Gaming companies risk “setting kids up for addiction” by including gambling tasks in their video games, the director of mental health for the NHS said.
The firms should either ban virtual “loot boxes” from their products or stop selling them to children, Claire Murdoch said.
In order to progress in games, children can spend money on extra items and in-game content which are stored in loot boxes.
But they do not always know what items they will be given until they part with their money, meaning users are encouraged to keep spending and playing.
There have been numerous cases of children spending money without their parents’ knowledge – one teenager spent £2,000 on a basketball game, while a 15-year-old lost £1,000 in a shooting game.
Gaming companies should introduce “fair and realistic” spending limits and make it clear to users what chance they have of obtaining the items they want, Ms Murdoch said.
The NHS is also calling for a regulator to oversee the gaming industry.
Ms Murdoch said: “Frankly, no company should be setting kids up for addiction by teaching them to gamble on the content of these loot boxes.
“No firm should sell to children loot box games with this element of chance, so yes, those sales should end.
“Young people’s health is at stake, and although the NHS is stepping up with these new, innovative services available to families through our long-term plan, we cannot do this alone, so other parts of society must do what they can to limit risks and safeguard children’s wellbeing.”
According to the Gambling Commission, 55,000 children are classed as having a gambling problem, while the NHS estimates 400,000 people have a serious gambling problem in England.
More than half of young people believe that playing video games could lead to gambling, according to a report by the Royal Society for Public Health in December.
A recent parliamentary report called for loot boxes to be regulated under gambling laws, a ban on loot boxes being sold to children, and an industry levy to fund independent research on the long-term effects of gaming.
Barnardo’s chief executive Javed Khan said: “It’s deeply concerning that children are being led down a path towards online gambling.
“Gaming developers are using techniques that reward children for spending more and more time on their platforms, increasing the risk of addiction and related mental health problems.
“The industry must do much more to incorporate child safety features into their products so children are protected from the dangers of online gaming.
“And the Government must commit to an online industry regulator to hold the industry to account.”
A new gambling addiction treatment centre in Sunderland was opened last week, meaning a total of three are in operation across England, with the Government hoping to have 15 centres running by 2024.
These will help patients with a range of complex problems including persistent gambling, compulsive behaviours, development disorders and difficulties earlier in childhood that underlie addiction.
The NHS’s first gaming addiction clinic was launched in London last October.
Dr Henrietta Bowden-Jones, psychiatrist and founder of the Central and North West London NHS Foundation Trust National Problem Gambling Clinic, said: “Loot boxes are only one of several features that will need to be investigated and indeed researched.
“We need an evidence-based approach to ensure our young people and gamers in general do not continue to be subjected to new and increasingly harmful products without our intervention.
“In summary, a regulatory body for the gaming industry is urgently needed, as is an advisory board made of experts to oversee the products being made available.
“This will allow the public to air their concerns about specific games and will guarantee the concerns will be heard and investigated.”
Shirley Cramer, chief executive of the Royal Society for Public Health, said: “The rise of gambling by stealth in video games is a threat to the health and wellbeing of young people, and we commend the NHS for coming out with this bold call.
“There is no doubt that loot boxes must be regarded as a form of gambling – and indeed our research showed that three in five young people regard them as such.
“And yet, the world of online gaming remains an unregulated, fast-evolving and opaque market with little to no safeguards for children.”
