Gambling and Substance Use: Early Evidence From Sports Betting Laws

Previous research documents a strong association between gambling and substance use, suggesting that these seemingly distinct behaviors may share similar environmental, neurobiological, and genetic causes. However, there is a dearth of credible empirical evidence on whether gambling has a causal impact on substance use or vice versa. This paper estimates the impact of gambling on substance use making use of the rapid roll-out of sports betting laws across US states. Using data from the Behavioral Risk Factor Surveillance System and a difference-in-difference (DID) estimation strategy to assess the impact of legalizing sports betting on smoking and drinking behavior among adults, we find that the legalization of online sports betting has increased binge drinking frequency-at the intensive margin among young men by approximately 10 percent, but find no discernible impact on smoking. The results are consistent across traditional two-way fixed effects models as well as more recently developed DID methods designed for staggered treatment adoption.

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Publication Details

Journal
Health Economics
Published
2026-03-11
DOI
https://doi.org/10.1002/hec.70088
Primary Topic
Gambling Behavior and Treatments
Type
article
Field-Weighted Citation Impact
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article

Gambling and Substance Use: Early Evidence From Sports Betting Laws

Keshar Ghimire, Kabir Dasgupta
Health Economics
Gambling Behavior and Treatments
article

Gambling and Substance Use: Early Evidence From Sports Betting Laws

Keshar Ghimire, Kabir Dasgupta
article en

Abstract

Previous research documents a strong association between gambling and substance use, suggesting that these seemingly distinct behaviors may share similar environmental, neurobiological, and genetic causes. However, there is a dearth of credible empirical evidence on whether gambling has a causal impact on substance use or vice versa. This paper estimates the impact of gambling on substance use making use of the rapid roll-out of sports betting laws across US states. Using data from the Behavioral Risk Factor Surveillance System and a difference-in-difference (DID) estimation strategy to assess the impact of legalizing sports betting on smoking and drinking behavior among adults, we find that the legalization of online sports betting has increased binge drinking frequency-at the intensive margin among young men by approximately 10 percent, but find no discernible impact on smoking. The results are consistent across traditional two-way fixed effects models as well as more recently developed DID methods designed for staggered treatment adoption.

Health Economics
Milacron (United States) (US), Federal Reserve (US)
Good health and well-being
Openalex Percentile: Top 30%
Gambling Behavior and Treatments
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