Recent research has unveiled a significant correlation between alcohol consumption patterns and sports betting behaviors, suggesting a troubling relationship that warrants public health attention. A comprehensive two-year longitudinal study conducted by researchers from the JAMA Network’s JAMA Psychiatry division has discovered that alcohol-related problems and sports gambling frequency tend to follow similar patterns, with increases in one corresponding to increases in the other. This synchronous relationship raises important questions about the combined impact these behaviors might have on public health as sports betting continues to expand across the United States.
The Expanding Landscape of Sports Betting in America
The sports betting industry has undergone dramatic expansion since the Supreme Court’s landmark decision to strike down the Professional and Amateur Sports Protection Act (PASPA) on May 14, 2018. This pivotal ruling, which determined that the 1992 law violated states’ rights, opened the floodgates for legalized sports betting across the country. Prior to this decision, Nevada stood as the only state offering comprehensive legal sports betting options. Now, just seven years later, 38 states plus Washington DC have legalized sports betting, with 30 of these jurisdictions offering online or mobile options that make placing wagers more accessible than ever before.
This rapid proliferation represents the fastest expansion of gambling in American history, transforming sports betting from a shadowy activity into a mainstream element of American sports culture. The industry’s growth is reflected in its staggering financial performance, with nationwide sports betting revenue reaching a record-breaking $13.71 billion in 2024—a 25.4% increase compared to the $11.04 billion generated in 2023. The final quarter of 2024 proved especially lucrative, with sportsbooks earning $3.66 billion during the fall sports season alone. States like New Jersey and Illinois marked significant milestones by surpassing $1 billion in annual sports betting revenue for the first time in 2024.
Methodology and Scope of the JAMA Psychiatry Study
The JAMA Psychiatry study that identified the relationship between alcohol consumption and sports betting behaviors employed a rigorous methodology to track these patterns over time. Conducted in the United States from 2022 to 2024, this two-year longitudinal study followed 4,363 American participants, comprising 2,243 males and 2,120 females or nonbinary individuals. These participants were recruited from nonprobability internet panels utilizing two distinct sources to ensure demographic diversity.
Researchers employed latent growth curve modeling to identify trajectories within both betting behaviors and alcohol consumption patterns. Data collection occurred at regular six-month intervals throughout the study period, allowing researchers to track changes in behavior over time. At each assessment point, participants were evaluated using the National Institute on Drug Abuse–modified Alcohol, Smoking, and Substance Involvement Screening Test 2 (ASSIST), a validated screening tool developed by the World Health Organization for detecting problematic substance use.
The ASSIST tool consists of eight questions that assess problematic substance use over the past three months and lifetime, making it an appropriate instrument for tracking changes in alcohol consumption patterns. This screening approach allowed researchers to identify the frequency of sports betting activities alongside various alcohol-related problems, creating a comprehensive dataset for analyzing how these behaviors evolved together over the two-year study period.
Key Findings on the Correlation Between Alcohol Use and Sports Betting
The study’s central finding revealed a strong positive correlation between sports gambling frequency and alcohol-related problems. Professor Joshua Grubbs, a key researcher involved in the study, emphasized that these behaviors “move very closely together” and are “very tightly connected,” suggesting a significant relationship that persists over time. The data demonstrated that individuals who increased their sports gambling frequency were simultaneously experiencing more alcohol-related problems, including more frequent binge drinking, heavier drinking episodes, and greater overall alcohol consumption compared to non-gamblers or those who gamble but do not bet on sports.
According to the JAMA Network researchers, the trajectories of alcohol-related problems and sports gambling did not move independently but rather showed a highly positive correlation, with increases in one corresponding to increases in the other. This synchronous relationship suggests that as individuals engage more frequently in sports betting activities, they simultaneously experience greater interference in their lives from alcohol use, more relationship problems due to drinking, and more instances of heavy alcohol consumption.
While the researchers caution that they cannot establish a causal relationship—meaning they cannot definitively state that sports gambling causes increased drinking or vice versa—they emphasize that the tight correlation between these behaviors over time strongly suggests they are interrelated phenomena. The time component of this study is particularly valuable, as Professor Grubbs notes that the tight connection between these behaviors suggests that reducing one might lead to reductions in the other.
