Aims: Research indicates that shared and specific underlying factors influence different addictions, sometimes resulting in co-occurring problems. The evidence concerning risk and protective factors for gambling and alcohol addiction, along with their co-occurrence, remains ambiguous. To address this gap, this study will conduct longitudinal research to examine the factors associated with at-risk behaviours over time.
Methods: We utilize a sample of 18- to 75-year-old participants (N = 1530) from Finland. Participants were surveyed every six months between 2021 and 2023, covering six rounds of data collection (in total 6650 observations). Measures included the Alcohol Use Disorders Identification Test and the Problem Gambling Severity Index. The analysis used multilevel regression models to investigate risk and protective factors over time.
Results: Based on population-average models, younger age and being a man were associated with all examined dependent variables. Psychological distress, a sense of belonging to family and friends, and belonging to an online community were associated with at-risk gambling. At-risk drinking was associated with education and income, marital status, and the sense of belonging to family and friends. Being in debt enforcement, education, and psychological distress were associated with the co-occurrence of the two addictive behaviours. The fixed effects highlighted the importance of psychological distress in the development of co-occurring gambling and drinking problems.
Conclusion: The findings indicate that partly different sociodemographic and psychosocial factors are important underlying contributors to alcohol and gambling problems. Psychological distress is a particularly crucial factor predicting co-occurring at-risk gambling and drinking, indicating that co-occurrence is accompanied by psychological burden.
Keywords: at-risk drinking; at-risk gambling; co-occurring addiction; longitudinal design.
© The Author(s) 2025. Medical Council on Alcohol and Oxford University Press.