Loot box purchases are associated with problem gambling severity and harms beyond traditional gambling activities

Loot boxes are virtual chests containing randomized in-game items. Given their structural similarities, loot boxes have been argued to be a form of gambling. Indeed, previous meta-analytic studies suggest that loot boxes are associated with problem gambling severity and act as a "gateway" to gambling. Yet, little is known about loot box purchasing among individuals who already gamble. In the present study, we assessed the demographic characteristics and addictions and mental health comorbidities of adult loot box purchasers, through a nationally stratified sample of regular gamblers who also regularly play video games (N = 3709). We also investigated whether loot box engagement is associated with problem gambling severity and gambling harms when controlling for traditional gambling activities. Of the total sample, 1,922 reported having purchased loot boxes (Mage = 38.72, 61.3% male). Loot box purchasers were more likely to be younger, single, employed, have a college degree or higher, and report upper-middle income. Loot box purchasers were significantly more likely to endorse addictions and mental health comorbidities (e.g., substance use, depression). When controlling for other forms of gambling (e.g., electronic gambling machines, sports betting), both the frequency of loot box purchasing and money spent were associated with problem gambling severity and gambling-related harms. The results from the present study provide further support that loot boxes when purchased with money may be conceptualized as a form of gambling and contribute to problem gambling risk and harms. Given the popularity of loot boxes and relative lack of age restrictions, jurisdictions may wish to regulate the purchase of loot boxes similarly to traditional forms of gambling.