

By Anne Blythe
Now that the NCAA tournament play-in games are over and brackets are set with a maze of paths to the Final Four, many North Carolina college basketball fans are about to develop a serious case of March Madness — obsessed with bracket busters, office pool standings and Cinderella stories.

For the second year in a row, those hardwood zealots will be able to participate legally in sports betting here on their home turf with little more than a phone in their hand. While wagering on sports has been seen as a male-dominant activity for many years — and it still is — researchers and counselors are seeing an influx of women drawn into the fray.
“We see a larger growth in females engaged in gambling, partly because of the social acceptability of it, and that it’s everywhere through advertising and things like that,” said Michelle Malkin, a criminology and criminal justice professor at East Carolina University who leads the school’s Gambling Research and Policy Initiative, which specializes in gambling-related crimes, addictive behaviors and marginalized populations.
There used to be a theory among gambling behavior researchers that men gravitated toward strategic, high-stakes, face-to-face games like poker, blackjack and sports betting — feeding on the thrill and excitement of the competition. Women were believed to favor more passive, chance-based games like slot machines and bingo — low-stakes activities that allowed solitary escapes to alleviate stress, loneliness and boredom.
“If you look at certain cultures, females were more likely at a young age to learn about mahjong, dominoes and things that their mothers and grandmothers played,” Malkin told NC Health News in a recent interview. “And they do that for money, but not at the high levels of money we tend to think about for gambling.”
Males, on the other hand, often grew up learning card games at poker nights with fathers, uncles and other men in their lives.
“And so it was just the social norms of raising females and males, but we’re seeing that change because males and females these days are gambling within video games — they’re all playing the video games,” Malkin said. “And they’re gambling online through iGaming and things like that.”
Women targeted
Those changing social norms have not been lost on sports betting operators. Tune into any major sports event these days, and you’re likely to see their advertising taking a cultural pivot — betting on women as a vast untapped market.
Fanatics Sportsbook rolled out an ad with Kendall Jenner during the Super Bowl, poking fun at the so-called “Kardashian Kurse” suggesting that men who become involved with the Kardashian-Jenner reality stars suddenly fall victim to injuries, scandals and poor performances.
DraftKings Sportsbook is banking on Lisa Leslie, the WNBA hall-of-famer, who stars in a 30-second commercial offering new customers a chance to bet five dollars and get $200 in bonus bets.
Former Louisiana State University gymnast Livvy Dunne, a Sports Illustrated swimsuit model and social media influencer, is featured in a Fanatics Sportsbook ad for the NCAA tournament that features her playing 10 different versions of herself promoting different customer incentives. She made a similarly themed ad for football last year whilesitting in a bubble bath on the Rose Bowl 50-yard line.
“It is pretty clear that women are increasingly being marketed to with, instead of an emphasis on competition, more of an emphasis on community and doing things together, which would appeal to more women,” said Rachel Volberg, a retired University of Massachusetts professor who has been involved in epidemiological research specialized on gambling and problem gambling since the mid-1980s. “The influencer marketing is clearly a tactic that the sports betting operators have taken from their success with influencers in male sports bettors, and they are now specifically marketing to women.”
Lots of revenue, little for prevention
Sports betting became legal in North Carolina on March 11, 2024, almost six years after a landmark U.S. Supreme Court decision that invalidated the Professional and Amateur Sports Protection Act of 1992, which restricted all but a few states from allowing sports betting. The change made North Carolina one of 38 states that offer legal sports betting and one of 30 that have online betting through smartphone apps or online sites.
It’s been big business for the sports wagering operators and for state revenue coffers.
In the first year alone, according to the North Carolina Lottery Commission, more than $6.6 billion in paid and promotional bets were placed from North Carolina accounts. Those wagers generated more than $713 million in gross revenue for those operators and more than $128 million for state coffers from the 18 percent tax on gross wagering revenue.
Two years in, the state has seen an influx of more than $262 million in tax revenue — with Super Bowl-driven February racking up an estimated $10.45 million in just that one month.
