But gamblers in the virtual world are three to four times more likely to develop problems than gamblers around a real table.

"Ten to 25 per cent of online gamblers are problem gamblers," said François Desbiens, public health director for the national capital region. "It's the kind of gambling that creates the most problems, because it's the most accessible."

You can now play poker on most cellphones, for example, and the equivalent of a video-lottery terminal is now on your desktop - at work and at home.

For those who can't seem to surf away from the panoply of gaming sites, the problems go beyond the financial realm to include everything from anxiety to suicidal thoughts and hypertension, and negligence or failure at work, at school or as a parent.

Young people - given their predilection for surfing the Net - are especially vulnerable recruits, Desbiens said. Between 2006 and 2008, the number of Quebec high-school students gambling online doubled to almost 25,000.

The doctors looked to Quebec's future in other jurisdictions, like British Columbia, where state-sponsored online gambling already exists - and where 29 per cent of players are excessive gamblers.

Loto-Québec plans to become a partner in its online venture with B.C. Lottery Corp. and Atlantic Lottery Corp., which covers the four Atlantic provinces.

But B.C.'s Play Now site is particularly worrisome, Desbiens said. The "Game Sense" box on the site, where players can exercise self-exclusion and call a help-line "when gambling isn't fun anymore," is about one-fifteenth the size of the Players' Club or Interac withdrawal box.

Just last year, the B.C. website raised its weekly betting limit from $120 to $9,999.

The doctors also looked to Sweden, an example often cited by Loto-Québec, which has had state-sponsored online gambling since 1998.

About 52 per cent of players on the Svenska Spel site were new recruits - who had never gambled online before - and 20 per cent of users were problem gamblers, Desbiens said.

Faced with a barrage of criticism yesterday, Loto-Québec offered its own, and contradictory statistics for Sweden - where it said the number of problem gamblers remained the same after Svenska Spel was established. And it accused the doctors of presenting "alarmist scenarios" that will never materialize, as they did before gaming halls in Quebec City and Trois Rivières were opened in 2007.

"Regardless of what the (public health directors) say, it should be noted that Quebecers currently have access to over 2,000 illegal and unregulated gaming sites that are of dubious integrity.

"Loto-Québec wants to channel the gaming offer in a controlled, safe environment with irreproachable integrity."

Loto-Québec has said it will ensure its online gaming site will not be accessible to minors. Age verification will be done by an outside firm using a process that could take days and, in some cases, require players to show up in person.

And it will set up a monitoring committee to follow up on potential problems.

For the health directors, as well as the general practitioners, the problems should instead be prevented.

"Fighting illegal gaming and the underground economy is inherently useful, but is increasing online gambling opportunities and legitimizing it really the best way to do it?" asked Louis Godin, president of the Fédération des médecins omnipraticiens du Québec.

"It seems premature as a society to give the green light to Loto-Québec, then wash our hands of the negative consequences that a (gambling) website could have for many of our citizens ... with the blessing of the state."

By Catherine Solyom