Hawaii and Utah are unique in the same way. They stand alone as the only states that have not legalized any form of gambling. This does not however mean that there are no compulsive gamblers there. Their lack of legalized gambling does extend to formal funding of help for the compulsive gambler and those affected by the gambler.
Hawaii has an estimated 23,831(2.2%) and Utah has 43,218(2.2%)of adults believed to presently have signs of a gambling problem. Both states are served by the National Council on Problem Gambling while neither has an associated organization within their boundaries. Calles from Hawaii for gambling are routed through the national helpline to Louisiana and Utah has them directed to the hotline provided by the Utah- Idaho Council on Problem Gambling.
Considering the ‘estimates’ provided are from surveyed individuals reporting, it is most likely the number is much higher. When looking at these 2 states it is fairly clear why gambling is not legal in them.
Hawaii is a tropical Island which has many great ways to enjoy time without gambling. It also has some unusual risks in the form of volcanic eruption (even though it is not often) and Sharks (which are also not common). People here have far more to do than in say a snowy northern state.
Utah is a state which was founded by Mormons and as a matter of foundational beliefs gambling is not socially acceptable. It is notable that there is a potential for that to change as time goes on because of a more fluid population in the continental states.