Online Gambling Addiction: The relationship between Internet gambling and
Sally M. Gainsbury, PhD, Doc.Clin.Psych, BPsych(Hons)
Senior Lecturer, Centre for Gambling Education & Research, Southern Cross University
Address: PO Box 157, Lismore NSW 2480, Australia
Cite as: Gainsbury, S.M. (2015). Online Gambling Addiction: the Relationship Between
Internet Gambling and Disordered Gambling. Current Addiction Reports, 2(2), 185-193.
Available at: http://download-v2.springer.com/static/pdf/25/art%253A10.1007%252Fs40429-
Keywords: Addiction; disordered gambling; problem gambling; gambling harm; protective
factors; risk factors; Internet gambling; interactive gambling; online gambling; mental health;
One of the most significant changes to the gambling environment in the past 15 years has
been the increased availability of Internet gambling Internet, including mobile, gambling is
the fastest growing mode of gambling and is changing the way that gamblers engage with this
activity. Due to the high level of accessibility, immersive interface, and ease at which money
can be spent, concerns have been expressed that Internet gambling may increase rates of
disordered gambling. The current paper aimed to provide an overview of the research to date
as well as highlight new and interesting findings relevant to Internet gambling addiction. A
comprehensive review was conducted of existing literature to provide an overview of
significant trends and developments in research that relates to disordered Internet gambling.
This paper presents research to inform a greater understanding of adult participation in
Internet gambling, features of this interface that may impact problem severity, the
relationship between Internet gambling and related problems, as well as considering the role
of the wider spectrum of gambling behaviour and relevant individual factors that moderate
Gainsbury – Online Gambling Addiction 2
Internet gambling (a term largely interchangeable with interactive remote, and online
gambling) refers to the range of wagering and gaming activities offered through Internet-
enabled devices, including computers, mobile and smart phones, tablets, and digital
television. This mode of gambling, facilitated by technological advances, increased Internet
availability and ownership of Internet-enabled devices, is not a separate type of gambling
activity. Rather it is a mode of access that is distinct from gambling in-person at terrestrial or
land-based retail outlets and placing wagers over the telephone. As such, it is a largely
automated activity that be conducted in private, at any time and location, using high-speed
Internet connections enabling rapid placement of bets and notification of outcomes. The
ability for large wagers, continuous gambling, rapid feedback, and instant, easy access to a
vast number of betting options has resulted in concerns that Internet gambling could
contribute to excessive gambling [1, 2].
As a result of the empirical comparisons demonstrating the fundamental parallels between
gambling problems and substance use, the fifth edition of the Diagnostic and Statistical
Manual of Mental Disorders (DSM-5) includes a new category of Non-Substance
Behavioural Addiction within the substance addictions category . Disordered gambling is
classified as the first behavioural addiction and will serve as a ‘blueprint’ for research on
other syndromes and arguably set a precedent for the compilation of evidence on other
similarly excessive behaviours  such as ‘Internet gaming disorder’ (currently in Section 3
of the DSM-5). Mounting evidence of distress and dysfunction related to excessive and
problematic Internet use and specifically Internet gaming led the DSM-5 Taskforce to
officially call for further research on this behaviour . Given the similarities in the
experience and excessive use of Internet gambling and gaming and the potential for harm
based on excessive Internet use, pathological use of Internet gambling also warrants specific
consideration . The current paper aims to provide an overview of the research to date as
well as highlighting new and interesting findings relevant to adult Internet gambling
addiction. A comprehensive review was conducted of existing literature to provide an
overview of significant trends and developments in research that relates to disordered Internet
Internet gambling is growing rapidly in terms of popularity, market share, and products
offered. The online global gambling market was valued at €6.1bn in 2013, with expected
annual growth of 10.1% to 2018 . Online gambling accounted for an estimated 8-10% of
the total global gambling market in 2012, and this proportion appears to be increasing -[7-9].
Globally, the largest online gambling product is wagering, accounting for 53% of the online
gambling market, followed by casino games (including slot machines/pokies/electronic
gaming machines, 25.4%), poker (14.2%), and bingo (7.4%) .
