Looking at gambling by region England, the latest NHS England figures show a surprisingly even map: the Health Survey for England 2024 found 48% of adults gambled in the past year, down from 65% in 2012, with little regional difference overall. Online gambling is the exception: 14% in the North East against 6% in London. This 2026 guide explains what the survey shows.
Twelve years of decline in gambling participation
The Health Survey for England gambling questions ask whether people spent money on any of 19 activities in the last 12 months. The 2024 survey, published by NHS England Digital on 27 January 2026, interviewed 9,220 adults aged 16 and over face to face.
In 2024, 48% of adults had gambled in the past year. The likely range for the whole population, allowing for sampling error, is 46.5% to 50.2%.
Comparing gambling participation 2012 vs 2024 shows a clear fall, from 65% to 48%. NHS England says the downward trend was seen among men (68% to 52%), among women (61% to 45%) and across all age groups.
| Measure (adults 16+, past 12 months) | 2012 | 2024 |
|---|---|---|
| Any gambling | 65% | 48% |
| Any gambling excluding the National Lottery | 43% | 37% |
| Online gambling excluding the National Lottery | 7% | 10% |
| PGSI score of 1 or more | 5% | 5% |
Much of the fall reflects fewer people buying lottery tickets. For a fuller picture of who gambles across Great Britain, see our guide on how many people gamble in the UK.
Online gambling is rising against the trend
Strip out the National Lottery and participation fell more gently, from 43% in 2012 to 37% in 2024. Among men it went from 46% to 38%, and among women from 40% to 35%.
Online gambling moved the other way. The share of adults gambling online, excluding the National Lottery, rose from 7% in 2012 to 10% in 2024.
The survey counts online slots, casino or bingo games, online betting with a bookmaker and betting exchanges as online gambling. It records play whatever the site’s licence, so it can include offshore casinos as well as GB-licensed operators.
The regional map: North East gambling vs the London gambling rate
For gambling by region England data, NHS England reports figures age-standardised, which adjusts for the different age profiles of each region. On that basis, the share of adults who gambled at all did not vary by region in 2024.
Online gambling did vary. Excluding the National Lottery, it was highest in the North East at 14% and lowest in London at 6%, so the North East rate was more than double the London rate.
Key point: NHS England only names the highest and lowest regions for online gambling in its report. The full regional breakdown sits in Table 23 of the HSE 2024 data tables.
The Gambling Commission’s Gambling Survey for Great Britain (GSGB) 2025 gives a fuller regional picture from a much larger online and postal sample. Its figures are higher than the HSE and are not age-standardised, so compare regions within each survey rather than across them.
| Region (GSGB 2025) | Gambled, past 12 months | Gambled online, past 4 weeks* |
|---|---|---|
| North East | 64.0% | 20.6% |
| North West | 62.2% | 19.4% |
| West Midlands | 62.0% | 18.5% |
| East of England | 62.4% | 15.5% |
| Yorkshire and the Humber | 61.0% | 15.9% |
| East Midlands | 60.6% | 16.3% |
| South East | 58.1% | 15.2% |
| South West | 56.6% | 12.2% |
| London | 48.5% | 13.1% |
| England | 58.7% | 15.9% |
*Excluding people whose only online gambling was lottery draws. Both surveys put the North East near the top for online play and London near the bottom, and you can compare these figures with gambling in Scotland.
Neither survey tells you which websites people used. Survey answers can cover European online casinos as well as British brands, while official market data cover licensed operators only.
Gambling by age and sex in 2024
Men were more likely to gamble than women in 2024: 52% compared with 45%. The gap was wider online, where 15% of men and 6% of women gambled, excluding the National Lottery.
Participation rose with age, from 31% among 16 to 24 year olds to 58% among those aged 55 to 64. NHS England notes that gambling is illegal for under-18s, which lowers the figure for the youngest group.
Online play peaked among 25 to 34 year olds at 15% and was lowest among those aged 75 and over, at 2%.
The most popular activities were National Lottery draws (31%), other lotteries (16%), scratchcards (13%), online betting with a bookmaker (7%) and betting on horse races (6%). Betting off the high street is a separate market from bookmakers outside GamStop, which are not licensed in Great Britain.
PGSI scores and problem gambling
The survey measures gambling harm with the Problem Gambling Severity Index (PGSI), a nine-question scale scored from 0 to 27. A score of 8 or more indicates problem gambling, 3 to 7 moderate risk and 1 or 2 low risk.
In 2024, 5% of adults scored 1 or more, the same as in 2012. That breaks down into 3% at low risk, 1% at moderate risk and less than 1% with problem gambling.
Men (7%) were more likely than women (3%) to score 1 or more. The rate fell with age, from 9% of 16 to 24 year olds to 1% of those aged 65 and over, and it did not vary by region.
The GSGB uses the same PGSI but finds higher rates, as our article on problem gambling statistics UK explains.
HSE vs GSGB: why the numbers differ
The two surveys use different methods. The HSE is a face-to-face household survey with gambling questions in a self-completion module, while the GSGB is completed online or on paper.
A Gambling Commission paper by Professor Heather Wardle, published in July 2026, compared the two. National Lottery participation was 30.6% in HSE 2024, against 40.7% in HSE 2015 to 2018 and 39.7% in GSGB 2023 to 2024.
It found that past-year gambling on each activity in HSE 2024 tended to be lower than in earlier HSE rounds or the GSGB. Future HSE rounds will show whether 2024 marks a real downward trend or a statistical outlier.
Spending tells a different story from participation. Our UK gambling industry statistics track how much operators win, and the survey data cover only GB-based households, not visitors or people using non-UK casino sites from abroad.
FAQ: gambling across England’s regions
Short answers from the Health Survey for England 2024.
Which region of England gambles most online?
The North East, where 14% of adults gambled online in 2024, excluding the National Lottery, after adjusting for age.
What is the London gambling rate?
London had the lowest online rate, 6%. Overall participation, adjusted for age, did not differ significantly by region.
How many adults in England gamble?
The HSE found 48% of adults aged 16 and over gambled in the past 12 months in 2024. The GSGB 2025 puts England at 58.7%.
Has problem gambling increased in England?
Not on the HSE measure. Five per cent of adults had a PGSI score of 1 or more in both 2012 and 2024.
When will the next HSE gambling data be published?
NHS England has not confirmed when gambling will next be included, so 2024 is the latest year available.
HSE figures cover adults aged 16 and over in private households in England in 2024. Regional HSE rates are age-standardised. GSGB 2025 regional figures cover adults 18+ with fieldwork from January 2025 to January 2026 and are not directly comparable with the HSE. The North East to London ratio is our calculation.
- NHS England Digital, Health Survey for England 2024: Adults’ health-related behaviours, tables 21 to 24.
- NHS England Digital, Health Survey for England 2024: Introduction.
- Gambling Commission, GSGB annual report 2025 data tables (xlsx), tables B.2 and B.6.
- Gambling Commission, GSGB: Different survey, same story? (Professor Heather Wardle).
Responsible Gambling in the UK
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