those who reported gambling in the past year, nearly one-quarter reported buying lottery or raffle tickets less than once per month (24.4%), while about one in seven reported purchasing tickets one to three times per month (13.6%). A similar percentage reported purchasing these types of tickets one to three times per week (13.8%). Instant win lottery (scratch) tickets or online games ranked second in terms of frequency of play, while electronic gambling machines ranked third.   

About 300,000 Canadians were at moderate-to-severe risk of a gambling problem

Gambling problems can range in severity. According to the 2018 CCHS-GAM RR, the vast majority of Canadians (95.0%) who reported gambling in the past year were non-problem gamblers, meaning they scored a 0 on the Canadian Problem Gambling Index (CPGI). Another 3.4% (636,000) were found to be at low risk (scored 1 or 2 on the CPGI).

However, 1.6% (304,000) of Canadians aged 15 or older who reported gambling in the past year were at moderate-to-severe risk of problem gambling (scored 3 or higher on the CPGI) (Table 4).

There were some differences by gender, as a higher percentage of men (2.0%) than women (1.2%) were considered to be at moderate-to-severe risk of gambling problems. Generally speaking, higher rates of gambling problems among men are consistent with higher rates of other addictive behaviours among them, such as drug and alcohol use.^Note  However, it is not entirely clear why more males than females develop gambling problems. One study suggested it might be related to marketing.^Note  Others have suggested that stigma and a lack of social acceptance of gambling by women in the past have kept their participation lower.^Note  Finally, other research indicates that the gender difference spans the life cycle, with adolescent boys also being at a higher risk of gambling problems than teenaged girls.^Note 

Other sociodemographic characteristics were associated with higher rates of gambling problems. These included living in lower-income households (bottom two quintiles), compared with those from households at the top 20% of the income distribution (2.7% and 2.1% compared with 1.1%, respectively); being single or never married (2.4%), or separated or divorced (3.4%) compared with being married or living common-law (1.1%); and living in the Prairies (2.5%) (Table 5).

Each of these findings is consistent with previous studies.^Note  For example, being married or common-law is associated with higher levels of social support,^Note  and people with more social support tend to gamble less often than those with lower levels of support.^Note  Additionally, the reasons people gamble differ by marital status, with those who are married citing gambling as a way to support a charitable cause, and those who are divorced reporting gambling as a means to forget their problems.^Note  Studies of pathological gamblers also find high rates of marital discord, divorce or separation, and lower levels of family functioning.^Note 

The vulnerability link between lower income and problem gambling has also been found repeatedly.^Note  A similar association also exists for people living in lower income neighbourhoods,^Note  those who are unemployed,^Note  and those on social assistance.^Note  The most likely explanation is that people with lower income, variously defined, are less likely to be able to afford gambling losses because of their more limited financial resources. They may also see gambling as an opportunity to get out of a low-income situation.

Daily cigarette smoking and heavy alcohol consumption was also associated with problem gambling.^Note  CCHS-GAM RR data indicate that among past-year gamblers, 4.3% of current cigarette smokers were at moderate-to-high risk of experiencing gambling problems. By comparison, those who were not cigarette smokers (1.2%) were much less likely to have a gambling problem.

A weaker association was observed for heavy alcohol consumption: 2.1% of past-year gamblers were at moderate-to-high risk of gambling problems if they also reported being a heavy drinker, compared with 1.3% if alcohol was not consumed in excess. Studies linking gambling problems with nicotine dependence in particular are numerous.^Note  It is thought that smoking and gambling share common neurobiological, genetic and environmental influences.^Note 

Those who rated their mental health as fair or poor were also more likely to be considered at moderate-to-severe risk of gambling problems than those who rated their mental health more positively. A person’s mental health can suffer from the stress associated with gambling itself, though the relationship between reduced mental health and gambling problems can go both ways—gambling has been used to cope with other stressful life events, such as job loss.^Note 

The percentage of Indigenous people (4.5%) who met the criteria for moderate-to-severe risk for problem gambling was three times the rate of the non-Indigenous population (1.5%). The CCHS-GAM RR problem-gambling rate for Indigenous people falls within a range of previous findings from studies of gambling behaviours among North American aboriginal populations.^Note  It is likely that many factors contribute to problem gambling among Indigenous people, including the harmful effects of colonialism that led to intergenerational trauma, discrimination and socioeconomic marginalization. Traumatic experiences, like child sexual abuse and residential schooling, may also be contributing factors.^Note   

Gambling involvement, measured by the number of activities played, increased the risk of having a gambling problem. At the lowest, the increase is 0.5% for people who reported just one gambling activity, while it was 7.3% for those reporting four or more types of gambling activities. 

