{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T21:21:09Z","timestamp":1792099269061,"version":"4.4.0"},"reference-count":49,"publisher":"BMJ","issue":"11","funder":[{"name":"Agenzia delle Dogane e dei Monopoli dello Stato"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2019,9,16]]},"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The aim of this study was to elucidate the pathway of associations linking gambling, alcohol intake, smoking habit, cannabis consumption between each other and with demographic and socioeconomic variables.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting and participants<\/jats:title>\n                    <jats:p>A survey was conducted in 2017 on a representative sample of 15\u2009602 Italian 14-year-olds to 17-year-olds attending 201 secondary schools.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome measures<\/jats:title>\n                    <jats:p>Structural Equation Models analysis was used to assess the pathway between gambling, alcohol intake, smoking, cannabis consumption, demographics and socioeconomic factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Irrespective of socioeconomic or demographic variables, gambling is positively associated with alcohol and cannabis consumption, while cannabis consumption is predicted by smoking and by alcohol intake, smoking is predicted by alcohol intake. Adolescents with a higher weekly income are more at risk of gambling, drinking alcohol and smoking, while the degree of economic dissatisfaction was positively associated with alcohol intake, cannabis consumption and smoking. Maternal employment appeared to be positively associated with adolescents\u2019 smoking, alcohol intake and cannabis consumption.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This is one of the first studies to shed light on the pathways of associations connecting various health-risk behaviours among adolescents with demographic and socioeconomic factors.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2019-031737","type":"journal-article","created":{"date-parts":[[2019,11,12]],"date-time":"2019-11-12T04:56:23Z","timestamp":1573534583000},"page":"e031737","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":20,"title":["Pathways connecting socioeconomic variables, substance abuse and gambling behaviour: a cross-sectional study on a sample of Italian high-school students"],"prefix":"10.1136","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2216-3807","authenticated-orcid":false,"given":"Alessandra","family":"Buja","sequence":"first","affiliation":[{"name":"Department of Cardiological, Thoracic, Vascular Sciences and Public Health, University of Padua, Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Mortali","sequence":"additional","affiliation":[{"name":"Centro Nazionale Dipendenze e Doping, Istituto Superiore di Sanit\u00e0, Roma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luisa","family":"Mastrobattista","sequence":"additional","affiliation":[{"name":"Centro Nazionale Dipendenze e Doping, Istituto Superiore di Sanit\u00e0, Roma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adele","family":"Minutillo","sequence":"additional","affiliation":[{"name":"Centro Nazionale Dipendenze e Doping, Istituto Superiore di Sanit\u00e0, Roma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simona","family":"Pichini","sequence":"additional","affiliation":[{"name":"Centro Nazionale Dipendenze e Doping, Istituto Superiore di Sanit\u00e0, Roma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"Genetti","sequence":"additional","affiliation":[{"name":"Explora Center for Research and Statistical Analysis, Vigodarzere, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Vian","sequence":"additional","affiliation":[{"name":"Explora Center for Research and Statistical Analysis, Vigodarzere, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Andreotti","sequence":"additional","affiliation":[{"name":"Explora Center for Research and Statistical Analysis, Vigodarzere, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0562-2717","authenticated-orcid":false,"given":"Giulia","family":"Grotto","sequence":"additional","affiliation":[{"name":"Department of Cardiological, Thoracic, Vascular Sciences and Public Health, University of Padua, Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincenzo","family":"Baldo","sequence":"additional","affiliation":[{"name":"Department of Cardiological, Thoracic, Vascular Sciences and Public Health, University of Padua, Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta","family":"Pacifici","sequence":"additional","affiliation":[{"name":"Centro Nazionale Dipendenze e Doping, Istituto Superiore di Sanit\u00e0, Roma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,11,11]]},"reference":[{"key":"2025121513544259000_9.11.e031737.1","doi-asserted-by":"crossref","first-page":"2089","DOI":"10.1111\/add.12719","article-title":"Country- and individual-level determinants of probable problematic gambling in adolescence: a multi-level cross-national comparison","volume":"109","author":"Molinaro","year":"2014","journal-title":"Addiction"},{"key":"2025121513544259000_9.11.e031737.2","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1515\/ijamh-2015-5013","article-title":"Alcohol and drug use among adolescents: an educational overview","volume":"27","author":"Gutierrez","year":"2015","journal-title":"Int J Adolesc Med Health"},{"key":"2025121513544259000_9.11.e031737.3","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association . Diagnostic and statistical manual of mental disorders. 