It’s Not Just Your Wallet: Sports Gambling Linked to a Surprising Health Risk for Men Under 35

Online sports betting may be pushing some young men to drink more heavily, according to a new study that adds to growing concerns about the public health effects of legalized gambling in the United States.

Researchers say the findings highlight how the rapid expansion of sports betting—especially through smartphone apps—may influence behaviors that extend well beyond gambling itself. Keshar Ghimire, the study’s senior author and an economist at the University of Cincinnati, says the rise of online betting platforms could “have spillover effects beyond gambling itself.”

The Rise of Sports Betting

The sports betting industry has grown dramatically since 2018, when the U.S. Supreme Court struck down a federal ban on the practice in the landmark case Murphy v. National Collegiate Athletic Association. Since then, states have rushed to legalize the activity, creating a fast-growing industry that is increasingly centered around online betting platforms.

Americans wagered nearly $41 billion on sports betting in the first quarter of 2025 alone, according to one estimate. Much of that activity is concentrated among younger men. A 2024 survey found that about one in four men age 30 or younger participate in online sports betting.

Because that same demographic group already shows higher rates of risky drinking behaviors, researchers have begun examining whether the spread of sports betting laws could influence alcohol consumption patterns. Policymakers and public health experts have increasingly warned that the harms associated with sports betting might not affect all groups equally.

The new study set out to explore whether legalizing sports betting changes patterns of alcohol and tobacco use. While past research has documented a strong correlation between gambling and substance use, the direction of that relationship has been harder to prove.

Study Finds Concerning Results

To investigate, the researchers analyzed data from the Centers for Disease Control and Prevention’s Behavioral Risk Factor Surveillance System, a large national survey that tracks health behaviors among adults across all 50 states and Washington, D.C. The team compared states that legalized sports betting with those that had not yet done so, looking at survey responses between 2016 and 2023.

Using a statistical method known as a difference-in-differences approach, the researchers were able to compare changes in behavior before and after legalization while also accounting for differences between states. Because sports betting laws were introduced at different times across the country, the team applied an advanced technique developed by economists Brantly Callaway and Pedro Sant’Anna to reduce bias in the results.

Overall, the study found little evidence that sports betting legalization changed drinking or smoking habits for the general population. But when the researchers looked more closely at specific groups, a clear pattern emerged among younger men.

The strongest effect appeared among men aged 35 and under who already had a history of binge drinking. In the study, binge drinking was defined as consuming five or more drinks in a single sitting.

For that group, the legalization of online sports betting was associated with a roughly 10 percent increase in how often they engaged in binge drinking. Specifically, the research found that binge-drinking men experienced an increase of about 0.46 additional binge-drinking days per month compared with the pre-legalization average of 4.6 days.

Importantly, the study found that sports betting did not appear to increase the number of people who binge drink. Instead, it intensified the behavior among those who were already engaging in it. Researchers refer to this as an increase along the “intensive margin,” meaning that existing binge drinkers were doing it more frequently.

“Online sports betting differs from traditional gambling because it is immediate, continuous, and easily accessible through smartphones,” Ghimire says. “That accessibility may make it easier for gambling to occur in settings where alcohol consumption is already common, such as watching live sports.”

Sports bars, watch parties and other social environments where games are viewed could amplify that connection. Betting apps are also designed to keep users engaged with frequent odds updates, in-game wagers and instant payouts, making it easy for betting and drinking to happen at the same time.

Gambling and Substance Use Have Long Been Linked

Still, Ghimire cautioned that the study does not directly identify the behavioral mechanisms behind the trend. The research “identifies the causal link but does not directly test the behavioral mechanisms behind it,” Ghimire says.

The study also highlights that gambling and substance use have long been linked in prior research. Earlier studies have shown that people with substance use disorders experience pathological gambling at higher rates, while individuals seeking treatment for gambling problems often struggle with alcohol or tobacco dependence.

Some research suggests that online gambling environments may be particularly risky. Studies have found that online gamblers are more likely to experience substance abuse and mental health disorders compared with people who do not gamble online.

Other recent research has explored the broader impacts of legalized sports betting. Some studies have found connections between sports betting access and declining financial health, including lower savings rates, higher credit card debt and increased overdraft activity. Others have examined links to mental health outcomes, with mixed results across different age groups.

The current study also comes with limitations. The findings rely on participants’ self-reported drinking habits, which means the true level of alcohol consumption may be higher than the survey data suggests.

That “could mean that the true level of consumption—and possibly the magnitude of the increase—is somewhat higher than what appears in the survey data,” Ghimire says.

Researchers also noted that the COVID-19 pandemic may have influenced drinking patterns during part of the study period. However, they argue that as long as those changes affected states similarly, the statistical approach should still produce reliable estimates.

Ultimately, the authors say their findings could help inform public health messaging as sports betting continues to expand across the country.

Currently, online sports betting is legal in 31 states and Washington, D.C., and many policymakers are still debating how to regulate the rapidly growing industry.

For Ghimire, the takeaway is that the effects of sports betting legalization may reach further than many people realize.

As he puts it, the rise of online gambling may carry consequences that extend well beyond the bets themselves.