Central government efforts to combat gambling problems
(RiR 2026:1)
Summary
The Riksdag’s goal is to reduce the negative consequences of excessive gambling. However, this has not been achieved. Moreover, gambling and related problems have increased among children and young people, who are a special priority protection group. Municipalities and regions are responsible for preventing and treating people with gambling problems. To support these efforts to reduce gambling problems, it is incumbent upon the Public Health Agency, the National Board of Health and Welfare and the county administrative boards to develop knowledge resources, coordinate measures and monitor efforts.
The Swedish National Audit Office considers that central government efforts to reduce gambling problems are not effective. While the Public Health Agency of Sweden’s and National Board of Health and Welfare’s knowledge resources are of high quality, they do not meet municipalities’ needs for practical guidance to detect and prevent gambling problems, especially among children and young people. Support for government agencies needs to be more effectively coordinated. To counteract rising gambling among children and young people, the Public Health Agency needs to develop knowledge resources with methods and approaches that are more based on proven experience where research is absent. Efforts to combat gambling problems also need to be integrated more clearly into overall work on combating harmful use and addiction.
Knowledge resources need to better meet municipalities’ needs
The audit shows that municipalities need more operational support that can be implemented in practice, especially in the absence of research on effective methods. The Swedish National Audit Office considers that, to compensate for the lack of research, the Public Health Agency needs to develop knowledge resources with methods that are based more on proven experience. The agency can achieve this by collecting and translating successful practices at municipalities into practical guidance, thereby lowering the threshold for municipalities to take preventive measures.
The Public Health Agency should also, within the national coordination on gambling, promote putting knowledge from different actors to practical use for municipalities. The agency should also work towards coordinating the various knowledge resources at government agencies, which are currently fragmented and problematic for municipalities. This involves both gambling and overall efforts to combat harmful use and addiction. The instructions for the Public Health Agency provide a clear mandate to develop methods and coordination in this direction.
The National Board of Health and Welfare needs to update its knowledge resources on treatment, since the experience-based knowledge dates from 2018. The county administrative boards should focus on their strengths – local knowledge and coordination – rather than developing and managing their own knowledge resources. They can contribute by highlighting municipalities’ needs and disseminating central government knowledge resources.
Central government initiatives need to be directed more at children and young people
The audit shows that knowledge resources at the Public Health Agency and National Board of Health and Welfare need to provide more practical guidance for detecting and preventing gambling problems, especially among children and young people. The Swedish National Audit Office considers that this is necessary in order to reverse the rising trend in this group. The Public Health Agency should support municipalities in prioritising risk groups and providing effective methods for detecting and preventing gambling problems. The National Board of Health and Welfare should develop recommendations on how activities in municipalities and regions can identify gambling problems among children and young people, and offer support and treatment. There is no such guidance currently.
The Public Health Agency should also develop more indicators for children and young people’s gambling and related problems in the national monitoring system, which can provide a basis for more needs-adapted knowledge resources.
Schools already work to protect children and young people from harmful use and addiction. Possibilities to reduce gambling among children and young people would increase if the National Agency for Education included gambling problems in its support for schools’ work to combat alcohol, narcotics, doping and tobacco (ANDT).
Efforts to combat gambling need to be integrated with other efforts to combat harmful use and addiction
Gambling addiction is similar to alcohol and drug addiction. As these areas share numerous risk and protective factors, it is effective to tackle them jointly. At the same time, gambling problems are more difficult to detect than other addictions.
This audit shows that the Public Health Agency of Sweden has not systematically integrated gambling into its work on alcohol, narcotics, doping and tobacco and gambling (ANDTG). There are indications that knowledge resources for gambling problems are less developed than for alcohol and drugs. The agency should therefore take into account gambling problems when prioritising which ANDTG knowledge resources are to be developed. The Public Health Agency also needs to better harness synergies between the national coordination on gambling and ANDTG.
The National Board of Health and Welfare has not included knowledge resources on gambling problems in the national guidelines on abuse and addiction, which reduces the likelihood of municipalities and regions using the recommendations in their activities. There is therefore a risk of failure to detect people with gambling problems and to provide them with relevant support.
Gambling problems are a complex societal problem often linked to other serious problems, such as suicide, mental illness and over-indebtedness. The Government should therefore consider including efforts to combat gambling problems in adjacent initiatives.
Recommendations
The Swedish National Audit Office makes the recommendations presented below.
To the Government
- Consider including issues concerning gambling problems in initiatives within adjacent areas.
To the Public Health Agency of Sweden
- To a greater extent, develop methods based on proven experience so that municipalities receive more practical guidance for detecting and preventing gambling problems, especially among children and young people.
- Promote efforts on the national coordination on gambling so that participating actors’ knowledge is translated into concrete and coordinated knowledge resources for municipalities.
- Develop indicators for children and young people’s gambling and related problems in the national monitoring system.
- Systematically take account of the needs within gambling when the government agency sets overall priorities for developing knowledge resources in the ANDTG field.
- Better harness synergies between national coordination on gambling and ANDTG.
To the National Board of Health and Welfare
- Develop knowledge resources for gambling problems, in particular with regard to recommendations for children and young people.
- Incorporate the knowledge resources for gambling problems into the national guidelines on abuse and addiction to promote a concerted effort to combat ANDTG.