BACKGROUND AND AIMS: Previous research has identified numerous risk and protective factors of adolescent problematic gaming (PG) at the individual and social levels; however, the influence of socio-economic indicators on PG is less known. This study aimed to measure the contribution of individual and socio-economic factors involved in PG risk among adolescents from 30 European countries.

DESIGN: Multi-level logistic regression analysis of survey data from the 2019 European School Survey Project on Alcohol and Other Drugs (ESPAD) cross-sectional study using self-administered anonymous questionnaires. The setting was thirty European countries. A representative cohort of 15-16-year-old students (n = 88 998 students; males = 49.2%).

MEASUREMENTS: The primary outcome measure was adolescents' (low and high) risk of PG. Individual key predictors included self-report assessments of socio-demographic characteristics, time spent gaming and family variables (parental regulation and monitoring, family support). Main country-level predictors comprised Gini coefficient for economic inequalities and benefits for families and children (% gross domestic product), retrieved from international public data sets and national thematic reports. The data analysis plan involved multi-level logistic regression.

FINDINGS: Participants who reported stronger parental regulation reported lower risk of PG. At the country-level, economic inequalities were positively associated with the risk of PG, while benefits for families and children were negatively correlated with the risk of PG.

CONCLUSIONS: Supportive family environments, lower country-level economic inequalities and higher government expenditures on benefits for families and children appear to be associated with a lower risk of problematic gaming among European adolescents.