title: Independent Versus Co-occurring Substance Use in Relation to Gambling Outcomes in Older Adolescents and Young Adults.
abstract: OBJECTIVE
  Gambling is prevalent among college students and can be associated with significant negative consequences. Students who report gambling also tend to report use of alcohol and cannabis, but little research has explored the associated risks of using these substances in relation to gambling episodes. This study explored associations between the independent and co-occurring use of alcohol and cannabis before/during gambling episodes and gambling outcomes.
  
  
  METHODS
  Students (n = 1,834) completed an online survey that included measures of gambling frequency, amount lost, negative gambling consequences, gambling problem severity, and substance use.
  
  
  RESULTS
  As hypothesized, individuals who reported using either alcohol or cannabis alone or both substances before/while gambling endorsed greater gambling quantity, frequency, negative consequences, and problem severity than individuals who used alcohol and cannabis in general but denied use of either substance before/while gambling. Use of both substances compared to use of alcohol alone was associated with greater gambling quantity, frequency, and negative consequences, although these groups did not differ on gambling problem severity. Cannabis use alone was no different on any outcome than use of both substances, and alcohol use alone was no different than cannabis use alone on any outcome.
  
  
  CONCLUSIONS
  Use of cannabis alone before/while gambling may confer the same level of risk for negative gambling outcomes as use of both cannabis and alcohol. Prevention efforts may, therefore, benefit from targeting cannabis use in relation to gambling. Additional investigation is needed in light of recent and upcoming state legislation on the legalization of cannabis.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington. Electronic address: jcronce@uoregon.edu.
authors.forename: Jessica M
authors.initials: JM
authors.lastname: Cronce
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington.
authors.forename: Joyce N
authors.initials: JN
authors.lastname: Bittinger
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington.
authors.forename: Cory M
authors.initials: CM
authors.lastname: Di Lodovico
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington.
authors.forename: Junny
authors.initials: J
authors.lastname: Liu
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology; D000428:Alcohol Drinking / Q000453:epidemiology*; D015897:Comorbidity; D005260:Female; D005715:Gambling / Q000191:economics / Q000453:epidemiology*; D006801:Humans; D008297:Male; D000074609:Marijuana Use / Q000453:epidemiology*; D012309:Risk-Taking; D057566:Self Report; D012720:Severity of Illness Index; D013334:Students / Q000706:statistics & numerical data; D055815:Young Adult
keywords: Adolescents; Alcohol; Cannabis; Gambling; Young adults