Background Public health models identify numerous contributors to gambling harm. Most research focuses on psychological factors, and most interventions on individual responsibility and problem gambling treatment. Instead, understanding policies, practices and contexts that underpin transitions into harmful gambling can inform preventive measures. This study aimed to explore environmental and social factors related to transitions into gambling harm among young adults in NSW, Australia, where per capita gambling losses are the highest in the world and young adults are the demographic most at risk of gambling harm. Methods The study recruited 20 NSW residents aged 18–23 years who reported past-year moderate-risk or problem gambling. Semi-structured interviews collected retrospective narrative accounts of their gambling experiences during childhood, adolescence, and early adulthood, and potential social and environmental influences on these experiences. Reflexive thematic narrative analysis was used. Results Participants reported routine exposure to gambling throughout their childhood through parents, gambling venues, advertising and simulated gambling. They recalled few cautionary messages and viewed gambling as a normal, benign and enjoyable adult activity. During adolescence, peer influence, family attitudes, advertising and simulated gambling were the main pro-gambling influences that could shape their growing anticipation of gambling. Most gambled as soon as they were legally allowed, if not before, as a rite of passage into adulthood, followed by early experimentation with gambling products. Their gambling then became routine, fostered by easy access, enticing product features, peer influences, and being targeted by gambling advertising. By early adulthood, they reported gambling-related harm, mainly to their emotional and financial wellbeing. Conclusions The study illuminates the range of pro-gambling influences that young people face when gambling products are widely accessible and heavily advertised. It shows how young people can become primed to gamble during their formative years and rapidly develop a gambling problem once they reach the legal gambling age. To address this public health issue, substantial changes are needed to reduce these environmental influences, including to gambling advertising, inducements, accessibility and harmful product features. Doing so can help reduce the cultural entrenchment of gambling and the consequent social influences that increase the risks of gambling harm for young people.

Simulated gambling games (SGGs) combine features of gaming and gambling in social casino games, practice games, and games with mini gambling components. SGGs may act as a gateway to monetary gambling and gambling harm through a stimulus exposure effect. Alternatively, people with certain psychological or other characteristics may tend to use both activities, reflecting a selection effect. SGGs might also help to suppress the allure of gambling and satisfy gambling urges, reducing gambling harm for some people. This review aims to help clarify these relationships by synthesising empirical evidence on the co-occurrence and migration between SGGs and monetary gambling, including harmful gambling. All cross-sectional studies of adolescents and adults have found positive relationships between engagement in SGGs and monetary gambling, and increased risk of harmful gambling. Longitudinal and experimental studies support a stimulus effect of SGGs on monetary gambling, with little evidence of a suppression effect. The most compelling evidence is from a 24-week randomised controlled trial where the number of simulated slots sessions played per week reliably predicted increases in slots expenditure in real gambling venues the following week. Minimal research exists on migration pathways between SGGs and harmful gambling. SGGs are most likely to stimulate monetary gambling; by contrast, evidence for any suppression effect is limited. While causal relationships are unclear, people already experiencing gambling harm are particularly attracted to SGGs, which expose them to additional gambling stimuli. Strengthening consumer protections in SGGs and restricting underage access may help reduce these risks.

Sports betting increases the risk of gambling harm in young people, but little is known about their pathways into harmful betting and dynamic influences over time. This study explored journeys towards gambling harm among young Australian sports bettors and key sources of influence on their experiences, from childhood to early adulthood. Fifty people aged 18–25 years reporting moderate or high harm from sports betting on the Gambling Harm Scale were interviewed. Using thematic narrative analysis, the finding’s master theme was the permeation of pro-gambling influences into all stages of participants’ lives. During childhood, these influences were present in everyday settings including family, advertising and simulated gambling. During adolescence, exposure to pro-gambling influences escalated with advertising, peer normalisation and increased simulated gambling, resulting in strong gambling intentions. In early adulthood, participants were immersed in a gambling culture through gambling as a rite of passage into adulthood, strong peer influence and intense advertising. Today’s young adults are the first generation with routine exposure to pro-gambling influences throughout their lives. Saturation advertising since childhood has told them that sports betting is a fun, exciting and lucrative activity, integral to friendships and social status, and necessary to demonstrate their sport loyalty, sport knowledge and Australian identity. Protective influences from parents and safer gambling messages have only limited capacity to compete with these commercial determinants of harm. Efforts are needed to reverse the cultural embedding of gambling into sport, its normalisation in youth culture and to curtail sports betting sponsorship, advertising and inducements.

