Abstract
Video games have emerged as one of the world’s fastest-growing industries. Although initially aimed at adults, video games have become an increasingly popular pastime among youth, with 90% of children playing video games today throughout the United States according to a Pew Research study (Anderson). The entertainment value of video games is one of several factors driving their popularity; other reasons include the sense of challenge and achievement they provide, in addition to social and interactive aspects. Yet this trend has many parents and experts concerned about the potential adverse impacts of such technology on children. Unlike traditional forms of entertainment, the effect of video games on young minds is relatively untested, as they are a product of the lightning pace of the technology industry.

One concerning element in many video games is loot boxes, which have significantly risen in usage over the past decade. Loot boxes describe a mechanic in which the customer can buy items within a video game for real-world currency (Drummond et al.). Unlike direct purchases, loot boxes do not guarantee users specific items: one simply pays for the chance to obtain such items. While video games are profitable without loot boxes, these add-ons have allowed the gaming industry to quickly become one of the most profitable markets both in America and worldwide. Globally, loot boxes have enabled video game companies to achieve gross income levels in excess of $117 billion in 2018, a number only projected to increase as childcare becomes increasingly dependent on technology and is further integrated into the lives of youth (Smith). Despite the profitability that they can yield for video game companies, loot boxes can be problematic when viewed as a means of exposing children to a form of gambling (Wardle and Zendle). 

Another troublesome facet of video games as they relate to child development is targeted advertisements. Targeted advertisements have existed for decades. Yet the growth of online gaming has contributed to the integration of targeted advertising into consumers’ daily lives. Unfortunately, targeted advertisements potentially pose more harm to children than loot boxes because of their prevalence. The widespread growth of both loot boxes and targeted advertisements into children’s lives via video games elicits the need for a review of harmful practices and recommendations for improvement.

Why Loot Boxes Are Used
The prevalence of loot boxes in video games can primarily be traced to profitability for video game companies. Professor of Psychology and Science Communication Peter J. Etchells of Bath Spa University remarks that “[loot boxes] have the advantage of effectively removing the cap on how much a given game will cost a player” (Etchells et al.). In particular, companies can market games free of charge, then extract profit through the heavy promotion of in-game loot boxes. Many video games employ these tactics to extract profit through cosmetic items such as custom skins for characters, and weapons, in addition to in-game currency. In the process, many video game companies seem to weaponize this monetization structure with unethical practices. Among these strategies is the misrepresentation of the odds in a loot box. One manifestation of this takes the form of a company advertising a particular loot box as being rare to suggest that the purchase of such a loot box may increase the odds of a “drop,” or the successful attainment of an item (Chen et al.). In addition, companies may simply obscure the cost through pity timers (which guarantee consumers a drop after consecutive unsuccessful loot box interactions). Experts warn that many industry tactics to incentivize loot box purchases eerily mimic those of tobacco or other illicit industries (Xiao et al.). Indeed, the competitive economic environment created within the widespread “freemium” model (used to describe a free-to-play video game with embedded microtransactions) may not be conducive to a safe digital environment for children. From this perspective, it seems that video game companies frequently target children because of their susceptibility to loot-box mechanics.   

One must acknowledge that loot box mechanics are not always employed for negative reasons, nor that consumers necessarily oppose the consumption of loot boxes. Within many video games that tend to target audiences aged 13-17, loot boxes may only yield cosmetic items such as character skins or gun models. These cosmetics simply enhance the look of a character without predatory or unethical tactics. Experts note, however, that problems may arise when players can obtain competitive benefits by purchasing loot boxes (Shen). Despite this trend, many players seem to not be opposed to loot box mechanics. Studies show that players – irrespective of age – are generally happy to be able to progress faster or obtain slight gameplay bonuses via the purchase of microtransactions. Thriving content-creation spaces emerge from “pack openings,” which consist of content creators on social media platforms revealing the contents of multiple loot boxes to excite prospective consumers (Bailey). In general, video game companies have no incentive to terminate the use of loot boxes as a premier gameplay feature unless regulatory action is enacted in some manner. This is because loot boxes can be extremely effective at generating revenue for these companies and expanding their markets. 

