Understanding the Overlap Between Cannabis Use and Gambling Behaviour: A Systematic Review of Empirical Findings and Consideration of Policy Implications

Relation of Cannabis Use Frequency and Gambling Behavior in Individuals Who Gamble Under the Influence of Cannabis

There appears to be a significant positive relation between problematic cannabis use and problem gambling behaviors. Recent reviews have noted that individuals who use cannabis more frequently may experience less acute executive functioning impairment than those who use cannabis less often. The current study explored the relation between cannabis use frequency and problem gambling outcomes in those who gamble under the influence of cannabis, to explore if increased cannabis use frequency increases reported gambling problems, or is the reported effect on their gambling behavior is lessened in individuals who consume cannabis regularly? 769 individuals who gambled at least weekly were recruited from a crowdsource platform. These individuals reported their gambling behavior and cannabis use. To explore the relation between cannabis use frequency and problem gambling severity, regression models following both a simple linear model and a quadratic model were generated and evaluated for model fit and significance. The quadratic model was found to best fit the relation between cannabis use frequency and problem gambling severity. The quadratic model was also found to best fit the relation between frequency of time spent gambling under the influence of cannabis and problem gambling severity. Those who consumed cannabis infrequently or very frequently reported fewer gambling problems overall compared to those who consumed cannabis at a moderate frequency. The acute relation between cannabis use and gambling may be more complex than simply amplifying problematic gambling behaviors.

Who Engages in Simultaneous Gambling and Alcohol Use, and Why? A Mixed-Method Study

Although previous studies have established the robust concurrent use of alcohol and gambling (i.e., using alcohol and gambling within a similar time period, but not together), there is a scarcity of empirical research focusing on the simultaneous use of alcohol while gambling (i.e., using alcohol while gambling). The wider substance use literature posits that the simultaneous use of substances is associated with increased severity of harm over concurrent use as well as greater social and behavioural consequences (Cummings et al., Journal of Psychoactive Drugs 51:351-359, 2019). The present study examined the psychological impact, mental health variables, and motives of simultaneously using alcohol on gambling behaviours in a sample of Canadian adults (N = 390). Participants who used alcohol while gambling were significantly more likely to endorse various facets of impulsivity, but specifically lack of premeditation. They were also more likely to gamble for enhancement and social reasons, and more likely to endorse greater alcohol use severity compared to those who did not. Interestingly, financial motives were a negative predictor, suggesting that people who gamble for financial reasons are less likely to engage in simultaneous alcohol use. The top reported reasons for using alcohol while gambling were to elicit positive emotions, to relax, and due to social circumstances. These findings corroborate previous work investigating simultaneous substance use and have potential implications for both policy and harm minimization by providing insight into the motivations for simultaneous gambling and alcohol use, and the greater harms resulting from simultaneous use.

Predictors of Change in Cannabis Use Status from Pre- to Post-Recreational Cannabis Legalization in Canada: Evidence from a Two-Wave Longitudinal National Survey

Objective

In October 2018, the Government of Canada legalized cannabis for recreational use nationwide. The effects of legalization on cannabis use have been primarily assessed through cross-sectional surveys.

Method

In the present study, a two-wave longitudinal design was used to explore potential demographic, substance use and behavioral addiction, and mental health predictors of change in cannabis use status following legalization. Canadian online panelists (18+) were initially surveyed about their gambling and substance use in 2018 (i.e., before cannabis legalization). From the original sample, 4,707 (46.2%) were retained in the follow-up survey one year later, post-cannabis legalization. These respondents were the focus of the present study.

Results

When queried about how legalization would impact their use, 61.8% said, 'I'll never use it', 21.1% stated "I'll use it about the same as I do now," 10.3% indicated, "I may try it for the first time," 5.0% answered, "I'll use it more," and 1.9% responded that, "I'll use it less." Consistent with these sentiments, within the retained sample there was a modest but significant increase in cannabis use from baseline (18.4%) to follow-up (26.1%). Regressions established that younger age, being male, substance use, tobacco or e-cigarette use, problematic gambling, and stated intention to use cannabis were predictors of later cannabis use.

Conclusions

This national cohort design indicates that cannabis use appears to have increased in Canada following legalization. The present study makes a unique contribution by also identifying variables that statistically forecast movement toward and away from cannabis use.