Gainsbury – Online Gambling Addiction 3
Internationally, an increasing number of jurisdictions are legalizing and regulating Internet
gambling . This follows recognition of the difficulties of enforcing prohibition and the
benefits of regulation, including requiring harm minimization measures to enhance consumer
protection, and generating taxation revenue . Although the prevalence of Internet gambling
appears to be relatively low, participation is increasing rapidly, particularly in jurisdictions
that permit access to regulated sites [11, 12]. For example, in Australia following the
legalisation of Internet wagering and lottery playing, prevalence rates in Internet gambling
rose from less than one percent in 1999 to 8.1% in 2011 . Similarly in the UK, an average
of 16% of respondents had participated in at least on form of online gambling in the previous
four weeks . In comparison, only 6% of the British population used the Internet to
gamble in the past year in 2007, although this figure does not include purchasing lottery
tickets online, which may have increased the participation rate .
Internet gambling use is likely to continue to grow as online platforms become increasingly
used to engage in entertainment and recreational activities, including through phones and
other wireless devices. Research suggests that the most commonly reported motivators and
advantages of Internet gambling are the convenience and accessibility of this mode [15-17].
Other commonly stated advantages of Internet gambling include greater value for money,
including payout rates and bonuses, the speed and ease of online gambling, greater number of
betting products and options, and the physical comfort of being able to gamble from home.
Internet gambling represents a fundamental shift in how consumers engage in gambling and
concerns have been expressed by various stakeholders about these changes. Disadvantages
cited by Internet gamblers include that it is easier to spend money online, it is too convenient,
and concerns about account safety [15-20]. Other concerns include that the high accessibility
to Internet gambling may increase gambling, particularly among technology-savvy youth, and
lead to an increase in the incidence and prevalence of disordered gambling [1, 21]. These
concerns have led to recommendations for Internet gambling to be prohibited, or conversely
regulated, in an attempt to institute policies to minimise harms [1, 12, 18, 22-24].
Internet gambling and problem gambling
Features of Internet gambling that may impact problem severity
Evidence suggests that there is a relationship, albeit complex, between the availability of
gambling opportunities and increased levels of related problems [25-30]. Consequently, it has
been asserted that the easy access to gambling provided by Internet modes may lead to the
development or exacerbation of gambling problems [1, 22, 24, 31].
Gainsbury – Online Gambling Addiction 4
Internet gambling also has some unique features that may pose additional risks for harm,
particularly for vulnerable populations. Internet gambling differs from land-based gambling
primarily in terms of its constant availability, easy access, and ability to bet for uninterrupted
periods in private, facilitated by the interactive and immersive Internet environment [2, 18,
32-35]. The use of digital forms of money (e.g., credit cards, electronic bank transfers, and e-
wallets) appears to lead to increased gambling and losses, particularly for problem gamblers,
as people feel that they are not spending ‘real’ money [16, 32, 36, 38, 39]. Surveys indicate
that 19-28% of online gamblers report it is easier to spend more money online [20, 39], while
15% consider this form to be more addictive than land-based gambling .
The immersive nature of Internet gambling is also clear through reports that online gamblers,
particularly those experiencing problems are more likely to report disruption to their sleep
and eating patterns than land-based gamblers [18, 36, 37]. Data collected by gambling
treatment services suggest that Internet gambling currently makes a small, but growing
contribution to gambling problems among those seeking formal help [37, 40, 41]. Surveys
have found that online problem gamblers are significantly less likely to have sought formal
help as compared to land-based problem gamblers; [20, 42, 43]. This suggests that problems
related to Internet gambling may be underrepresented in treatment-seeking samples and are
likely to increase over time as more people participate in this mode and problem severity
The relationships between Internet gambling and gambling problems
Initial concerns over the harmful effects of Internet gambling are sensible as numerous
studies have found greater levels of problem gambling severity amongst samples of Internet
as compared to non-Internet gamblers [13, 31, 41, 43-48]. For example, in an Australian
nationally representative prevalence survey, the overall problem gambling rate among
Australian non-Internet gamblers was 0.9%. In comparison, the rate among Internet gamblers
was three times higher at 2.7% . Fewer than 60% of Internet gamblers were classified as
non-problem gamblers, compared to more than 80% of non-Internet gamblers, which was a
significant difference. Furthermore, the average PGSI score of Internet gamblers was
significantly higher than that of non-Internet gamblers. Similarly, a total of 16.4% of Internet
gamblers were classified as either moderate or problem gamblers, compared to a rate of 5.7%
among non-Internet gamblers . However, there is little evidence available that would
enable the causation of Internet-related gambling problems to be determined and most
longitudinal studies contain too few Internet gamblers to provide meaningful analyses.
