Gambling Advertising and Problem Gambling in the United States: Multi‐Level Evidence Beyond Sports‐Betting Legal Status

ABSTRACT US gambling debates often center on the legal status of sports‐betting, but advertising can also be used as a distinct policy lever. This paper presents the findings of two related studies. Study 1 links quarterly state‐level gambling advertising outlays across paid media (2014–2023) to Google Trends indices for 116 problem‐gambling help‐seeking queries across 41 states (1640 state‐quarters). Study 2 combines surveys with passive digital traces from 419 exposure‐eligible mobile‐platform users. Higher state‐level ad spend, but not sports‐betting legal status, was associated with greater help‐seeking search interest, and this association strengthened over time. Platform‐specific gambling‐ad exposure on Facebook, TikTok, and X was associated with gambler status, gambling frequency, and the probability of any observed gambling‐site visit. Clean gambling ads were also associated with higher 24‐h odds of subsequent gambling touchpoints, especially web visits; among gamblers, ad‐triggered touchpoints were associated with problem‐gambling scores more consistently than raw clean ad volume. Convergent state‐level and individual‐level evidence links gambling advertising with engagement and harm‐related indicators, while the observational designs do not identify causal effects. The findings support stronger restrictions on advertising volume, placement, inducements, and targeting.