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This study aimed to estimate the prevalence of underage gambling in Europe stratified by type of game and on\u2010\/off\u2010line mode and to examine the association with individual and family characteristics and substance use.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Our study used data from the 2015 European School Survey Project on Alcohol and Other Drugs (ESPAD) cross\u2010sectional study, a survey using self\u2010administered anonymous questionnaires.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Thirty\u2010three European countries.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>Sixteen\u2010year\u2010old\u2010year\u2010old students (<jats:italic>n<\/jats:italic>\u00a0=\u00a093\u2009875; <jats:italic>F<\/jats:italic>\u00a0=\u00a050.8%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements<\/jats:title><jats:p>The primary outcome measure was prevalence of past\u2010year gambling activity. Key predictors comprised individual behaviours, substance use and parenting (regulation, monitoring and caring).<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>A total of 22.6% of 16\u2010year\u2010old students in Europe gambled in the past year: 16.2% on\u2010line, 18.5% off\u2010line. High prevalence variability was observed throughout countries both for mode and types of game. With the exception of cannabis, substance use shows a higher association with gambling, particularly binge drinking [odds ratio (OR)\u00a0=\u00a01.46, 95% confidence interval (CI)\u00a0=\u00a01.39\u20131.53), life\u2010time use of inhalants (OR\u00a0=\u00a01.57, 95% CI\u00a0=\u00a01.47\u20131.68) and other substances (OR\u00a0=\u00a01.78, 95% CI\u00a0=\u00a01.65\u20131.92)]. Among life habits, the following showed a positive association: truancy at school (OR\u00a0=\u00a01.26, 95% CI\u00a0=\u00a01.18\u20131.35), going out at night (OR\u00a0=\u00a01.32, 95% CI\u00a0=\u00a01.26\u20131.38), participating in sports (OR\u00a0=\u00a01.30, 95% CI\u00a0=\u00a01.24\u20131.37). A negative association was found with reading books for leisure (OR\u00a0=\u00a00.82%, 95% CI\u00a0=\u00a00.79\u20130.86), parents\u2019 monitoring of Saturday night activities (OR\u00a0=\u00a00.81, 95% CI\u00a0=\u00a00.77\u20130.86) and restrictions on money provided by parents as a gift (OR\u00a0=\u00a00.89, 95% CI\u00a0=\u00a00.84\u20130.94).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Underage gambling in Europe appears to be associated positively with alcohol, tobacco and other substance use (but not cannabis), as well as with other individual behaviours such as truancy, going out at night and active participation in sports, and is associated negatively with reading for pleasure, parental monitoring of evening activities and parental restriction of money.<\/jats:p><\/jats:sec>","DOI":"10.1111\/add.14275","type":"journal-article","created":{"date-parts":[[2018,5,28]],"date-time":"2018-05-28T08:30:13Z","timestamp":1527496213000},"page":"1862-1873","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":89,"title":["Prevalence of youth gambling and potential influence of substance use and other risk factors throughout 33 European countries: first results from the 2015 ESPAD study"],"prefix":"10.1111","volume":"113","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1140-0312","authenticated-orcid":false,"given":"Sabrina","family":"Molinaro","sequence":"first","affiliation":[{"name":"Institute of Clinical Physiology National Research Council  Pisa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisa","family":"Benedetti","sequence":"additional","affiliation":[{"name":"Institute of Clinical Physiology National Research Council  Pisa 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