Attitudes, Risk Factors, and Behaviours of Gambling among Adolescents and Young People: A Literature Review and Gap Analysis

Gambling is occurring in a rapidly changing landscape, with new trends and technologies affecting gambling behaviour and problem gambling across a range of populations. Gambling activity among adolescents and young people has received considerable research attention due to a high prevalence of gambling reported among these groups in recent years. Despite legislation worldwide to constrain gambling among adolescents and young people, modern technology, such as online gaming apps and online gambling venues, has significantly increased their exposure to the risks of problem gambling. It is important, therefore, to have up to date information about what is currently known about gambling and to explore gaps in our knowledge. This gap analysis presents the results of a systematic approach to reviewing the current literature on gambling behaviour, attitudes, and associated risk factors for gambling and problem gambling among adolescents and young adults (aged 10–25 years). The review included studies published between January 2015 and August 2020 and included 85 studies for final synthesis. Findings reveal further research is needed on the implications for young people of emerging technologies and new trends in gambling in the digital age. The current gap analysis reveals that this should include more research on the development and impact of both treatment and intervention strategies, and policy and regulatory frameworks from a public health perspective.

Are the qualitative data collection methods adequate to address the research question?
Are the findings adequately derived from the data?
. Is the interpretation of results sufficiently substantiated by data?
Is there coherence between qualitative data sources, collection, analysis and interpretation?
1. Is the sampling strategy relevant to address the research question?
Is the sample representative of the target population?
Is the statistical analysis appropriate to answer the research question?  (2017) Jauregui (2019) 1. Is the sampling strategy relevant to address the research question?
Is the sample representative of the target population?
. Is the risk of nonresponse bias low?
Is the statistical analysis appropriate to answer the research question?
Is the statistical analysis appropriate to answer the research question?
Is the statistical analysis appropriate to answer the research question? Students over 18 and whose friend, parents, sibling gamble, were more likely to be currently engaged in gambling behaviour. Having friends that gambled, accepted gambling, and parents with a gambling problem, predicted gambling among students. The study concluded that gambling is common among students.

Knowledge gap [Intervention programs]
Need for systematic design and evaluation of evidence-based intervention programs for adolescents Andrie et al. The study provides evidence for the effectiveness of gambling education programs in high school curricula.

Knowledge gap [intervention programs]
Further research to explore the relationship adolescent gamblers have with significant others and how this affects their attitudes and perceptions. Also, further research to develop and evaluate intervention programs.

Cross-sectional research
To understand the impact of online gambling on gambling problems in a large-scale nationally representative sample of Italian youth, and to identify and then further examine a subgroup of online gamblers who reported higher rates of gambling problems Rates of problem gambling were five times higher among online gamblers than non-online gamblers.
Factors that increased the risk of becoming a problem online gambler included living with nonbirth parents, having a higher perception of financial family status, being more involved with gambling, and the medium preferences of remote gamblers (e.g., Internet cafes, digital television, and video game console).

Knowledge gap [Sub-populations]
Future studies should quantify the extent of involvement in online gambling to enable evaluation of regular Internet gambling.
The comparisons between the more nuanced groups of gamblers (offline gambling only, online gambling only, online and offline gambling but on different activities, online and offline gambling but on the same activities) warrant additional study. Future studies may benefit from including impulsivity traits and reasons for gambling to better elucidate the differences between online and non-online gamblers. Canale et al.

Cross-sectional research
To understand the impact of online gambling on gambling problems in a large-scale nationally representative sample of Italian youth, and to identify and then further examine a subgroup of online gamblers who reported higher rates of gambling problems Rates of problem gambling were five times higher among online gamblers than non-online gamblers. Factors that increased the risk of becoming a problem online gambler included living with nonbirth parents, having a higher perception of financial family status, being more involved with gambling, and the medium preferences of remote gamblers (e.g., Internet cafes, digital television, and video game console).

Knowledge gap [Sub-populations]
Future studies should quantify the extent of involvement in online gambling to enable evaluation of regular Internet gambling. The comparisons between the more nuanced groups of gamblers (offline gambling only, online gambling only, online and offline gambling but on different activities, online and offline gambling but on the same activities) warrant additional study. Future studies may benefit from including impulsivity traits and reasons for gambling to better elucidate the differences between online and non-online gamblers. Ciccarelli et al.
Italy Nonrandomised experimental study To examine attentional bias among adolescent problem gamblers and non-gamblers Problem gamblers displayed greater bias towards attending to gambling related cues than nonproblem gamblers.

