CasinoReviews.net’s five-year Google Trends analysis says the deepest U.S. search hotspots for gambling addiction are concentrated outside states with regulated online casinos. The report found that eight of the 10 metropolitan areas with the highest levels of “gambling addiction” searches were in states without such markets, based on relative per-capita search indices across nearly 200 U.S. metro areas.
The analysis looked at Google Trends data from August 2021 through February 2026 and compared what it called crisis-related searches for “gambling addiction” with prevention-focused searches for “gambling helpline.” It also noted that, in regulated markets, helpline information is commonly displayed across gambling advertisements, betting apps, promotional emails and other customer-facing materials.
Even so, the report said Cincinnati and Boston saw measurable increases in gambling helpline searches only after regulated online betting launched in their states. That pattern led CasinoReviews.net to argue that responsible-gaming awareness campaigns may be related to help-seeking behavior.
The report pointed to other markets that appeared to have little visible help-seeking. In Beaumont and Abilene, it said, residents often access offshore casinos or sweepstakes-style products that operate outside the responsible-gaming protections required in regulated jurisdictions, and search behavior showed more addiction-related queries but little preventive activity. It also said legalization alone may not be sufficient, citing Wyoming as a state that legalized online sports betting while still ranking among leading markets for gambling-addiction searches and recording no measurable gambling-helpline search activity.
Not every regulated or gaming-heavy market fit the same pattern. Nevada metropolitan areas ranked highly for both addiction and help-related terms, which the report linked to the state’s long concentration of land-based gaming activity.
A UC San Diego-led study published in JAMA Internal Medicine found that searches for help with gambling addiction rose 23% nationally after Murphy v. NCAA, amounting to roughly 6.5 million to 7.3 million searches through June 2024, and that eight states saw significant increases after sportsbooks opened. A separate rapid evidence assessment found that responsible-gambling messages work better when they are self-appraisal focused, segmented by risk and delivered dynamically.
