Online Ludo: A Legal Conundrum and a Lurking Risk for Gambling Disorder

Dear Sir,

Ludo, a popular board game dating back to the Mahabharata, is widely played today in its online avatars. ¹ These online versions of ludo compete with more well-known games for both users and revenue. Most such games offer “in-app purchases” for allowing the players to play continuously. This key aspect allows gameplay for purposes beyond entertainment, as illustrated by a 23-year-old male who presented to our hospital with an unhealthy pattern of playing ludo online.

The patient (who also had a diagnosis of schizophrenia and cannabis use disorder) had racked up a debt of multiple lakhs of rupees playing ludo “competitions.” These “competitions” would use purchasable “tokens” as the prize, which would then be redeemed into actual cash. He reported a “rush” while winning, felt unable to control playing (even during the hospital stay, he would play using money borrowed from fellow patients), and kept on increasing the amount played in the hope of recovering his losses. This caused significant dysfunction and necessitated a diagnosis of gambling disorder. The case history is detailed in the online-only supplementary file.

Games are categorized as “games of chance” or “games of skill.” ² In a game of chance, the outcome is strongly influenced by a randomizing device, e.g., dice or playing cards. In contrast, in a game of skill, the outcome is determined mainly by mental or physical skill, knowledge, training, attention, experience, and adroitness of the player. ³ Gambling is considered to comprise not only chance but also a hope of gaining something. ⁴ The Supreme Court of India has held that the most important aspect of gambling is chance, although it is not entirely devoid of skill. ⁵ In India, the Public Gambling Act, 1867, provides punishment for public gambling and the keeping of “common gaming house.” ⁶ It is understood that the dominant element (skill or chance) determines the category of a game. However, the legality of online ludo (as a game of chance or skill) is under legal review.

Our case demonstrates the unique crossroads of gambling and gaming involved in the pathological use of online ludo. The patient engaged simultaneously in pathological gambling and disordered gaming. He met the proposed criteria for both Internet Gaming Disorder in DSM-5 and gaming disorder (GD), predominantly online in ICD-11, besides meeting those for gambling disorder.^7,8 The diagnostic conundrum was amplified by the requirement that non-gambling internet games be included while describing Internet gaming disorder. The nature of a non-gambling game is a legal definition and not a clinical one. It is also subject to legal review in the case of online ludo.

The diagnostic difficulty aside, we wish to highlight the enormous financial and public health implications of these games. India has the second largest (and rapidly increasing) base of online gamers, at an estimated ~433 million in Financial Year 2020–2021. ⁹ The estimated worth of this market is Indian rupees 13,600 crores. Real money games (RMG), like online ludo, which include those in which token money is wagered on the outcome of the game and a monetary prize is received, account for about 16% of the market and 37% of the revenue, underlining their outsized financial implications. Almost all the revenue of RMG games (including online ludo) is made from selling tokens that facilitate playing the game. As reported by the patient, most popular online ludo games involve playing for financial stakes using points or coins as a proxy for money. Using monetary rewards increases the risk of gaming/gambling disorders in users of these apps. ¹⁰

The financial implications of online ludo are demonstrated by the fact that it is the second highest grossing game category in the country. ⁹ With a projected annual growth of 10% and increasing smartphone penetration, the prevalence of people playing online ludo (and consequently, people suffering from GD) is slated for a boom.

Despite these numbers, online ludo and similar games that involve the use of token money have been grossly understudied. By involving both a potential for monetary rewards and the rush of victory, these games present a lurking public health problem. Our case amply demonstrated this and should serve as a wake-up call for policymakers to this emerging challenge.

Supplemental Material

Supplemental material for this article is available online.