What increases the risk of problem gambling in adolescents? Findings from the Greek arm of the ESPAD study

Background: Gambling is becoming increasingly prevalent among adolescents and a significant portion of this population is bound to develop problem gambling with short and long-term consequences. Although growing, there is still a limited evidence base from which to draw conclusions about the individual and situational factors involved in problem gambling among adolescents.

Methods: Self-reports on gambling and problem gambling were collected from a nationally representative sample of 17 733 pupils aged 16 to 18 (school grades 10 to 12) as part of the Greek arm of the 2019 European School cross-sectional Survey Project on Alcohol and Other Drugs (ESPAD). The two-item Lie/Bet Scale was used to identify respondents at risk or already with a problem gambling status (here forth, problem gambling). Bivariate and multivariable logistic regression analyses (correcting for the cluster effect) were carried out with problem gambling as dependent variable (yes/no) and covariates drawing on a wide array of areas, including socio-demographics, substance use and other risk behaviour, gaming, school, family, psychosocial wellbeing and physical health.

Results: Overall, 37.8% of adolescent students aged 16-18 in Greece reported recent gambling (in the past 12 months). As per Lie/Bet scale, 13.3% were identified with a problem gambling status—10.7% were ‘at risk’ and 2.6% ‘already with a pathological gambling’ status. Problem gambling was independently associated with male sex (adjusted odds ratio [aOR] = 5.0, 99%CI = 3.7-6.6), older age (aOR = 1.6, 1.2-2.1 for the 17- and aOR = 1.3, 1.0-1.7 for the 18-year-olds, compared to the 16-year-olds), very recent drunkenness (in the past 30 days; aOR = 1.9, 1.4-2.4), lifetime use of drugs other than cannabis (aOR = 2.1, 1.5-2.9), low perceived risk from trying cannabis once or twice (aOR = 1.2, 1.0-1.5), at least 2 crime/victimization experiences in the past 12 months (aOR = 2.0, 1.6-2.5), repetitive truancy in the past 30 days (aOR = 1.4, 1.1-1.8), problem gaming (aOR = 1.7, 1.4-2.1) and being exposed to members of family who gamble, with significantly different strength of association between males (aOR=1.6, 1.3-2.0) and females (aOR = 2.6, 1.8-3.8). In the bivariate analyses, no significant associations were found between problem gambling and family affluence and parental control, while significant bivariate associations with restructured family, strict allowance approach, low parental monitoring, low parental support, low parental educational status, poor psychological wellbeing, poor somatic health, and poor school performance did not hold on to the multivariable model.

Conclusions: Gambling among adolescents is prevalent in Greece and a substantial minority of adolescents are at risk or have already a problem gambling profile. Except from male sex and older age, other problem behaviours and -importantly- exposure to gambling in family emerge as key independent factors of problem gambling in this population.