Shaquille O’Neal wants you to gamble. So does Peyton Manning, Terry Bradshaw, the NFL, NBA and MLB. Four years into a nationwide betting boom, addiction researchers are seeing signs that young, high-income men face increased risks of gambling problems.

And not coincidentally, you are seeing a lot of ads for sports betting on your TV screen.

Sparked by a 2018 Supreme Court decision that overturned the law that had made sports betting illegal outside of Nevada, gambling now blankets sports in the U.S., legal in 31 states and the District of Columbia. Five more states will soon join them, and two ballot initiatives await a vote on Tuesday in California. Projected to grow to a $6 billion industry by 2023, sports wagering features ads for Caesars, DraftKings and FanDuel. Limited to six per game by the NFL, these now herald bathroom breaks on football Sundays.

“It is a hot topic, and we want to be careful assessing what it means to suddenly have many more people betting on sports,” said clinical psychologist Shane Kraus of the University of Nevada, Las Vegas, a co-author on the new JAMA Network Open survey study finding that daily betting on fantasy sports and esport video games raises the risks for sports gambling problems among bettors. “There is a real potential for more problem gambling right now, but there is also the potential for a moral panic, which we don’t want.”

The survey of 2,800 people paints a picture of sports betting as a sizable but niche preoccupation nationwide, with only 6.2 percent of the public saying they bet on sports in the last year. Young, religious, high-income men were more likely to wager on sports. Symptoms of gambling problems — measured by questions suggesting damage to your family or own life — were seen most strongly in the ones who bet daily on fantasy sports and on esports.

About 1 in 50 Americans is estimated to have a serious to moderate gambling problem. The new study backs up recent National Council on Problem Gambling (NCPG) surveys, which found problem sports gambling as a particular risk among young, high-income men with college educations, said Keith Whyte, the group’s executive director. Those men are about twice as likely as high school graduates to bet on sports, said Whyte.

“Sports bettors, right now, are quite different than other gamblers,” said Whyte. “I don’t think we have done a good job of trying to reach this new, high-risk sports betting population.”

Other forms of gambling, from casinos to the lottery, more often attract less-educated, lower-income bettors, he added. The average gambler might more often wager with friends in these settings, unlike the new kind of sports gambler, placing bets on their phone. Horse racing is one exception to the sports betting rule, wagers that rely on the more traditional gambler.

One hypothesis for why more-educated men might gamble on games more is that the data-driven focus of modern sports betting, fostered by fantasy football leagues’ fascination with statistics, appeals to those trained to have an analytical outlook in college. Those same young men are more likely to live their lives on their cellphones, where new gambling apps reside, with a bet always one easy click away.

“Now they have the option to go online and do it all electronically, they don’t have to travel, and they can get all the data they want,” said addiction expert Ken Winters, a senior scientist with the Oregon Research Institute, a psychology research institute based in Springfield, Oregon. “They combine their interest in sports with their perceived knowledge and skill with numbers. It’s a wonderful recipe for sports betting to expand and become more popular.”

Kraus is more cautious, noting that while more educated men were more likely to bet on sports in his group’s survey study, risky gambling problems were found more often among the ones with less education. Men with more education might have more money to burn on bets, but also cut their losses more easily. “We really need to follow these men for the next two to three years to see what happens to them to understand what is going on here,” he said.

Cultural shift

NCPG surveys do show increases in sports betting since 2018, when states started embracing legalization, and tax revenues, from sportsbooks. While sports betting was once taboo — but widespread — decades ago, roughly 4 in 5 people now approve of it, said Whyte: “It’s one of largest, but perhaps most understudied or least understood, cultural shifts in America, and we are in the cutting edge now.”

The NFL (which last year had revenues of $17 billion) announced a $6.2 million initiative with the NCPG last year urging fans to set limits on their betting. Ads for a problem gambling website that the NCPG runs appear once per NFL game, in cooperation with the league, and generate about 30,000 calls a week, he added. About 45 million people a year bet on an NFL game, according to the American Gaming Association, which is closer to the 17.2 percent lifetime rate for sports gambling reported in the JAMA Network Open study, rather than the yearly rate estimated by the study’s authors.

Professional sports leagues, like the NFL, once barred any mention of betting from their broadcasts, blacklisted players and managers who gambled and, within living memory, decried wagering as a threat to the “integrity” of their sports. No more.

“I was surprised when I first saw leagues making deals with gambling enterprises, and then I realized we were going to be seeing ads for it every time we turned on a game,” said Winters. Not just ads, but sports pages like the Washington Post’s and cable channels like ESPN now feature betting advice. This new gambling industrial complex is “in a frenzy for customer acquisition, and [is] spending enormous amounts on advertising and sponsorships,” notes one recent business report.

“Leagues are doing it, arenas are doing it, teams are doing it. They just can’t resist sources of revenue when it became legal,” said Winters.

There’s a reason they run the ads

For researchers, just getting their arms around the size of problem sports gambling is complicated, added Jeffrey Derevensky, director of the International Centre for Youth Gambling Problems and High-Risk Behaviours at Canada’s McGill University. Unlike alcoholism or opioid use disorders, which leave evidence behind such as cases of cirrhosis or overdoses, gambling problems are seen in divorces, bankruptcies and survey results. That leaves researchers watching calls to gambling hotlines and years behind on broader trends.

“From a public health perspective, we are really concerned about all these gambling ads,” said Derevensky. That many ads depict sports celebrities living luxury lives, partying and betting, might also explain the demographics of the new sports gambling, he said: “There’s a reason [companies] run them.”

In response to questions from Grid on the gambling ads, Cait DeBaun of the American Gaming Association noted that the gambling industry has funded research on problem gambling. “A thriving casino gaming industry is dependent upon building long-term, responsible relationships with customers and ensuring those who need help, have it,” said DeBaun. Ads steer gamblers toward legal gambling instead of illegal, unregulated sportsbooks, she added, and comprise only 1 percent of all advertising.

However, Derevensky cited particular concern with online sports betting operations moving toward “micro-bets” on in-game happenings — so-called parlays like a bet on a field goal missing — that could appeal to problem gamblers chasing their losses and getting deeper in a hole. “Chasing your losses is the signature of a problem gambler.”

He was also critical of the imbalance during NFL games of the six ads promoting sports gambling, set against the one “Responsible Play” ad per game urging fans to set limits on their wagers.

The NCPG’s Whyte agrees with him: “I think that is a fair criticism,” he said, adding that his group is working to produce its own ad targeted specifically at problem gamblers, rather than bettors in general like the NFL’s gambling warning. “We need to work harder to reach people with real problems.”

If you feel you may have a problem with gambling, you can get help from the National Council on Problem Gambling by call or text at 1-800-522-4700, or online chat at ncpgambling.org/chat.

Thanks to Lillian Barkley for copy editing this article.