Calls to Ontario’s mental health and addictions helpline from boys and men aged 15 to 24 with gambling-related concerns rose 317 percent between the years before the province launched its first online gambling platform in 2015 and the period after it opened to private operators in 2022, a new study has found. The research, published in the Canadian Medical Association Journal on March 2, 2026, also recorded a 144 percent increase in gambling-related contacts across all age groups and a 108 percent jump among men aged 25 to 44.
The pattern of Ontario online gambling harm captured by the data does not match the focus of Canada’s gambling policy debate. Federal and provincial discussion has centered on sports betting advertising and celebrity endorsements. The helpline data points elsewhere. Electronic gaming machines accounted for 46 percent of gambling-related contacts in the study period. Table games accounted for 25 percent. Sports betting, the product driving the legislative conversation, accounted for 12 percent.
The CMAJ study analyzed 745,716 contacts to ConnexOntario, the province’s free 24-hour mental health and addictions helpline, between January 2012 and September 2025. Of those, 37,087 were gambling-related, with a mean caller age of 39 and a male majority of 68.2 percent. Researchers used an interrupted time series analysis to compare contact rates before and after two distinct policy changes: the launch of the government-operated PlayOLG platform in January 2015, and the expansion to private online operators in April 2022.
Total monthly wagers in Ontario rose 654 percent across the post-privatization window, climbing from roughly $1 billion to $8 billion. Active player accounts per 100,000 people aged 15 and older increased from about 2,160 to more than 7,300, a 239 percent rise. The province now has more than 1.2 million active player accounts on licensed operator sites.
Dr. Daniel Myran, the study’s lead author and a researcher at the Ottawa Hospital Research Institute, said the surge among young men matches “exactly who’s being targeted by the advertisements” in Ontario’s regulated market. He flagged in-game sports betting, which allows wagers to be placed in real time during a match, as a particularly high-risk product because the bet cycle compresses to seconds and is often triggered by push notifications driven by predictive models.
The legislative response in Canada has been focused on sports betting advertising rather than online casino products. Bill S-211, the National Framework on Sports Betting Advertising Act, passed the Canadian Senate on Oct. 21, 2025 and is now before the House of Commons. The bill would direct Canadian Heritage to develop national rules on ad volume, placement and the use of celebrities and athletes in gambling promotion. Ontario’s own 2024 advertising rules banned athletes and celebrities from appearing in sportsbook commercials in the province. Both efforts target sports advertising. The helpline data suggests the products driving the largest share of help-seeking are online slots and table games.
That gap between the policy conversation and the harm data is visible in the Ontario online gambling market revenue mix. In March 2026, online casino games produced 82 percent of operator revenue. Sports betting produced 16 percent. Online casino handle has grown roughly 26 percent year over year. Sports betting handle was down 9 percent in the same month. Ontario’s regulated iGaming market is, by both handle and revenue, a casino market with a sports betting attachment.
A helpline call rate measures help-seeking, not the underlying prevalence of disorder. Both readings, however, point in the same direction. Either more Ontarians are developing gambling problems, or more are reaching out for help, and either trajectory aligns with what advocates and clinicians have been describing since 2022.
The Centre for Addiction and Mental Health and the Responsible Gambling Council have both called for stronger restrictions on advertising and on product design. Sen. Marty Deacon of Ontario, the sponsor of Bill S-211, has tied the rise in problem gambling to the volume of advertising that followed federal legalization of single-event sports betting in June 2021. The CMAJ paper’s authors said the findings support stronger harm reduction measures and broader access to responsible gambling resources, particularly for younger men.
The Ontario market has continued to grow regardless. Ontarians wagered $98.3 billion on licensed iGaming sites in calendar 2025, with operators producing about $4 billion in gross gaming revenue. The province takes 20 percent of that revenue in tax. Alberta becomes the second Canadian province to open a private online gambling market on July 13, 2026, with 28 approved operators. Among the Canada gambling sites jurisdictions, other provinces continue to operate lottery-corporation monopolies and have not signaled plans to liberalize.
Ontario marks the fourth anniversary of its regulated online gambling market in April 2026. The helpline data is one public accounting of what some of that growth has cost. The legislative response, focused on sports advertising rather than on the online casino products generating most of the harm signal in the data, is the response Canada is currently choosing.
