A study published in Journal of Developmental & Behavioral Pediatrics links gambling and substance use disorders among middle school students. The study followed 1,325 students in 6th, 7th and 8th grades in an Italian school system. All of the study participants were also a part of the school’s drug and alcohol prevention program.

The students were surveyed about their experiences with gambling, specifically if they ever bet online, used scratch lottery tickets or played video poker. The students were also surveyed about drug, alcohol and tobacco use. The results showed that there is a high rate of gambling in this age group. About 35 percent of girls and 46 percent of boys in eighth grade participated in some sort of gambling. The most common form was scratch lottery tickets. Those who admitted to gambling also reported a higher rate of substance use. Around 60 percent of the gambling students smoked cigarettes, 63 percent smoke marijuana and 73 percent consumed alcohol.

Additional studies with older participants also link gambling and substance use disorders.