Abstract According to public health research, exposure to casinos is a risk factor for disordered gambling. Consequently, casino self-exclusion programs, which pro- vide gamblers with the opportunity to voluntarily seek limits on their access to gambling venues, can serve as a barometer of the concentration of disordered gambling in an area. This study reports on the distribution, both temporally and geographically, of 6,599 people who applied to exclude themselves from Missouri casinos between November, 1996 and February, 2004. Analyses used Microsoft MapPoint to plot the location of casinos and self-excluders (SEs) across Missouri and its constituent counties. These regional exposure analyses showed that the Western region around Kansas City is an epicenter of disordered gambling as, to a lesser extent, is the Eastern region around St. Louis. The annual number of SE enrollments increased during the first few years of the Missouri self-exclusion pro- gram and then leveled off during the later years. These findings have important implications for public health and the development of public health interventions for disordered gamblers. Keywords Gambling Æ Pathological gambling Æ Self-exclusion Introduction Responsible gambling programs, like casino self-exclusion, are in demand. In short, casino self-exclusion programs are intended to provide individuals with the oppor- tunity to limit their access to gambling venues. Using these programs, individuals R. A. LaBrie Æ S. E. Nelson Æ D. A. LaPlante Æ H. J. Shaffer Harvard Medical School, Boston, MA 02115, USA A. J. Peller Æ G. Caro Æ R. A. LaBrie (&) Æ S. E. Nelson Æ D. A. LaPlante Æ H. J. Shaffer Division on Addictions, Cambridge Health Alliance, 101 Station Landing, 2nd Floor, Medford, MA 02155, USA e-mail: richard_labrie@hms.harvard.edu 123 J Gambl Stud (2007) 23:231–243 DOI 10.1007/s10899-006-9037-1 ORIGINAL PAPER Missouri Casino Self-Excluders: Distributions Across Time and Space Richard A. LaBrie Æ Sarah E. Nelson Æ Debi A. LaPlante Æ Allyson J. Peller Æ Gabriel Caro Æ Howard J. Shaffer Published online: 29 December 2006 Ó Springer Science+Business Media, LLC 2006