Adverse Psychological Effects of Loot Boxes
Loot boxes risk exploiting psychological vulnerabilities in young consumers. One way that this can occur is by weaponizing social pressure to attack the vulnerability of many adolescents. For example, studies have found that a primary motivation for loot box purchases was cosmetic gains or other benefits that had the secondary purpose of increasing social standing. Video game companies also employ virtual currencies as an intermediary to delegate financial costs and responsibility away from themselves (Uddin). Other studies have confirmed these findings, one of which states that loot boxes “...weaponize behavioral psychology, perfectly pitched to exploit all the cognitive weaknesses that make people so susceptible to addiction and compulsion” (Brewer). By taking advantage of these cognitive weaknesses, loot boxes can trap customers into a cycle of repeated purchases that can be understood as a form of addiction (Wardle and Zendle). A study analyzing chronic loot box purchasers reported that the combination of auditory, haptic, and visual feedback produced feelings of excitement and thrill. Some participants of the study even reported feeling a buzz or a rush. The study also found that many enjoyed the experience of opening a loot box, even without a material in-game benefit (Nicklin et al.). 

By targeting children, video game companies can exacerbate factors influencing loot box purchase decisions: social pressure, financial sense, and visual/audial effects. Prevailing research finds that by weaponizing psychological and cognitive weaknesses, loot boxes can maintain extreme profitability in often unethical manners. In particular, it seems that video game companies have weaponized addiction as a medium for exploiting psychological vulnerabilities, particularly in children. Jerry Shen, a University of Illinois Chicago Doctorate student, explores these ideas in a University of Illinois Chicago Law Review article. His review finds that video game companies carefully design the loot box purchase and reward process to connive players into addictive practices. For example, many video games guilt the user into purchasing loot boxes in the hope of an often unattainable gain. The World Health Organization has ordained that addiction to loot boxes or addiction to gaming fell under both The International Statistical Classification of Diseases and Related Health Problems (“ICD-11”) and The Diagnostic and Statistical Manual of Mental Disorders (“DSM-5”). Video game companies have even been known to hire psychologists and sociologists for the specific purpose of engineering addictions into their products (Shen). A study by Lelonek-Kuleta et al. at the University of Lublin found that children were more susceptible to video game companies’ methods to foster addiction. Since children do not have fully developed brains, they cannot clearly articulate the costs associated with their actions (i.e. purchasing a loot box). In addition, social pressures amplify in an environment with adolescents and children. Often, YouTube or Twitch streamers will promote the sale of loot boxes to children, who may not necessarily understand the ramifications associated with such a purchase (Lelonek–Kuleta et al.). New research will likely continue to illuminate the connection between loot box mechanics and adverse psychological effects – especially for vulnerable populations such as children. 

Loot Boxes and Gambling
Perhaps the most disturbing psychological trend found among loot box purchasers is a predisposition to gambling issues. While not always legally defined as gambling, loot boxes are continually being identified as such by numerous experts on the basis of firm evidence (Drummond and Sauer). Some reports even show that people who purchase loot boxes are well aware of the parallels between gambling and loot box purchases (Wardle and Zendle). Beyond semantics, frequent loot box use is associated with symptoms that are typically seen in those suffering from problem gambling (Etchells et al.). Dr. David Zendle, a researcher at the University of York, explored these connections and found evidence to support this observation. This is especially true with respect to players of the video game Heroes of the Storm. Zendle found that those who spent more money on loot boxes in this game correlated with more prevalent symptoms of problem gambling. In fact, loot boxes offered in this game were often a more effective indicator of gambling issues than common gambling games such as slot machines or online betting (Zendle). Andrew Brady, a researcher at the Dublin Business School, corroborates this conclusion. He found that frequent purchasing of loot boxes often snowballed into addiction, which is also a symptom of gambling (Brady and Prentice). Disturbingly, studies also showed that consumers addicted to loot boxes tended to relish uncertainty and find pleasure in speculation (Adam et al.). A study led by Lelonet-Kuleta et al. at the University of Lublin found that common cognitive errors, such as the gambler’s paradox, also occurred in those with chronic loot box problems (Lelonek–Kuleta et al.). 

