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Article History

Received: 24 March 2025

Accepted: 4 October 2025

First Online: 30 January 2026

Declarations

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: All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 (5). Informed consent was obtained from all panellists included in the study.

: Imran M. Keshani: Imran Keshani declares no conflict of interest in relation to this manuscript.Stephanie S. Merkouris: In the last three years, Stephanie Merkouris has received research and consultancy funding from multiple sources, including via hypothecated taxes from gambling revenue. Stephanie Merkouris has received research funding from the Victorian Responsible Gambling Foundation, New South Wales Office of Responsible Gambling, Health Research Council of New Zealand, and the New Zealand Ministry of Health. She has been the recipient of a New South Wales Office of Responsible Gambling Postdoctoral Research Fellowship.Simone N. Rodda: Simone Rodda has received research funding from the Health Research Council of New Zealand, New Zealand Ministry of Health, Health New Zealand, Victorian Responsible Gambling Foundation, and New South Wales Office of Responsible Gambling.Max Abbott: Max Abbott declares no conflict of interest in relation to this manuscript.Henri-Jean Aubin: Henri-Jean Aubin declares no conflict of interest in relation to this manuscript.Maria E. Bellringer: In the last 3 years, Maria Bellringer received research funding from New Zealand Ministry of Health, Health Research Council of New Zealand, and Greo Evidence Insights. Maria Bellringer received consultancy funding from Health New Zealand, Victorian Responsible, Gambling Foundation, and Asian Family Services. She is a member of the Lotto NZ Responsible Gaming and Corporate Social, Responsibility Voluntary Stakeholder Panel—she does not receive financial reimbursement for this role.Anne H. Berman: Anne Berman works full-time at Uppsala University. All her research work is funded within her employment or by research funding agencies, including the Swedish Research Council and the Swedish Public Health Agency, and she collaborates with colleagues who are funded by the Svenska Spel AB Independent Research Council. Anne Berman also works part-time as private clinical psychologist and psychotherapist, occasionally treating persons with addiction problems. She received fees from Svenska Spel AB (Sweden) for evaluating research plans (grants) in their independent research council during the years 2013–2022, and from Gothenburg University (2023) for being an opponent for one PhD thesis concerning gambling. During 2015 to 2019, she led the Swedish National Helpline for Gamblers and their family members. She declares no conflict of interest in relation to this manuscript.Joel Billieux: Joel Billieux is an associate editor for the Journal of Behavioral Addictions, and topic editor for Current Addictions Reports. Joel Billieux is also a board member of the following journals: Computers in Human Behaviors, Current Addiction Reports, Addictive Behaviors, SN – Comprehensive Clinical Medicine, Addictive Behaviors Reports, International Gambling Studies, ALOMA: Revista de Psicologia, Ciències de l’Educació i de l’Esport. Joel Billieux declares no conflict of interest in relation to this manuscript.Henrietta Bowden-Jones: Henrietta Bowden-Jones is part of the NHS gambling treatment network, which was funded until early 2022 in part by GambleAware commissioning. Henrietta Bowden-Jones declares no personal conflict of interest to declare in relation to this manuscript.Colette J. Browning: Colette Browning declares no conflict of interest in relation to this manuscript.Per Carlbring: Per Carlbring reports past and ongoing industry-academia collaborations with several gambling providers, including project-specific funding, but has no personal financial ties to the gambling industry. He attests to having no direct conflicts of interest related to this manuscript. Per Carlbring has been the principal investigator in studies on pathological gambling, sponsored by the Public Health Agency of Sweden and regulated gambling enterprises. He has provided pro bono expertise on gambling to the National Board of Health and Welfare (Socialstyrelsen) in Sweden. Per Carlbring served on the Board of Directors for the Osmond Foundation, which owns Osmond Labs, a pharmaceutical entity researching psychedelic substances for mental health disorders.Sari Castrén: Sari Castrén works full time at the Finnish Institute for Health and Welfare and all her research work is funded within the objectives of §52 Appropriation of the Lotteries Act. Sari Castrén also works as a clinical psychologist at Addiktum Clinic Helsinki, Finland, as a private practitioner (part time) treating persons mainly with addiction problems, and at Mehiläinen Medical Center, Forum Helsinki, where she offers treatments to various psychological issues. She also lectures about Behavioral Addictions (e.g. national and international conferences) and training and supervising professionals to treat gambling disorder (MI, CBT) as a part of her duty at the Finnish Institute for Health and Welfare and addictions in general privately. She has received fees from Helsinki University, Tampere City, Vocational School Stadi, Mehiläinen, for her lectures on behavioural addictions and training professionals and writer’s fees from the Finnish Medical Society Duodecim, Myllyhoitoyhdistys ry, Finnish Medical Doctors Association, Finnish Society of Addiction Medicine, and received fees from Svenska Spel (Sweden) for evaluating research plans (grants) in years 2021, 2022, 2023, and 2024, and Tampere University for preliminary examination of PhD work (2022), and Lund University (2023), Sweden, for being an opponent for one PhD thesis. She declares no conflict of interest in relation this manuscript.Samuel R. Chamberlain: Samuel Chamberlain receives honoraria for editorial work at Elsevier journals.Darren R. Christensen: Darren Christensen declares no conflict of interest in relation to this manuscript.Zsolt Demetrovics: Zsolt Demetrovics is part of The University of