Exposure to Gambling Advertisements and Gambling Behavior in Young People.

A cross-sectional survey of 4617 adolescents and young adults from 38 schools in two German states was conducted in 2014 to assess the association between gambling advertisements and gambling behavior. Exposure to ten gambling advertisements was measured with masked ad images; students indicated contact frequency and brand recall. Main outcomes were several gambling behaviors including probable pathological gambling assessed with the South Oaks Gambling Screen (SOGS ≥ 5). A total of 65.4 % of the students reported gambling at least once in their life; 42.2 % gambled in the last 12 months; 6.9 % gambled in the last week, and 2.8 % reported probable pathological gambling. The average frequency that one of the selected ads had been seen at least once was 29.5 %, the average brand recall rate was 9.4 %. After adjustment for confounding, multilevel mixed-effects logistic regressions revealed that high gambling ad exposure was positively related to all assessed gambling outcomes, with the strongest association for weekly gambling. Future studies need to clarify the temporal sequence and specificity of these associations.