In general, studies have found that there exists a strong connection between gambling and loot box purchasing in video games. The formation of this link is concerning, considering the limited legal protections against such measures. Should loot box purchasing be considered a form of gambling, as current research suggests, children can gamble with almost no limits through loot boxes, which are ever present in many of the most popular children’s games. Potential solutions must address these pressing issues by, for example, lengthening the process to purchase loot boxes. Unfortunately, there are many factors to consider when pursuing regulations on loot box purchasing such as consumer approval and the classification of what constitutes a loot box under the law. Simple, sweeping changes may not properly consider these intricate details and lead to unforeseen future issues.  

Socio-Economic Factors Regarding Loot Box Purchasing
Studies have revealed an inconclusive relationship between race and other socioeconomic factors and the purchasing of loot boxes; some studies find statistically significant associations between the two while others find that they have little to no correlation. The American Academy of Pediatrics found that socioeconomic standing was a partial predictor of loot box purchasing (Radesky et al.). However, a study conducted by von Meduna et al. that hypothesized a connection between loot box purchasing and socioeconomic standing found that there was no correlation between the two, except unemployment: those that were unemployed were statistically less likely to purchase loot boxes (von Meduna et al.). Interestingly, Richard et al. of McGill University uncovered compelling data regarding the socio-economic status of most loot box purchasers: loot box purchasers were primarily employed, had achieved a below-average level of education, and were less likely to be single (Richard et al.). If any overarching observation is to be made, it is that there is likely a relationship between employment and the propensity to purchase loot boxes. University of Amsterdam Social and Behavioral Sciences Professor Jeroen S. Lemmens corroborates this conclusion through another study. It finds similar conclusions: full-time employed individuals typically spent more on loot boxes than other demographics. Interestingly, this conclusion does not support the connection between gambling and loot boxes, which is all but confirmed through numerous other effects (Lemmens). While the evidence does suggest that employment correlates with loot box spending, other socio-economic ties may have little to no relationship. In light of these findings, further research is required to articulate the effect that socioeconomic standing has on loot box purchasing. 

Targeted Advertisements and Video Games
Outside of loot-box mechanics, video game companies have also monetized their products through in-game advertisements and related tactics that target children. These types of targeted advertisements have risen to prominence within the past decades. Unfortunately, these services tend to rely on intrusive data collection that customers and legislation often view as an invasion of privacy. As with most industry practices, advertisements are often more effective against children. This especially holds true for targeted advertisements in video games: children players are often not intelligent enough to detect that the advertisements they see are a product of the personal data collected against them (van Reijmersdal et al.). 

Unfortunately, this effect is well documented by numerous studies. Kervin et al. found that children are not aware that they are being targeted by advertisers, leading to more effective ad campaigns by video game companies. The same study found that children who could not detect such practices, which included the majority of the study, were at an increased risk of finding information associated with undesirable behavior (Kervin et al.). Another study by the American Academy of Pediatrics confirmed these conclusions, finding that children were often persuaded by advertisements when they did not understand that they were viewing targeted content. The American Academy of Pediatrics also expresses concern that these practices often encompass advertising for illicit substances such as marijuana or tobacco within video games. More hopefully, it also expressed that children who were aware of the tactics used against them could resist such temptations (Radesky et al.). Should this hold in future studies, technology education will become a crucial armament for children against targeted advertisements in video games.  

