title: Gambling in China: socio-historical evolution and current challenges.
abstract: OBJECTIVE
  This paper provides an overview of gambling issues in China, including historical development, governmental responses and social consequences.
  
  
  METHODS
  Based on materials written in Chinese or English available at academic databases and other online resources, historical, cultural and policy analyses were conducted. The focus is on mainland China, but reference is made to Hong Kong and Macao to illustrate differences.
  
  
  RESULTS
  Throughout Chinese history, gambling was strictly prohibited by law. In contrast, small-stakes betting for entertainment instead of monetary gain, defined as 'gaming' in this paper, has been culturally acceptable and tolerated by governments. After banning gambling for three decades, the Chinese government attempts to meet public demand for 'gaming' and to confine gambling to 'gaming' by issuing national lotteries. In response to increased economic wealth, gambling opportunities were allowed to develop, but were restricted to Macao. Social problems such as illegal and youth gambling are, however, emerging. The 'gaming' perception may predispose Chinese individuals to wagering activities and increase the risk of gambling disorder, which has been widely seen as misconduct rather than a mental disorder. Currently, the country has a dearth of gambling research and limited prevention and rehabilitation services, almost none at national level.
  
  
  CONCLUSIONS
  A distinction between small-stakes 'gaming' and large-stakes 'gambling', which has cultural roots, plays an important role in relevant governmental policies and social responses in mainland China. Gambling disorder prevention and treatment is not yet on the national agenda. The country's knowledge and services gaps on gambling problems need to be filled out.
authors.affiliation: Department of Psychology, Faculty of Social Sciences, University of Macau, Macao, China.
authors.forename: Anise M S
authors.initials: AM
authors.lastname: Wu
authors.forename: Joseph T F
authors.initials: JT
authors.lastname: Lau
mesh_terms: D002681:China / Q000453:epidemiology; D003469:Culture; D005715:Gambling / Q000453:epidemiology* / Q000266:history; D033161:Government Regulation; D006291:Health Policy / Q000331:legislation & jurisprudence / Q000639:trends; D049668:History, 15th Century; D049669:History, 16th Century; D049670:History, 17th Century; D049671:History, 18th Century; D049672:History, 19th Century; D049673:History, 20th Century; D049674:History, 21st Century; D049690:History, Ancient; D049691:History, Medieval; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D008256:Macau / Q000453:epidemiology; D011998:Recreation; D012959:Socioeconomic Factors
keywords: China; disorder; gambling; perception; prevention; treatment