Gibraltar. The University of Gibraltar received funding from the Gibraltar Gambling Care Foundation, an independent, not-for-profit charity, and donations from gambling operators through the LCCP RET process supervised by the UK Gambling Commission.Jeffrey Derevensky: Jeffrey Derevensky has provided consultancies for numerous national and international governmental agencies and a number of gambling operators. He is a member of the World Health Organization task force examining gambling and gaming issues. He has received honoraria and expenses for speaking at multiple conferences.Fernando Fernandez-Aranda: Fernando Fernandez-Aranda received consultancy honoraria from Novo Nordisk and expenses for speaking at multiple conferences.Sally Gainsbury: Sally Gainsbury has consulted for The Star, True Legal Ltd., New Zealand Crown Council, NSW Independent Liquor & Gaming Authority, KPMG, QBE, Gamble Aware, Behavioural Insights Team, GREO, Norths Collective; received research support from Entain Australia, Sportsbet, Wymac Gaming Solutions, Cambridge Health Alliance, NSW Office of Responsible Gambling, West HQ, Australian Hotels Association, University of Sydney, International Council on Responsible Gambling; provided presentations for Leagues Clubs Australia, Australian Cricketers’ Association, The Star, Asian Racing Federation, Washington State Council.Meredith K. Ginley: Meredith Ginley declares no conflict of interest in relation to this manuscript.Mark D. Griffiths: MDG has received research funding from Norsk Tipping (the gambling operator owned by the Norwegian government). MDG has received funding for a number of research projects in the area of gambling education for young people, social responsibility in gambling and gambling treatment from Gamble Aware (formerly the Responsibility in Gambling Trust), a charitable body which funds its research program based on donations from the gambling industry. MDG undertakes consultancy for various gambling companies in the area of player protection and social responsibility in gambling.Anders Håkansson: Anders Håkansson has research funding from the state-owned gambling operator of Sweden and from its research council, and from the research council of the Swedish alcohol monopoly. None of these organisations had any role in, and no influence on, Anders Håkansson’s participation in the present project.David C. Hodgins: David Hodgins has received conference speaker honoraria from the International Center for Responsible Gaming and the Illinois Problem Gambling Council. David Hodgins receives partial salary support from the Alberta Gambling Research Institute.Alun Jackson: Alun Jackson declares no conflict of interest in relation to this manuscript.Susana Jimenez-Murcia: Susana Jimenez-Murcia has received consultancy honoraria from Novo Nordisk A/S.Daniel L King: Daniel King declares no conflict of interest in relation to this manuscript.Jason Landon: Jason Landon has received research funding from the New Zealand Ministry of Health.Amandine Luquiens: Grant regulated by a public organism ‘French observatory of addictive behaviors- OFDT’ and constraining all French monopolistic gambling service providers to redistribute 0.002% of stakes on their platforms to academic research. The gambling service provider implied in that grant was the ‘Paris Mutuel Urbain’ (PMU). Independency of the research with no constraint on the protocol, the analysis, and the publication were guaranteed by a strict convention between universities, hospitals, and the PMU. Data sharing agreement for the ‘OSE’ study, through an academic-private convention with the FDJ and for a previous study with Winamax: Independency of the research, with no constraint on the protocol, the analysis, and the publication, was guaranteed by a strict convention between the hospital and the FDJ/Winamax, and no funding was part of the conventions.Olof Molander: Olof Molander reports having received funding from the Independent Research Council of Svenska Spel (unrelated to the current study). Olof Molander declares no conflict of interest in relation to this manuscript.AndersNilsson: Anders Nilsson declares no conflict of interest in relation to this manuscript.Brian L. Odlaug: Brian Odlaug is employed by Coloplast (USA) and was previously employed by H. Lundbeck A/S (Denmark). He receives royalties from Oxford University Press and Johns Hopkins University Press.Marc Potenza: Marc Potenza has consulted for Opiant Therapeutics, Game Day Data, Baria-Tek, and Boehringer Ingelheim; has been involved in a patent application with Yale University and Novartis; has received research support from Mohegan Sun Casino, Children and Screens and the Connecticut Council on Problem Gambling; has participated in surveys, mailings or telephone consultations related to drug addiction, impulse-control disorders, or other health topics; has consulted for and/or advised gambling, non-profit and legal entities on issues related to impulse control, internet use, and addictive disorders; has provided clinical care in a problem gambling services program; has performed grant reviews for research-funding agencies; has edited journals and journal sections; has given academic lectures in grand rounds, CME events, and other clinical or scientific venues; and has generated books or book chapters for publishers of mental health texts.Shane A. Thomas: Shane Thomas declares no conflict of interest in relation to this manuscript.James Whelan: James Whelan receives funding from the Tennessee Department of Mental Health and Substance Abuse Services and for the International Center for Responsible Gambling. James Whelan has also received travel and Honoria funds for the International Center for Responsible Gambling.Nicki A. Dowling: In the last 3 years, Nicki Dowling has received research and consultancy funding from multiple sources, including via hypothecated taxes from gambling revenue. Nicki Dowling has received research funding from the Victorian Responsible Gambling Foundation, New South Wales Office of Responsible Gambling, Svenka Spel’s Independent Research Council, Health Research Council of New Zealand, and New Zealand Ministry of Health.