Betting on the Future: A Systematic Review of Modern Gambling Interventions for College Students

Gambling among college students is a growing public health concern, with approximately 10.2% experiencing problem gambling and 6.1% meeting criteria for gambling disorder. These rates are significantly higher than those in the general adult population. The transitional nature of college life, combined with increased independence, peer influence, and the widespread availability of online gambling platforms, places students at heightened risk. The purpose of this study was to conduct a systematic review of randomized controlled trials (RCTs) aimed at reducing gambling behaviors among college students. This systematic review evaluated RCTs published over the past 25 years targeting gambling behaviors among college students. Following PRISMA guidelines, a comprehensive search was conducted across four databases to assess the effectiveness of psychotherapeutic, psychoeducational, and personalized feedback interventions. A total of 14 studies met the inclusion criteria. Interventions based on cognitive-behavioral therapy (CBT) and motivational interviewing (MI) consistently reduced gambling frequency and harm. Personalized normative feedback (PNF) interventions significantly lowered perceived gambling norms and self-reported behaviors. Technology-driven strategies, including smartphone-based interventions and pop-up messages prompting time limits, improved accessibility and reduced gambling duration. Group-based CBT interventions demonstrated particular effectiveness through peer accountability and skill-building. However, gaps remain in addressing online gambling behaviors, cultural adaptability, and co-occurring mental health conditions. Evidence supports the efficacy of CBT, MI, and PNF-based interventions in reducing gambling among college students. Digital and group-based approaches show promise for scalability. Future public health interventions should address the unique risks of online gambling and integrate mental health support. OSF Registration DOI: https://doi.org/10.17605/OSF.IO/D97QX .