Parental guidelines have long warned against the adverse effects of targeted advertisements both within and apart from the context of video games. For example, the Family Educational Rights and Privacy Act (FERPA), passed in 1978, includes protections against data collection by third parties within education such as private colleges. Unfortunately, the rise of online gaming has significantly exacerbated the problem. While exposure to targeted advertisements is all but guaranteed on the modern internet, the unique vulnerability of children is exacerbated when exposed to such advertisements through video games. Chen et al. found that “...unexpected objectionable contents may occur and be harmful to children's mental health” because video games are not necessarily rated based on the content of the advertisements that they promote (Chen et al.). This particular problem is of concern, as reports estimate that nearly 96% of children’s video games contain in-game advertisements of numerous forms. To increase the effectiveness of such advertisements, video game companies provide gameplay benefits in exchange for interacting with an advertisement, which can be particularly effective with children (Radesky et al.). Studies show that children may sometimes possess the knowledge to scrutinize various practices used to hold their attention, yet are still effectively targeted by such methods (Rozendaal et al.). Due in part to their effectiveness towards children, careful consideration of these potential impacts demands a revised legal framework concerning in-game advertising. 

Gambling advertisements have been heavily scrutinized, though not always through video games as a medium. For instance, television gambling advertisements have been criticized in the past, with studies finding that often these advertisements reach children despite laws prohibiting such exposure. In fact, some advertisements were played during programs reserved for children (Håkansson and Widinghoff). Numerous studies corroborate these conclusions in other advertisement mediums; a study focused on in-game advertising found that many accepted such advertisements when a gameplay benefit was provided. Another study found that gambling advertisements online often normalized gambling to children, creating a risk for long-term problem gambling (Lewis and Porter). However, the effects are not limited to children; almost all studies find that the problems caused by gambling advertisements affected individuals of all ages adversely. These studies recommend that local authorities improve the legal infrastructure surrounding such advertisements, as the existing legislation was nearly inadequate for a proper appraisal of the situation (Syvertsen et al.). Since gambling advertisements affect both adults and children adversely, effective legislation surrounding such issues is necessary. 

Socio-Economic Factors of Targeted Video Game Advertising
While research concerning the connection between loot-box purchasing and socio-economic status is inconclusive, substantial evidence has been found in the relationship between targeted advertisements and socio-economic status. Studies found that targeted food advertisements often advocated for less healthy food when targeting ethnic minorities (Backholer et al.). Indeed, the targeted nature of advertisements predisposes gamers to undesirable practices such as racial discrimination. Another study found that African American women were more likely to be targeted by predatory advertisements for high-risk student loans. Whether as a means of skirting regulations or as a side-effect of automated targeting, targeted advertisements can bypass regulation regarding racial discrimination through “social sorting” (Chang et al.). Numerous studies have found unique ways that targeted advertisements exploit legislation to target individuals based on factors that are not ethical, such as race or age. 

The targeted advertisement of illicit substances such as alcohol or marijuana towards young adults in video games is of particular concern. Studies have long shown that advertising these substances generally correlates with increased usage. Tobacco advertising, for example, has long been known as an indicator of an adolescent’s predisposition to begin smoking (Lovato et al.). Additionally, many of these studies have found that race is a statistically significant factor when measuring correlation. Black, Hispanic, and American Indian youth are more likely to be exposed to ads encouraging alcohol consumption (Radesky et al.). Radesky’s findings are corroborated by Henriksen et al., who find that black teens in California are more likely to begin smoking should they be exposed to advertisements that encourage it (Henriksen et al.). By targeting children and racial minorities, companies that manufacture illicit products can exploit adolescents and children for profit. In light of these disturbing findings, future legislation addressing such advertising is crucial. 

While it is prohibited to use factors such as race to target individuals, it seems that video game advertisers have adopted the tools to do so. Meta’s Facebook, in particular, provides free-form attributes for potential advertisers to target. These free-form attributes can be used to track race, for instance, using housing trends. A more malicious example from the study allowed an advertiser to target anti-Semetic individuals via the free-form attribute of an anti-Semitic slur. Another free-form attribute is the “LGBT community,” used as a filter to exclude gay or queer individuals from targeting parameters. Speicher’s study concludes that simply banning racial targeting is not sufficient, as malicious actors possess tools to emulate such discrimination with dangerous effectiveness (Speicher et al.). Combating such discrimination will likely be difficult as the definition of such free-form factors is very flexible. Regardless, future solutions will require complex legislation, effective policy management, and enforcement by video game advertising platforms. 