On the other hand, there were no bivariate differences in the rates of moderate-to-severe gambling problems by sexual orientation, immigration status, age, or cultural or racial background.

Of course, sociodemographic characteristics, mental health, health behaviour and other factors may not be independently associated with problem gambling. When the effects of gender; age; geography; income; marital status; immigration status; population groups and Indigenous identity; sexual orientation; mental health; smoking; heavy drinking; and number of gambling activities were taken into account in multivariable logistic analyses, most previously identified risk factors remained statistically significant (Table 6). These included being male, a resident of the Prairies, in a lower income household, unmarried (single, or divorced or separated), a daily smoker, as well as people identifying as Indigenous, having fair or poor mental health, and participating in multiple types of gambling activities.

Likely owing to the higher rate of moderate-to-severe gambling problems among males, the male-only results were more similar to the overall results than those for females. 

In addition, the multivariable analysis of males suggests that sexual-minority males, such as gay men, have higher odds of having gambling problems than heterosexual males. Directly comparable studies are not available, although there is some related literature which suggests that problem gaming, problematic Internet use,^Note  and alcohol and drug use^Note  can be more common in non-heterosexual or sexual minorities.

Conclusion

Overall, the results of this study showed that problem gambling, while affecting a minority of the population, continues to be an issue in Canada. Among past-year gamblers, two percent of men and about one percent of women were either at severe or moderate risk for gambling-related problems, representing about 304,000 Canadians.

Surveys that collect data about gambling are important for informing and supporting health promotion and surveillance programs. Substantial numbers of Canada’s population gamble, and a minority develop gambling-related problems. With the advent of online gambling, it is now easier than ever to gamble.

This study provides an updated profile of past-year gamblers, including data on gambling activities, frequency of play, household expenditures on games of chance, and the characteristics of those who were at moderate-to-severe risk for developing gambling-related problems. The data presented here were collected prior to the pandemic, and prior to the Safe and Regulated Sports Betting Act ^Note  which legalized single-event sports betting in Canada in 2021. The results serve as an important baseline of gambling behaviour in Canada permitting future monitoring of changes in gambling behaviour over time and as a result of the new legislation. This information can also be used to update educational and awareness materials.

Some populations were more vulnerable to gambling problems, including males, those from lower-income households, Indigenous people, individuals who considered their mental health as fair or poor, daily smokers, and individuals who participated in multiple forms of gambling activities.

Michelle Rotermann and Heather Gilmour are senior analysts in the Health Analysis Division of Statistics Canada

Data sources, methods and definitions

The CCHS collects information related to health: status, care use and determinants for the Canadian population aged 12 years and older, living in the provinces and territories (Statistics Canada). Rapid Response modules are offered on a cost-recovery basis with this gambling module funded by the Canadian Consortium for Gambling Research. 

Excluded from the study are people living on reserves and other Aboriginal settlements, people in two health regions in northern Quebec, full-time members of the Canadian Forces, the institutionalized population, and youth aged 12 to 17 living in foster homes. These groups represent about 3% of the target population.^Note  Details about the CCHS, including survey frames, sampling strategy, weighting and questionnaires, are available elsewhere.^Note 

Data were collected from July 3, 2018, to December 24, 2018, by computer-assisted telephone and in-person interviews. Most interviews were conducted exclusively by telephone (82%). The overall CCHS-GAM RR 2018 response rate was 58.8%, corresponding to a final file size of 26,648 respondents, representing 31.4 million Canadians aged 12 or older.^Note  The gambling module was applicable to those aged 15 or older and was asked to 24,983 non-proxy respondents in the 10 provinces only.  

Analytical technique

Weighted frequencies and cross-tabulations were calculated to examine, by selected characteristics, estimates of past-year gambling prevalence and problem gambling, as well as participation in and frequency of play of different gambling activities.

