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How sports betting has evolved and its association with gambling harms has not been studied.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ioi240097-5\"><jats:title>Objective<\/jats:title><jats:p>To describe how US sports betting evolved after <jats:italic>Murphy v National Collegiate Athletic Association<\/jats:italic> and offer insights into the potential health effects of sportsbooks, which are platforms for wagering on sporting events.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ioi240097-6\"><jats:title>Exposure<\/jats:title><jats:p>Enactment of (1) <jats:italic>Murphy v National Collegiate Athletic Association<\/jats:italic> nationally and (2) the opening of retail or online sportsbooks in states.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ioi240097-7\"><jats:title>Design, Setting, and Participants<\/jats:title><jats:p>In this longitudinal study, aggregate US internet search trends for gambling addiction and wagers on sports were described before and after the emergence of legalized sportsbooks.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ioi240097-8\"><jats:title>Main Outcomes and Measures<\/jats:title><jats:p>Internet searches per 10 million queries that mentioned <jats:italic>gambling<\/jats:italic> and <jats:italic>addiction<\/jats:italic>, <jats:italic>addic<\/jats:italic>t, <jats:italic>anonymous<\/jats:italic>, or <jats:italic>hotline<\/jats:italic> (such as <jats:italic>gambling addiction hotline<\/jats:italic>) made to Google from January 1, 2016, through June 30, 2024.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ioi240097-9\"><jats:title>Results<\/jats:title><jats:p>The number of states with operational sportsbooks increased from 1 during 2017 to 38 during 2024. Total sports wagers increased from $4.9 billion during 2017 to $121.1 billion during 2023, with 94% of wagers during 2023 being placed online. There were 23% (95% CI, 15%-30%) more searches nationally for gambling addiction help-seeking after <jats:italic>Murphy v National Collegiate Athletic Association<\/jats:italic>. Massachusetts (47%; 95% CI, 21%-79%), New Jersey (34%; 95% CI, 21%-45%), New York (37%; 95% CI, 26%-50%), and Pennsylvania (50%; 95% CI, 35%-66%) each had more searches than expected after the opening of any sportsbooks in their state. Additional analyses suggest the opening of online, vs retail, sportsbooks corresponded with a larger increase in searches.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ioi240097-10\"><jats:title>Conclusions and Relevance<\/jats:title><jats:p>The results of this time series study suggest that access to sportsbooks, sports wagers, and potential help-seeking for gambling addiction increased substantially and highlight the need to address the health implications of sportsbooks, including recognition and treatment of gambling problems and their broader societal implications.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamainternmed.2024.8193","type":"journal-article","created":{"date-parts":[[2025,2,17]],"date-time":"2025-02-17T16:33:06Z","timestamp":1739809986000},"page":"382","source":"Crossref","is-referenced-by-count":37,"title":["Growing Health Concern Regarding Gambling Addiction in the Age of 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