Sports gambling is legal in many US states and has become increasingly common. Because heavy drinking is part of sports gambling culture, this study examined whether changes in alcohol use are linked with sports gambling in a representative sample of US adults.
l
Since the first New Jersey law legalizing the activity in 2018, sports gambling is now legal in 39 US states. As would be expected, it has increased in prevalence across the US with as many as 1 in 5 US adults having gambled on sports in the past year. Sports betting is poised to significantly increase risk for the development of gambling disorder across the United States, considering its availability (e.g., on one’s smart phone), low barrier of entry (bets as low as $1, with free promotional bets offered to start), and significant “gamification” designed to increase engagement by making betting more like a game in and of itself.
Sports betting is also often intertwined with alcohol consumption, which appears to be a significant part of the sports betting culture. Alcohol consumption often precedes and simultaneously co-occurs with gambling behavior, which increase the chances of more risky gambling decisions. Though there appears to be a general risk of heavy alcohol consumption among those who gamble – where individual traits like impulsivity increases risk for both problem behaviors – those participating in sports betting may be at unique risk even relative to those who gamble in other ways. Indeed, people who sports gamble have higher rates of binge drinking and alcohol problems relative to those who do not gamble or those who gamble in ways other than sports betting. However, the relationship between sports betting and heavy drinking frequency over time has not been established; in other words, it is unclear if changes in one behavior would track with or influence changes in the other behavior. The current study was designed to look at this; specifically, to examine the trajectories of sports gambling frequency and heavy drinking frequency over time in a representative sample of US adults.
This was a nonrandomized, longitudinal study of 4,363 US adults. Sampling took place in 2 ways. First, a sample of US adults were recruited, stratified and matched to US norms for age, gender, education, census region, and race and ethnicity as of the 2019 American Community, which resulted in a sample of 2,806 US adults. Next, the authors oversampled sports gambling adults matched to the demographic data of sports gamblers from the census-matched sample, which resulted in an additional 1,557. Participants were first recruited in the spring of 2022 and were asked to complete surveys every 6 months in addition to the baseline, resulting in 5 total waves of data across 2 years.
The study measured heavy drinking with a single question about the frequency of drinking 4+/5+ drinks for women and men, respectively. Similarly, it measured sports gambling frequency with a single question. Because only one item each was used to measure these behaviors and the items were not provided with the study, caution should be taken when interpreting the findings. For example, the degree of actual alcohol or gambling problems or consequences cannot be determined from these particular single-item measures. Nevertheless, at the very least, it did document changes in heavy drinking frequency and its relation to sports betting over time.
The authors wanted to examine trajectories, or changes in occurrence over time, of sports betting and heavy drinking frequency. The authors used a complex modeling approach to extract the initial level and the rate of change in sports betting and alcohol problems over time. The authors then looked at relationships between these initial levels and rate of change between the 2 phenomena. In all analyses, the authors controlled for age, education level, and gender.
Certain groups are more likely to engage in both heavy drinking and sports gambling
The sample was, on average, 49.6 years old and 49% of the census-matched sample was female or nonbinary, though only 38% of the sports gambling over-sample was female or nonbinary. As might be expected, males and younger people tended to have higher rates of heavy drinking and sports betting. Interestingly, those with higher levels of education also had the highest levels of these risk behaviors. For example, those with a 4-year college degree comprised 32% of the sports gambling over-sample but only 21% of the census-matched sample.
Changes in sports gambling tracked closely with changes in alcohol consumption
The graph below depicts the study’s results. At the initial assessment, sports betting and heavy drinking frequency were related to one another. This was also the case for each additional assessment that followed. Heavy drinking frequency reduced slightly over time, and there was not much variability across the sample. In other words, most people demonstrated this trend. Sports betting did not decline over time but rather remained stable. However, there was evidence that this was not the same across all people, and that some people increased while others decreased. Those who had higher levels of heavy drinking frequency at baseline had greater declines in heavy drinking frequency over time. Those who had higher levels of sports betting at baseline also had greater declines in sports betting over time. Change in heavy drinking frequency was strongly correlated with changes in sports betting (r = .61), suggesting that these 2 variables are likely to move together over time, and that an increase in one would lead to an increase in another.
The current sample included adults of any age, though the sample was, on average, close to 50 years of age. Alcohol consumption rises in late adolescence and peaks in emerging adulthood, and typically decreases over the rest of the lifespan. These findings mirror the general trend of reducing alcohol consumption across the lifespan. Sports betting did not increase or decrease among the sample during this time. This should not be taken to mean that sports betting did not increase across the United States; these analyses measured changes in gambling within a person already enrolled, suggesting that individual levels may have remained stable. However, it does not provide any data addressing increases more broadly in the population at large. Rising availability would suggest increasing prevalence rates of sports betting nationally, although there is no data available to specifically speak to this question.
