title: Country- and individual-level determinants of probable problematic gambling in adolescence: a multi-level cross-national comparison.
abstract: OBJECTIVE
  To estimate the role of family and socio-economic indicators of welfare state in accounting for probable problem gambling during adolescence in a representative sample of students living in nine European countries.
  
  
  METHODS
  Data from the 2011 European School Survey Project on Alcohol and Other Drugs (ESPAD) Study were used for cross-sectional analyses of adolescent probable problem gambling.
  
  
  METHODS
  Representative surveys in nine European countries.
  
  
  METHODS
  A total of 31 236 16-year-old students.
  
  
  METHODS
  Respondents' probable problem gambling, socio-demographic characteristics and parenting (regulation, monitoring and caring) were measured individually. Indicators of wealth (gross domestic product per capita, GDP), expenditure on public health (% GDP) and benefit in kind for families/children (% GDP) were obtained from national public databases.
  
  
  RESULTS
  Students who perceived more parental caring [odds ratio (OR) = 0.92, 95% confidence interval (CI) = 0.85-0.98] and monitoring (OR = 0.57, 95% CI = 0.53-0.62) reported less involvement in probable problem gambling. Moreover, students who perceived stronger parental regulation (OR = 1.16, 95% CI = 1.09-1.23) were more likely to be possible problematic gamblers. At the country level, expenditure on public health was associated negatively with probable problem gambling (OR = 0.87, 95% CI = 0.78-0.97), whereas GDP per capita (OR = 1, 95% CI = 1.00-1.00) and the benefits in kind for families/children (OR = 1.16, 95% CI = 0.89-1.51) showed no association with probable problem gambling.
  
  
  CONCLUSIONS
  Family characteristics and expenditure on public health may play a key role in explaining probable problem gambling among adolescents in Europe.
authors.affiliation: National Research Council, Clinical Physiology Institute, Pisa, Italy.
authors.forename: Sabrina
authors.initials: S
authors.lastname: Molinaro
authors.forename: Natale
authors.initials: N
authors.lastname: Canale
authors.forename: Alessio
authors.initials: A
authors.lastname: Vieno
authors.forename: Michela
authors.initials: M
authors.lastname: Lenzi
authors.forename: Valeria
authors.initials: V
authors.lastname: Siciliano
authors.forename: Mercedes
authors.initials: M
authors.lastname: Gori
authors.forename: Massimo
authors.initials: M
authors.lastname: Santinello
mesh_terms: D000293:Adolescent; D003431:Cross-Cultural Comparison; D003430:Cross-Sectional Studies; D005060:Europe; D005195:Family Relations; D005260:Female; D005715:Gambling / Q000453:epidemiology* / Q000523:psychology; D006801:Humans; D007206:Individuality; D008297:Male; D012959:Socioeconomic Factors
keywords: Family; gambling; health expenditures; multi-level analysis; students