Knowledge gap [attentional bias among adolescent gamblers]
Further research on the precise nature of relationship between adolescent biases of attention re gambling stimuli Cozensa et al.

Cross-sectional design
To investigate the role that general impairment in mentalization plays in gambling disorder Results indicated that problem gamblers tended to focus more on the immediate outcomes of their behaviour or reward/outcome than non-problem gamblers.

Knowledge gap [more research in general]
Australia research group behaviours influenced attitudes towards, and the consumption of, gambling products among young sports betting gamblers normal and accepted activity, embedded within sport.
Need for development and evaluation of public health campaigns as a part of a public health approach to address the impact of marketing tactics in shifting social norms DeCamp (2020)

Cross-sectional research
To examine the association between gaming loot boxes and problem gambling In contrast to other loot box studies that examined adults, a lower prevalence of loot box purchase was observed among youth gamers i.e. a lower proportion of youth gamers purchased loot boxes than adult gamers. Overall, loot boxes and gambling share similarities, however, risk and protective factors may not be the same.

Knowledge gap [more research in general]
Large knowledge gap in area of loot-boxes particularly given the prevalence of them among internet games Derevensky et al. Canada

Discussion article
Discussion of problem gambling gaming, internet, and smartphone use among children and adolescents Changing face of gambling due to technological advances revolutionising the gambling industry. Very few adolescent children and adolescents voluntarily seek treatment for behavioural disorders. Parents play an essential role in helping prevent and modify their children's behavioural problems/addictions.

Knowledge gap [longitudinal research]
Further examination of the developmental trajectories and risk and protective factors for smartphone addiction and online gambling addiction needed Derevensky et al.
Canada Discussion paper Discussion paper of adolescent gambling literature More forms of gambling now available, and the social acceptability of gambling has resulted in more adolescents engaging in gambling, despite the 18 years old age restriction. The term 'gaming' helps to normalise gambling as a socially acceptable form of entertainment. Young people are reluctant to seek treatment for problem gambling.

Knowledge gap [more research in general]
More research needed given rapidly changing gambling environment Dixon et al. (2016) Australia

Cross-sectional research
Examination of the relationship between gambling attitudes, involvement, and problems in adolescence Parental discipline and adolescent coping styles protected against at-risk gambling for those who gambled infrequently but did not protect those adolescents where gambling involvement was high.

Knowledge gap [more research in general]
More research on influence of parental attitudes and adolescent gambling involvement Italy

Cross-sectional research
To examine immigration status on sensation seeking and problem gambling Immigrant adolescents had higher problem gambling and risky behaviours than nonimmigrants. Moderation analyses showed higher sensation seeking related to problem gambling after controlling for gender for immigrants.

Knowledge gap [Intervention programs]
More research on sensation seeking and problem gambling among this target group -immigrants Donait et al.

Cross-sectional
To examine time perspectives Results showed that the present time perspective

Knowledge gap [Intervention programs]
Italy research and gambling in adolescent boys was associated with problem gambling, and future time perspective negatively associated.
Development and evaluation of intervention programs which help adolescents focus on future goals, to mitigate risk of development of problem gambling Dussault et al.

Canada
Longitudinal study To examine the discrepancy of self-reporting of age first gambled by asking same question four times across a year Older youth had greater discrepancies, along with time passed. The authors caution researchers when using self-report to examine age first gambled among youth.

Knowledge gap [more research in general]
More research into how psychological-related variables could affect the discrepancies found in the age of initiation of gambling activity Dussault et al. Canada

Cross-sectional research
To examine the characteristics of youth poker players Results found 4 classes/groups of players: 1 played only simulated poker (i.e. not for real money), 2 only at school, 3 only at home, 4 a diverse pattern. The authors emphasise that adolescent poker players should not be considered a homogenous group.

Knowledge gaps [Sub-groups]
More research on sub-groups of gambling (different forms of gambling) Elton-Marshall et al. (2016) Canada

Cross-sectional research
To examine online and landbased gambling behaviour among adolescents in 3 Canadian provinces prior to the implementation of legalised online gambling Adolescents were engaging in online gambling at a significantly higher rate than has been previously found and were using technology to engage in simulated gambling.