One caveat important to mention was that alcohol use was measured with a single item of heavy drinking frequency and sports gambling measured with a single item of betting frequency. While this does not invalidate the study results, it does suggest caution should be made when interpreting the findings. That said, the results may suggest that alcohol problems may track closely with sports betting, with increases in one leading to increases in another. In other words, alcohol problems may be a risk factor for sports betting, and sports betting is a risk factor for alcohol problems. While there are traits, like impulsivity, that underlie both heavy alcohol use and gambling, which would explain why they change together, data suggest that social contexts for sports gambling may also promote heavy drinking while drinking disinhibits people and impairs judgment which can increase other behaviors like more risky and consequential gambling (e.g., bigger bets and losses). Irrespective of what explains the correlation, treatments and other services for each of these problem behaviors may consider assessing for and, as needed, addressing both phenomena simultaneously as one may be an important trigger for the other. Importantly, both sports betting and alcohol problems are often embedded within social contexts, suggesting that social network change interventions (e.g., increasing time spent with friends who do not drink heavily or gamble) may be used as treatment elements for both problem behaviors.
Those who are younger, who are men, and who have higher education, tended to have higher rates of heavy drinking and sports betting. These risk behaviors tend to go together and may change in tandem with reductions or increases in one behavior leading to reductions or increases in the other. Because of this strong relationship, interventions, whether at a policy or individual level, that target both behaviors may be more successful than interventions targeting either behavior in isolation.
Grubbs, J. B., Connolly, A. J., Graupensperger, S., Kim, H. S., & Kraus, S. W. (2025). Sports gambling and drinking behaviors over time. JAMA Psychiatry, 82(5), 526-530. doi: 10.1001/jamapsychiatry.2025.0024.
l
Since the first New Jersey law legalizing the activity in 2018, sports gambling is now legal in 39 US states. As would be expected, it has increased in prevalence across the US with as many as 1 in 5 US adults having gambled on sports in the past year. Sports betting is poised to significantly increase risk for the development of gambling disorder across the United States, considering its availability (e.g., on one’s smart phone), low barrier of entry (bets as low as $1, with free promotional bets offered to start), and significant “gamification” designed to increase engagement by making betting more like a game in and of itself.
Sports betting is also often intertwined with alcohol consumption, which appears to be a significant part of the sports betting culture. Alcohol consumption often precedes and simultaneously co-occurs with gambling behavior, which increase the chances of more risky gambling decisions. Though there appears to be a general risk of heavy alcohol consumption among those who gamble – where individual traits like impulsivity increases risk for both problem behaviors – those participating in sports betting may be at unique risk even relative to those who gamble in other ways. Indeed, people who sports gamble have higher rates of binge drinking and alcohol problems relative to those who do not gamble or those who gamble in ways other than sports betting. However, the relationship between sports betting and heavy drinking frequency over time has not been established; in other words, it is unclear if changes in one behavior would track with or influence changes in the other behavior. The current study was designed to look at this; specifically, to examine the trajectories of sports gambling frequency and heavy drinking frequency over time in a representative sample of US adults.
This was a nonrandomized, longitudinal study of 4,363 US adults. Sampling took place in 2 ways. First, a sample of US adults were recruited, stratified and matched to US norms for age, gender, education, census region, and race and ethnicity as of the 2019 American Community, which resulted in a sample of 2,806 US adults. Next, the authors oversampled sports gambling adults matched to the demographic data of sports gamblers from the census-matched sample, which resulted in an additional 1,557. Participants were first recruited in the spring of 2022 and were asked to complete surveys every 6 months in addition to the baseline, resulting in 5 total waves of data across 2 years.
The study measured heavy drinking with a single question about the frequency of drinking 4+/5+ drinks for women and men, respectively. Similarly, it measured sports gambling frequency with a single question. Because only one item each was used to measure these behaviors and the items were not provided with the study, caution should be taken when interpreting the findings. For example, the degree of actual alcohol or gambling problems or consequences cannot be determined from these particular single-item measures. Nevertheless, at the very least, it did document changes in heavy drinking frequency and its relation to sports betting over time.
The authors wanted to examine trajectories, or changes in occurrence over time, of sports betting and heavy drinking frequency. The authors used a complex modeling approach to extract the initial level and the rate of change in sports betting and alcohol problems over time. The authors then looked at relationships between these initial levels and rate of change between the 2 phenomena. In all analyses, the authors controlled for age, education level, and gender.
Certain groups are more likely to engage in both heavy drinking and sports gambling
The sample was, on average, 49.6 years old and 49% of the census-matched sample was female or nonbinary, though only 38% of the sports gambling over-sample was female or nonbinary. As might be expected, males and younger people tended to have higher rates of heavy drinking and sports betting. Interestingly, those with higher levels of education also had the highest levels of these risk behaviors. For example, those with a 4-year college degree comprised 32% of the sports gambling over-sample but only 21% of the census-matched sample.
