The Intersection of Gambling with Smoking and Alcohol use in Great Britain: A Cross-Sectional Survey in October 2022

Abstract Objectives Gambling is often associated with cigarette smoking and alcohol consumption. This study aimed to explore the intersection of gambling across all risk levels harm with smoking and alcohol use among adults in Great Britain. Design: A nationally representative cross-sectional survey in October 2022. Setting: Great Britain. Participants: A weighted total of 2,398 adults (18 + years). Outcome measures: We examined the prevalence of gambling in the past year and, among those reporting gambling, assessed the associations between any risk of harm from gambling (scores of > 0 on the problem gambling severity index) and cigarette smoking and higher risk alcohol use. We also explored the average weekly expenditure on gambling, smoking and alcohol use among those categorised at any-risk of harm from gambling. Results Overall, 43.6% (95% CI 41.2–45.9) of adults gambled in the past year. Among those who gambled in the past year 7.3% (5.3–9.3) were classified at any-risk of harm from gambling, 16.0% 13.2–18.8) were currently smoking, and 40.8% (37.2–44.4) were drinking at increasing and higher risk levels. There were no apparent associations between any risk of harm from gambling and current cigarette smoking (ORadj = 0.80, 95% CI 0.35–1.66) or drinking at increasing and higher risk levels (ORadj = 0.94, 0.52–1.69), respectively. Analyses using Bayes factors indicated that these data were insensitive to distinguish no effect from a range of associations (OR = 0.5–1.9). The mean weekly spend on gambling was £7.69 (95% CI 5.17–10.21) overall, and £45.68 (12.07–79.29) among those at any risk of harm from gambling. Conclusions Pilot data in a population-level survey on smoking and alcohol use yielded estimates of gambling participation and at-risk gambling that are similar to other population-level surveys. Further data are needed to elucidate the intersections more reliably between gambling, smoking and alcohol use, and inform population-level approaches to reduce harms conferred by these behaviors.