To account for survey design effects, coefficients of variation and 95% confidence intervals were estimated with the bootstrap technique^Note  using SAS 9.4 and SAS-callable SUDAAN 11.0.3. Differences between weighted frequencies and cross-tabulations were calculated with t-tests, and results at the p < 0.05 level were considered statistically significant.

Definitions

Past-year gambling was based on responses to the following questions: In the past 12 months, how often have you spent money on or at, bet on, purchased: 1) instant lottery tickets, such as scratch, break-open or pull-tabs, or instant online games; 2) lottery or raffle tickets; 3) electronic gambling machines, such as slot machines, Video Lottery Terminals, electronic blackjack, electronic roulette or video poker; 4) casino table games (e.g., poker, blackjack, baccarat, or roulette at any location, whether at a casino, a private residence, online or anywhere else, excluding electronic machine versions); 5) money bets on sports, such as hockey, football, horseracing, billiards or golf, including pools, sports lottery, or bets made with friends; 6) Bingo, excluding instant games; 7) speculative financial market activities, such as day trading, penny stocks, shorting, options, or currency futures; 8) any other form of gambling not mentioned. Respondents who reported at least one form of gambling in the past 12 months were considered gamblers.    

Past-year gamblers were also classified according to how frequently they participated in each activity in the 12 months before they were interviewed: never, less than monthly, 1 to 3 times per month (combined once per month and two three times per month), 1 or more times per week (combined once per week and several times per week).

The Canadian Problem Gambling Index (CPGI)^Note  was used to assess 12-month prevalence of problem gambling. The CPGI is a nine-item instrument that assesses two problem-gambling domains: problem gambling behaviour and consequences of that behaviour for the individual or others. These nine questions are scored to determine the severity of problem gambling.

The Canadian Problem Gambling Index assessment items

• Did you bet more than you could afford to lose?
• Did you gamble with more money to get the same excitement?
• Did you go back another day to try to win back the money you lost?
• Have you borrowed money or sold anything to get money to gamble?
• How often has your gambling caused any financial problems for you or your household?
• Have you felt that you might have a problem with gambling?
• Has your gambling caused you any health problems, including stress or anxiety?
• Have people criticized your betting or told you that you had a gambling problem, regardless of whether or not you thought it was true?
• Have you felt guilty about the way you gamble or what happens when you gamble?

Respondents who gambled at least once a month, on at least one type of gambling, were asked the nine assessment questions. Each question has four response options: never = 0, sometimes = 1, most of the time = 2, and almost always = 3. The total score, ranging from 0 to 27, was obtained by summing the scores from the 9 4-point recoded (0–3) items; higher scores denote greater problems. Respondents who gambled less than monthly in the past year were considered to never have endorsed any of the nine assessment items, and were given a score of 0.  

The CPGI scores were divided into 4 categories (0; 1 to 2; 3 to 7; and 8 or over) to indicate increasing levels of gambling problems.^Note  The 3-to-7 level is believed to denote a significant risk and may be associated with heavy gambling, correlates of gambling problems, and is sometimes accompanied by adverse gambling consequences. The 8-or-over level is believed to represent the most extreme group, comprised of those who have experienced adverse consequences from gambling and might have lost control of their behaviour.^Note  Consistent with other research, ^Note  the two highest levels, corresponding to scores of 3 or higher, indicated moderate and severe problem gambling and were combined for parts of this analysis to boost sample size and statistical power.

Non-gamblers: respondents in this group have not gambled in the past 12 months

Non-problem gambling: Scored 0 on the CPGI

Low-risk gambling: Scored between 1 and 2

Moderate-risk gambling: Scored between 3 and 7

Problem gambling: Scored between 8 and 27  

Moderate to high: Scored 3 or more

Selection of covariates was guided by the gambling literature and availability in the CCHS-GAM.

Limitations

This study has several limitations common to survey research.

The findings may reflect some underreporting for gambling behaviour common in survey research. Although survey weights ensured that the sample is representative of the target population, bias may exist if the gambling habits of respondents and non-respondents differed systematically.

The data are cross-sectional and thereby permit the observation of associations between variables at only one point in time. Smaller sample sizes in some parts of the analysis may also have reduced the ability to reach statistical significance. As well, some variables relevant to gambling were not available in the CCHS-GAM, including amount of money spent, hours of play, reasons for gambling.