A public health approach towards gambling harm prevention has garnered attention in the last two decades. Yet, policies to prevent gambling harm are still dominated by a responsible gambling approach. In this article, the authors discuss the characteristics of policy-making and research communities to explain why prevention policies have seen little changes over the last two decades. The authors argue for a need to move gambling harm prevention “upstream” to address the root causes of the problem. They also suggest improving communication of research as a means of influencing policies and actions.