5th edn. Arlington, VA: American Psychiatric Publishing, 2013.","DOI":"10.1176\/appi.books.9780890425596"},{"key":"2025121513544259000_9.11.e031737.4","doi-asserted-by":"publisher","DOI":"10.1037\/0021-843X.114.4.612"},{"key":"2025121513544259000_9.11.e031737.5","doi-asserted-by":"publisher","DOI":"10.1023\/A:1021275130071"},{"key":"2025121513544259000_9.11.e031737.6","doi-asserted-by":"publisher","DOI":"10.1111\/j.1465-3362.2009.00097.x"},{"key":"2025121513544259000_9.11.e031737.7","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1007\/s10899-016-9618-6","article-title":"Comorbidity of alcohol and gambling problems in emerging adults: a bifactor model conceptualization","volume":"33","author":"Tackett","year":"2017","journal-title":"J Gambl Stud"},{"key":"2025121513544259000_9.11.e031737.8","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.88.7.1093"},{"key":"2025121513544259000_9.11.e031737.9","doi-asserted-by":"publisher","DOI":"10.1177\/070674379804300104"},{"key":"2025121513544259000_9.11.e031737.10","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1037\/a0019114","article-title":"Effects of alcohol and initial gambling outcomes on within-session gambling behavior","volume":"18","author":"Cronce","year":"2010","journal-title":"Exp Clin Psychopharmacol"},{"key":"2025121513544259000_9.11.e031737.11","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.93.7.1155"},{"key":"2025121513544259000_9.11.e031737.12","doi-asserted-by":"publisher","DOI":"10.1016\/j.adolescence.2008.06.008"},{"key":"2025121513544259000_9.11.e031737.13","doi-asserted-by":"publisher","DOI":"10.1007\/s10899-007-9086-0"},{"key":"2025121513544259000_9.11.e031737.14","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1111\/ijsw.12021","article-title":"Prevalence and correlates of problematic gambling among Danish adolescents","volume":"23","author":"Kristiansen","year":"2014","journal-title":"Int J Soc Welf"},{"key":"2025121513544259000_9.11.e031737.15","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2010.05.003"},{"key":"2025121513544259000_9.11.e031737.16","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1007\/s11524-012-9751-1","article-title":"Environmental influences associated with gambling in young adulthood","volume":"90","author":"Martins","year":"2013","journal-title":"J Urban Health"},{"key":"2025121513544259000_9.11.e031737.17","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1556\/2006.6.2017.043","article-title":"SOGS-RA gambling scores and substance use in adolescents","volume":"6","author":"Buja","year":"2017","journal-title":"J Behav Addict"},{"key":"2025121513544259000_9.11.e031737.18","doi-asserted-by":"publisher","DOI":"10.1016\/S0306-4603(99)00048-9"},{"key":"2025121513544259000_9.11.e031737.19","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1007\/BF01019925","article-title":"Toward the development of an adolescent gambling problem severity scale","volume":"9","author":"Winters","year":"1993","journal-title":"J Gambling Stud"},{"key":"2025121513544259000_9.11.e031737.20","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1023\/A:1014584213557","article-title":"An assessment of the validity and reliability of the SOGS-RA","volume":"18","author":"Poulin","year":"2002","journal-title":"J Gambl Stud"},{"key":"2025121513544259000_9.11.e031737.21","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1111\/ajad.12214","article-title":"Relationship of gambling with tobacco, alcohol, and illicit drug use among adolescents in the USA: review of the literature 2000-2014","volume":"24","author":"Peters","year":"2015","journal-title":"Am J Addict"},{"key":"2025121513544259000_9.11.e031737.22","unstructured":"Muthen LK , Muthen BO . Mplus User\u2019s Guide. 5th edn. Los Angeles, CA: Muthen & Muthen, 1998-2009."},{"key":"2025121513544259000_9.11.e031737.23","unstructured":"Kline RB . Principles and practice of structural equation modeling. 3rd edn. New York, NY: Guilford Press, 2010."},{"key":"2025121513544259000_9.11.e031737.24","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1016\/j.drugalcdep.2017.06.024","article-title":"Risk factors for gambling and substance use among recent college students","volume":"179","author":"Caldeira","year":"2017","journal-title":"Drug Alcohol Depend"},{"key":"2025121513544259000_9.11.e031737.25","unstructured":"Consiglio Nazionale delle Ricerche IFC- Instituto di Fisiologia Clinica . Consumi d\u2019azzardo 2017. Available: https:\/\/www.epid.ifc.cnr.it\/images\/downloads\/Report\/Gioco\/Consumi_azzardo_2017.pdf [Accessed 16 Apr 2019]."},{"key":"2025121513544259000_9.11.e031737.26","unstructured":"Governo Italiano . Relazione annualeal parlamentosullo stato delle tossicodipendenzein Italia. Available: http:\/\/www.politicheantidroga.gov.it\/media\/2153\/relazione-al-parlamento_2017.pdf [Accessed 16 Apr 2019]."