Patterns of gambling and other risky behaviors among adolescents. A latent class analysis study on the 2021/22 Health Behaviors in School Children Survey data (2026)

Research on adolescent gambling often examines this behavior in isolation, overlooking evidence of comorbidity between alcohol/drug use disorders and problem gambling. This study aimed to address this gap by examining patterns of risky behaviors (i.e., substance use and gambling) among a representative sample of 7,795 adolescents aged 15 and 17 living in the Lombardy region of Italy. Latent Class Analysis was used to identify subgroups of individuals characterized by common behavioral patterns. We tested the invariance of gender and age cohort, as well as the relations between class membership, gambling behavior severity, and indicators of health status and life satisfaction. The analysis identified four distinct patterns of risk behaviors across gender and age cohorts. The first pattern is characterized by a low prevalence of risky behaviors. The other three patterns are distinguished by predominant substance use, either a single substance or a combination of multiple substances. Gambling was not observed as a singular behavior within any of these profiles. Rather, it co-occurred with polyconsumption patterns that were associated with higher levels of gambling severity, as well as poorer health and life satisfaction. These findings suggest that a more nuanced understanding of gambling can be achieved by examining it alongside other risk behaviors. During adolescence, a multifaceted health promotion approach that encompasses the prevention continuum and policy responses is necessary to address concurrently shared risk and protective factors of multiple risk behaviors at individual, social, community, and societal levels. [Author's abstract]