Risk-Taking, Social Support, and Belongingness Contribute to the Risk for Cannabis Use Frequency in University Students

Background: Cannabis use and misuse is known to be associated with a variety of negative health, academic, and work-related outcomes; therefore, it is important to study the factors that contribute to or moderate its use. Objectives: The aim of this study was to determine whether risky behavior, belongingness and social support as clustering variables play a role in cannabis use frequency. Method: In a university student sample, participant data on risky behavior, belongingness and social support were used to generate vulnerability profiles through cluster analysis (low vulnerability with low risk, low vulnerability with high belonging, moderate vulnerability, and high vulnerability). Using an analysis of variance, the vulnerability profiles were compared with respect to cannabis use frequency and quantity. Through chi-square tests we assessed whether these profiles are overrepresented in certain demographics. Results: The cluster analysis yielded four groups, which differed in their vulnerability for cannabis use. The most vulnerable cluster group had higher cannabis use frequency relative to the two least vulnerable groups. Low income vs. high income was also associated with high vulnerability group membership. International students were overrepresented in the low vulnerability with high belonging group relative to the low vulnerability with low-risk group. The opposite was observed for domestic students. Conclusions: This research adds to the expanding body of literature on cannabis use and misuse in Canada, which may contribute to public health policy and the prevention and treatment of cannabis addiction by providing new insight on who may be at risk.

Cannabis use in repeated representative cross-sectional studies on Italian adults after the COVID-19 pandemic

Lockdown measures in response to the COVID-19 pandemic in 2020 yielded dramatic changes in drug consumption. A cross-sectional study was conducted on a representative sample of 6003 Italian adults (18-74 years) in April-May 2020 - reporting information before lockdown and at the time of interview - and two years later (i.e., in February-March 2022). Italian adults using cannabis decreased from 7.0% in pre-pandemic to 5.9% during lockdown (percent change -15.7%) and to 6.7% in 2022 (-4.3%). The reduction was particularly evident among adults aged 55-74 years, whereas cannabis use strongly increased among those aged 18-34 years. In the last period considered (2022), cannabis use was significantly more frequent in men (adjusted odds ratio, OR = 1.43), adults aged 18-34 years (p-trend <0.001), individuals with a low or high level of education (OR = 1.42 and 1.46, respectively), those from Central or Southern Italy/islands (OR = 1.50 and 1.38, respectively), and those with an economic status above the average (OR = 3.07). In 2022, cannabis use was also more frequently reported in current smokers (OR = 3.52), current e-cigarette and heated tobacco product users (OR = 6.09 and 2.94, respectively), individuals with a risky alcohol consumption (OR = 4.60), gamblers (OR = 3.76), those with anxiety and depression (OR = 2.50 and 2.80, respectively), those using psychotropic drugs (OR = 8.96), those with a low quality of life (OR = 1.91), and those sleeping less (OR = 1.42). After the COVID-19 pandemic, cannabis use was more frequent in individuals with other addictive behaviours, and with anxiety and depressive symptoms.

A call for qualitative and mixed-methods research on gambling and cannabis

Gambling disorder and cannabis use disorder are both considered major public health issues. Despite the well-documented frequency of substance use disorders among people with gambling disorder, little is known about the experiences of those who both engage with gambling and cannabis. A scoping review was undertaken to investigate studies focusing on the experiences of people who gamble and use cannabis. Unexpectedly, no qualitative or mixed-methods studies that included an in-depth qualitative component to study the lived experiences of this population were found. This absence highlights the critical need to diversify research methods and fill the gap in knowledge of the lived experiences of people who both gamble and consume cannabis.

Problem gambling severity, gambling behavior, substance use, and mental health in gamblers who do and do not use cannabis: Evidence from a Canadian national sample

INTRODUCTION

Cannabis use frequently co-occurs with gambling, and evidence indicates that both acute and chronic cannabis use may influence gambling behavior. The primary aim of the present study was to further contribute to the literature on this relationship by examining data collected from a Canadian national study of gambling.

METHODS

Respondents consisted of 10,054 Canadian gamblers recruited from Leger Opinion's (LEO) online panel. In this study, gamblers who used cannabis were compared with non-users across a number of gambling as well as demographic and mental health variables.

RESULTS

Of the total sample, 25.4 % reported past 12-month cannabis use. Among the 2,553 cannabis-users, 21.3 % reported daily use, and 69.9 % reported using once a month or more. A total of 56.2 % indicated they had used cannabis while gambling in the past 12 months. Bivariate analysis found significant differences between cannabis use and non-use on numerous demographic, mental health, and gambling-related variables. Individuals with greater problem gambling severity scores, more hours gambling, and a larger range of gambling activities were more likely to endorse using cannabis. Hierarchical logistic regression revealed that tobacco use, and having experienced significant child abuse were predictors of cannabis use. Non-use of cannabis was associated with older age, less engagement in online gambling, and being less likely to consume alcohol.

CONCLUSION

The present findings both corroborate previous studies and expand upon the relationship between cannabis and gambling.