Gambling and gambling-related problems in France Marc Valleur Hôpital Marmottan, Paris, France ABSTRACT Aims To provide an overview of the gambling landscape and gambling-related problems in France, including the history, legislation, gambling policy and epidemiological data on excessive gambling. Method A literature review, using Medline, PsycInfo and Toxibase/OFDT databases, based on the systematic monitoring of scientific literature since 2008 (including French and international papers). Results Since 1776 and the creation of the royal lottery, state monopoly has been the main pillar of gambling policy in France. Increases in gambling venues and opportunities, growing evidence of gambling- related problems, pressures from the European Commission and the growth of on-line gambling have led to major changes in this policy: while land-based gambling remains mainly in the form of a state monopoly, on-line gambling was partially liberalized in 2010, and regulation authorities were established. The first epidemiological survey was conducted in 2010. Rates of problematic gambling in France are within the average of other European countries. Treatment has begun to be made available within addiction centres. Conclusion A majority of on-line gamblers in France use legal websites, which was one of the initial goals of liberalization. Recent studies confirm that the prevalence of problem gambling in France is far higher among on-line gamblers than among land-based gamblers; however, this difference cannot be attributed only to greater addictiveness of on-line gambling. Keywords France, gambling, history, on-line gambling, policy, prevalence, problem gambling. Correspondence to: Marc Valleur, Hôpital Marmottan, 17 rue d’Armaillé, 75017 Paris, France. E-mail: marc.valleur@gmail.com Submitted 14 November 2014; initial review completed 12 January 2015; final version accepted 20 April 2015 INTRODUCTION This paper describes gambling and pathological gambling in France by examining available recently published litera- ture. Scientific monitoring was launched in 2008, when INSERM (National Institute for Science and Medical Re- search) published a collective expert report procedure on gambling (contexts and addictions) [1]). Therefore, the documentation centre of Marmottan Hospital began the systematic monitoring of the topic in journals, newspapers and relevant websites. We also searched Medline, PsycInfo and Toxibase/OFDT databases (for the years 2010–14). The following search terms were used: ‘pathological gam- bling’, ‘excessive gambling’, ‘gambling policy’ and ‘France’. Fewer than 25 papers were found to be relevant for this review. HISTORY The history of gambling in France from the Middle Ages to the present reflects the perpetual tension between a very prohibitionist framework and exceptions to this [2–4]. There are diverse influences supporting prohibition. First, the roots of prohibition are theological: it is unlawful to ‘put God to the test’ for the sole purpose of seeking pleasure. This theological aspect of prohibition has en- dured despite the acknowledgement by Saint Thomas Aquinas of a purely ‘distributive fate’ [5], and also despite the early works of Girolamo Cardano (1501–76), who anticipated the idea of ‘randomness’. Even after the works of Pascal (1623–62) and Fermat (1601?–65) laid the foundations of probability theory, the sacrilegious aspect of gambling would long permeate legal writings on gambling. A second reason for prohibition is that gambling is considered immoral: it seeks to appropriate other people’s money and thus stems from greed and miserli- ness. Not even the judgements of Cardano or Paschasius Justus [6] would be enough to damage Aristotle’s opin- ion, that gambling was the product of greed and miserliness. Finally, prohibition is related to the perception that gambling is at the root of disorder and disruption to law and order. Frequent unrest, disputes, swearing, blasphemy and cursing during gambling sessions reinforce the idea of gambling as ‘diabolical’. © 2015 Society for the Study of Addiction Addiction NATIONAL GAMBLING EXPERIENCES doi:10.1111/add.12967