Knowledge gap [Research on specific factors: Gambling intentions/behaviours/actions]
Further research is needed to understand whether adolescents are betting on the outcomes of video games or engaging in video games that include gambling for money, or both. Further research is needed to identify which websites youth are accessing. Estevez et al.

Cross-sectional research
To investigate the severity of gambling and gambling related cognitions as predictors of emotional regulation and coping strategies in adolescents Problem gamblers scored higher on gambling severity, emotional dysregulation, cognitive biases, and maladaptive coping strategies than nonproblem gamblers.

Knowledge gap [sub-groups]
More research needed on female adolescent and young adult gambling involvement Estevez et al.

Cross-sectional research
To investigate attachment and behavioural addictions in adolescents Results showed parent-child attachment was negatively associated with all behavioural addictions: gambling, internet, video gaming.

Knowledge gap [more research in general and intervention programs]
Further research on the role of parental and peer attachment and its relationship to coping mechanisms. Development and evaluation of gambling intervention programs for children and adolescents Estevez et al.

Cross-sectional research
To examine the role of alexithymia in adolescents and young people and its relationship with gambling and attachment Problem gamblers scored higher on substance, alcohol, gaming disorders and alexithymia, and lower in parental attachment than non-problem gamblers. Alexithymia was found to mediate the negative relationship between parental To examine gambling attitudes, health correlates, and excitement seeking among adolescents Excitement-seeking gambling was associated with greater at risk/problem gambling, greater alcohol use, and more permissive giving cognitions than non-excitement seeking gambling.

Knowledge gap [more research in general]
More research needed on reasons why adolescents gamble

Cross-sectional research
To investigate self-injurious behaviour and gamblingrelated attitudes, perceptions, and behaviours among adolescents Adolescents acknowledging self-harming behaviours were more likely to report at risk or problem gambling and more permissive giving gambling cognitions.

Knowledge gap [Intervention programs]
Research needed on development and evaluation of intervention programs for adolescent problem gambling targeting distress tolerance Gambling has become a significant public health issue and over the past 25 years the phenomenon of gambling among children and adolescents has grown, however, the issue remains hidden in too many societies and among health care professionals.

Knowledge gap [more research in general]
Research involving collaboration between scientific societies, governments and stakeholders, and use research findings to design effective social policies and public health intervention options Males more likely to have at risk or problem gambling. Review examines association of gender, drug use, technology, age differences, impulsivity/sensation seeking, role of society as a risk factor.

Knowledge gap [Intervention programs] Research needed on development and evaluation of intervention programs
Gavriel-Fried et al. (2015) Israel

Cross-sectional research
To examine the link between competitive sports and gambling behaviours Significant association found between involvement in competitive sports and gambling frequency for both genders. Link with problem gambling only for males.

Knowledge gaps [Intervention programs]
A need for development and evaluation of the integration of gambling prevention programs among youths who are involved in competitive sports Ginley et al. USA

Cross-sectional research
To explore college students' beliefs about gambling Males more likely to have gambled past year than females and report higher frequency of gambling. Adverse consequences from gambling reported by 15% of males compared to only 4% of females.

Knowledge gap [More research in general]
Further research on young peoples' gambling expectancies and association with risky gambling. Also, longitudinal research.

Cross-sectional research
To examine the prevalence of problem gambling among German students and use of different forms of gambling Past 12-month participation in gambling was 40% with PG rate of 1.7 and 2.2 in the two States surveyed. Males with background of migration more at risk and displayed greater psychopathological symptoms. Slots and online associated with more problem gambling.

Knowledge gap [Longitudinal]
Need for longitudinal research to examine believes about gambling over time Gonzalez-Roz et al. (2017) Spain

Cross-sectional research
To examine gambling prevalence and behaviour among Spanish adolescents Having a relative with gambling problems predicted risk gambling. Living with only one parent or no parents and participation with EGMs during past year predicted problem gambling. Mixed-mode gambling predicted both at risk and

Knowledge gap [sub-groups]
Further research on sub-groups of gamblers re how they access gambling e.g. land-based vs online only vs mixed modes of access. Also, intervention programs. Early childhood smoke exposure corresponded to 18% increased chances of gambling participation at age 12.