},{"key":"2025121513544259000_9.11.e031737.27","first-page":"166","article-title":"The co-occurrence of gambling with substance use and conduct disorder among youth in the United States","volume":"20","author":"Barnes","year":"2011","journal-title":"Am J Addict"},{"key":"2025121513544259000_9.11.e031737.28","doi-asserted-by":"publisher","DOI":"10.1126\/science.1188374"},{"key":"2025121513544259000_9.11.e031737.29","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1975.01760250115013"},{"key":"2025121513544259000_9.11.e031737.30","doi-asserted-by":"publisher","DOI":"10.1001\/jama.289.4.427"},{"key":"2025121513544259000_9.11.e031737.31","doi-asserted-by":"publisher","DOI":"10.1016\/j.adolescence.2006.06.003"},{"key":"2025121513544259000_9.11.e031737.32","doi-asserted-by":"publisher","DOI":"10.1016\/S0167-6296(02)00099-1"},{"key":"2025121513544259000_9.11.e031737.33","doi-asserted-by":"publisher","DOI":"10.1016\/S0167-6296(96)00498-5"},{"key":"2025121513544259000_9.11.e031737.34","doi-asserted-by":"crossref","DOI":"10.1186\/1747-597X-2-15","article-title":"Predictors of risky alcohol consumption in schoolchildren and their implications for preventing alcohol-related harm","volume":"2","author":"Bellis","year":"2007","journal-title":"Subst Abuse Treat Prev Policy"},{"key":"2025121513544259000_9.11.e031737.35","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1016\/j.amepre.2004.09.002","article-title":"Associations between individual and contextual factors and smoking in 13,293 Mexican students","volume":"28","author":"Arillo-Santillan","year":"2005","journal-title":"Am J Prev Med"},{"key":"2025121513544259000_9.11.e031737.36","doi-asserted-by":"crossref","DOI":"10.1186\/1747-597X-5-19","article-title":"Are adolescents with high socioeconomic status more likely to engage in alcohol and illicit drug use in early adulthood?","volume":"5","author":"Humensky","year":"2010","journal-title":"Subst Abuse Treat Prev Policy"},{"key":"2025121513544259000_9.11.e031737.37","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1007\/BF03405467","article-title":"A meta-analysis of marijuana and alcohol use by socio-economic status in adolescents aged 10-15 years","volume":"99","author":"Lemstra","year":"2008","journal-title":"Can J Public Health"},{"key":"2025121513544259000_9.11.e031737.38","doi-asserted-by":"publisher","DOI":"10.1111\/j.1745-9125.1992.tb01113.x"},{"key":"2025121513544259000_9.11.e031737.39","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.2011.03447.x"},{"key":"2025121513544259000_9.11.e031737.40","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2016-310444"},{"key":"2025121513544259000_9.11.e031737.41","doi-asserted-by":"crossref","first-page":"1060","DOI":"10.1542\/peds.93.6.1060","article-title":"Parental monitoring and peer influences on adolescent substance use","volume":"93","author":"Steinberg","year":"1994","journal-title":"Pediatrics"},{"key":"2025121513544259000_9.11.e031737.42","doi-asserted-by":"publisher","DOI":"10.1016\/S1054-139X(00)00092-6"},{"key":"2025121513544259000_9.11.e031737.43","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1007\/s10578-018-0838-0","article-title":"Timing of family adversity during adolescence and its impact on alcohol and tobacco initiation: a longitudinal study among Taiwanese adolescents","volume":"50","author":"Hsu","year":"2019","journal-title":"Child Psychiatry Hum Dev"},{"key":"2025121513544259000_9.11.e031737.44","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2011-2663"},{"key":"2025121513544259000_9.11.e031737.45","doi-asserted-by":"crossref","first-page":"632","DOI":"10.1016\/j.sbspro.2015.09.099","article-title":"Stress coping strategies of drug and alcohol addicted patients in Latvia","volume":"205","author":"Sudraba","year":"2015","journal-title":"Procedia Soc Behav Sci"},{"key":"2025121513544259000_9.11.e031737.46","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.53.8.1001"},{"key":"2025121513544259000_9.11.e031737.47","doi-asserted-by":"publisher","DOI":"10.1542\/peds.111.3.564"},{"key":"2025121513544259000_9.11.e031737.48","doi-asserted-by":"crossref","unstructured":"Robertson EB , David SL , Rao SA . Preventing drug use among children and adolescents. In: A research-based guide for parents, educators, and community leaders. 2nd edn. Bethesda, MD: US Department of Health and Human Services, National Institute on Drug Abuse 2003 NIH Publication no 04-4212(A), 2003.","DOI":"10.1037\/e313702005-001"},{"key":"2025121513544259000_9.11.e031737.49","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1023\/A:1019994500301","article-title":"Preventing early adolescent substance use: a family-centered strategy for the public middle school","volume":"3","author":"Dishion","year":"2002","journal-title":"Prev Sci"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2019-031737","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T21:54:49Z","timestamp":1765835689000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2019-031737"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,11]]},"references-count":49,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2019,11,11]]},"published-print":{"date-parts":[[2019,11]]}},"alternative-id":["10.1136\/bmjopen-2019-031737"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2019-031737","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,11]]}}}