This study aimed to identify parental influences on adolescent gambling using an online survey of 1,183 Australian parents (69% mothers) with an adolescent aged 12-17 years. The survey assessed a comprehensive range of demographic, adolescent and parent influences on adolescent gambling participation and gambling problems, focusing on gambling-related parental factors (i.e., parent problem gambling, parental attitudes to adolescent gambling, parental facilitation of gambling), parenting practices, and the parent-adolescent relationship. The results of multiple regression analyses revealed that parental facilitation of adolescent gambling was the strongest predictor of adolescent gambling participation and gambling problems, while other significant independent predictors were adolescent simulated gambling, poor parental monitoring, and less positive parent-adolescent relationships. The results emphasize the importance of targeting parents in strategies for reducing gambling and gambling-related harm in adolescents.

The widely adopted functional definition of gambling-related harm implies a three-part pathway: gambling engagement gives rise to harmful consequences, which in turn reduce health and wellbeing. This pathway has not previously been tested in general-population data. A population-weighted Australian analytic sample (N=4,001) was used to test whether this structure holds empirically. A risk-weighted gambling involvement index was derived from form-specific frequencies, with greater weight given to forms most strongly associated with gambling problems. Weighted mediation models showed that gambling harms statistically accounted for the observed association between gambling involvement and reduced wellbeing: indirect effects through harms were consistently negative and robust to demographic adjustment, while direct effects of gambling involvement were essentially zero once harms were included. The pattern held for both an expanded 26-item harm composite and the shorter 10-item gambling harms screen (GHS-10), and was clearest for life satisfaction and mental wellbeing. These results provide the first cross-sectional pathway-based support for the structure implied by this definition in representative population data. As a corollary, they support the construct validity of direct harm screens, which behave as expected of measures occupying the harm position in this pathway. Population-level effect sizes were modest, reflecting the concentration of harm burden in a minority of gamblers, but the wellbeing deficit among those reporting harms was substantial.

BACKGROUND AND AIMS:Whether gambling marketing has a causal effect on harm is of regulatory interest. Direct marketing offers (emails, push notifications and text messages) are frequently received by people with active gambling accounts, but they can opt out. This study aimed to test whether opting out of direct marketing reduces betting and short-term gambling harms in a real-world gambling environment. DESIGN:Stratified randomised field experiment with a between-participants design, embedded in a 14-day ecological momentary assessment (EMA). SETTING:Nationwide, Australia (July-August 2023). PARTICIPANTS:Participants (n = 227; 61.7% men; mean age = 45), 52.0% of whom scored in the moderate-risk or problem range on the Problem Gambling Severity Index (PGSI), were regular Australian sports and race bettors recruited from online panels who agreed in principle to opt out of receiving direct marketing from all wagering operators with whom they held accounts. INTERVENTION:Participants were stratified by PGSI risk category, age group and gender and then randomly allocated either to an opt-out condition (n = 96), in which they opted out of direct marketing from their wagering operators and provided proof, or to a control condition (n = 131) that continued to receive direct marketing as usual. MEASUREMENTS:Seven EMA surveys were administered every 48 hours over a 14-day period during a high-volume betting season. Outcomes were self-reported number of bets placed, gambling expenditure (in Australian dollars, AUD) and short-term gambling harms in the previous 48 hours, assessed with a 10-item adapted Short Gambling Harm Screen (SGHS). FINDINGS:The opt-out group placed 23% fewer bets [B = -0.11, 95% confidence interval (CI) = -0.20, -0.03, P = 0.011], spent 39% less money (B = -0.53, 95% CI = -0.84, -0.21, P = 0.001) and reported 67% fewer short-term gambling harms (B = -0.22, 95% CI = -0.36, -0.07, P = 0.004) compared with the controls. CONCLUSIONS:Opting out of receiving direct marketing from wagering operators appears to be associated with statistically significantly fewer bets made, amount spent gambling and short-term gambling harms.