Knowledge gap [more research in general]
More research on association between two major public health issues: smoking and problem gambling. Design and evaluation of relevant public health campaigns Gori et al. (2015) Italy

Cross-sectional research
To examine the relationship between adolescent gambling severity and attitudes Frequent exposure to media messages may result in normalisation of gambling. At-risk gamblers more likely to be involved in heavy drinking and use of sedatives. 53% engaged in gambling during the past year. Norway

Cross-sectional research
To investigate the prevalence and correlates of PG, including motivational variables (future gambling intentions, attitudes toward gambling, and gamblingrelated knowledge) among 17-year-old Norwegians 26% had gambled during the previous month. 20.3% gambled with no problems, 4.1% at-risk and 1.5 moderate risk and 0.2% problem gambling. Males more likely to be at-risk or problem gamblers. Prevalence. Motivational variables (future gambling intentions, attitudes toward gambling, and gambling-related knowledge) distinguished best between those who did not gamble, non-problem gamblers, and risk and problem gamblers.

Knowledge gap [longitudinal]
Longitudinal research needed to examine attitudes over time, and alternative measures of gambling behaviour could be used other than self-report (e.g. parental ratings) Ho (2017) Ethiopia

Cross-sectional research
To examine the risk factors of adolescent pathological gambling Social poker and gambling in Amusement Gaming Centres on gambling type machines were predictive of problem gambling among adolescents. Internet gambling was not predictive of problem gambling.

Knowledge gap [intervention programs, public health]
Development and evaluation of responsible gambling practices from public health perspective to prevent underage gambling are needed.

Cross-sectional research
To investigate gambling behaviour among adolescent girls in Croatia and examine psychosocial predictors 7.4% regular gamblers (once a week or more), 11.2% mild problems, 3.2% serious problems. 63% had ever gambled in their life (once a year or less and once a month or less combined), scratchies and lotto most preferred among lifetime gamblers with sports betting more preferred among regular gamblers.

Knowledge gap [intervention programs]
More research needed on needs of female adolescent gamblers to guide development of specific intervention programs, and longitudinal research is needed. Jaisoorya et al.

Cross-sectional research
To examine gambling behaviour among high school students in India 27.9% of students had ever gambled, 7.1% problem gamblers. Of those who had ever gambled, 25.2% were problem gamblers (one in four). Problem gamblers were more likely to be males, have academic failure, higher rates of alcohol and tobacco use, and psychological distress including suicidality.

Knowledge gap [more research in general]
More research needed on adolescent problem gambling in India given the reported prevalence Jauregui & Cross-sectional To examine the role of Difficulties in emotional regulation mediated the

Knowledge gap [intervention programs]
Estevez (2020) Spain research attachment, coping, and emotion Regulation in gambling among adolescents and young people relationship between gambling motives and gambling severity. Attachment with parents and peers was negatively associated with problem gambling. Emotional regulation difficulties were positively related to problem gambling.

More research needed on development and evaluation of intervention programs
Jauregui et al. Spain

Cross-sectional research
To investigate gambling motives and their association with addictive disorders and negative and positive mood in youth Higher scores on problem gambling were associated with higher scores in enhancement (seeking to increase positive emotion), coping and social motives.

Knowledge gap [intervention programs]
More research needed on development and evaluation of intervention programs Kaltenegger et al. Sweden

Cross-sectional research
To investigate the relationship between impulsivity and risky gambling Impulsivity was a risk factor for at risk gambling and episodic drinking.

Knowledge gap [intervention programs]
Prevention measures should address adolescents who exhibit risk factors for gambling and aim at reducing psychological problems.

Cross-sectional research
To examine gambling factors related with the level of adolescent problem gamblers Risk factors were nearby gambling facilities, personal relationship with people that gamble, being male more likely to have a problem with gambling.

Knowledge gap [intervention programs]
Research needed on development of interventions which target not only individuals, but environmental strategies e.g. accessibility and regulation -more research on the environmental factors Kang et al. 2020)

Cross-sectional
Examination of gambling subgroups among Korean out-of-school adolescents Three subgroups emerged: rarely gambled, immediate gain gambling, broad gambling. Immediate gain gambling scored higher on problem gambling severity and time and money spent gambling. Broad gamblers gambled mostly for fun and excitement, not to win money. Immediate gain gamblers gambled mainly to win money.

