A national survey conducted by The Harris Poll on behalf of the National Council on Problem Gambling (NCPG) indicates that early exposure to gambling is widespread in the United States, while routine healthcare discussions about gambling behavior remain uncommon.

The online survey, carried out from February 19–23, 2026, included 2,072 adults ages 18 and older, among whom 1,975 were 21 and older. Results show that 65% of adults aged 21 and above participated in at least one form of gambling before reaching the legal age of 21, which is the minimum age for most forms of gambling in many states.

Growing Concern About Youth Exposure

Among those who reported gambling before turning 21, 40% played lottery or scratch-off tickets, 37% took part in home games for money with friends or family, 23% placed a sports bet, 21% engaged in online casino-style games, 16% played fantasy sports and 3% reported another form of gambling activity.

The data reveals a generational divide in sports wagering. Thirty-three percent of respondents aged 21 to 44 said they had placed a sports bet before turning 21, compared with 11% of respondents aged 55 and older. The findings suggest that younger adults were more likely to report underage gambling than older generations.

Public concern about youth gambling exposure also emerged in the survey. Sixty-six percent of respondents said they are concerned about the impact of underage exposure to gambling or gambling-like activities, and 25% described themselves as very concerned. Concern levels were higher among households with children under 18, with 71% expressing concern compared to 62% among households without children.

Respondents were asked to consider exposure through sports betting advertisements, online games with betting elements and features such as loot boxes. The survey results were released during Problem Gambling Awareness Month (PGAM).

“Youth are at significantly greater risk for developing gambling problems, and as gambling becomes increasingly normalized in media, sports, and online spaces, the risks grow,” said Heather L. Maurer, MA, CAE, Executive Director of NCPG. “Prevention and education are essential to ensure young people, families, educators, and policymakers understand the potential harms and are protected from early exposure.”

Thirty-nine states and the District of Columbia now offer legal sports betting, and online prediction markets operate nationwide. When presented with a description of prediction markets, 30% of Americans said they view them as most similar to gambling. That share exceeded the 24% who likened them to financial forecasting and the 18% who described them as investing.

“We need consistent consumer safeguards across emerging products like prediction markets, which are functionally gambling platforms,” said Cole Wogoman, NCPG’s Director of Government Relations and League Partnerships, in a press release. “If they involve financial stakes, uncertain outcomes, and repeated participation, we must consider the public health implications and ensure appropriate, consistent protections are in place.”

Addiction Viewed as Serious Health Issue

The survey also assessed attitudes toward gambling addiction. Seventy-nine percent of respondents said gambling addiction is as serious as or more serious than alcohol or drug addiction, and 30% characterized it as more serious.

“What we’re seeing is that the majority of Americans recognize gambling addiction as a legitimate behavioral health issue,” Heather added. “The next step is ensuring our public health systems, policies, and prevention strategies reflect that understanding.”

Despite this recognition, only 15% of respondents reported that a primary care provider had ever asked about their gambling habits. The contrast with routine screening for alcohol and tobacco use stood out in the findings.

“This represents a significant missed opportunity for early identification and intervention,” Heather said. “Gambling-related harm is often invisible until it becomes severe. Screening in healthcare settings can help normalize conversations and connect people to support earlier.”

The study measured sampling precision using a Bayesian credible interval. For this survey, the margin of error is ±2.7 percentage points at a 95% confidence level.

In addition to survey findings, the NCPG recently announced that federal research funding for gambling addiction has opened for the first time. The funding will support research into how problem gambling disproportionately affects veterans and service members.

The survey asked adults aged 21 and older to reflect on gambling participation before age 21 and did not distinguish between states where certain forms of gambling are legal at 18 and those restricted to 21 and older, nor between participation with regulated versus unregulated operators.