BACKGROUND AND AIMS: This systematic review examines whether sports betting behaviors differ among and between sports bettors in different countries, evaluates psychosocial problems related to sports betting behaviors and how problems may vary by country, and lastly, summarizes the current regulatory guidelines for sports betting.

METHODS: We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and included peer-reviewed articles from PubMed, Web of Science, and PsycINFO. Studies on sports betting behavior were included if they were published in English or Chinese between January 1, 2010 and March 28th, 2022. We gathered regulatory information from peer-reviewed articles, legal acts, and relevant websites. Of 2,450 articles screened, 65 were included in the final review.

RESULTS: Marketing and promotion of sports betting were more prominent for sports betting in Australia and the United Kingdom. Interviews with sports bettors demonstrated that sports betting is persuasive and normalized. Psychosocial problems do not appear to differ greatly by country, and sports betting appears to be associated with elevated levels of problem gambling. Responsible gambling approaches have helped address risky sports betting behaviors. China and South Korea have imposed more strict regulations and restrictions on sports betting access in comparison to countries such as Australia or the United States.

DISCUSSION AND CONCLUSIONS: Currently, sports betting is easy to access, normalized, and contains many attractive features for sports bettors. Psychoeducation about potential risks of sports betting and encouragement of responsible gambling strategies could help lessen risky sports-betting behaviors, though cross-cultural adaptations should be explored.