The public health community has called for governments to recognise the harms associated with gambling, and for gambling policies to include population-based harm prevention approaches. This Health Policy explores the translation of this call into global policy action by systematically reviewing legislation of jurisdictions that introduced major gambling legislation change (ie, restricting or extending gambling provision) between Jan 1, 2018, and Dec 31, 2021. We mapped the global availability of legal gambling and changes in its provision, and conducted critical frame analysis on a sample of 33 jurisdictions introducing major policy change to assess the extent to which the protection of health and wellbeing was embedded within legislation. More than 80% of countries worldwide now legally permit gambling. Harmful gambling was recognised as a health and wellbeing issue in most of the analysed jurisdictions, but near-exclusive focus was given to individual-level harms rather than to wider social and economic harms, or harms to others. Most of the proposed prevention measures focused on individual responsibility. Gambling policies worldwide are changing, but addressing gambling as a public health issue is not yet translating into comprehensive policy action across jurisdictions.

公共卫生界呼吁各国政府认识到与赌博相关的危害，并呼吁赌博政策纳入基于人群的危害预防方法。本卫生政策通过系统审查 2018 年 1 月 1 日至 2021 年 12 月 31 日期间引入重大赌博立法变更（即限制或扩大赌博规定）的司法管辖区的立法，探索将这一呼吁转化为全球政策行动。合法赌博的可用性及其规定的变化，并对引入重大政策变化的 33 个司法管辖区样本进行了关键框架分析，以评估立法中对健康和福祉的保护的程度。目前全球超过 80% 的国家/地区合法允许赌博。在大多数分析的司法管辖区，有害赌博被认为是一个健康和福祉问题，但几乎只关注个人层面的伤害，而不是更广泛的社会和经济伤害或对他人的伤害。大多数拟议的预防措施都侧重于个人责任。全球范围内的赌博政策正在发生变化，但将赌博作为一个公共卫生问题来解决尚未转化为跨司法管辖区的全面政策行动。