[Problem and pathological gambling. Epidemiology and prevention].

With the expansion of the German gambling market, questions emerge concerning the magnitude of gambling-related problems in the general population and the effectiveness of preventive measures. Current prevalence rates of problem and pathological gambling range from 0.29-0.64% and 0.19-0.56%, respectively. In an international comparison, which is complicated by different methodological approaches of the primary studies, the rates fall at the lower end of the spectrum. In general, an increasing availability of gambling is connected with rising consumption among the population as well as--at least temporarily--with a growing number of gambling addicts. Whether the prevalence rate stabilizes at a certain level or even leads to a decrease after a gradual social adaption needs to be empirically evaluated. From the public health perspective, a gambling market that is strictly regulated by a state monopoly should be established to prevent targeted stimulation of demand and to implement effective safeguards. A preliminary evaluation of prevention measures can only be based on limited findings and, therefore, also has to focus on evidence on other harmful products such as alcohol and tobacco. For the sector of amusement with prize machines, direct interventions into structural characteristics and availability are recommended.