RESEARCH QUESTIONS
How do simultaneous drinking and gambling influence gambling pathology? What types of gambling are preferred by those who drink and gamble simultaneously?

PURPOSES
In the present study the influence of simultaneous drinking and gambling on gambling pathology was examined. This study also identified the types of gambling preferred by those who drink and gamble simultaneously.

HYPOTHESIS
None stated.

PARTICIPANTS
Participants were 2,631 US residents aged 18 or older (52% males) who participated in a national random-digit-dial telephone survey.

PROCEDURE
A national random-digit-dial telephone survey was conducted with a representative sample of US residents aged 18 or older from August 1999 to October 2000. The respondents were recruited by selecting randomly from among the adults in each household. Of all the households contacted that had a resident aged 18 or older, 65% yielded an interview. The interviews were conducted by trained interviewers in a Computer-Assisted Telephone interviewing facility at a Research Institute on Addictions. The survey assessed: whether individuals lived in an urban residence, socioeconomic status, gambling and alcohol use behaviours, cigarette use, and drug use. 

MAIN OUTCOME MEASURES
The measure of urban residence was based on the percentage of the persons living on the respondent's census block group that were classified as living in an urban place of residence. Socioeconomic status was based on three equally weighted factors: family income, years of education, and occupational prestige. Gambling frequency was assessed via the total number of times that a type of gambling was played in the past year. For particular games, respondents were asked how much they spent the last time they played the game, whether they won or lost, how much they won. For frequency of drinking and gambling at the same time, participants were asked how often in the past 12 months they had engaged in drinking and gambling at the same time. The 13-item Diagnostic Interview Schedule for PG was used to measure PG (those who endorsed ≥ 5 PG criteria were classified as having PG). To assess alcohol consumption, respondents were asked how frequently they drank each of five types of alcoholic beverages in the past year, as well as how much they drank of each on each occasion. Questions also assessed cigarette smoking per day. For drug frequency, participants were asked how many times they had used four different types of drugs in the past year. Finally, the measures of alcohol abuse and dependence and drug abuse and dependence came from the Diagnostic Interview Schedule for DSM-IV criteria. Alcohol or drug abuse was signified by the occurrence of one or more serious negative consequences. Alcohol or drug dependence was signified by the occurrence of three or more signs of dependence.

KEY RESULTS
Males were more likely than females to drink while gambling. Simultaneous drinking and gambling was more closely associated with video keno, pull tabs, dice (not in a casino) and casino gambling than with other types of gambling. Those who drank while gambling were more likely to be problem gamblers, even when frequency of gambling, size of the average win or loss, and average alcohol consumption was accounted for. Those gamblers who were drinkers, but who did not drink while gambling, had a prevalence of problem gambling of close to zero. They had a lower prevalence of problem gambling than gamblers who didn't drink alcohol at all in the past year, and a much lower prevalence than those who drank while gambling.

LIMITATIONS
In addition to the reliance on self-report and possible vulnerability to non-response bias shared by all surveys, a limitation of one of the variables, the average size of last win or loss was based only on the last occasion of each type of gambling; if the respondent visited a casino 10 times in the year before the interview, the measure reflected only the last visit. This study did not consider broad cultural and community influences that may bear on the relationship between drinking and gambling.

CONCLUSIONS
Simultaneous drinking and gambling is associated with more reckless gambling. The results did not support the theory that gambling while under the influence of alcohol is the cause of more risky gambling behavior.