British Columbia has just completed a year-long assessment with about 165 video gamers to see whether intensive gaming leads to gambling addiction.

The B.C. study comes as regulators around the world are becoming concerned about the way video-game and gambling-product developers are starting to use features from each other – the “gamification” of gambling and the “gamblification” of popular video games, as the phenomenon is being called.

The assessment, which ran from October, 2018, to mid-November, 2019, will be used to analyze risk factors and make recommendations about the need for more counselling support for video gamers, said David Horricks, who oversees the province’s policies on gambling. The results will be released some time in 2020.

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The people in the assessment, who saw counsellors already working in the area of problem gambling, “were provided with up to five sessions to investigate how much gaming is related to future gambling problems,” he said.

“This whole industry is new and people are just starting to understand the implications of the merging of these industries. We’re at the very front of this,” Mr. Horricks said.

Politicians and regulators in Europe and Asia, as well as some in the U.S., have either lobbied for or been successful in getting certain video games classified as gambling products that need to be licensed and can’t be marketed to young people, according to an article in Gambling Insider last year.

Mr. Horricks’s department will make some recommendations about the value of counselling for problem video gaming. But, he said, it wouldn’t make recommendations about legal regulation of video games, a larger issue that would need a more formal study.

But even this smaller clinical assessment was welcomed as an important first step by those who work in counselling for problem video-gaming or gambling.

Although gamers don’t necessarily lose money, they spend a lot of time on their own instead of socializing or doing other activities. This can have severe consequences, such as divorces, damaged family relations and impacts on mental health.

“I believe [the assessment] is a direction to take. There’s so much we haven’t explored about how video games are designed,” said Benjamin Wong, a Vancouver counsellor who specializes in video-game addiction. “We’re seeing a lot of dynamics in gambling behaviours in video games.”

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Both he and Mr. Horricks emphasized that it’s not just young people who are vulnerable to problem video-gaming, although that’s often when issues emerge.

Mr. Wong, who started seeing people with gaming disorders back in 2008, said he regularly gets clients in their 30s and 40s. The provincial study had about 50 people under 19 in the program, with the rest over 19. Most were from the Lower Mainland or Vancouver Island.

Certain groups of people are more vulnerable to developing problems with excessive video-gaming, he said, such as those who are newcomers to the country or who are socially isolated.

And things are getting worse, he said.

“The severity has been increasing.”

The Attorney-General’s Ministry, which oversees the “responsible and problem gambling program,” spends about $6-million a year on outreach to communities, education support (including lesson plans for teachers on the problems of gambling), and one-to-one counselling. It provides counselling services to about 1,500 people for problem gambling.

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Mr. Wong said problem video-gaming needs to be part of that effort.

“I would encourage public money to be put into this as soon as possible.”

Mr. Horricks said the B.C. assessment was started last year because outreach workers were hearing a lot from parents and others concerned about video-game addiction.

Counsellors such as Mr. Wong and gaming researchers are alarmed about aspects of video-gaming that prime people for gambling.

“One example is the phenomenon of loot boxes, a scenario where gamers are encouraged to spend real money or in-game currency in exchange for goods that are hidden in the game,” Mr. Wong said.

The emotional charge of hoping for a big win and either getting it or experiencing a near miss produces the same psychological effect as gambling.

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The year-long provincial assessment was run with little fanfare.

Although Mr. Wong had heard of it, University of B.C. researcher Gabriel Brooks, who presented a paper on the gambling-like aspects of video games at a B.C. Lottery Corporation-organized conference in March this year, had not.

Mr. Brooks, a PhD student with UBC’s Centre for Gambling Research, said he is now focusing, with lab director Luke Clark, on whether problem video-gaming and problem gambling are equally likely to affect certain people (a correlation, but not a causal relationship) or whether the first type of addiction leads to the second.

Mr. Brooks and Mr. Clark are part of a growing worldwide community of researchers looking at the connections between gambling and video-gaming.

Mr. Brooks said elements of gambling are present in many modern Triple A video games – those that have had a lot of money spent on them in development and are highly promoted. That includes games such as PlayerUnknown’s Battlegrounds, Apex Legends and Fortnite.

Although he hasn’t studied whether counselling would be helpful for problem video-gaming, his guess is that it would, based on the effectiveness of counselling for problem gambling.

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“If you look at the analog with treatment for problem gambling, it shows therapy can be beneficial.”