Knowledge gap [sub-groups vulnerable adolescents]
More research needed on vulnerable sub-groups of adolescent gamblers: e.g. those not attending formal education who are generally not picked up in school/educational institution surveys To explore the types of simulated games and gambling platforms used by adolescents, adolescent's experiences, motivations and behaviours vis a`-vis simulated gambling and the potential interrelationships between simulated and monetary forms gambling Enjoying social interactional effects appeared to be the main reasons young people engage in simulated gambling games. The study documented characteristics of both a catalyst pathway and a containment pathway emphasizing that for some young people simulated gambling may increase the likelihood of involvement in real money gambling while it may decrease it for others.

Knowledge gap [Research on specific factors: Psychological]
More research is needed to explore and clarify the psychological mechanisms at play in various forms of online simulated gambling, which may help understand how players are induced to continue playing or to transition from simulated gambling to monetary gambling forms.
Kryszajtys et al. To examine implicit association and explicit intention regarding gambling and sport among underage youth An implicit association found between gambling and sport for both males and females. Stronger association among sports that are generally associated with gambling (football, basketball rather than gymnastics or archery). Further, a stronger association found among sports where gambling logo was sports relevant (Bet365) than

Knowledge gap
More research is needed on the impact of gambling marketing on adolescents.

Cross-sectional research
To examine the psychological, social and financial consequences of problem gambling among adolescents Findings showed 3-7% of adolescents regularly participate in serious gambling activities. Greatest risk, older male adolescents who struggled academically and have lower educated fathers and report low family satisfaction and attend vocational training facilities.

Knowledge gap [more research in general]
More research is needed to further examine if education improving knowledge misconceptions about gambling helps reduce risk of developing problem gambling among adolescents.

Marchica et al. (2017)
USA Cross-sectional research Examined the relationship between regular participation (more than once a month) in sport-relevant gambling activities among adolescents and those identified as being at-risk for a gambling problem Regular involvement in sports betting, fantasy sports betting, and daily fantasy sports betting among adolescents was associated with a higher risk of gambling problems. Further, although males participate more frequently in these activities, females who participate have a stronger likelihood of being at-risk. Students aged 16-19 years old are at a higher risk for developing a gambling problem compared to younger adolescents when regularly engaging in sports-related gambling. Moreover, regularly participating in daily fantasy sports is the strongest predictor of at-risk gambling behaviour in 13 to 15-year-old students. A hierarchical logistic regression supports that controlling for gender and age, all forms of sport-relevant gambling activities are significant predictors of at-risk gambling.

Method gap [More representative samples/other sampling gaps]
Future studies should investigate the participation rates and impact of fantasy sports (both daily and league based) among adolescents on a larger scale in order to identify how this growing activity may affect problem gambling behaviours.

Cross-sectional research
To investigate gender differences of substance use and gambling patterns among adolescents Sensation seeking was associated with higher gambling problems in both males and females and with alcohol among females.

Knowledge gap [sub-groups and intervention programs]
More research needed on different groups of gamblers, and the development and evaluation of treatments to target them

Cross-sectional research
To examine commonalities between gambling behaviour and problem gambling among video game players and between video game playing and addicted playing among gamblers Gamblers, relative to non-gamblers, were more likely to play video games. Video game players were more likely than nonplayers to gamble. Both social and problem gamblers had higher rates of video game playing than did non-gamblers, and addicted gamers had higher rates of gambling than did social and non-gamers.

Knowledge gap [Research on specific factors: Gambling intentions/behaviours/actions; Psychological]
It would be of interest to determine the extent to which individuals distinguish between gambling and video game playing with respect to skill in determining the outcome. Further research into motivations for playing on the basis of gender would help to inform treatment strategies.

Method gap [More representative samples/other sampling gaps]
Research with young people who are not in school would provide valuable insight into the gambling behaviour of young adults in general.

Melendez-Torres
Cross-sectional To examine the prevalence of Males gambled more frequently than females, Knowledge gap [More research in general and longitudinal et al. (2020) UK survey gambling behaviours and their associations with socioemotional harm among 11-16 year olds more affluent families had higher level of adolescent gambling, lower connection to school associated with gambling and socioemotional harms. Form gambling fruit/slot machines, private bets with friends for money, cards with friends for money, and lotto. Gambling socioemotional harms positively correlated with age, and this interaction was more pronounced for males.

research]
More research into how adolescents view gambling and whether this predicts future gambling problems in adulthood Australia Qualitative research To explore the experiences of young Australian adults who gamble regularly at gambling machine venues Overall, gambling was seen as positive social activity. The results highlighted the tension between individual agency, societal expectation, and familial influence.