The Growing Epidemic of Gambling Addiction in the United States
The findings from the JAMA Psychiatry study take on added significance when viewed in the context of America’s growing gambling addiction crisis. According to the National Council on Problem Gambling (NCPG), approximately 2 million adults in the United States are now severely addicted to gambling, while an additional 4-6 million people experience mild to moderate gambling problems. Perhaps most alarming is the 30% increase in gambling problems recorded between 2018—when sports betting was first widely legalized—and 2023, highlighting the potential public health consequences of expanded betting access.
The impact on younger demographics appears particularly concerning. In New Jersey, which was the first state to legalize sports betting, the proportion of individuals under 25 seeking help from gambling support services increased dramatically from 11.5% in 2018 to 19.6% in the first ten months of 2023. This suggests that younger adults may be especially vulnerable to developing problematic gambling behaviors as sports betting becomes more accessible and culturally normalized.
Rising Concerns Evidenced Through Addiction Help Searches
Beyond clinical diagnoses and support service utilization, researchers have identified another indicator of growing gambling-related problems: online searches for help with gambling addiction. A study by University of California San Diego medical researchers revealed a 23% increase in Google searches for queries like “am I addicted to gambling” between 2018 and June 2024. This trend appears directly linked to the expansion of sports betting access, as individual states consistently showed spikes in addiction help searches following the introduction of legal sportsbooks.
The impact varies significantly by state, with some jurisdictions experiencing dramatic increases in help-seeking behavior. Ohio saw a 67% increase in gambling addiction help searches, while Pennsylvania and Massachusetts experienced increases of 50% and 47%, respectively. Particularly noteworthy is the finding that online sports betting appears to drive substantially greater increases in addiction help searches compared to traditional brick-and-mortar sportsbooks. In Pennsylvania, for example, the introduction of retail sportsbooks led to a 33% rise in searches for gambling addiction help, while the subsequent introduction of online sports betting triggered a much larger 61% surge in such searches.
High-Risk Demographics and Behavioral Patterns
The research identifies a specific demographic profile at elevated risk for developing problematic patterns involving both sports gambling and alcohol consumption. According to Professor Grubbs, sports gambling particularly appeals to “high-risk” individuals who tend to display greater impulsivity in general, potentially predisposing them to a range of risky behaviors. This high-risk group predominantly consists of younger males in their 20s and 30s who have disposable income, making sports gambling especially appealing to them.
Individuals in this demographic are not only more likely to engage in sports betting but also more prone to participate in other types of substance use, experience gambling-related problems, and engage in high-risk financial activities such as cryptocurrency trading. This suggests that certain personality factors and demographic characteristics may create a perfect storm for the development of co-occurring problematic behaviors around both alcohol use and sports betting.
Screening Tools and Intervention Approaches
The correlation between alcohol-related problems and sports betting behaviors underscores the importance of effective screening and intervention approaches. The ASSIST tool used in the JAMA Psychiatry study represents one of several validated screening measures for substance use and gambling harm. Originally developed for use in clinical settings, particularly primary care, the ASSIST can be administered by any health worker in approximately 5 to 10 minutes, making it a practical tool for identifying individuals who may be at risk.
In addition to the ASSIST, other screening tools like the Alcohol Use Disorders Identification Test (AUDIT) can help identify problematic alcohol consumption patterns that might co-occur with gambling behaviors. The AUDIT focuses specifically on alcohol use, consumption, dependence, and related problems in the past year, providing a complementary assessment approach.
Given the findings from the JAMA Psychiatry study, researchers recommend implementing screening and treatment interventions specifically targeted at sports bettors who also consume alcohol. The tight correlation between these behaviors suggests that integrated treatment approaches addressing both issues simultaneously might be more effective than addressing each behavior in isolation.
Public Health Implications and Future Directions
As sports betting continues to expand across the United States and becomes increasingly embedded in American sports culture, the findings from this research highlight the importance of understanding the potential public health consequences. The parallel trajectories of alcohol use problems and sports betting frequency suggest that public health approaches may need to consider these behaviors as interconnected rather than separate issues.
While the research cannot establish causality, the strong correlation between these behaviors over time provides valuable insights for both prevention and intervention efforts. As Professor Grubbs suggests, the tight connection between these behaviors implies that reducing one might lead to reductions in the other. This insight could inform more effective treatment approaches for individuals experiencing problems with both sports betting and alcohol use.
As the sports betting industry continues its rapid growth—with an estimated 68 million Americans betting on the Super Bowl alone in early 2025—understanding and addressing these interconnected health risks becomes increasingly important. The findings from the JAMA Psychiatry study offer a crucial foundation for developing evidence-based policies and interventions to mitigate the potential harms associated with the expanding availability of sports betting in America.
