Wallis Turley | Former Intern
A New Campus Risk: Online Sports Betting
Online sports betting has expanded rapidly across higher education institutions, creating a fast‑growing public health challenge associated with sports culture, peer influence, and 24/7 mobile access. Following the 2018 Supreme Court decision in Murphy v. National Collegiate Athletic Association (NCAA), states were given the authority to decide whether to legalize sports betting within their jurisdictions. Today, thirty-nine states and the District of Columbia have passed legislation to legalize sports betting, with thirty allowing online sports betting via smartphone apps or websites. A recent study of electronic health records of 197 million U.S. adults (2018–2026) found that gambling disorder diagnoses have risen 60% in states that legalized gambling. These trends carry particular significance for students enrolled in higher education.
Unlike traditional gambling, students at colleges, universities, and community colleges now have around-the-clock access through their phones to place bets in their dorms, in class, and even during games, creating constant exposure and opportunities to gamble. According to a national survey from the NCAA, approximately 67% of all college students on campus bet on sports. Moreover, researchers estimate that 6% of college students have a serious gambling problem, a rate about double that of the U.S. adult population. In one survey of college students, an estimated 21% reported using their financial aid packages or student loans to gamble, and 60% admitted using someone else’s ID or account to gamble while underage. Together, these statistics reveal an emerging public health concern that online sports betting poses in higher education.
Problem gambling is defined as any gambling behavior that causes damage to a person or their family. Problematic gambling behavior includes, but is not limited to, gambling despite negative consequences, chasing losses, and constantly thinking about gambling. This term describes harmful behavior at any level of impact on one’s life. Problem gambling ranges from mild disruption to more serious financial or personal repercussions, and anyone who gambles may be at risk of developing problematic behaviors.
In contrast, gambling disorder (sometimes referred to as gambling addiction) is a clinical diagnosis. The American Psychiatric Association defines this mental health condition as recurrent problematic gambling behavior over a minimum of twelve months. At least four diagnostic criteria must be met for a gambling disorder diagnosis, including symptoms such as persistent preoccupation with gambling, increasing bets to achieve the same excitement, repeated unsuccessful attempts to cut back, irritability when trying to stop, gambling to relieve negative emotions, chasing losses, gambling when distressed, lying about gambling, jeopardizing relationships or professional opportunities, or relying on others for financial support related to gambling. This term reflects a more severe and significant impairment.
Although people often use these terms interchangeably, each describes a level of severity that gambling behavior can create, from disruptive habits to a severe condition that requires medical attention and professional treatment. It is important to recognize that problem gambling behavior can later develop into a gambling disorder.
Research shows that gambling disorders have the highest suicide risk of any form of addiction. The National Council on Compulsive Gambling reports that one in five people with gambling disorders attempt suicide. This level of risk makes it clear that higher education institutions have an obligation to address gambling harm with urgency.
Students are a vulnerable community to the risks and harms of gambling, and researchers at the University of Buffalo have proposed that there are the “Five A’s” which help explain why students in higher education are particularly susceptible to developing gambling addictions: (1) age, (2) availability, (3) acceptability, (4) advertising, and (5) access. For students across colleges, universities, and community colleges, the risks are not only financial harm. There is a correlation between sports betting and a decline in academic performance and mental health among college students. These associations [WT1] challenge the misconception that sports betting harms are limited to financial losses, revealing impacts across multiple aspects of students’ daily lives and overall well-being.
Since online sports betting is a new product, one survey found that only about 22% of colleges have established formal gambling policies. This discrepancy reveals a critical gap in higher education harm reduction strategies, particularly as online sports gambling becomes increasingly popular among college and university students.
Alcohol Regulation as a Model for Harm Reduction
In the United States, alcohol regulation as a harm reduction strategy for students of legal drinking age prioritizes reducing negative consequences rather than promoting strict abstinence. These alcohol policies provide a blueprint for understanding how evidence-based regulation can reduce harm in other high-risk behaviors, like online sports betting. Higher education institutions historically lacked formal policies to address alcohol misuse. Now, the National Institute on Alcohol Abuse and Alcoholism, through the College Alcohol Intervention Matrix (CollegeAIM), provides evidence-based interventions ranked by effectiveness and cost to guide higher education administrators in tailoring these strategies for their campus needs. [WT2]
Individual-level methods aim to shift students’ knowledge, attitudes, and behaviors around alcohol use. Education and awareness programs like AlcoholEdu for College incorporate cognitive-behavioral skills training and personalized feedback to equip students with the tools for safer alcohol related decision-making. Brief Alcohol Screening and Intervention for College Students (BASICS) uses two individual counseling sessions to help students identified as heavy drinkers change their drinking patterns. These programs highlight that health behavior begins at the individual level, and higher education institutions can help inform students in making safer and more informed choices.