Young adults bear the greatest burden of harm from sports betting. This study explored 1) the lived experiences of sports betting harm when people enter adulthood, 2) barriers and catalysts to change, and 3) change strategies used. Interviews with 50 people aged 18–25 who reported sports betting harm were analysed using thematic analysis. Findings highlight the multidimensional nature of harm across financial, emotional, vocational, relationship and health domains. The incremental but rapid accumulation of harm in the context of normalised sports betting could mask its emergence. Realising they showed signs of addiction could shake participants’ self-image, as their stereotypes of ‘addicted’ gamblers conflicted with marketing representations of sports betting as ‘quirky and cool’. Barriers to change included not being ready, not acknowledging the harm, doubts about professional treatment, and confidence they could stop betting if necessary. Catalysts for change included acknowledging the harm, fear of addiction, feeling exploited, awareness of the extent of their losses, and reaching crisis point. Most change strategies entailed self-help, such as budgeting, setting limits, deleting betting apps and closing accounts. Fewer participants sought informal or professional help. Most participants wanted to reduce their betting and be free of gambling urges. These experiences reflect the slow, difficult journey away from harm – in contrast to the rapid journey into harm, with its immediate and potential legacy effects on wellbeing. Measures are needed to reverse sports betting normalisation in youth culture, increase understanding of its risks for harm and addiction, and improve consumer protection tools and help-seeking.

Measuring gambling-related harm is crucial for public health initiatives, but existing screens like the Problem Gambling Severity Index (PGSI) have limitations. The 10-item Short Gambling Harms Screen (SGHS/GHS-10) addresses some gaps, but lacks comprehensive domain coverage and robust validation against health utility benchmarks. This study aimed to develop and validate an extended 20-item Gambling Harms Scale (GHS-20). Objectives included achieving better representation across harm domains, selecting items based on unique associations with health utility decrements, and benchmarking the scale's scores against health utility. Data were collected from 2,603 Australian adults who gambled in the past year. Participants completed 31 candidate harm items, the PGSI, the WHOQOL-BREF (measuring quality of life), and the SF-12 (for SF-6D health utility derivation). Item selection utilised latent trait modelling and lasso regression. The final GHS-20 scale was benchmarked against SF-6D health utility using propensity score weighting to balance demographic factors and generalised additive modelling (GAM) to control for comorbidities. Lasso regression identified items providing unique explanatory information, resulting in the 20-item GHS-20, which includes items from all six gambling harm domains. The GHS-20 demonstrated excellent reliability (alpha=.98, omega=.90), correlated positively with the PGSI (r=.78) and negatively with health utility (r=-.38). GAM analysis revealed a significant, near-linear negative relationship between GHS-20 scores and health utility, with statistically significant decrements observed even at low scores. The GHS-20 is psychometrically robust, and can comprehensively assess gambling harm and calculate population harm burden.

There is almost no research on adolescent gambling from the perspective of parents, despite their important role in preventing adolescent engagement in potentially risky and harmful activities. This study used a quantitative online survey of 1,185 parents (69% mothers) of adolescents (aged 12 to 17 years) to examine parental attitudes and knowledge of adolescent gambling and adolescent exposure to parental gambling. Most parents disapproved of adolescents being exposed to gambling and that gambling was less concerning than other adolescent issues (e.g., bullying, drugs). Despite being concerned by gambling, parents reported that adolescent gambling was common and often gambled in the presence of their adolescent; particularly fathers. Fathers were also more likely to hold positive attitudes towards adolescent gambling, and reported higher levels of adolescent gambling and simulated gambling. These findings suggest that public health strategies to prevent adolescent gambling should build parental awareness of gambling and its risks and harms.

Gambling-related harms significantly impact not only gamblers but also people socially connected to them (affected others or AOs), yet quantifying these impacts has remained challenging. This study developed and validated two scales for measuring harm to people due to someone else's gambling - the 10-item and 20-item Gambling Harms Scale for Affected Others (GHS-10-AO and GHS-20-AO) - benchmarked to health utility metrics. Using data from 2,018 Australian adults with close relationships to gamblers, we employed psychometric item selection, propensity weighting, and control for comorbidities to establish evidence for causal links between reported harms and health utility decrements measured by the SF-6D. Emotional, relational, and financial harms were the most prevalent items selected. Both scales demonstrated excellent reliability (α = 0.89 for GHS-10-AO; α = 0.94 for GHS-20-AO) and strong correlations with health utility measures (r = -0.47 to -0.48 with SF-6D). The relationship between harm scores and health utility showed significant non-linearity, with increasing convexity at higher harm levels. These scales provide the first validated instruments for quantifying health impacts to AOs using a common metric comparable to gambler-focused harm measures, enabling population-level assessment of current gambling harm in the adult population; inclusive of gamblers and connected others. The instruments fill a critical gap in gambling harm measurement and offer jurisdictions tools for monitoring progress toward harm minimisation that encompasses impacts on both gamblers and those around them.

