The cards they're dealt: types of gambling activity, online gambling, and risk of problem gambling in European adolescents.

Objective: This study aims to identify risk factors associated with gambling engagement and the likelihood of problem behavior, distinguishing by type of gambling activity and examining the impact of online gambling.

Methods: Data about 85,420 students aged 16 from 33 countries participating in the 2019 European School Survey Project on Alcohol and Other Drugs (ESPAD) were analyzed through a three-stage sequential probit model, specifically focusing on four types of activity: lotteries, slot machines, cards, and betting. Furthermore, predicted probabilities were calculated for subsamples of students engaging in different types of gambling activities to explore their influence on the likelihood of problem gambling behavior, conditioned on online gambling involvement.

Results: Certain groups, such as males and those with a history of school difficulties, exhibit a higher likelihood of problematic gambling behavior. Online gaming significantly influences adolescent gambling behavior, with slot machines demonstrating the highest predicted probabilities of risky behavior when combined with online gaming.

Policy Implications: The findings highlight that gambling is quite common among adolescents, and that gamblers and problem gamblers display different profiles, suggesting the importance of targeted interventions and support for vulnerable individuals. Public policies should prioritize the regulation of high-risk gambling activities, particularly slot machines, by enhancing the enforcement of age restrictions and the education on the real odds of winning and potential harms of gambling, particularly among adolescents. It is crucial to foster policies and interventions that address the risks associated with online gambling for this age group.