Despite some indications of a positive correlation, the relationship between Internet gambling
participation and problems has not been confirmed. Some studies have found similar rates of
gambling problems among Internet and land-based gamblers [15, 41]. Research also suggests
Gainsbury – Online Gambling Addiction 5
that very few Internet gamblers gamble exclusively online [12, 24, 48, 49]. Further analyses
of prevalence studies that control for factors such as demographic variables and gambling
involvement have found that participation in Internet gambling does not independently
predict problem gambling severity [13, 20, 36, 46, 50-52]. For example, even though Internet
gamblers were more likely to be classified as being at-risk or experiencing gambling
problems in a nationally representative survey, when other variables were controlled for,
Internet gambling participation was not predictive of problem gambling severity .
Similarly, using data from the 2007 British Gambling Prevalence Study, LaPlante and
colleagues  found that gambling formats (particularly Internet gambling) and problem
gambling were not significantly related when gambling involvement was included in the
model (based on the number of gambling activities used in the past 12 months). This finding
was in contrast to earlier analyses  and demonstrates the importance of controlling for
Further evidence to question the extent to which Internet gambling increases rates of problem
gambling can be taken from prevalence studies. Despite rates of Internet gambling increasing
in several jurisdictions, little evidence has been found to suggest that the prevalence of
problem gambling has increased [13, 53, 54]. An analysis across 30 European jurisdictions
failed to identify any association between prohibitions against online gambling, gambling
licensing systems, the extent of legal gambling opportunities and the prevalence of gambling
The impact of Internet and land-based gambling on gambling problems
Evidence is emerging that Internet gambling is not only not predictive of gambling problems,
but that when other variables are controlled for individuals who gamble online may have
lower rates of gambling problems. Studies that have isolated Internet-only gamblers have
found that these gamblers have lower rates of gambling problems than gamblers who only
gamble offline, and those who use both online and offline modes [48, 51, 56]. Gamblers who
engage in online as well as offline modes appear to have the greatest risks of harm, which is
likely related to their greater overall gambling involvement [48, 56, 57].
The relationship between Internet and problem gambling is likely mediated by the use of
land-based gambling. A study examining actual Internet gambling account activity combined
with a self-report measure of gambling problems confirmed that gambling involvement, as
indicated by number of games played and days bets placed on in past year, is predictive of
gambling problems amongst the sample of Internet gamblers analysed . These results are
consistent with a wide-body of research which suggests that gambling disorder is related to
high levels of involvement (in terms of expenditure, time, frequency. and variety of gambling
forms used) [13, 36, 52, 59, 60-63]. Therefore, research suggests that highly involved
gamblers are more likely to engage with Internet modes, including those with existing
Gainsbury – Online Gambling Addiction 6
gambling problems, than less involved gamblers. However, a study comparing behavioural
data from an online gambling sites with self-report of gambling problems found that not all
highly involved gamblers were at risk for gambling-related problems, and likewise, not all
those with low involvement screened negatively for gambling-related problems . This is
an important finding as it demonstrates (unsurprisingly) that a single gambling index (such as
a frequency of gambling, or expenditure) is not adequate to predict gambling problems.
Involvement in Internet gambling appears to be more likely among gamblers with existing
problems as compared to non-problem gamblers . Studies have found that one-third to
one-half of Internet gamblers experiencing gambling problems attribute these to land-based
forms of gambling, and over half report that they had existing problems before they ever
gambled online [13, 20]. This is consistent with one study reporting that problem Internet
gamblers prefer land-based over Internet gambling . Few studies have investigated the
types of gambling that are most likely to be associated with problems related to Internet
gambling. In an Australian national survey, almost half of all gamblers stated that land-based
electronic gaming machines were the primary cause of their problems, including among
Internet gamblers . Internet gamblers are most likely to associate their problems with
casino games, sports and race wagering, and poker [13, 20].In particular, sports betting
appeared to be associated with moderate risk and problem gambling, a finding not replicated
among land-based only gamblers [13,20]. However, this finding may be specific to the
Australian context as sports wagering is one of the few legal forms of online gambling.
