It is important to note that the robustness of this link does not necessarily mean that loot box spending causes problem gambling: It may well be the case that these factors are instead linked because problem gamblers are more likely to engage with loot boxes, or that some third factor (such as impulsivity) drives engagement with both loot boxes and gambling activities. Indeed, engagement with loot boxes has been repeatedly linked to problem gambling: The more that gamers use loot boxes, the more severe their gambling problems tend to be ( Brooks & Clark, 2019 Li, Mills & Nower, 2019 Zendle, 2019a Zendle et al., 2018 Zendle, Meyer & Over, 2019 Zendle & Cairns, 2018 Zendle & Cairns, 2019). Loot boxes share several formal features with gambling, and there has been widespread interest in the idea that engaging with loot boxes may lead to problem gambling ( Brooks & Clark, 2019 Drummond & Sauer, 2018 King & Delfabbro, 2018 King & Delfabbro, 2020 Li, Mills & Nower, 2019). The most widely-discussed example of this convergence are loot boxes: Items in video games that may be bought for real-world money, but which contain randomized contents ( Zendle et al., 2020). A blurring of the lines has occurred between video games and gambling activities.