Background and aims:Wagering direct marketing is prolific, but no research has examined its relationship with gambling harm, nor the effects of direct marketing from wagering affiliates and tipsters. This study aimed to 1) examine the extent to which frequent bettors receive more direct promotional messages from wagering operators, free betting information services, and paid tipsters, and 2) assess longitudinal associations between message exposure and the number of bets placed, amount spent on betting, and short-term betting-related harm. Methods:An ecological momentary assessment administered seven surveys over two weeks to collect repeated measurements of exposure to direct messages and number of bets placed, betting expenditure and short-term betting harm. Linear mixed effects regression models analysed 4,020 observations from 814 Australian participants who bet at-least fortnightly on sports or races. Results:Over the two weeks, participants using each type of service received on average 12.7 messages from wagering operators, 11.8 from free services and 21.7 from tipsters. Number of bets, expenditure and harm all increased with each additional message from wagering operators. Betting consumption and harm also increased with each message received through a digital channel from free services and tipsters. Receiving messages through emails, texts and app notifications from any source was accompanied by increased expenditure and harm. Messages from wagering operators were particularly potent for higher-risk bettors. Discussion and conclusions:Direct messages can immediately stimulate betting, expenditure, and gambling-related harm, justifying further restrictions. Many frequent bettors use affiliate betting services that currently have little regulatory oversight or consumer protections.

BACKGROUND:Gambling-related harms can negatively impact the health and wellbeing of those around the person who gambles (affected others, AOs). The stress-strain-coping-support (SSCS) model proposes that the type of coping strategies AOs use, and the availability of social support, can effectively reduce some of these negative consequences. The current study aimed to explore the assumptions in the SSCS model by examining the role of coping styles and social support on the experience of harm and psychological distress in AOs. METHOD:A community sample (N = 1,131) of AOs completed the Problem Gambling Severity Index (PGSI), Gambling Harm Scale for Affected Others (GHS-AO-20; harm), Significant Other Closeness Scale, Kessler-6 (K6; psychological distress), Brief Coping Questionnaire (coping styles) and the Multidimensional Scale of Perceived Social Support (social support). Data were analysed using hierarchical multiple regression. RESULTS:The use of maladaptive coping styles was positively associated with harm and psychological distress. Social support was significantly negatively correlated with harm and distress. When all predictors were included in regression analyses, the only significant predictors of harm and distress were being exposed to a more severe gambling problem, being closer to the person with the gambling problem, greater use of maladaptive coping styles, and lower levels of social support. Some interaction effects were identified. CONCLUSIONS:Some commonly used coping behaviours may inadvertently exacerbate harm and distress, while social support appears to be protective against negative health impacts. Education, treatment, and support to AOs could provide options that address these findings.

Gambling patterns among young people are diverse, yet factors that affect changes in their gambling behaviour as they mature remain poorly understood. This study explores gambling trajectories and related sources of influence during childhood, early adolescence and later adolescence, and amongst adolescents at different levels of gambling risk. Qualitative interviews and online communities with 89 Australians aged 12-17 years explored their gambling experiences, from childhood to the present. Reflexive thematic narrative analysis revealed that children often learn how to gamble through their parents. Parents, peers, sports interests, advertising and simulated gambling continue to transfer gambling knowledge and skills throughout adolescence. Gambling is further reinforced through social rewards and is highly normalised through advertising. At-risk/problem gambling adolescents tended to report positive early memories of gambling, but also harmful parental gambling. They reported having friendship groups where betting is highly normalised. They purposefully honed their betting knowledge to demonstrate skill, and also gambled with in-game items (skins). Conversely, non-gamblers reported very little exposure to parental gambling, mirrored their parents' negative attitudes to gambling, were unlikely to have friends who gambled, and reported less interest in professional sport. Reducing youth gambling and gambling harm requires measures to tackle multiple layers of influence.

Aims Understanding how gambling harm is distributed is essential to inform effective harm reduction measures. This first national Australian study of gambling harm-to-self examined the extent, distribution, risk factors, and health related quality of life (HRQoL) impacts of this harm. Methods A Random Digit Dialling sample of 15,000 Australian adults was weighted to key population variables. Key measures included the Gambling Harms Scale-10 (GHS-10), PGSI, SF-6D, gambling behaviours, and demographics. Analyses included ordinal logistic regression. Results Amongst gamblers, 14.7% reported harm on the GHS-10, including 1.9% reporting high-level harm. While high-level harm occurred mainly in the problem gambling group (77.3%), other PGSI groups accounted for most of the more prevalent low (98.5%) and moderate (87.2%) harms reported. Proximal predictors of greater harm were use of online gambling and more frequent gambling on electronic gaming machines (EGMs), race betting sports betting, poker, skin gambling, scratchies, and loot box purchasing. Distal predictors were being younger, male, single, Aboriginal or Torres Strait Islander, and speaking a non-English language at home. At the population level, the greatest aggregate HRQoL impacts were amongst lower-risk gamblers, confirming the results of other studies regarding the ‘prevention paradox’. Conclusions The distribution of harm across gambler risk groups indicates the need for preventive measures, not just interventions for problem gambling. Reducing harm requires modifying product features that amplify their risk, especially for EGMs, race betting and sports betting that are both inherently risky and widely used. Gambling harm exacerbates health disparities for disadvantaged and vulnerable groups, requiring targeted resources and support.

