Problematic Gaming in Association with Substance Use among Adolescents in Latvia

Objectives
With the rise of digitalisation, gaming has become a common leisure activity among adolescents, potentially influencing their mental and physical well-being and reducing real-life socialisation with peers. However, evidence on factors associated with problematic gaming remains limited. This study aimed to examine the prevalence of problematic gaming and its association with substance use among adolescents aged 15-16 years in Latvia.

Materials and Methods
Data were obtained from a nationally representative sample of Latvian adolescents aged 15–16 years (n = 2726) participating in the 2019 European School Survey Project on Alcohol and Other Drugs (ESPAD). Problematic gaming was assessed using the "Self-perceived Problems Related to Gaming" scale. Substance use indicators included alcohol and e-cigarette use in the past 30 days, daily cigarette smoking, and cannabis use in the past 12 months. Logistic regression models were used to evaluate unadjusted and adjusted associations, including an assessment of interaction by gender Adjustments were made for sex, parental education, and family economic status.

Results
Problematic gaming was reported by 23.1% of adolescents, with significantly higher prevalence among boys (36.4%) compared to girls (9.6%) (p < 0.001). Problematic gaming was negatively associated with smoking (aOR = 0.73, p <0.05), alcohol consumption (aOR = 0.74, p < 0.05), and cannabis use (aOR = 0.52, p < 0.001). No significant association was observed with e-cigarette use, and no significant interaction with gender was identified.

Conclusions
Problematic gaming was associated with lower odds of alcohol consumption, cigarette smoking, and cannabis use. These findings suggest that spending free time gaming, often in isolation rather than with peer groups, and deriving satisfaction from gaming may contribute to reduced likelihood of substance use.