Potential Solutions
Many countries such as the Netherlands have already placed severe restrictions on several of the adverse practices mentioned previously, specifically loot boxes. However, many experts are conflicted about the effectiveness of such regulations. To the detriment of gamers, the necessary legislation for proper regulation is often intricate and difficult to construct. It also tends to face resistance from both public and corporate lobbyists. Brett Abarbanel, the Director of Research at the International Gaming Institute at the University of Nevada, summarizes the potential issues: lax definitions of gambling allow video game companies to easily skirt regulation, yet strict definitions of gambling categorize elementary video game mechanics as subject to strict regulation (Abarbanel). As such, solutions to these problems are difficult to find. This is not to mention the gargantuan task of regulating the advertising industry, which is generally willing to skirt regulations using unethical methods that often come at the detriment of the very people whom the regulations are designed to protect. As local and federal governments alike attempt to tackle these complex issues, they must consider many factors when finding solutions. 

Analyzing loot boxes in particular, one will find conflicting research on the effectiveness of regulation. Jerry Shen of the University of Illinois’ Chicago Law Review explores the methods that the People’s Republic of China (PRC) took to address the issue. The PRC chose to adopt legislation mandating the disclosure of the probability that players possess to receive an item in each loot box. However, Shen finds that this measure was generally insignificant since most consumers did not possess the tools to understand the percentages that were revealed. This is because video games containing loot boxes tend to be marketed to children under 18, most of whom do not possess the requisite mathematical skills to properly assess the aforementioned percentages. In addition to the legislation mentioned above, the PRC has also set what many consider to be extreme limits on video gaming for children, even implementing a cap on video game spending. However, companies such as Tencent continue to promote loot boxes within their video games (Shen). One can argue that no truly effective legislation surrounding the purchase of loot boxes has yet been enacted. 

University of Manchester Senior Lecturer in Entrepreneurship Matthew McCaffrey suggests an alternative solution emphasizing self-regulation rather than government intervention. He argues that the regulation of loot boxes is a lost fight. Regulation risks worsening the problem by pushing loot boxes into illicit markets that are often harder to enforce. Such regulation can also cause economic issues. McCaffrey cites the “raising rivals cost” phenomenon: restrictions on loot boxes would aid monopolies within the gaming industry, as the regulation would likely harm smaller to medium-sized companies more than larger companies (McCaffrey). While McCaffrey’s argument is compelling, it fails to consider that self-regulation has guided the consumer through the rise of loot boxes and has failed thus far by most metrics (Wardle and Zendle). However, legislators have experienced success in some instances. Shen expresses confidence within select components of loot-box legislation in the Netherlands; more specifically, removing flashy elements from loot-box opening and adding friction to repeat loot-box purchasing. Shen also presents another potential solution: to allow judiciary courts to recognize elements of video games, such as desirable cards or characters, as having legal value. This would allow courts to recognize loot boxes as gambling and regulate the industry similarly (Shen).  

Regulation in the face of the advertising industry in the modern era faces complex requirements. While Congress has passed strong legislation regarding digital advertising in the past, advertisers can skirt these regulations. For example, advertisers can unethically target users of a certain race or sexuality. Although previous legislation prohibits such discrimination, advertisers can use free-form attributes to bypass regulation. However, experts have found some cause for hope: Radesky et al. from the American Academy of Pediatrics found that digital literacy plays a significant role in the effectiveness of such targeting. For example, lower-income households with lower digital literacy rates often expressed confidence in children’s apps marketed as educational, despite limited research suggesting so (Radesky et al.). Numerous other studies have found that while a lack of digital literacy exacerbated the effectiveness of targeted advertisements, it is often an effective measure of removing such inequity. Kervin et al. conducted one such study, describing media literacy as a critical tool for contemporary youth (Kervin et al.). Targeted advertisements and loot boxes target children due to their often inferior ability to detect such tactics; therefore, increasing digital literacy may directly solve this problem (Radesky et al.). 

