Displacement, mental health and gambling among adolescents in Ukraine: a 2024 school-based survey

Background

Armed conflict and displacement affect adolescent mental health and behaviour. Following russia’s full-scale invasion of Ukraine in 2022, many adolescents experienced displacement and traumatic events. While substance use is well studied, behavioural addictions such as gambling receive less attention. This study examines links between displacement, mental health and gambling using data from the European School Survey Project on Alcohol and Other Drugs 2024.

Methods

A school-based survey was conducted in 2024 among adolescents aged 14-17 (n = 8,819) across 20 regions of Ukraine using standardised ESPAD methodology. Displacement and war-related trauma were self-reported. Mental health indicators (depression, anxiety, stress) were assessed using validated scales. Gambling behaviour was measured via indicators of partial and problem gambling. Subgroup analyses compared displaced and non-displaced adolescents.

Results

Overall, 27.3% of adolescents reported displacement. High levels of depression (32%), anxiety (35%) and stress (21.7%) were observed. Gambling addiction was higher among displaced adolescents (26.7%) than non-displaced peers (15.2%). Prevalence was highest among displaced boys (19% partial; 15.2% problem) and girls (10.8% and 7.2% respectively). War-related trauma was also associated with gambling addiction, with nearly double prevalence among exposed adolescents (21.9% vs 10.8%).

Conclusions

Displacement and war-related trauma are associated with increased gambling risks among adolescents. Behavioural addictions should be considered part of the mental health impact of conflict. In contexts of reduced access to traditional substances, gambling may represent an emerging risk pathway, warranting further investigation and integration into adolescent health responses.

Key messages

• Displacement is linked to higher levels of gambling problems among adolescents, highlighting increased vulnerability in crisis settings.

• Exposure to war-related trauma is associated with markedly higher gambling risks among adolescents, underscoring the need for targeted prevention and support.