TOPLINE:

The legalization of online sports betting was causally linked to an approximately 10% increase in binge drinking frequency among men aged 35 years or younger, especially in existing binge drinkers, with no impact on smoking behavior, new research showed. Effects were more pronounced in men who were Black, unmarried, or not college-educated.

METHODOLOGY:

• Researchers assessed the effects of legalizing sports betting on substance use by analyzing nationally representative data from the Behavioral Risk Factor Surveillance System (BRFSS) between 2016 and 2023.
• Participants were categorized based on exposure to sports betting laws, including “any legalization” and “online legalization,” with comparisons made between states that had and had not yet legalized betting under a staggered policy implementation.
• Measures of tobacco use included lifetime smoking of more than 100 cigarettes, current smoking status, and smokefree tobacco use; alcohol use measures included number of drinking days in the past 30 days, drinks per day, and binge drinking frequency and prevalence.
• The analysis was controlled for sociodemographic and state-specific factors.

TAKEAWAY:

• The legalization of online sports betting was causally associated with a significantly increased frequency of binge drinking among young men aged 35 years or younger who were already engaged in binge drinking behavior (average treatment effect, 0.46 binge drinking days), representing approximately a 10% increase relative to the pretreatment average of 4.6 binge days (P < .01). No such association was found in young women.
• Among young men, statistically significant increases in binge drinking frequency were observed in those who were Black individuals (P < .01), aged 25-34 years (P < .05), unmarried (P < .05), and not college-educated (P < .01).
• There were no associations between legalization of sports betting, whether online or retail, and smoking behavior or use of smokefree tobacco in the full sample or any demographic subgroups examined.

IN PRACTICE:

“We provide early causal evidence on the relationship between expanded gambling opportunities and substance use behaviors,” the investigators wrote.

“These findings suggest that the public health impact of [sports betting laws] may manifest in targeted ways — notably through elevated alcohol consumption in young males who already are heavy drinkers — rather than as broad‐based increases in all forms of substance use,” they added.

SOURCE:

This study was led by Kabir Dasgupta, Federal Reserve Board, Washington, DC. It was published online on March 11 in Health Economics.

LIMITATIONS:

The analysis captured only the initial years after sports betting legalization; therefore, longer-term effects remained uncertain. Additionally, the BRFSS data were based on self-reported behaviors, possibly understating true consumption levels.

DISCLOSURES:

The investigators reported receiving no funding and having no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.