Trends in problematic gambling among school-aged adolescents based on three Spanish nationwide population-based studies (2018-2023): a gender-based analysis of risk and protective factors.

This observational study investigated the prevalence and associated factors of problematic gambling (PG) among adolescents aged 14 to 18 years old who reported gambling in the past 12 months, using data from three Spanish Nationwide Population-Based studies (ESTUDES) conducted between 2018 and 2023. The associations between PG and socio-demographic characteristics, as well as variables related to videogames, internet use (esports, gaming disorder, excessive internet use), gambling forms, and type of games, were analyzed. The prevalence of PG decreased between 2018 and 2023 (4.74% vs. 4.03%, P < .001). A higher probability of PG was associated with land-based gambling (OR 10.67; 95% CI 9.59-11.87), online gambling (OR 5.31; 95% CI 4.62-6.10), being male (OR 2.58; 95% CI 2.27-2.93), having parents with no formal education (OR 2.05, 95% CI 1.49-2.82), being 17-18 years old (OR 1.67; 95% CI 1.52-1.83), and meeting the criteria for internet gaming disorder (IGD) (OR 1.98; 95% CI 1.72-2.27). Furthermore, adolescents with compulsive internet use (CIU) were less likely to present PG compared to those without CIU (OR 0.49; 95% CI 0.44-0.54). Gender differences were observed in the likelihood of PG: spectating and playing esports were associated with higher odds of PG in females (OR 1.62 and 2.16, respectively), but lower odds in males (OR 0.77 for both activities).