Ontario hospital exec urges action on online gambling advertising ban
A top Canadian mental health hospital executive has added his voice to calls for tighter restrictions on online sports gambling ads in the country.
Bill Marra, the Chief Executive of Hotel-Dieu Grace Healthcare in Windsor, Ontario, has written an open letter warning that the rapid expansion of online betting is having devastating consequences. Hotel-Dieu Grace Healthcare is home to a specialized program for problem gambling.
Marra said that attendance in the hospital’s gambling treatment program has doubled over the last five years, a trend he links directly to aggressive marketing.
“It is very difficult for anyone that’s monitoring a sporting event, reading something online or watching it live to not be exposed to online gambling enticements,” he said.
He added that repeated exposure is known to increase addiction risk, and that some people, particularly those with established substance-use disorders, are more vulnerable.
Although he acknowledged that eliminating online gambling was unrealistic, Marra urged governments to curb risk through targeted advertising limits and increased funding for treatment services, highlighting the cases of families facing bankruptcy and of self-harm tied to addiction.
His comments come as dozens of Canadian senators have called on Prime Minister Mark Carney to ban sports-betting ads altogether, comparing the issue to the 1989 ban on cigarette advertising.
In a statement released to CBC, Ontario’s Alcohol and Gaming Commission said it enforces some of North America’s strictest rules and continues to work to protect vulnerable groups.
Charlotte Capewell brings her passion for storytelling and expertise in writing, researching, and the gambling industry to every article she writes. Her specialties include the US gambling industry, regulator legislation, igaming, and more.
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Why the ad fight spilled into health care
Calls to rein in online gambling promotions have been building across jurisdictions as regulators, lawmakers and industry veterans debate how fast the legalized market should grow and how visible it should be. The sharp rise in advertising tied to mobile sportsbooks and online casinos has collided with concerns from health leaders about addiction risk, underage exposure and the adequacy of consumer protections. Those threads converged in recent months as U.S. states tested new limits on marketing near young people, Australian officials sparred over a proposed national phaseout of betting ads and regulators warned that the national guardrails are lagging the industry’s expansion.
New Jersey has become a bellwether. Lawmakers there advanced companion measures that would restrict marketing near schools and colleges and scrutinize language used in promotions. The Assembly’s Tourism, Gaming and the Arts Committee approved A5562, and a matching bill, S4366, was introduced in the Senate to ban ads that appear to target anyone under 21 and to block placements near educational institutions. The proposals would require the Division of Gaming Enforcement to test the effectiveness of common messaging and produce a finite list of approved phrases for operators. The state’s online casinos posted a record US$2.4 billion in revenue last year, but saturation advertising has raised questions about exposure among teens and college students. In other states, policymakers have already imposed marketing limits aimed at youth audiences or restricted specific claims used in promotional offers, signaling a broader policy turn toward tighter controls. Read more about the New Jersey proposals in lawmakers taking action on ads near colleges and schools.
Policy momentum meets political friction
As the United States experiments with state-by-state rules, Australia is locked in a national debate over whether to phase out gambling ads altogether. The push follows the “You Win Some, You Lose More” report delivered in 2023 under the late Labor MP Peta Murphy, which recommended a three-year ban on gambling advertising. Independent MP Andrew Wilkie sought a free vote to accelerate adoption, but his motion failed 85 to 14. Prime Minister Anthony Albanese has held the line, pointing to harm-minimization steps such as the BetStop self-exclusion register while arguing that the caucus will set policy. The government has yet to respond to the report’s 31 recommendations, and reform timelines remain uncertain. The latest temperature check is here: Albanese holds firm as Australian MPs push for a ban.
Political caution reflects the perceived trade-offs. Sports bodies and media companies rely on sponsorship and ad dollars, and officials warn that abrupt curbs could push bettors to illegal sites. Advocates counter that visible marketing normalizes frequent wagering and can compound harm among at-risk consumers. That tension has left both countries weighing intermediate steps, including stricter time-of-day limits, mandated safer-gambling messaging and tighter enforcement around inducements.
Industry voices break ranks
The volume of ads during marquee sporting events has become a flashpoint, drawing criticism not only from public health advocates but also from veterans of the gaming business. In Australia, former Tabcorp Chief Executive Elmer Funke Kupper criticized the prevalence of betting promotions in and around the Australian Football League Grand Final, the most-watched program of the year. He questioned whether prior agreements to curb placement close to games were being honored and urged the government to move faster on reforms. The response from Communications Minister Anika Wells was that consultations are ongoing, but consumer advocates say the process has tilted toward incumbents. The critique from inside the sector underscored how ad saturation risks alienating mainstream audiences and triggering a stronger policy response. Details of Kupper’s intervention are in a former Tabcorp executive’s criticism of government delays.
Industry dissent matters because regulators often rely on operator cooperation to implement guardrails that balance commercial realities with consumer protection. When senior figures concede that current ad loads may be excessive, it strengthens the case for enforceable limits rather than voluntary codes. That dynamic is now central to both the Australian and North American debates.
A patchwork of U.S. limits is taking shape
Since the U.S. Supreme Court struck down the Professional and Amateur Sports Protection Act in 2018, sports betting has spread to 38 states, but advertising rules remain uneven. Massachusetts Gaming Commission Chair Jordan Maynard has called for Congress to consider nationwide standards, including curbs on gambling advertisements and a federal self-exclusion option. He likened the current market to a highway without speed limits and warned against using the threat of an unregulated market to block reforms. The comments highlight growing pressure for federal involvement as operators push back against proposals to curb in-play betting or bar wagers on individual student-athletes. Maynard’s remarks are summarized in a Massachusetts call for stricter advertising rules.
At the state level, New York restricts ads in media primarily consumed by those under 21, and Massachusetts and Ohio have limited the language operators can use in promotions. New Jersey’s pending bills would go further by standardizing approved phrases and analyzing what messages resonate, an approach that could inform other states. The direction of travel suggests that while an outright national ban is unlikely in the short term, regulators are converging on stricter youth protections, clearer disclosures and fewer inducements.
Sweepstakes fight underscores blurred lines
Advertising pressure has also reached the adjacent sweepstakes sector, where products that mimic casino-style engagement face inconsistent rules. New Jersey lawmakers passed Assembly Bill 5447 to ban sweepstakes gaming, including promotional sweepstakes that do not require purchase. The Social and Promotional Games Association urged Gov. Phil Murphy to veto the measure, arguing it mischaracterizes lawful promotional campaigns used by mainstream brands and would damp innovation. The group says these platforms already employ geolocation and age checks and favors a regulatory framework over prohibition. The pushback illustrates how quickly marketing and product categories can overlap in consumers’ eyes and in regulators’ enforcement, complicating clean policy lines between entertainment, promotions and gambling. For more, see the SPGA’s appeal to veto a sweepstakes ban.
For health systems, these policy battles have immediate stakes. Clinics report rising demand for problem gambling services, and families face financial and mental health crises tied to compulsive betting. Advertising sits at the center because it drives acquisition and engagement at scale. Governments are testing whether targeted limits, standardized messaging and expanded treatment funding can temper risk without starving sports and media of crucial revenue. The next phase will be defined by whether voluntary restraint gives way to enforceable standards and whether jurisdictions align on what responsible promotion looks like in a market that is still maturing.







