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sociated with organized crime and were treated as vice crimes by law enforcement institutions. Then, beginning in 1964, gambling expanded greatly after New Hampshire initiated the first modern state lottery, signifying a change in traditional social and moral barriers. As of this writing, some form of gambling is legal in all but 3 states, casino or casino-style gambling is available in 21 states, and 37 states have lotteries (National Opinion Research Center, 1999). In 1988, Congress passed the Indian Gaming Regulatory Act, which allows tribes to operate any form of gambling currently legalized in the state in which the tribe resides. Resistance by many state legislatures to casino gambling and state-sanctioned sports betting continues, but in numerous jurisdictions other forms of gambling have become institutionalized, with state budgets increasingly dependent on gambling revenues.
The advent of state-sponsored lotteries marked a significant policy shift in which the states moved from tolerance to active sponsorship and aggressive marketing of their own games. Public support of this shift is beyond question, with over 80 percent of adults in the United States participating in various forms of commercial or state-sponsored gambling sometime during their lives. Collectively Americans wagered over $551 billion in 1997 in legal gambling activities (International Gaming and Wagering Business, 1998). Although gambling is popular and has social and economic benefits, there are also costs involved for individuals, families, and communities stemming from pathological and problem gambling.
In August 1996, President Clinton signed P.L. 104-169, establishing the National Gambling Impact Study Commission, whose purpose is to conduct a comprehensive study of the social and economic impacts of gambling in the United States. Section 4(a), (2)(C) of the new law called for "an assessment of pathological or problem gambling, including its impact on individuals, families, businesses, social institutions, and the economy." The act further states under Section (b)(1): "In carrying out its duties under section 4, the Commission shall contract with the National Research Council of the National Academy of Sciences for assistance in con-