Method gap [intervention strategies] Development of intervention strategies needed and should involve significant others, family, friendship groups
The findings need to be confirmed using more recent data and by comparing with other market data. Oksanen et al. Finland

Cross-sectional
To investigate gambling activities and association with behavioural risk factors and protective factors 15-25 year olds Competent online gambling (involving some level of perceived skill: poker, sports, online casino) a risk for problem gambling.

Knowledge gap
More research needed on new forms of online gambling, distinguishing between perceived skill-based and chance-based, and related policy development. Australia

Randomised experimental design
To compare the influence of gambling advertisements posted on social media by gambling operators, on social media by peers, and gambling operators print media, on male youth gambling attitudes and intentions Gambling operator adverts more influential than peer posted adverts, on both traditional print and social media, suggesting greater regulation for such industry adverts on social media

Method gap [intervention strategies, public health]
More research is needed on the influence of gambling advertising on youth, and development and evaluation of interventions from a public health perspective.
Paleologou et al. Greece

Cross-sectional research
To investigate problem gambling and concurrent emotional and behavioural problems among adolescents Hyperactivity/attentional problems were related to problem gambling. Also related were emotional problems, peer problems, conduct problems. Prosocial scores were negatively associated with problem gambling.

Knowledge gap
Further investigation needed for concurrent emotional/behavioural problems in adolescents with gambling problems Pallesen et al.

Cross-sectional
To examine relationships between gambling frequency, health risk-taking and poor health, and support (parental, friends, school).
Poor health and health risk-taking associated with increased gambling. Social support from family, school related to decreased gambling boys and girls.

Knowledge gap [treatment/intervention]
Interventions are needed and should target other risk-taking into consideration, and increase social support from parents and schools.

Rash & McGrath
Canada

Cross-sectional research
To investigate the motives for not gambling among young adult non-gamblers The results revealed eight specific motives for why participants chose not to gamble: 'financial reasons and risk aversion'; 'disinterest and other priorities'; 'personal and religious convictions'; 'addiction concerns'; 'influence of others' values'; 'awareness of the odds'; 'lack of access, opportunity, or skill'; and 'emotional distress'.

Knowledge gap
Need for design and evaluation of preventative strategies for gambling disorder Reardon et al. USA

Cross-sectional research
To examine personality factors associated with adolescent gambling Findings indicated that sensation seeking had the greatest predictive ability for problem gambling.
The importance of sensation seeking as a vulnerability among adolescents with respect to developing problem with gambling, is emphasised.

Knowledge gap [sub-groups]
Further research is needed for each age group, and longitudinal research spanning several developmental periods is needed

Rider et al. (2019) Cross-sectional research
To examine gambling behaviours among TGD-male assigned at birth had higher gambling participation and prevalence of problem gambling

Knowledge gap [sub-groups/vulnerable groups]
More research is needed for vulnerable sub-groups of adolescent USA transgender gender diverse (TGD) and cisgender adolescents then female at birth assigned TGD adolescents. Both male and female assigned at birth TGD adolescents had higher problem gambling than cisgender males and females.
gamblers along with the development and evaluation of targeted intervention programs.
Sancartier et al. Canada

Cross-sectional research
To examine gambling behaviour among young adults aged 19 to 20 years Male problem gambler reported lack of social support as barrier to recovery, females reported relying more on escape and avoidance behaviours. Being male increased the odds of being a moderate/high risk problem gambler by 25 times. Higher alcohol use among high risk problem gambling males. Low risk gambling was associated with drug use but not high-risk gambling.

Knowledge gap [sub-groups of gamblers and intervention programs]
Intervention programs are needed to target different groups of gamblers: low risk and high risk. Also, more research is needed to investigate how gender and problem gambling severity interact.

Cross-sectional research
To examine the acceptability of gambling activities and compare social factors with psychological factors Results suggest social factors more influential than psychological factors.