Conversely, for some Internet problem gamblers, this mode of gambling appears to be the
proximal cause of problems, with problem gamblers reporting that their problems started
after they first gambled online and around half specifically attributing problems to this mode
[13,20]. These results are consistent with other research findings [57, 48], suggesting that for
some problem gamblers, Internet gambling played an important causal role, while others had
existing problems, which were likely exacerbated by Internet gambling. However, most
studies examining the relationship between Internet gambling and problems are cross-
sectional, which do not allow for causality to be determined and self-report is subject to bias
and reliant on accuracy of reporting. Longitudinal research will be an important addition to
this field to address these issues. As Internet gambling increases in popularity and use it is
likely that the next generation of gamblers will use Internet modes earlier in their gambling
career, which may increase the proportion of individuals who experience problems that are
attributed to this mode. However, there is a growing recognition that Internet gamblers are a
heterogeneous group and research needs to consider how Internet gambling behaviour may be
integrated more broadly with offline gambling [48, 65].
Gainsbury – Online Gambling Addiction 7
Risk factors for Internet gambling problems
Analysis of demographic variables suggests that Internet problem gamblers overall do not
represent a distinctly different cohort than gamblers who experience problems related to land-
based gambling. Risk factors for Internet problem gambling identified include being male,
younger adults, and being from a culturally diverse background [13, 20, 41, 66, 67]. The
consistent relationship found between problematic Internet gambling and younger age
suggests that this population is particularly vulnerable to harms related to this form and use of
Internet gambling amongst young males is an area that warrants further attention in terms of
research as well as harm minimisation.
Risk factors identified do not appear to be universal, for example, Gainsbury, Russell, Wood,
Hing, and Blaszczynski  found problem Internet gamblers more likely to be young, less
educated and have greater debts than non-problem Internet gamblers. A subsequent study
found only age differed between Internet and non-Internet problem gamblers when
controlling for Internet gambling participation and there were no significant differences based
on education or income . In contrast, Jiménez-Murcia and colleagues  found that
online problem gamblers had higher educational levels, higher socio-economic status than
non-Internet problem gamblers, however, both groups showed similar psychopathological
profiles or personality characteristics. Other studies have also found that Internet gamblers
are more likely to have higher educational levels and socio-economic profiles [e.g., 43, 48,
65], as well as higher levels of problem gambling than non-Internet gamblers. However these
are associations that do not control for the interaction between variables so it is difficult to
draw firm conclusions about problem as compared to non-problem Internet gamblers. It is
likely that the profile of those at-risk for developing Internet gambling problems will change
as this mode of gambling becomes more accepted and widely used and further research is
Physical and mental health comorbidities
Studies have also found higher rates of health and mental health comorbidities, including
smoking and alcohol consumption, as well as substance abuse or dependence, and mood
disorders among Internet as compared to non-Internet gamblers [13, 15, 30, 31, 43, 44, 47,
49, 57, 67, 69, 70]. (One study found that Internet gambling frequency was significantly
associated with poor physical and mental health, after controlling for demographics and
pathological gambling, but overall gambling frequency was not . A study examining
irrational and erroneous thinking found that greater levels of erroneous cognitions
significantly predicted problem gambling severity when controlling for other variables among
Internet gamblers . As psychological comorbidities and irrational thinking are related to
Gainsbury – Online Gambling Addiction 8
problems amongst land-based gamblers these results suggest that the clinical characteristics
of Internet problem gamblers are similar to offline gamblers.
There is also evidence that Internet problem gamblers have higher rates of drug and alcohol
use than non-problem gamblers. Analysis of 1,119 surveys completed by online gamblers
indicated that compared to non-problem gamblers, problem gamblers were more likely to
smoke cigarettes, have a disability, and drink alcohol while gambling online . This is
consistent with higher rates of mood and substance use disorders and self-harm among highly
involved Internet gamblers . An Australian telephone survey found that illicit drug use
was a significant predictor of having greater levels of gambling problems . These results
may indicate that Internet who are at risk for gambling problems may engage in a range of
risk-taking behaviours, for example due to high levels of impulsivity .
