Gambling poses a growing worldwide threat to public health, with its rapid expansion via mobile phones and the internet harming far more people than previously thought, a report warns.

Much stronger global regulatory controls are urgently needed to curb the impact of commercial gambling on global health and wellbeing, a group of leading experts in gambling, public health, global health and regulatory policy concluded.

About 450 million people have at least one behavioural symptom or have experienced a harmful personal, social or health consequence of gambling, the 45-page report from the Lancet public health commission on gambling found.

Of those, at least 80 million people suffer from gambling disorder, a mental health condition identified by a pattern of repeated and continuous betting despite negative consequences on a person’s life. The estimates of the numbers experiencing significant harm to their health as a result of gambling are likely to be conservative, the experts said.

Incredibly sophisticated marketing, ever-widening easy access to the internet and mobile phones are enabling the gambling industry to reach more people than ever before. These included adolescents and younger children who were routinely exposed to advertising of gambling products in ways that were unprecedented before the digital revolution, the report found.

Prof Heather Wardle, the co-chair of the commission, said the huge global threat posed to public health was rooted in the fast changing nature of gambling.

“Most people think of a traditional Las Vegas casino or buying a lottery ticket when they think of gambling. They don’t think of large technology companies deploying a variety of techniques to get more people to engage more frequently with a commodity that can pose substantial risks to health, but this is the reality of gambling today,” she said.

“Anyone with a mobile phone now has access to what is essentially a casino in their pocket, 24 hours a day. Highly sophisticated marketing and technology make it easier to start, and harder to stop gambling, and many products now use design mechanics to encourage repeated and longer engagement.”

Wardle, a specialist in gambling research, policy and practice from the University of Glasgow, added: “The global growth trajectory of this industry is phenomenal; collectively we need to wake up and take action. If we delay, gambling and gambling harms will become even more widely embedded as a global phenomenon and much harder to tackle.”

A systematic review and meta analysis conducted for the commission estimated that gambling disorder affected 15.8% of adults and 26.4% of adolescents who used online casino or slot products, and 8.9% of adults and 16.3% of adolescents who gambled using sports betting products.

Online casino and online sports betting are two of the most rapidly expanding areas for commercial gambling globally, the report found.

Commercial gambling is clearly associated with financial losses and the risk of financial ruin, but it is also associated with physical and mental health problems, relationship and family breakdown, heightened risk of suicide and domestic violence, increased crime against property and people, and loss of employment, the experts concluded.

The commission report noted that this impact was not spread evenly through populations, and specific groups faced an “elevated risk” of harms including adolescents and younger children who were routinely exposed to advertising of gambling products. In addition, gambling is often embedded into the architecture of video games.

Dr Kristiana Siste, one of the report’s experts, said: “We need to take action to protect children from the harms of gambling. We know that early exposure to gambling increases the risk of developing gambling disorders later in life, and children and adolescents are particularly vulnerable to the allure of easy money and the game-like designs of online gambling.”

The report also warned how a complex ecosystem enabled the multibillion dollar gambling industry to promote its products and protects its interests.

This includes innovative digital marketing approaches rooted in “deep surveillance” to target consumers online, as well as widespread sports and broadcast media sponsorship.

The experts also raised concerns about how the betting industry undermined legitimate science on the impact of gambling, reframed discussions about its harmful effects to promote individual responsibility and consumer freedom, and influenced political processes around regulation.

Prof Malcolm Sparrow, one of the experts behind the report, said the findings pointed to the need for increased regulation of gambling.

“While the industry continues to promote gambling as harmless entertainment, countries and communities are experiencing rapidly increasing threats from gambling harms.

“The commission urges policymakers to treat gambling as a public health issue, just as we treat other addictive and unhealthy commodities such as alcohol and tobacco.”