Gambling rarely stands alone: clustered addictive behaviours and socioeconomic vulnerability in adolescents

Recent European studies estimate that between 15% and 80% of adolescents have engaged in gambling, reflecting substantial heterogeneity in measurement approaches and highlighting limitations in current surveillance systems. This variability may obscure the magnitude and urgency of the problem. Evidence suggests that adolescents exposed to socioeconomic vulnerability are more likely to engage in gambling and other co-occurring risk behaviours. This study aims to analyse gambling initiation patterns and their relationship with addictive behaviours within a socioeconomic framework.

This cross-sectional observational study included 2,407 adolescents and young adults aged 14-21 years from the Autonomous Community of Madrid. Schools were selected using simple random sampling from an official registry, and approximately 95% of eligible students participated. Data were collected using a self-administered questionnaire with adequate psychometric properties (KMO = 0.843; Cronbach's alpha = 0.861). Group differences were assessed using chisquare and Mann-Whitney U tests, and multivariate associations were examined using logistic regression models (odds ratios with 95% confidence intervals).

Overall, 8.6% of participants reported gambling behaviour. Gamblers were significantly older (median 18 vs 16 years, p < 0.001), more likely to be employed (OR = 2.68, 95% CI: 1.49-4.84, p = 0.001), and more likely to have repeated a school year (OR = 4.66, 95% CI: 3.07-7.06, p < 0.001). Gambling was also significantly associated with alcohol, tobacco, and illicit substance use (all p <0.001), as well as indicators of socioeconomic vulnerability.

Adolescent gambling appears to be part of a broader cluster of socioeconomic disadvantage and co-occurring addictive behaviours rather than an isolated activity. These findings highlight the importance of integrated prevention strategies targeting multiple risk behaviours in vulnerable youth populations.