Marijuana and Gambling Associations from Connecticut High School Survey data Iris M. Balodis

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Marijuana and Gambling Associations from Connecticut High School Survey data Iris M. Balodis Assistant Professor Peter Boris Centre for Addiction Research Department of Psychiatry and Behavioural Neurosciences McMaster University

Papers

Gambling is Common in Adolescence 80%+ adolescents report lifetime gambling Gambling Disorder (GD): 1-4% in general adult population At-Risk / Problem Gambling (ARPG) 21% in adolescence/young adulthood Poor social, occupational functioning Co-occurring psychiatric conditions (Desai & Potenza, 2008; Ellenbogen, Gupta & Derevensky, 2007; Jackson, Dowling Tomas Bond & Patton, 2008; Petry Stinson & Grant, 2005; Shaffer & Korn, 2002; Yip, White, Grilo & Potenza, 2011).

Smoking is Common in Adolescence 50%+ of high school students have tried smoking 1/6 currently smoke Most adults who smoke started in adolescence Associated with negative psychiatric and medical measures Few studies have examined relationships between gambling and smoking in adolescents (CDC, 2012; Lantz, 2003; Schoenborn et al., 2013)

Smoking is Common in Adolescence First adolescent study to examine gambling behaviours and attitudes by smoking status and problem gambling severity

High School Survey Methodology Survey data from Connecticut high school students (N = 1591) 154-item self-report survey Gambling behaviours, types, locations, triggers, motivations Any game you bet on for money OR anything else of value Grouped by gambling status: At-risk/Problem Gambling (ARPG) Low-risk Gambling (LRG) Smoking status Current Smokers Non-Smokers

At-Risk/Problem Gambling (ARPG) adolescents who smoke: (compared to ARPG who don t smoke) Gambling types & locations: Slot machine, poker machine Strategic gambling online, school & casino Gambling in response to triggers: Feeling pressure to gamble Gambling to relieve anxiety Gambling partners With strangers & alone time spent gambling Earlier gambling onset scratch-offs & lottery tickets Perceived parental approval endorsement of PG prevention measures

Low-Risk Gambling (LRG) adolescents who smoke: (compared to LRG who don t smoke) Gambling types & locations: Non-strategic gambling school gambling Gambling in response to triggers: Gambling to relieve anxiety Gambling reasons: financial reasons Gambling partners With friends & alone time spent gambling Earlier onset of gambling scratch-offs & lottery tickets Perceived parental disapproval endorsement of PG prevention measures

Smoking is associated with more severe gambling behaviours in adolescents Smoking as clinical indicator more severe/problematic gambling in adolescence Integrating smoking information into prevention and intervention efforts with all adolescent gamblers.

Marijuana Use is Common in Adolescence 43% report lifetime use 5% report weekly, or daily use Source: 2012 Canadian Community Health Survey Mental Health

Connecticut High School Survey First study to systematically examine relationships between adolescent marijuana use and, problem gambling severity Range of health/functioning and gambling-related variables 2252 Respondents Lifetime Marijuana Use Have you ever smoked marijuana? Yes = lifetime marijuana user 993 (44.1%) No= lifetime marijuana non-user 1259 Problem Gambling Severity Non-gambling 392 (17.4%) Low-risk gambling 1233 (54.8%) At-risk problem gambling 627 (27.8%) Hammond et al., 2014

Adapted from Hammond et al., 2014 Results Marijuana Rates and Problem Gambling 44% reported life-time marijuana use 63% in past 30 days Adolescents with past 30 days marijuana use Daily 26% 3-6 mes/ week 14% No Regular Marijuana Use 33% 1-2 mes/ week 27% Gambling groups At-risk/ problem gambling 28% Nongambling 17% Low-risk gambling 55% Problem gambling severity is associated with marijuana use ARPG group greater in the marijuana-use group (35% vs 22%)

Gambling Behaviours & Motivations in Marijuana-use & Non-use groups

Gambling behaviours in both marijuanausing and non-using groups ARPG vs LRG adolescents: Engage in strategic, non-strategic and machine gambling Gamble online, at school, casino Have motivations of excitement, escape/reduction of dysphoria, financial reasons, social reasons for gambling Gamble to reduce anxiety Gamble with family, other adults, strangers and alone Spend significantly more time gambling

Health/functioning measures in both marijuana-using and non-using groups Elevated odds in LRG and ARPG groups (vs NG) Cigarette smoking Alcohol use Other drug use Caffeine Aggression Depression Participation in extracurricular activities

Health/Functioning Measures: Marijuana-Gambling Group Interactions Marijuana-using group reported greater impairment across health/functioning measures BUT weaker associations with problem gambling severity Suggests that some problem-gambling-related impairments may be attributable to marijuana use

Limitations/Future Directions Cross-sectional no causal determinations Self-report responder bias, under-, over-reporting Not nationally-representative Non-response bias Non-diagnostic/dichotomous measures Exclusion of special groups Examining potential mediators Data from early 2000 s Gambling landscape changes Marijuana landscape changes Longitudinal research How marijuana use modifies gambling behaviours

Motivational Neurocircuitry Chambers, Taylor & Potenza, 2003

Clinical Implications / Future Studies Parental permissiveness/approval Increase screening for gambling and substance use Integrated approach in systems of care Limit gambling availability and gambling access to venues

Thank you Marc Potenza Corey Pilver Christopher Hammond Christine Franco Lori Rugle Marv Steinberg Linda Mayes Robert Malison Suchitra Krishnan-Sarin Rani Hoff Andrea Weinberger Jeremy Wampler James MacKillop Michael Amlung