A broad quantitative literature has explored the extent and distribution of gambling-related harm. However, any quantitative measure involves a number of statistical decisions around item selection and weighting that may affect its ability to provide an accurate summary of a gambler's lived experience. This may especially be an issue with a condition as varied and multifaceted as gambling-related harm. The present research therefore used qualitative methods to validate the categorization of gamblers into four levels of harm via the Gambling Harms Scale (10-items) (GHS-10) through an analysis of 30 semi-structured interviews with gamblers. Results showed that unharmed gamblers saw gambling as just another leisure activity, which relieved stress and brought them closer to other people. Low harm gamblers were similar but could experience emotional stresses over their level of gambling expenditure. Just under half of all moderate harm gamblers experienced occasional severe financial impacts and emotional stresses from their gambling. Finally, all high harm gamblers experienced chronic financial impacts and emotional stresses, which spilled over into relationship problems for three quarters of this group, and negative impacts on health or work/study for around half of this group. These results showed that the severity of participants' lived experience of gambling increased with their GHS-10 score, providing a qualitative validation for this quantitative self-report measure. This qualitative validation for a quantitative scale is argued to be a promising avenue for future gambling research.

Background Gambling abstinence when underage lowers the risk of harmful gambling in later life. However, little research has examined why many young people refrain from gambling, even though this knowledge can inform protective strategies and lower risk factors to reduce underage gambling and subsequent harm. This study draws on the lived experience of adolescent non-gamblers to explore how social determinants while growing up have shaped their reasons and choices to not gamble.Methods Fourteen Australian non-gamblers, aged 12-17 years, participated in an in-depth individual interview (4 girls, 3 boys) or online community (4 girls, 3 boys). Questions in each condition differed, but both explored participants' gambling-related experiences while growing up, including exposure, attitudes and behaviours of parents and peers, advertising, simulated gambling and motivations for not gambling. The analysis used adaptive grounded theory methods.Results The grounded theory model identifies several reasons for not gambling, including not being interested, being below the legal gambling age, discouragement from parent and peers, concern about gambling addiction and harm, not wanting to risk money on a low chance of winning, and moral objections. These reasons were underpinned by several social determinants, including individual, parental, peer and environmental factors that can interact to deter young people from underage gambling. Key protective factors were parental role modelling and guidance, friendship groups who avoided gambling, critical thinking, rational gambling beliefs, financial literacy and having other hobbies and interests.Conclusions Choices to not gamble emanated from multiple layers of influence, implying that multi-layered interventions, aligned with a public health response, are needed to deter underage gambling. At the environmental level, better age-gating for monetary and simulated gambling, countering cultural pressures, and less exposure to promotional gambling messages, may assist young people to resist these influences. Interventions that support parents to provide appropriate role modelling and guidance for their children are also important. Youth education could include cautionary tales from people with lived experience of gambling harm, and education to increase young people's financial literacy, ability to recognise marketing tactics, awareness of the risks and harms of gambling, and how to resist peer and other normalising gambling influences.

Background and aims:COVID-19 lockdowns limited access to gambling but simultaneously elevated psychosocial stressors. This study assessed the relative effects of these changes on gambling risk status during and after the Australian COVID-19 lockdown from late-March to late-May 2020.Methods:The study administered three surveys to people who had gambled within the past year at T1. Wave 1 asked about before (T1, N = 2,125) and during lockdown (T2, N = 2,125). Subsequent surveys focused on one year (T3; N = 649) and two years after lockdown (T4, N = 458). The dependent variable was changes in reporting any problem gambling symptoms (PGSI 0 vs 1+). Bivariate analyses and multinomial logistic regression tested for significant associations with: demographics, psychosocial stressors (perceived stress, psychological distress, loneliness, health anxiety about COVID, financial hardship, stressful life events), gambling participation and gambling frequency.Results:Gambling participation and at-risk gambling decreased between T1 and T2, increased at T3, with little further change at T4. When gambling availability was curtailed, decreased gambling frequency on EGMs, casino games, sports betting or race betting, and lower psychosocial stress, were associated with transitions from at-risk to non-problem gambling. When gambling availability resumed, increased EGM gambling frequency, decreased online gambling frequency, and higher psychosocial stress were associated with transitions from non-problem to at-risk gambling.Discussion and conclusions:Gambling availability appears a stronger influence on gambling problems, at the population level, than psychosocial risk factors. Reducing the supply of high-risk gambling products, particularly EGMs, is likely to reduce gambling harm.