At the campus level, harm reduction strategies reshape the physical and social environment to reduce high-risk drinking. Common campus policies include prohibiting alcohol at campus sporting events, restricting alcohol advertising, and enforcing the minimum legal drinking age through compliance checks. These campus strategies demonstrate how altering context and access can reduce harmful behaviors associated with alcohol.
State-level interventions rely on coordination among governments, law enforcement, and local businesses to carry out the law. These efforts include enforcing minimum legal drinking age laws, partnering with local bars and restaurants to require responsible beverage service training for servers, and regulating the sales hours of alcohol. States can also increase taxes on the sale of alcohol and utilize zoning laws to limit the density of alcohol establishments as another method of reducing alcohol availability. By addressing the physical availability and pricing of alcohol, states can improve public health and strengthen community safety on a large scale.
Applying Proven Strategies to Protect Students
While higher education institutions require first-year students to participate in courses addressing the harms of drugs and alcohol, similar attention has not been given to online sports gambling. Higher education administrators can implement the lessons learned from alcohol regulation and apply them to this emerging public health concern.
One idea is to incorporate gambling as a topic in the first-year orientation curriculum. Created in 2023, the NCAA requires that student-athletes take an online interactive course titled “Stay in the Game: Understanding the Risks of Sports Betting,” which outlines the signs of problem gambling and the risk factors associated with engaging in sports betting. More than 50,000 student athletes across forty-nine states have completed the program. Additionally, all NCAA campuses have access to EPIC Global Solutions, a company that provides in-person and virtual workshops and seminars on gambling harm education. A limitation of these programs is that they are tailored for student athletes and not the general student population. Although the NCAA has not released any public data on the program’s effectiveness, this level of participation indicates promising engagement and operational feasibility.
Higher education institutions can strengthen campus controls by restricting sports betting promotional and marketing materials. In 2021, Louisiana State University (LSU) signed a lucrative multi-year, seven-figure deal with Caesars Sportsbook to brand its football stadium and advertise sports betting across campus. According to the NCAA, 58% of students reported that they are more likely to bet after seeing betting ads. LSU ended the contract following public backlash to the partnership and a promotional gambling email offering free bets that was sent to students, including students below the legal gambling age. This incident illustrates how university partnerships with sportsbooks can generate public concern and prompt broader scrutiny.
In response, the American Gaming Association created self-regulatory industry standards to prohibit member sportsbooks from partnering with colleges to advertise sports betting; these guidelines are not legally binding. It is also worth noting that Caesars Sportsbook has not been a member of the American Gaming Association since 2020. Although industry standards represent a step towards responsible marketing, industry self-regulation cannot fully protect students. Higher education institutions should adopt explicit, enforceable policies that prohibit gambling promotions.
State-level regulation is currently the main approach for governing online sports betting, including rules specifically aimed at protecting college and university athletics. Regulations vary widely across the U.S., with some states banning bets on in-state college teams, while others allowing exceptions for tournament play.
The NCAA is currently urging state legislatures and gambling commissions to ban proposition bets, which involve wagering on specific player’s statistics during a game, like total yards or number of rebounds, rather than the final score. In collegiate athletics, proposition bets are particularly problematic because these micro-wagers single out the individual performance of amateur athletes, making them easy targets when they have a bad game. In recent years, student-athletes have faced a surge in online harassment, including online direct messages with abusive language and even death threats from bettors angry about losing player-based wagers. State-level bans on proposition bets are intended to reduce the escalating harassment and protect student-athletes from being singled out by frustrated gamblers.
Although state laws can offer the strongest levels of protection, political barriers often limit their implementation. These limits create a patchwork of rules that leave students vulnerable depending on where they attend college or university.
Online sports betting puts students in higher education at risk for financial, academic, and mental health harms. As the online sports betting market expands, policymakers, public health professionals, and higher education leaders must implement evidence-based interventions that support students’ safety and well-being. Higher education institutions can strengthen these efforts by adopting alcohol regulations as a practical and enforceable model for addressing this emerging public health threat of online sports betting harms.
DISCLAIMER: The views and opinions expressed in this piece are those of the author and do not reflect the views of the O’Neill Institute.
