This report assesses changes in gambling attitudes, gambling participation, and problem gambling prevalence among monthly gamblers in the four most recent online panels in Massachusetts, carried out between 2022 and 2024. There was a rise in participation in most gambling activities from 2022 to 2023 followed by declines in Spring 2024 with no significant changes in Fall 2024. There were rises in problem gambling prevalence among monthly gamblers, as well as a rise in family and relationship harms. Given rising rates of sports betting frequency, education and harm reduction strategies targeting sports bettors are warranted. There is a need for an expansion of responsible gambling tools to support individuals reporting financial harms and/or family or relationship harms.