The reciprocal association between problem gambling and mental health symptoms/substance use: Cross-lagged path modelling of longitudinal cohort data

Abstract
To date, studies have highlighted cross-sectional and unidirectional prospective relationships 
between problem gambling and mental health symptoms or substance use. The current study aims to: (1) examine the reciprocal relationships between problem gambling and mental health symptoms (depression, generalized anxiety)/substance use variables (hazardous alcohol use, daily tobacco use, and drug use) using cross-lagged path models in a prospective general population cohort sample; and (2) determine whether these associations are moderated by age and gender. This study involved secondary data analysis from 1109 respondents who provided data during Wave 2 or 3 (12-months apart) of the Tasmanian Longitudinal Gambling Study (Australia). Depression (odds ratio (OR) = 2.164) and generalized anxiety (OR = 2.300) at Wave 2 were found to have cross-lagged associations with the subsequent development of any-risk gambling (low-risk, moderate-risk, or problem gambling) at Wave 3. Hazardous alcohol use, daily tobacco use, and drug use at Wave 2 were not associated with the development of any-risk gambling at Wave 3. Any-risk gambling at Wave 2 was not associated with the subsequent development of any mental health symptoms or substance use variables at Wave 3. Age and gender failed to be significant moderators in the associations between any-risk gambling and mental health symptoms or substance use variables. Future longitudinal and event-level research is required to further substantiate these prospective relationships, with a view to developing targeted preventions and interventions. Link to the article

Citation: Dowling, N.A., Butera, C.A., Merkouris, S.S., Youssef, G.J., Rodda, S.N., Jackson, A.C. (2019). The reciprocal association between problem gambling and mental health symptoms/substance use: Cross-lagged path modelling of longitudinal cohort data. Journal of Clinical Medicine, 8(1888). doi:10.3390/jcm8111888.

Pathways connecting socioeconomic variables, substance abuse and gambling behaviour: a cross-sectional study on a sample of Italian high-school students

Abstract
Objectives: The aim of this study was to elucidate the pathway of associations linking gambling, alcohol intake, smoking habit, cannabis consumption between each other and with demographic and socioeconomic variables.

Setting and participants: A survey was conducted in 2017 on a representative sample of 15 602 Italian 14-year-olds to 17-year-olds attending 201 secondary schools.

Outcome measures: Structural Equation Models analysis was used to assess the pathway between gambling, alcohol intake, smoking, cannabis consumption, demographics and socioeconomic factors.

Results: Irrespective of socioeconomic or demographic variables, gambling is positively associated with alcohol and cannabis consumption, while cannabis consumption is predicted by smoking and by alcohol intake, smoking is predicted by alcohol intake. Adolescents with a higher weekly income are more at risk of gambling, drinking alcohol and smoking, while the degree of economic dissatisfaction was positively associated with alcohol intake, cannabis consumption and smoking. Maternal employment appeared to be positively associated with adolescents’ smoking, alcohol intake and cannabis consumption.

Conclusions: This is one of the first studies to shed light on the pathways of associations connecting various health-risk behaviours among adolescents with demographic and socioeconomic factors. Link to the article

Citation: Buja, A., Mortali, C., Mastrobattista, L., et al. (2019). Pathways connecting socioeconomic variables, substance abuse and gambling behaviour: a cross-sectional study on a sample of Italian high-school students. BMJ Open, 9(e031737). doi: 10.1136/bmjopen-2019-031737

Gambling with your health: Associations between gambling problem severity and health risk behaviours, health and wellbeing [article]

Abstract
The current study examined the association between gambling problem severity and health risk behaviours, health and wellbeing. A cross-sectional survey (including representative population and supplementary convenience samples) was conducted with 2303 adult residents of a British Island. Gambling problem severity was assessed using the Problem Gambling Severity Index. The EQ-5D-5L, WEMWBS and AUDIT-C were used to measure general health, mental wellbeing and alcohol use, respectively. Other measures included diet, physical exercise and tobacco use. Differences between gambling severity levels for each measure were analysed using logistic regression adjusting for age, sex and income.
Compared to non-problem gamblers, moderate/high severity gamblers had higher odds of a poor diet, low physical exercise and poor general health. Tobacco use was associated with both low and moderate/high severity gambling. Low severity, but not moderate/high severity gambling, was signifcantly associated with binge and higher risk drinking behaviours. Health risk behaviours tended to cluster, with a graded relationship between gambling problem severity and odds of reporting at least two health risk behaviours. Compared to non-problem gamblers, low severity gamblers were approximately twice as likely and moderate/high severity gamblers were three times as likely, to have low mental wellbeing. Findings suggest associations between gambling problems and a range of health risk behaviours and health issues, and crucially that such issues are not limited to gamblers with the highest severity of problems. Addressing gambling across the whole continuum of risk should be a key public health priority.
Link to the article

Citation: Butler, N., Quigg, Z., Bates, R. et al. (2019). Gambling with your health: Associations between gambling problem severity and health risk behaviours, health and wellbeing. Journal of Gambling Studies. https://doi.org/10.1007/s10899-019-09902-8

The effects of alcohol expectancy and intake on slot machine gambling behavior (open access)

By Dominic Sagoe, Rune Aune Mentzoni, Tony Leino, Helge Molde, Sondre Haga, Mikjel Fredericson Gjernes, Daniel Hanss, and Ståle Pallesen.

