The convergence of simulated gambling, monetary gambling and gambling harm - An integrative literature review of stimulus and suppression pathways

Sep 4, 2026

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This report delivers an integrative public health literature review examining the convergence of simulated gambling, monetary gambling, and gambling harm. It synthesizes conceptual and empirical evidence on stimulus and suppression pathways, with emphasis on risk and protective factors that may link simulated gambling experiences to later harm. The review also evaluates prevalence patterns for loot box purchasing, profiles of purchasers, evidence for concurrence and migration, and evidence-based harm reduction strategies. Findings support targeted prevention and minimization of gambling harm.

LanguageEnglish

CategoryPaper Templates

FormatDOCX

Pages108

Reading Time38 min

AccessFree to download

Executive summary

What is simulated gambling?

Research objectives

Methods

Key findings

Concurrence and migration between simulated gambling, monetary gambling and gambling harm

Prevalence of loot box purchasing

Profiles of loot box purchasers

FINAL REPORT The convergence of simulated gambling, monetary gambling and gambling harm: An integrative literature review of stimulus and suppression pathways Prepared for: The New Zealand Ministry of Health Prepared by: Experimental Gambling Research Laboratory, Central Queensland University, Australia: Nerilee Hing, Michelle Gossner, Lisa Lole, Matthew Rockloff and Matthew Browne 3 July 2025 Acknowledgements We thank the Ministry of Health in New Zealand for supporting this study under its Gambling Harm Research Program 2023/24 – 2024/25. We also acknowledge the in-kind contributions to the project made by CQUniversity. Disclosure statement The authors declare no conflict of interest in relation to this report or project. Disclaimer This report was prepared under contract to the New Zealand Ministry of Health. The copyright in this article is owned by the Crown and administered by the Ministry. The views of the authors do not necessarily represent the views or policy of the New Zealand Ministry of Health. The Ministry makes no warranty, express or implied, nor assumes any liability or responsibility for use of, or reliance on, the contents of this report. Citing this report Hing, N., Gossner, M., Lole, L., Rockloff, M., & Browne, M. (2025). The convergence of simulated gambling, monetary gambling and gambling harm: An integrative literature review of stimulus and suppression pathways. Wellington: Ministry of Health. Table of contents TOC \o "1-1" \h \z \u HYPERLINK \l "_Toc195429392" Executive summary PAGEREF _Toc195429392 \h 2 HYPERLINK \l "_Toc195429393" Chapter 1. Background PAGEREF _Toc195429393 \h 10 HYPERLINK \l "_Toc195429394" Chapter 2. Methods for the literature review PAGEREF _Toc195429394 \h 15 HYPERLINK \l "_Toc195429395" Chapter 3. Research evidence on the concurrence and migration between simulated gambling, monetary gambling, and gambling harm PAGEREF _Toc195429395 \h 20 HYPERLINK \l "_Toc195429396" Chapter 4. Factors proposed as shaping the concurrence and migration between simulated gambling, monetary gambling and gambling harm PAGEREF _Toc195429396 \h 44 HYPERLINK \l "_Toc195429397" Chapter 5. Empirical evidence for risk and protective factors related to simulated gambling that can increase or reduce gambling harm PAGEREF _Toc195429397 \h 64 HYPERLINK \l "_Toc195429398" Chapter 6. Harm reduction strategies PAGEREF _Toc195429398 \h 79 HYPERLINK \l "_Toc195429399" References PAGEREF _Toc195429399 \h 86 HYPERLINK \l "_Toc195429400" Appendix A. Search string for each database PAGEREF _Toc195429400 \h 105 HYPERLINK \l "_Toc195429401" Appendix B. Summary of quality assessment process across all journal articles PAGEREF _Toc195429401 \h 106 Executive summary This report presents a literature review on the convergence of simulated gambling, monetary gambling and gambling harm. Using a public health framework, it also reviews conceptual and empirical evidence for risk and protective factors for gambling harm that might arise from simulated gambling and suggests strategies to help reduce this harm. What is simulated gambling? Simulated gambling comprises games with features that resemble or function like commercial gambling activities (King, 2018). This study categorises simulated gambling products into two main types: Loot boxes are virtual containers available for purchase or received as rewards in most mainstream digital games. When unlocked, loot boxes provide players with digital items, such as weapons, special abilities or cosmetic items (skins). Players often do not know what the prize is in advance, or how many loot boxes they need to purchase to win a desired item. Simulated gambling games are categorised in this study into 1) social casino games, 2) demo or practice games, and 3) games with mini gambling components. These games replicate the look and feel of gambling games as a central or peripheral feature of play, alt

FAQs

What does the report mean by simulated gambling?

Simulated gambling refers to games with features that resemble or function like commercial gambling activities. It includes products such as loot boxes and games with mini gambling components, even when real money cannot be won.

What research objectives does the report address?

The report synthesizes evidence on concurrence and migration between simulated and monetary gambling, reviews conceptual risk and protective factors, assesses empirical evidence to identify gaps, and proposes strategies to prevent and minimize gambling harm linked to simulated gambling.

How were studies selected for the review?

The review used a systematic search of academic and peer-reviewed grey literature. Included studies investigated the relationship between simulated and monetary gambling, were peer-reviewed, published since 2000, published in English, and available as full text, following PRISMA guidance.

Sep 4, 2026

Upload by Fahsai