Risk gambling in Brazil: National Prevalence and Structural Correlates from the Third Brazilian National Alcohol and Drugs Survey (LENAD III).

The rapid expansion of online gambling in Brazil has outpaced the consolidation of regulatory safeguards, raising concerns about gambling-related harm at the population level. The Third Brazilian National Alcohol and Drugs Survey (BNADS/LENAD III) investigated gambling participation and risk gambling, providing nationally representative estimates of the magnitude of the problem and identifying vulnerable groups to inform public policy. LENAD III is a survey conducted in Brazil in 2022-2023 with 16,608 individuals aged 14 years and older. Gambling participation and risk were assessed using the Problem Gambling Severity Index (PGSI). Weighted prevalence estimates and multivariable logistic regression models were used to examine associations between structural, sociodemographic, behavioural factors, and risk gambling. Past-year gambling was reported by 17.6% of the population. Overall, 6.6% fell within the PGSI risk spectrum, while 2.8% were classified as moderate- or high-risk. Risk gambling was substantially more frequent among online gamblers. In multivariable models, online gambling remained the strongest correlate of gambling-related harm. Risk gambling in Brazil is substantial and disproportionately concentrated in online betting. Regulatory responses should prioritize structural measures that address product design, advertising exposure, and access control. Strengthening enforcement and aligning regulation with public health principles are urgent priorities.