Background and aims: Although alcohol intake and gambling often co-occur in related venues, there is conflicting evidence regarding the effects of alcohol expectancy and intake on gambling behavior. We therefore conducted an experimental investigation of the effects of alcohol expectancy and intake on slot machine gambling behavior.
Methods: Participants were 184 (females = 94) individuals [age range: 18–40 (mean = 21.9) years] randomized to four independent conditions differing in information/expectancy about beverage (told they received either alcohol or placebo) and beverage intake [actually ingesting low (target blood alcohol concentration [BAC] < 0.40 mg/L) vs. moderate (target BAC > 0.40 mg/L; ≈0.80 mg/L) amounts of alcohol]. All participants completed self-report questionnaires assessing demographic variables, subjective intoxication, alcohol effects (stimulant and sedative), and gambling factors (behavior and problems, evaluation, and beliefs). Participants also gambled on a simulated slot machine.
Results: A significant main effect of beverage intake on subjective intoxication and alcohol effects was detected as expected. No significant main or interaction effects were detected for number of gambling sessions, bet size and variation, remaining credits at termination, reaction time, and game evaluation.
Conclusion: Alcohol expectancy and intake do not affect gambling persistence, dissipation of funds, reaction time, or gambling enjoyment.

“I can sit on the beach and punt through my mobile phone”: The influence of physical and online environments on the gambling risk behaviours of young men

Deans, E. G., Thomas, S. L., Daube, M., & Derevensky, J.

Gambling is rapidly emerging as an important public health issue, with gambling products causing considerable health and social harms to individuals, families and communities. Whilst researchers have raised concerns about online wagering environments, few studies have sought to explore how factors within different gambling environments (both online and land-based) may be influencing the wagering, and more broadly the gambling risk behaviours of young men. Using semi-structured interviews with 50 Australian men (20–37 years) who gambled on sport, we explored the ways in which online and land-based environments may be risk-promoting settings for gambling. This included the appeal factors associated with gambling in these environments, factors that encouraged individuals to gamble, and factors that encouraged individuals to engage in different, and more harmful types of gambling. Interviews were conducted over the course of a year (April 2015 to April 2016). We identified a number of situational and structural factors that promoted risky gambling environments for young men. In the online environment, gambling products had become exceedingly easy to access through mobile technologies, with young men subscribing to multiple accounts to access industry promotions. The intangibility of money within online environments impacted upon risk perceptions. In land-based environments, the social rituals associated with peer group behaviour and sport influenced risky patterns of gambling. The presence of both gambling and alcohol in pub environments led individuals to gamble more than they normally would, and on products that they would not normally gamble on. Land-based venues also facilitated access to multiple forms of gambling under the one roof. We identified a number of factors in both land and online environments that when combined, created risk-promoting settings for gambling among young men. By exploring these contextual conditions that give rise to gambling harm, we are better able to advocate for effective public health responses in creating environments that prevent harmful gambling.

Deans, E. G., Thomas, S. L., Daube, M., & Derevensky, J. (2016). ‘I can sit on the beach and punt through my mobile phone’: The influence of physical and online environments on the gambling risk behaviours of young men. Social Science & Medicine. http://doi.org/10.1016/j.socscimed.2016.08.017

Impact of alcohol consumption on clinical aspects of gambling disorder

Similarities between gambling disorder and substance use disorders have been extensively described. To date, however, few studies using large clinical samples have been carried out that reliably assess the relationship between different levels of alcohol consumption and gambling disorders. The present study aimed to assess the impact of baseline alcohol consumption levels on the clinical profile in a large sample of treatment-seeking individuals. Nine hundred and fifty-one consecutive outpatients diagnosed with gambling disorder according to DSM-IV criteria were compared after being included in three alcohol consumption groups (low risk, abuse and risk of dependence) based on their total raw scores on the AUDIT questionnaire. Results showed a high prevalence of risk of alcohol dependence in GD patients who were immigrants, unemployed, and had a low level of education. A positive linear trend was also found between alcohol consumption level and the prevalence of other current and life-time comorbid mental disorders, and for the presence of drug abuse. Statistically significant differences were found between the three alcohol consumption groups in terms of the evolution and severity of the gambling disorder, self-directedness personality trait, and levels of general psychopathology, hostility and paranoid ideation. In conclusion, the results showed an association between increased alcohol consumption and greater dysfunction.

Gambling advocacy: lessons from tobacco, alcohol and junk food

Abstract:

Objective: To explore the attitudes and opinions of public health experts in gambling and related unhealthy commodity industries towards the tactics used by the gambling industry to prevent reform and the advocacy responses to these tactics. Methods: In-depth interviews (30–60 minutes) with a convenience sample of 15 public health experts and stakeholders with a public health approach to gambling (n=10), or other unhealthy commodity industries (food, alcohol, tobacco, n=5)…

Thomas, S. L., David, J., Randle, M., Daube, M., & Senior, K. (2015). Gambling advocacy: lessons from tobacco, alcohol and junk food. Australian and New Zealand Journal of Public Health, n/a–n/a. http://doi.org/10.1111/1753-6405.12410