Changes in sports gambling tracked closely with changes in alcohol consumption
The graph below depicts the study’s results. At the initial assessment, sports betting and heavy drinking frequency were related to one another. This was also the case for each additional assessment that followed. Heavy drinking frequency reduced slightly over time, and there was not much variability across the sample. In other words, most people demonstrated this trend. Sports betting did not decline over time but rather remained stable. However, there was evidence that this was not the same across all people, and that some people increased while others decreased. Those who had higher levels of heavy drinking frequency at baseline had greater declines in heavy drinking frequency over time. Those who had higher levels of sports betting at baseline also had greater declines in sports betting over time. Change in heavy drinking frequency was strongly correlated with changes in sports betting (r = .61), suggesting that these 2 variables are likely to move together over time, and that an increase in one would lead to an increase in another.
The current sample included adults of any age, though the sample was, on average, close to 50 years of age. Alcohol consumption rises in late adolescence and peaks in emerging adulthood, and typically decreases over the rest of the lifespan. These findings mirror the general trend of reducing alcohol consumption across the lifespan. Sports betting did not increase or decrease among the sample during this time. This should not be taken to mean that sports betting did not increase across the United States; these analyses measured changes in gambling within a person already enrolled, suggesting that individual levels may have remained stable. However, it does not provide any data addressing increases more broadly in the population at large. Rising availability would suggest increasing prevalence rates of sports betting nationally, although there is no data available to specifically speak to this question.
One caveat important to mention was that alcohol use was measured with a single item of heavy drinking frequency and sports gambling measured with a single item of betting frequency. While this does not invalidate the study results, it does suggest caution should be made when interpreting the findings. That said, the results may suggest that alcohol problems may track closely with sports betting, with increases in one leading to increases in another. In other words, alcohol problems may be a risk factor for sports betting, and sports betting is a risk factor for alcohol problems. While there are traits, like impulsivity, that underlie both heavy alcohol use and gambling, which would explain why they change together, data suggest that social contexts for sports gambling may also promote heavy drinking while drinking disinhibits people and impairs judgment which can increase other behaviors like more risky and consequential gambling (e.g., bigger bets and losses). Irrespective of what explains the correlation, treatments and other services for each of these problem behaviors may consider assessing for and, as needed, addressing both phenomena simultaneously as one may be an important trigger for the other. Importantly, both sports betting and alcohol problems are often embedded within social contexts, suggesting that social network change interventions (e.g., increasing time spent with friends who do not drink heavily or gamble) may be used as treatment elements for both problem behaviors.
Those who are younger, who are men, and who have higher education, tended to have higher rates of heavy drinking and sports betting. These risk behaviors tend to go together and may change in tandem with reductions or increases in one behavior leading to reductions or increases in the other. Because of this strong relationship, interventions, whether at a policy or individual level, that target both behaviors may be more successful than interventions targeting either behavior in isolation.
Grubbs, J. B., Connolly, A. J., Graupensperger, S., Kim, H. S., & Kraus, S. W. (2025). Sports gambling and drinking behaviors over time. JAMA Psychiatry, 82(5), 526-530. doi: 10.1001/jamapsychiatry.2025.0024.
l
Since the first New Jersey law legalizing the activity in 2018, sports gambling is now legal in 39 US states. As would be expected, it has increased in prevalence across the US with as many as 1 in 5 US adults having gambled on sports in the past year. Sports betting is poised to significantly increase risk for the development of gambling disorder across the United States, considering its availability (e.g., on one’s smart phone), low barrier of entry (bets as low as $1, with free promotional bets offered to start), and significant “gamification” designed to increase engagement by making betting more like a game in and of itself.
Sports betting is also often intertwined with alcohol consumption, which appears to be a significant part of the sports betting culture. Alcohol consumption often precedes and simultaneously co-occurs with gambling behavior, which increase the chances of more risky gambling decisions. Though there appears to be a general risk of heavy alcohol consumption among those who gamble – where individual traits like impulsivity increases risk for both problem behaviors – those participating in sports betting may be at unique risk even relative to those who gamble in other ways. Indeed, people who sports gamble have higher rates of binge drinking and alcohol problems relative to those who do not gamble or those who gamble in ways other than sports betting. However, the relationship between sports betting and heavy drinking frequency over time has not been established; in other words, it is unclear if changes in one behavior would track with or influence changes in the other behavior. The current study was designed to look at this; specifically, to examine the trajectories of sports gambling frequency and heavy drinking frequency over time in a representative sample of US adults.