Knowledge gap [More research in general]
Further research needed concerning the influence of social norms which may influence young peoples' acceptance of gambling as a legitimate activity. Longitudinal research is needed.
Savolainen et al. Finland

Cross-sectional research
To examine the role of perceived social support and peer group identification in problem gambling Adolescents who identified more strongly with online peer groups were more likely to have gambling problems than those who identified with offline peers. Adolescents with offline peers has lower problem gambling. Perceived social supports moderated these effects.

Knowledge gap
Longitudinal research required. Further research is needed to examine the role of social support and the specific type of social support e.g. family vs friends, peers.
Sharman et al. UK

Cross-sectional research
To investigate psychosocial correlates in treatment seeking problem gamblers Results indicated that the younger age of gambling participation, the more severe the gambling problem was. Those who began gambling early were also more likely to abuse drugs, commit crime or have histories of violent behaviour, less likely to report a positive family upbringing environment and more likely to have a parent with a gambling and or drug/alcohol problem.

Knowledge gap [ more research in general]
More research is needed to examine the nature of these associations: poor family environment, gambling participation at an earlier age, and their association with problem gambling.
Sharman et al. Results indicated that loneliness moderated the association between daily gambling online gambling community participation (e.g. a Facebook group) and excessive gambling.

Knowledge gap
Research is needed to understand emerging group processes within online social communities, and communities' significance in their users' everyday life, and to investigate how an increased understanding can be utilised in a harm-reductive manner.

Method gap [Intervention programs]
Further research on the development and evaluation of programs which educate youth on adaptive coping strategies and the need for policies and programs to provide better alternatives to youth unemployment Tara et al. (2016) Canada

Cross-sectional research
To examine internet and land-based gambling among adolescents The overall prevalence of online gambling among all adolescents was 9.4 %, the most common form was sports. Gambling online is common among adolescents despite restrictions.

Knowledge gap [Intervention programs] Development and evaluation of intervention programs needed
Vitaro et al.
Canada Longitudinal twin study To examine gambling behaviour and substance use during late adolescence in a genetically informed twin study Findings indicate that common genetic factors largely accounted for gambling participation and substance use at ages 17 and 19. Substance use and gambling participation share a common genetic component that account for their concurrent longitudinal links during late adolescence.

Knowledge gap
Future research is needed to examine what specific phenotypes may be associated with development of gambling participation and substance use.

Cross-sectional research
To examine the relationships between parental gambling, child gambling and child delinquency The association between child delinquency and gambling participation grew in proportion to the strength of parental participation in gambling activities.

Knowledge gap [longitudinal research]
Longitudinal research is needed to confirm these findings and establish causal direction of variables.
Wardel ( To explore gambling behaviours and attitudes among adolescents and relationship with smoking status At risk problem gamblers were more likely to be smokers and report parental approval of gambling.

Knowledge gap
Further longitudinal research is needed to examine the influence of peer involvement on the occurrence of gambling and smoking among high school students. The results provide evidence for the importance of social beliefs in formulating specific gambling cognitions and gambling behaviours.

Knowledge gap [intervention programs]
The findings need to replicate with a larger representative sample. Findings can be used to inform treatment programs for adolescents.

Cross-sectional research
To examine the relationships between disordered gambling, internet gaming addiction, and illusory control Results suggested that non-gambling-related internet usage was not related to disordered gambling and using the internet for gambling related activities (gathering information -not gambling) was related to disordered gambling.

Knowledge gap
More research needed to examine the relationship between loot boxes and gambling Yu & Ma (2019) Hong Kong

Literature review
To review the literature on youth gambling in Hong Kong Parental problem gambling is positively related to children's gambling and mental health (depression anxiety stress).

Knowledge gap [vulnerable groups]
Most youth studies use secondary school samples. More research is needed to examine 'hidden' youth who may be at greater risk. Zhai et al. (2020) USA

Cross-sectional research
To examine substance use, gambling, and violence among adolescents Gambling participation past 12 months was associated with drug use and violence including carrying weapon and fighting for both males and females.

Knowledge gap
More research needs to examine link between delinquent behaviour and problem gambling.

Cross-sectional research
To investigate the relationship between weapon carrying and problem gambling among high school students in USA Weapon carriers had higher prevalence at risk problem gambling, greater parental approval of gambling, greater permissive gambling cognitions, and more family concerns compared to nonweapon carriers.

Knowledge gap
More research is needed to examine relationship between violence and gambling among adolescents. Development of targeted interventions are needed for at risk youth.