Nonetheless, the relationships between Internet gambling, gambling problems and other
mental health issues are still unclear . For example, multiple studies in Sweden did not
support the assumption that Internet gambling would attract people with low social support,
psychological problems, physical problems or health problems such as risky alcohol
consumption . Similarly, offline gamblers were more likely to report health and
psychological impacts of problem gambling than Internet gamblers in an Australian study
comparing at-risk and problem gamblers . Furthermore, in a nationally representative
Australian telephone survey, Internet gamblers were less likely to drink alcohol and smoke
when they were gambling online than when gambling in land-based venues, indicating they
were unlikely to be using Internet modes to avoid restrictions on smoking or alcohol .
Overall, existing studies fail to define specific personal or behavioural risk factors to
differentiate between Internet and non-Internet problem gamblers. There is some evidence
that these do represent at least partially different cohorts, however, the heterogeneity in each
group makes identification of specific risk factors difficult to identify. No studies have
established the causation between associations found and the direction of any link between
problem online gambling. The individual factors related to Internet gambling problems are
under-researched and would benefit from longitudinal studies to clarify the mechanism of
action of any relationships between variables.
Intense gambling involvement has been verified as a predictor of gambling problems for
online and offline gamblers. Other gambling-related behaviours have also been identified as
being potential markers of risky Internet gambling. Gambling online on unregulated sites [41,
74] and using multiple different accounts  and different online activities [20, 48, 57] have
been found to be predictive of higher levels of gambling problems. It is possible that
unregulated sites attract individuals who are at greater risk for experiencing problems and use
Gainsbury – Online Gambling Addiction 9
of multiple online accounts and multiple activities are proxy indicators of gambling
involvement, a known predictor of harm.
Analyses of player accounts, including players who exhibit what appears to be risky
behaviour, as well as those who have closed accounts due to stated gambling problems, have
enabled markers of problem gambling, including early predictors, to be identified. Potential
predictors of risky Internet gambling or the emergence of problems include: engaging in
multiple online gambling activities, high variability in betting, multiple bets per day, many
active betting days per month, many bets per betting day, high overall stakes and net loss,
increasing bet size and losses, chasing losses, and intervals of increasing wagering size,
followed by rapid drops [58, 59, 76-80]. One notable finding from studies of the bwin.party
dataset (which include most of the behavioural analyses that have been conducted) is the
consistent finding that participation in Live Action sports betting (also known as in-play) is
an independent predictor of problem gambling severity, when controlling for gambling
involvement [58, 59, 79]. This type of betting allows frequent and repeated bets to be placed
during a single sporting event, with rapidly determined outcomes, which may be particularly
attractive to people who are highly impulsive and at greater risk for disordered gambling
. However, this relationship has not been investigated in independent samples.
In addition to behavioural variables, other information about gamblers’ risk levels can be
observed by online operators. Analysis of customer communication with online operators
identified risk markers that predicted customers closing their accounts due to stated gambling
problems. These included expressed doubts about results of games, requests for account
reopening, queries about financial transactions and account administration, the frequency of
contacts per month (urgency), and use of a threatening tonality . These results were based
on a relatively small sample with a limited control group. A subsequent study found that
automated text analyses of email correspondence aided by human assessment could identify
anger (abusive tonality) as well as urgency (time-related words) and a lower use of
justification for demands and/or actions, which were found to predict self-exclusion .
Single, unmistakable indicators for problems are uncommon, and therefore detection of risk
indicators usually relies on algorithms to detect interaction between these. Further research is
still required to untangle whether game-specific characteristics play a causal role in the
emergence of gambling problems. Research is also needed on a variety of different player
accounts, as the vast majority of research has been done with a single dataset from one
European gambling site, which may not be generalizable to other online gamblers.
Identifying, detecting, and acting on early risk indicators may reduce gambling-related harms
sustained by Internet gamblers. However, few online operators have shared their data to be
used for research purposes or implemented policies and strategies to detect potentially risky
players and implement appropriate resources. Such preventative action is generally not
Gainsbury – Online Gambling Addiction 10
required by Internet gambling regulators, meaning that further action is reliant on operator
Taken together, the evidence reviewed here suggests that Internet gambling does not cause
gambling problems in, and of, itself. However, use of Internet gambling is more common
among highly involved gamblers and for some Internet gamblers, this medium appears to
significantly contribute to gambling problems. Internet gamblers are a heterogeneous group
and the impact of this mode of access on gambling problems is moderated by a range of
individual, social, and environmental variables. As Internet gambling continues to evolve and
participation increases, particularly among young people who are highly familiar with
Internet technology and online commerce, it is likely that related problems will emerge.