This was a nonrandomized, longitudinal study of 4,363 US adults. Sampling took place in 2 ways. First, a sample of US adults were recruited, stratified and matched to US norms for age, gender, education, census region, and race and ethnicity as of the 2019 American Community, which resulted in a sample of 2,806 US adults. Next, the authors oversampled sports gambling adults matched to the demographic data of sports gamblers from the census-matched sample, which resulted in an additional 1,557. Participants were first recruited in the spring of 2022 and were asked to complete surveys every 6 months in addition to the baseline, resulting in 5 total waves of data across 2 years.
The study measured heavy drinking with a single question about the frequency of drinking 4+/5+ drinks for women and men, respectively. Similarly, it measured sports gambling frequency with a single question. Because only one item each was used to measure these behaviors and the items were not provided with the study, caution should be taken when interpreting the findings. For example, the degree of actual alcohol or gambling problems or consequences cannot be determined from these particular single-item measures. Nevertheless, at the very least, it did document changes in heavy drinking frequency and its relation to sports betting over time.
The authors wanted to examine trajectories, or changes in occurrence over time, of sports betting and heavy drinking frequency. The authors used a complex modeling approach to extract the initial level and the rate of change in sports betting and alcohol problems over time. The authors then looked at relationships between these initial levels and rate of change between the 2 phenomena. In all analyses, the authors controlled for age, education level, and gender.
Certain groups are more likely to engage in both heavy drinking and sports gambling
The sample was, on average, 49.6 years old and 49% of the census-matched sample was female or nonbinary, though only 38% of the sports gambling over-sample was female or nonbinary. As might be expected, males and younger people tended to have higher rates of heavy drinking and sports betting. Interestingly, those with higher levels of education also had the highest levels of these risk behaviors. For example, those with a 4-year college degree comprised 32% of the sports gambling over-sample but only 21% of the census-matched sample.
Changes in sports gambling tracked closely with changes in alcohol consumption
The graph below depicts the study’s results. At the initial assessment, sports betting and heavy drinking frequency were related to one another. This was also the case for each additional assessment that followed. Heavy drinking frequency reduced slightly over time, and there was not much variability across the sample. In other words, most people demonstrated this trend. Sports betting did not decline over time but rather remained stable. However, there was evidence that this was not the same across all people, and that some people increased while others decreased. Those who had higher levels of heavy drinking frequency at baseline had greater declines in heavy drinking frequency over time. Those who had higher levels of sports betting at baseline also had greater declines in sports betting over time. Change in heavy drinking frequency was strongly correlated with changes in sports betting (r = .61), suggesting that these 2 variables are likely to move together over time, and that an increase in one would lead to an increase in another.
The current sample included adults of any age, though the sample was, on average, close to 50 years of age. Alcohol consumption rises in late adolescence and peaks in emerging adulthood, and typically decreases over the rest of the lifespan. These findings mirror the general trend of reducing alcohol consumption across the lifespan. Sports betting did not increase or decrease among the sample during this time. This should not be taken to mean that sports betting did not increase across the United States; these analyses measured changes in gambling within a person already enrolled, suggesting that individual levels may have remained stable. However, it does not provide any data addressing increases more broadly in the population at large. Rising availability would suggest increasing prevalence rates of sports betting nationally, although there is no data available to specifically speak to this question.
One caveat important to mention was that alcohol use was measured with a single item of heavy drinking frequency and sports gambling measured with a single item of betting frequency. While this does not invalidate the study results, it does suggest caution should be made when interpreting the findings. That said, the results may suggest that alcohol problems may track closely with sports betting, with increases in one leading to increases in another. In other words, alcohol problems may be a risk factor for sports betting, and sports betting is a risk factor for alcohol problems. While there are traits, like impulsivity, that underlie both heavy alcohol use and gambling, which would explain why they change together, data suggest that social contexts for sports gambling may also promote heavy drinking while drinking disinhibits people and impairs judgment which can increase other behaviors like more risky and consequential gambling (e.g., bigger bets and losses). Irrespective of what explains the correlation, treatments and other services for each of these problem behaviors may consider assessing for and, as needed, addressing both phenomena simultaneously as one may be an important trigger for the other. Importantly, both sports betting and alcohol problems are often embedded within social contexts, suggesting that social network change interventions (e.g., increasing time spent with friends who do not drink heavily or gamble) may be used as treatment elements for both problem behaviors.
Those who are younger, who are men, and who have higher education, tended to have higher rates of heavy drinking and sports betting. These risk behaviors tend to go together and may change in tandem with reductions or increases in one behavior leading to reductions or increases in the other. Because of this strong relationship, interventions, whether at a policy or individual level, that target both behaviors may be more successful than interventions targeting either behavior in isolation.
Grubbs, J. B., Connolly, A. J., Graupensperger, S., Kim, H. S., & Kraus, S. W. (2025). Sports gambling and drinking behaviors over time. JAMA Psychiatry, 82(5), 526-530. doi: 10.1001/jamapsychiatry.2025.0024.
SIGN UP FOR THE BULLETIN
