The link between risk gambling and the use of alcohol, illicit drugs and tobacco among adolescents

In a study among European adolescents, the authors found positive associations between gambling and alcohol, tobacco, other substances (but not cannabis), truancy, going out at night, and regular and organized sports activities. In the same study, negative correlations could also be found between gambling and reading, parental supervision of evening activities on Saturdays, and parents being restrictive in giving money as a gift. Similar associations have been demonstrated in several international studies.

Gamblers are more likely to consume alcohol and use illicit drugs

In a previous report published in 2019 we analyzed the associations between having gambled during the past 12 months and alcohol-, illicit drugs- and tobacco experiences. The target group were students in ninth grade (aged 15-16) and 11th grade (age 17-18). The results indicated that it was more likely to have consumed alcohol, binge drinking and used illicit drugs, among students who had gambled.

For students in year 9 we also found a positive association between those who had been bullied and gambling. Regarding the students in grade 11, we found a corresponding association with daily use of snuff. An unexpected result was that daily smoking was negatively related to gambling, that is, the probability of having gambled in the last 12 months was lower among daily smokers. Finally, we also noted that given that the student was 18 years old, the probability of having gambled was elevated, compared to minors. The legal age limit for gambling in Sweden is 18 years.

Definitions of concepts – what do we mean by risk gambling?

We have investigated the occurrence of risk gambling among Swedish students in 9^th and 11^th grade. More specifically, the association between risk gambling and experiences of alcohol, illicit drugs, and tobacco use, and the association with different gambling types.

In this report, we use the measure of risk gambling as an indication of gambling problems. The purpose of doing this is to catch gambling that clearly implies an elevated risk, or problem with gambling, as opposed to merely having gambled. The measure includes both being at risk for developing gambling problems, as well as having serious gambling problems. Risk gambling has been defined as a student reporting at least one negative financial consequence, or at least one addiction symptom, in the past 12 months. The risk gambling measure is a short version of the instrument PGSI (Problem Gambling Severity Index) and has been evaluated by the Public Health Agency in Sweden. It is often used for surveys at the population level, for example in the national public health survey.

The risk gambling measure was introduced in The Swedish Council for Information on Alcohol and Other Drugs (CAN) annual school survey in 2019 and this is the first time these results have been analyzed in more detail. To obtain a sufficiently large base of students who are risk gamblers, we have collapsed data from the years 2019, 2020, and 2021. However, it should be noted that no survey was carried out in 2020 among students in year 11, due to the covid-19 pandemic. Therefore, the years 2019 and 2021 form the basis for the older students. In year 9 the analytical sample comprised of 14 598 students and in year 11 9011 students. The response rate varied between 69% to 82% at school level.

Boys gamble more frequently

A greater proportion of boys than girls have gambled, both in the last 12 months and the last 30 days. It was also more common to report risk gambling among boys compared to girls. While the levels of gambling are the same among girls in year 9 and year 11, gambling and risk gambling increases with age among boys. Three percent were risk gamblers among students in grade 9, and in grade 11 the corresponding proportion was five percent.

When it comes to the geographical distribution, risk gambling is relatively evenly distributed in Sweden in the younger group. At its highest four percent and the lowest two percent of the students in year 9 reported risk gambling in any county in Sweden. Regarding the students in year 11, the geographical spread was greater. From a maximum of seven percent and as low as two percent, with the largest shares of risk gamblers in Blekinge, Dalarna, and Gävleborg counties.

The most common gambling types among students in ninth grade are lottery, poker, and e-sport betting. As for gambling mode it is more common to gamble online on e-sports and sports betting, while it is more common to physically play poker and lotteries. Among their older peers the most common gambling types are poker, lottery, and sports betting. The differences between online gambling and other modes are over all small.

The gambling type that had the strongest association with risk gambling among students in year 9 was e-sport betting, but poker and casinos also had a positive association with risk gambling. Similar results were found among students in grade 11. When it comes to the association between alcohol-, illicit drugs- and tobacco experiences and risk gambling our analysis showed that

• using these substances before the age of 14,
• use of illicit drugs the last 12 months, and
• daily use of snuff,

increased the likelihood of reporting risk gambling among students in grade 9. In grade 11 the results were similar, but we also found an association between binge drinking and risk gambling, as well as if the student had turned 18. Boys had a significantly higher probability of reporting risk gambling in both grades.

Summing up

In summary – age, being a boy, substance use, and certain gambling types are associated with risk gambling.

By and large, this report confirms previous studies which have been carried out internationally looking at risk gambling and the use of different substances. Most of the studies have been conducted on a cross-sectional material, which means that they can’t determine the causal order of the associations. In other words, it is not possible to answer the question of whether gambling causes, or precedes the use of alcohol, tobacco and/or illicit drugs. It is also plausible that both risk gambling and use of other substances are explained by factors that we do not have considered.

It is clear that minors gamble for money, regardless of the set age limit of 18 years. Gambling takes place online as well as in other physical locations.  The report also points to the proportion of boys with risk gambling, and that it increases with age. We also found a link between risk gambling and the use of alcohol, illicit drugs and tobacco, and that certain gambling types have a stronger association with risk gambling than others. How minors gain access to the gambling market, particularly online, has not been examined in this report, but it is necessary knowledge when trying to minimize harmful effects of gambling.

The article is written by:

Johan Svensson, PhD. The Swedish Council for Information on Alcohol and Other Drugs and Stockholm University, Department of Public Health Sciences &

Martina Zetterqvist B.Soc.Sci.  The Swedish Council for Information on Alcohol and Other Drugs

on request of PopNAD.