Research and regulation will have to evolve to further the understanding of the impact of this
mode of access on the experience and incidence of gambling disorders.
There appear to be some unique differences between Internet and land-based gamblers who
experience problems . Theoretical models for gambling and problem gambling have been
developed based on land-based gambling, largely not considering the recent emergence of
Internet modes. It is important to revisit these conceptual models to verify if they account for
pathological gambling among Internet gamblers, and whether any new variables or
interactions should be included to explain the emergence of gambling problems. Research
will likely continue to distinguish the characteristics (mediators and moderator) that may be
used to identify online gamblers who are at-risk for gambling-related problems. This is
necessary to develop a more comprehensive understanding of how people develop gambling
Research is needed to understand how to reduce the likelihood of people transitioning to
disordered gambling. The Internet offers a potentially strong environment for the provision of
responsible gambling, including player-focused tools and resources for moderating play such
as expenditure tracking, self-set spend limits, time-outs, and information[19, 84].
Furthermore, operators can enact strategies to assist customers including targeted
notifications (e.g., pop-up messages) based on patterns of play, and other tailored contacts
derived from analysis of player accounts to identify risky behaviour [2, 85]. Enhancing the
provision of a responsible gambling environment will require cooperation between
independent researchers to design, evaluate, and verify strategies, operators to enable access
to appropriate data and implement procedures, and regulators to require the use of effective
responsible gambling policies. Treatment and prevention strategies must be revisited to
ensure that these are relevant and effective for Internet gamblers. Brief online interventions as
well as in-depth online treatment programs may be relevant for Internet gamblers .
Online self-exclusion programs should be developed that would allow individuals to exclude
themselves from multiple gambling sites simultaneously.
Gainsbury – Online Gambling Addiction 11
The findings presented here are important for policy makers due to evidence that Internet
gambling in itself is not harmful. The research is also relevant for clinicians, as it suggests
that in addition to some gambling forms being more likely to lead to problems, how
individuals access these also has an impact on subsequent harms. This highlights the
importance of considering the broad spectrum of gambling behaviour and how different
patterns of gambling may be associated with the experience of gambling-related harm.
Further research is required to identify the protective factors of online gambling
environments that may reduce levels of harms among Internet gamblers. These may include
the capacity for lower bet sizes than in land-based venues (due to lower costs for operators),
the ability to track wins, losses, and deposits using an online account, gambling only for short
sessions due to other activities concurrently occurring in the home, or outside of a gambling
venue, presence of others when gambling, and access to responsible gambling tools and
Compliance with Ethics Guidelines
Conflict of Interest
Dr. Gainsbury has received grants from Gambling Research Australia, NSW Office of Liquor, Gaming
and Racing, Echo Entertainment, Aristocrat Leisure Industries, Manitoba Gambling Research
Program, and Sportsbet pertaining to research to understand and enhance the responsible provision
of Internet gambling; research to understand optimal treatment approaches for gambling; research
to enhance responsible gambling strategies; and assessment of problem gambling among casino
employees. Dr. Gainsbury has received honoraria from the Department of Broadband
Communication and the Digital Economy, Department of Social Services, Gaming Technologies
Association, British Columbia Lottery Corporation; and Nova Scotia Provincial Lotteries and Casino
Corporation for research and expertise to inform responsible gambling messages and responsible
gambling strategies for Internet gambling. Dr. Gainsbury has received travel accommodations or
expense reimbursement from the British Columbia Lottery Corporation, Clubs ACT, Leagues Clubs
Australia, National RSL Clubs, Nova Scotia Gaming Corporation, and Casinos Austria to attend and
present at conferences on topic of responsible gambling. Dr. Gainsbury was a board member on
Techlink Entertainment’s Responsible Gambling Advisor Board from January 2012 through May
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the
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* Of importance
Gainsbury – Online Gambling Addiction 12
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Gainsbury – Online Gambling Addiction 16
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Gainsbury – Online Gambling Addiction 17
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