Should gaming disorder include non-digital gaming activities, e.g., collectible card games, tabletop games?

This commentary critically considers the case for including non-digital gaming within the scope of gaming disorder. The ICD-11 category for gaming disorder refers to gaming (i.e., 'digital gaming' or 'video-gaming') which may be predominantly 'online' (i.e., over the internet) versus 'offline'. Non-digital forms of gaming (i.e., gaming that does not involve any electronic devices and is not conducted over the internet) are not explicitly recognized. We suggest that gaming in both digital and non-digital formats is an activity of relevance to addiction studies and public health, and that an exclusive focus on digital gaming may overlook potential non-digital game-related risks and harms. We refer to popular collectible card games (e.g., Pokémon, Magic: The Gathering [MtG]) and tabletop games (e.g., Warhammer 40K), as these activities seem to have the most in common with online games, particularly in relation to similarities to digital monetization schemes (e.g., loot boxes). We call for research to investigate the relative costs and benefits of engagement in non-digital gaming activities. If highly involved players of non-digital games tend to not report gaming disorder symptoms or harm, then it may be worthwhile examining how these players differ from digital game players. Finally, investigating non-digital gaming may produce new insights into developing effective interventions and preventive measures for problematic digital gaming.