Alcohol Use Associated With Gambling Harm in a Population Representative Australian Sample

INTRODUCTION: This study examined whether alcohol use while gambling and engaging in heavy episodic drinking (HED) are associated with gambling harm in Victoria, Australia. It also explored whether combined alcohol use behaviours further increase harm, and whether economically disadvantaged individuals experience greater harm from alcohol use. METHODS: Data were used from the representative 2023 Victorian Population Gambling and Health Study subsample (N = 3114; 47.9% female; mean age = 46). Regressions were used to test whether HED (six or more drinks per occasion) and drinking while gambling predicted gambling harm and number of harms, measured using the Short Gambling Harm Screen. RESULTS: Alcohol use while gambling was associated with gambling harm (OR = 2.58, 95% CI [1.53, 4.35], p < 0.001) and number of harms (IRR = 2.57, 95% CI [1.65, 4.00], p < 0.001), controlling for HED, gambling expenditure and socio-demographic variables. HED was associated with harm in bivariable models only (OR = 2.20, p < 0.001), not in adjusted models. The interaction between HED and consuming alcohol while gambling was associated with increased gambling harm. DISCUSSION AND CONCLUSIONS: Drinking while gambling was associated with increased gambling harm, as were combined alcohol use behaviours. HED was not independently associated with harm. Those with heavier drinking patterns who also consumed alcohol while gambling were at particularly elevated risk. Findings are consistent with restricting alcohol use in gambling venues to reduce gambling-related harm.