Quantitative self-report measures for gambling-related harm experienced by gamblers themselves are established in the literature, whereas similar measures of gambling-related harm to affected others (AOs, a.k.a. concerned significant others) are given less attention. The impact of gambling-related harm varies significantly among different relationship types, such as partners, family members, and friends. Moreover, while many studies concentrate primarily of AOs of individuals meeting the threshold criteria for “problem gambling”, AOs of gamblers with less severe issues can also experience harm. The present work takes a qualitative approach to understanding gambling-related harm as experienced by AOs, by exploring the lived experience of 30 AOs across these three relationship types, and the full spectrum of AO harm according to the Short Gambling Harm Screen for Concerned Significant Others (SGHS-CSO) self-report measure. The results showed that the level of AO harm varied both across and within each relationship type depending on how heavily the gambler gambled, whether the two people gambled together, how close the relationship was, the AO’s level of social support, and also how interdependent the two people’s life situations were. AOs enacted multiple strategies to help reduce harm for the gambler and themselves, or alternatively distanced themselves from the gambler. The findings indicate that SGHS-CSO comparisons may work reasonably well within a given relationship type, but also suggest ways to improve the comparability of measured harm across different AO relationship types.

Effective gambling messages should curb time and money spent on gambling, since these are the behaviours proximal to gambling-related harm. Studies that aim to find what messages best achieve these objectives are scarce, and most focus on electronic gaming machine (EGM) gambling rather than sports and race betting. The present study aimed to gather longitudinal evidence on previously identified messaging strategies. In an experiment, two types of messages, positive-emotional and norm-based, were contrasted against a control condition with generic messages (e.g., gamble responsibly). By stratified random assignment, participants (N = 2,074, 36% female), were exposed to 3 unique messages in each of 3 weeks, exclusive of pre- and post-surveys in weeks 1 and 5, respectively. There were no significant differences by condition in amounts-bet commercially on sports or race betting, time spent gambling, gambling-harm experienced, gambling-urges nor risk-related gambling beliefs. However, there was a significant decrease in all these outcomes over weeks 1 through 5. The messages may not have been the factor that contributed to the decrease in outcomes over time, as participating in the study may have also prompted self-reflection on gambling expenditure. Positive-emotional messages were rated most helpful and easily understood, and the highest-rated message was the control message, "only bet what you can afford." Despite no differences found between the conditions, the present study provided evidence that self-reflection on gambling expenditure is well-rated by gamblers as being helpful. Future experiments should be conducted to gauge the robustness of this finding.

Wagering affiliate marketing is a performance-based system where online wagering operators pay third parties (affiliates) to recruit and engage customers for them. Despite widespread use, it has attracted limited research attention in Australia and elsewhere. This exploratory Australian study aimed to capture key informant perspectives on (1) the key features of wagering affiliate marketing and (2) how it may increase the risk of gambling harm. Interviews were conducted with 44 individuals from 28 organisations representing wagering operators, wagering affiliates, gambling regulators and legal advisors, and gambling support providers. Based on thematic analysis, the findings identified numerous features in business and payment models used in wagering affiliate marketing that can increase the risk of gambling harm. Affiliate marketers are paid generous commissions by wagering operators to purposefully encourage new customers to bet and existing customers to bet more. In direct conflict with harm minimisation objectives, affiliate marketers are incentivised to target bettors with high-loss potential and people at-risk of gambling harm and engage in deceptive and predatory practices likely to attract vulnerable people. The current regulatory environment has limited capacity to monitor and prevent harmful and illegal practices and is further hampered by both the scale of the industry and its dynamic and hidden marketing practices. The findings can inform future research to test relationships between gambling affiliate marketing and gambling harm. They can also prompt consideration of more effective regulation and ways to increase consumer awareness about misleading affiliate practices.