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Pathological Gambling: A Critical Review (1999)
Commission on Behavioral and Social Sciences and Education (CBASSE)

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. "7: Organization and Technology of Gambling." Pathological Gambling: A Critical Review. Washington, DC: The National Academies Press, 1999.

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ket. In the past few decades, researchers have examined the effects of changes in the legal status of gambling. In particular, the entry of legal gambling enterprises into a locale creates many new opportunities for the public to gamble easily and without stigma. Researchers interested in legalization have emphasized how legalization may have increased people's access to gambling by giving them closer proximity to gambling establishments and making gambling products and services more available.

It is not known whether increased access changes fundamental gambling patterns or switches gamblers from one venue to another. Hybels (1979) argued that related types of gambling (e.g., wagering related to horse racing) may be complementary, that is, when a new kind of gambling is introduced in a particular gambling domain, people gamble more. Lesieur and Sheley (1987) noted that illegal and legal gambling can cooccur; they describe "line sellers," who sell (illegal) tickets on the basis of the display board at legal bingo games. There is conflicting evidence on whether new games displace other gambling or augment total gambling. Kaplan (1990) argues that the decline in racetrack attendance preceded the establishment of state lotteries and that racetrack attendance doesn't differ much between lottery and nonlottery states. However, Coate and Ross (1974) and McDonald (1976) reported that the opening of offtrack betting venues in New York City hurt racetrack attendance. Thalheimer and Ali (1992) found that opening a telephone betting service reduced racetrack attendance and betting overall. This evidence points to a tentative conclusion that, once people have had access to many gambling options, their gambling expenditures level off and are relatively fixed.

Legalization has been linked to pathological gambling. Volberg (1994) reported that the percentage of pathological gamblers as a percentage of the total population was less than 0.5 percent of the population in states where gambling had been legal for less than 10 years, whereas it was 1.5 percent in states where gambling had been legal for more than 20 years. Two prevalence studies reviewed by the committee show increases in the number of pathological gambling before and after legalized gambling (Cox et al., 1997; Emerson and Laundergan, 1996). However, some studies have failed to show that legalization results in in-

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