Betting on trouble: A silent wave of gambling among Tunisian adolescents

Abstract Background Once considered an adult pastime, gambling has discreetly made its way into the daily lives of Tunisian adolescents. Despite its recognized psychosocial risks, youth gambling remains largely overlooked. This study aimed to estimate the prevalence of gambling and identify adolescents at risk of developing gambling-related problems. Methods Data were drawn from the 2021 Tunisian Mediterranean School Survey Project on Alcohol and Other Drugs (MedSPAD), targeting students aged 16-18. A self-administered questionnaire assessed both online and offline gambling behaviors. Two validated tools-the Lie/Bet Questionnaire and the South Oaks Gambling Screen-Revised for Adolescents (SOGS-RA)-were used to screen for risky and problem gambling. Data analysis was conducted using STATA. Results Among 6,201 students surveyed, 32.8% reported having engaged in gambling [95%CI: 31.3–34.5], with a significantly higher prevalence among boys (p < 10−4). The most reported activity was offline card or dice games (15.7%), followed by online sports betting - especially ‘Promosport’ - at 9.2%, three times more common among boys (17.6% vs 3.8%, p < 10−4). Approximately 10% were identified as at risk using the Lie/Bet tool. According to the SOGS-RA, 16.8% were at risk of problem gambling and 13.3% were classified as problem gamblers. Boys were found to be two to four times more vulnerable than girls. Conclusions These findings spotlight gambling as an emerging public health issue among Tunisian adolescents. The high prevalence, especially among boys, calls for urgent, gender-sensitive prevention strategies. Targeted interventions are essential to halt the progression of gambling behaviors into full-blown addiction in this vulnerable age group. Key messages • mbling is a significant emerging public health issue among Tunisian adolescents, with a higher prevalence observed in boys. • Gender-sensitive prevention strategies are crucial to mitigate the risk of gambling addiction in this vulnerable population.