Traditional gambling, betting in video games, and financial trading: Associations with gambling severity and associated harm in young adults.

The digitization of gambling has led to the proliferation of gambling-like products in areas such as video games and financial investment platforms. Although these practices share structural mechanisms and risk profiles with gambling, evidence on their relationship with associated harm and their joint role in predicting gambling severity remains limited. This study examined the association between recent participation (within the last 60 days) in these activities, along with traditional forms of gambling, and gambling severity (PGSI) and related harm (SGHS). The sample is derived from a randomized controlled trial (ClinicalTrials.gov ID: NCT06681103), from which only the pre-intervention baseline assessment data were utilized. A total of 1,889 young people aged 18-34 living in Spain were recruited, of whom 53.9% (n=1,018) had recently participated in gambling or similar activities, forming the sample analyzed. Both indicators were modelled using hierarchical ordinal regression, with adjustments made for overall involvement (frequency and number of activities) and sociodemographic factors. The associations with severity remained after all adjustments, with adjusted ORs (aORs) between 1.9 and 3.6 (p<0.01), with video game betting and commodity trading standing out, with magnitudes similar to those observed for slot machines, casinos, and sports betting. In the SGHS, only eSports betting and commodity trading (aOR=2.23, p<0.05) retained their association with a higher number of harms after sociodemographic adjustment, while lotteries showed inverse associations with both indicators (aOR=0.58 in PGSI, and aOR=0.56 in SGHS, p<0.05). The results emphasize the importance of incorporating these new forms of digital spending into the detection and prevention of gambling harm among young adults.