In 1970 casino gambling was confined to Nevada; New Hampshire, New Jersey and New York were the only states with lotteries. Today either casinos or lotteries--usually both--are legal in 47 states, as shown on the map. In addition, widespread but illegal gambling thrives on the Internet.
Because of its potential for addictive behavior, casino gambling has aroused the interest of health professionals. The activity is pervasive: A 1998 survey found that 29 percent of Americans had taken their chances at a casino in the previous 12 months. More probably do so now, because several other states have legalized casinos since then. Health concerns also swirl around state lotteries, particularly those that sell high-price instant games for $20 or more. Internet gambling is troubling, too, because it is a solitary activity that can be pursued uninterrupted for hours and so may prove uniquely addictive. Available from numerous overseas Web sites, it is illegal under federal law and the laws of six states yet is widely practiced and rarely prosecuted.