The worldwide rise of online gambling poses a significant public health threat, according to a report released Thursday.  The report, which was published in the Lancet Public Health journal, found that almost 16 percent of adults and more than 26 percent of adolescents who use slot machine games and online casinos have a gambling disorder. The researchers estimated that this addiction could affect more than 16 percent of adolescents and nearly 9 percent of adults who gamble using sports betting products.  “Gambling is not a simple leisure activity; it is a health-harming addictive behaviour,” the researchers wrote. “The harms associated with gambling are wide-ranging, not only affecting an individual's health and wellbeing, but also their wealth and relationships, affecting families and communities with potential lifelong consequences, and deepening health and societal inequalities.”  The report was done by a commission consisting of 22 member experts from around the world who looked over surveys and published studies related to the matter.  The study estimated that gambling, in some form, is legal in more than 80 percent of countries worldwide. Sports betting is legal in 38 U.S. states and Washington, D.C., according to the American Gaming Association. Mobile sports betting is legal in 30 states.  Around 5 percent of women and nearly 12 percent of men experience a risk of gambling. On a worldwide scale, the study estimated that up to 449 million people could be affected, concluding that around 80 million adults suffer from a gambling disorder.  The commission laid some blame on governments around the world for not focusing on implementing protections for citizens. They suggested governments institute age requirements in order to participate, share marketing efforts that display the negative effects of gambling addiction and give better care to those suffering from the addiction.  “Our systematic review also uncovered substantial deficiencies in the global monitoring of gambling harms,” the researchers wrote. “Monitoring has relied primarily on population surveys, despite recognised methodological issues with these approaches, which are likely to produce conservative estimates.”  “Moreover, in many countries, even general population surveys are unavailable. Consequently, the evidence base remains fragmented and clearly incomplete given the global scale of the issue.”