Advances in digital literacy have accompanied effective legislation surrounding data collection. One such example is the European Union’s General Data Protection Regulation (GDPR), which experts describe as among the most influential legislation surrounding digital privacy to date. While the United States has yet to adopt similar legislation, GDPR may serve as a template. Since they also operate in Europe, where GDPR compliance is necessary, many American companies have already instituted infrastructure to allow for such reforms. One study found that while GDPR likely would require further legislation, it effectively allowed users to control the data collected by large advertisers on their digital identity (Zaeem and Barber). Data privacy laws will likely continue to advance as the average consumer becomes more digitally literate, just as digital advertising will adapt. Legislation must stay ahead of digital advertisers to protect consumers, especially children. 

Conclusion
The rapid expansion of the video game industry, particularly with the prevalence of loot boxes and targeted advertisements, has led to growing concerns about the impact of such technology on children. The profitability of loot boxes has allowed video game companies to capitalize on their audience and become one of the most lucrative industries in America. However, many experts agree that the mechanics of loot boxes are predatory, and the exploitation of psychological vulnerabilities, particularly among children, is a significant concern. The widespread use of targeted advertisements, coupled with the integration of technology into children’s lives, also poses a substantial risk. Regulatory action is required to ensure the protection of youth, and that game developers prioritize the well-being of their audience over profit. While not all loot boxes and targeted advertisements are harmful, game developers must acknowledge their potential adverse effects and take appropriate measures to ensure their audience’s safety. The current environment presents a significant opportunity to educate and raise awareness about the potential harms of video games and their role in society.

Furthermore, various studies have explored the relationship between loot box purchasing and socioeconomic factors with inconsistent results. While some studies found a correlation between socioeconomic standing and loot box purchasing, others found little to no correlation. Unemployment was the only factor that correlated with loot box purchasing. Most loot box purchasers were employed, had below-average levels of education, and were less likely to be single. Full-time employed individuals spent more on loot boxes than other demographics. However, this finding does not support the connection between gambling and loot boxes. Further research is needed to understand the effects of socioeconomic standing on loot box purchasing.

In addition to loot boxes, video game companies have monetized children’s gaming through in-game advertisements. Regulatory agencies do not consider advertisements when rating games and these ads may contain objectionable content that can harm children’s mental health. A majority of children’s video games employ in-game ads, and video game companies offer gameplay benefits in exchange for interacting with these ads, making them effective with children. Children possess knowledge that enables them to scrutinize the practices used to secure their attention, yet they are still effectively targeted by such methods. Moreover, researchers have found correlations between the aforementioned video game tactics and gambling. Gambling advertisements, in particular, have been heavily examined for their effects on children and adults alike. They often normalize gambling to children, creating a risk for long-term problem gambling. Experts recommend that future legislation surrounding these issues is necessary.

The issues surrounding targeted advertisements and loot boxes are complex. In turn, they require careful consideration and action from governments, regulators, and industry leaders alike. To date, it is unclear whether related regulations passed by countries such as the Netherlands can effectively address these issues. Legislation must balance consumer protection with the challenges of implementing and enforcing effective regulation, which is sometimes unpopular. Self-regulation has thus far failed to address the issues surrounding loot boxes adequately. Additionally, the advertising industry presents unique challenges due to its ability to skirt regulations and target vulnerable populations such as children. Increasing digital literacy among consumers, especially parents and children, may offer a promising solution to this problem. Data privacy laws, regulations, and related educational initiatives will likely continue to evolve alongside the digital landscape of video games. In turn, there is a potential for such efforts to play a vital role in protecting young gamers from loot boxes and targeted advertising.

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