Unpacking the stakes: a cross-sectional study of health effects and predictors of gambling behaviour among male in-school adolescents in Osun State, Nigeria.

BACKGROUND

Gambling is a major public health issue increasingly affecting adolescents globally and worsened in Nigeria by weak enforcement of betting laws among other factors. The burden of gambling and its health effects among Nigerian adolescents is not well understood. Hence, this study assessed the prevalence of gambling, as well as the association between gambling and other health-related factors among male adolescents in Osun State, Nigeria.

METHODOLOGY: Using a multistage sampling technique, this study utilised a descriptive, cross-sectional design and was conducted among 517 male senior secondary school students attending ten randomly selected schools. Health related factors were measured using the Kessler Psychological Distress Scale and the Jenkins Sleep Scale, while alcohol and drug risk was assessed using the CRAFFT screening tool. The multivariable logistic regression model adjusted for age, fathers' occupation, parental and peer gambling, mother's educational attainment, access to betting, smartphone ownership, sleep disturbance, anxiety, and substance use.

RESULTS

The study revealed a lifetime prevalence of gambling among male adolescents in Osun State, Nigeria, to be 40%. Significant associations were found between gambling and anxiety (p < 0.001) as well as substance use (p < 0.001). Respondents aged 15-17 years had 1.7 times higher odds of gambling in the past year compared to those aged 12-14 years (AOR: 1.7, 95% CI: 1.02-2.8, p = 0.042). Similarly, those aged 18-19 years had four times higher odds of gambling compared with the 12-14-year-olds (AOR: 4.0, 95% CI: 1.4-11.6, p = 0.007). Adolescents with parents who gamble had significantly higher odds of gambling (AOR: 7.0, 95% CI: 3.2-15.2, p < 0.001 ), as did those with gambling friends (AOR: 2.0, 95% CI: 1.2-3.5 p = 0.007 ). Access to betting shops (AOR: 2.1, 95% CI: 1.3-3.4 p = 0.003) and having a smart phone (AOR: 2.1; 95% CI: 1.0-4.2, p = 0.042), frequent sleep disturbances (AOR = 3.1, 95% CI: 1.4-6.9, p = 0.007) and substance use (AOR = 4.9, 95% CI: 2.3-10.6, p < 0.001) increased the odds of gambling in the past year. Participants with anxiety symptoms had significantly higher odds of gambling in the past year (AOR = 5.3, 95% CI: 2.3-12.4, p < 0.001).

CONCLUSION

Gambling among adolescents was associated with increased anxiety and substance use. Parental and peer influences were also key factors in gambling engagement. Addressing adolescent gambling effectively requires a multi-faceted strategy, including parental education and involvement, peer-led prevention programs, restricting access to gambling platforms, and strict enforcement of gambling laws.