A scoping review of the association between loot boxes, esports, skin betting, and token wagering with gambling and video gaming behaviors

Background and aims: Many new digital gambling-like activities such as loot boxes, esports betting, skin betting, and token wagering have recently emerged and grown in popularity. This scoping review aimed to: (a) synthesize the existing empirical research literature on gambling-like activities and their associations with gambling and video gaming behaviors, including problem gambling and video gaming; (b) identify sociodemographic, psychological, and motivational factors associated with engagement in gambling-like activities; and (c) identify research gaps and areas for further research. 

Methods: A systematic search of Ovid, Embsco, and ProQuest databases and Google Scholar was conducted in May 2021 and last updated in February 2022. The search yielded a total of 2,437 articles. Articles were included in the review if they were empirical studies that contained quantitative or qualitative results regarding the relationship between gambling-like activities and gambling or gaming. 

Results: Thirty-eight articles met inclusion criteria and were included in the review. Overall, the review results suggest that all forms of gambling-like activities were positively associated with gambling and gaming with small to medium effects. Gambling-like activity participation was also positively associated with mental distress and impulsivity. Gaps identified included a lack of inquiry into skin betting and token wagering, a lack of diversity in the research methods (i.e., mainly cross-sectional surveys), and a paucity of research that includes more ethnically, culturally, and geographically diverse populations. 

Discussion: Longitudinal studies with more representative samples are needed to examine the causal link between gambling-like activities and gambling and video gaming.