Unlike some states that direct a percentage of the sports betting revenue stream toward gambling addiction education and treatment programs, North Carolina allocates just $2 million annually for those initiatives, despite the surge incalls to the gambling hotline from bettors or their loved ones looking for help.
“Which is nothing to cover the state,” said Jessica Auslander, a licensed addiction and mental health counselor who specializes in gambling disorders in her practice based in the Charlotte area. “We have a flat dollar amount despite the growth of the lottery and the legalization of sports betting. We’re not seeing any of those dollars go back to public health, so we’re still struggling when people are looking for treatment.”
Auslander started treating people with gambling disorders in 2013. At that time, she lived in Ohio, a state she says, “has a well more developed network around problem gambling.”
When she moved to North Carolina in 2016, she found a different landscape.
“I didn’t realize at the time that I was the only certified gambling counselor in the whole state,” Auslander told NC Health News. “I came from a more robust professional community, and I come down here — and I’m it.”
New classification
Gambling wasn’t officially classified as an addiction until 2013, when it was added to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association.
Before that, people who had gambling problems were thought to have an impulse control disorder, but mounting research showed that gambling disorder affects the brain’s reward system in ways similar to substances such as alcohol or narcotics. That prompted the reclassification as a behavioral addiction.
Not all sports betting leads to problems. Many people engage in low-risk wagering for entertainment without developing issues. Problem gambling, can exist along a spectrum,, research shows, and not every instance of high spending or chasing losses immediately translates into a clinical disorder. They can be warning signs, though.
“Problem gambling is it might get out of control here or there, but you’re not chasing your losses,” Auslander said. “You’re not gambling again to get even. You’re not preoccupied with it, You don’t have to bet more and more money to get the same kind of level of excitement.
“Problem gambling can be: ‘I did something that went too far, caused a problem but I walked it back.’”
Since establishing her practice in Weddington, Auslander has had a steady gambling-related caseload, but the legalization of sports betting has brought many new bettors into the fold.
“That just increased the availability and people’s awareness of it — and made it more accessible because it’s mostly out-based, so people can walk around with their phones on and a tablet and they can be betting 24/7,” Auslander said.
Even though the sports betting industry is trying to enhance its customer base with more women, Auslander has had a relatively equal number of men and women seeking her help.
“The women that I see, I have a few in their 40s, and that is sports betting or poker and they are former athletes,” Auslander said. “Or I have older women — so we’re talking retirement age — and the appeal for them for gambling — they’re not necessarily doing sports betting — but they’re engaging in more casino-based or online gaming type things. So gaming. That has a component of gambling in it. Or online slot machines, those kinds of things.”
Most of the women, Auslander said, are “mostly motivated by boredom, depression, grief, isolation, those kinds of factors.”
“I think as we continue to increase the access to gambling, we’re going to see an increase in all demographics,” Auslander added. “This industry wants there to be something for everybody.”
Rowland Edet, a doctoral student at the University of Nebraska-Lincoln, wrote In “Breaking the Odds: A Gendered Analysis of Women and Gambling Behavior” published in the peer-reviewed Gaming Research and Review Journal at the University of Nevada-Las Vegas, suggested that as more women are drawn to gambling, often prompted by different motivations than men, that policies should reflect gender differences.
“To reduce harm, public health frameworks must prioritize interventions that address the distinct ways women engage with gambling,” Edet wrote. “One key measure is restricting gender-targeted advertising, particularly messages that frame gambling as empowering or stress-relieving — common themes in campaigns aimed at women.”
GET HELP FOR A GAMBLING PROBLEM
North Carolina offers free, confidential help for people struggling with gambling and for family members affected by it.
- Call the NC gambling hotline at 877-718-5543.
- Text “morethanagamenc” to 53342.
- Find a Gamblers Anonymous meeting.
- Fill out North Carolina’s “self-exclusion form,” which blocks you from gaming.
- Betting apps in North Carolina are required to allow you to place limits on your activity. Find out more at ncgaming.gov/responsible-gaming.
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