Efficacy assessment of the universal problem-gambling prevention program "What at stake?"

Despite restrictions in place to prevent minors from gambling, data reveal a significant prevalence of gambling among adolescents. 22% of European adolescents gambled at least once in the last 12 months (ESPAD, 2019). This trend was also reflected in Spain, with 21.5% recorded in 2023. The rate of risky gambling is 4-6% and 1.2% for problem gambling. Initiation in gambling before the age of 18 increases the probability of developing an addictive disorder as an adult, underlining the importance of designing and implementing evidence based preventive strategies. “What at stakes?” is a universal prevention program in the school setting consisting of four sessions of approximately one hour, aimed at adolescents between 14 and 17 years of age. The objective is to evaluate the effectiveness of the universal prevention program on gambling, "What at stake?". 
Methods. Participants: 11,440 Spanish adolescents over a 3-year period and a sample of 500 Portuguese adolescents. Design: PRE-POST comparison with equivalent control group. Measures: Risk perception, cognitive biases on the control of gambling outcomes, intention to gamble, frequency of gambling, attitudes towards gambling advertising. 
Results. The results indicate that the program succeeds in reducing the intention to gamble, favourable attitudes towards advertising, the perception of normality about gambling and the presence of cognitive biases. These results are consistent over the 3 years. The results were also satisfactory in the Portuguese sample.