Key Takeaways From a Qualitative Study of Combined Gambling and Substance Use.

Many college students engage in gambling and other risky behaviors at the same time, but little is known about what they expect to result.

Research shows that individuals combine gambling with substances, including alcohol, cannabis, caffeine, and nicotine. What students think will happen in these situations (called “outcome expectancies”) plays an important role in whether they choose to engage. Understanding these expectations can help improve prevention and intervention efforts.

Positive outcomes college students expected for combining gambling and substances included having more fun, better chances of winning, feeling more relaxed, having more energy, and experiencing a “better high.”

When asked about gambling while drinking alcohol, students anticipated that they would be “more likely to take risks so MAYBE a win?” and might experience “more confidence, more comfortable, more ‘fun’ subjectively.” In response to questions about gambling while using cannabis, some expected that they would be “enjoying gambling more” and would feel “buzzed while playing, less stress.” For gambling combined with energy drinks, students predicted they would “feel energized” and that energy drinks would “keep you aware,” and nicotine while gambling would “feel good” and provide “focus.”

Most common negative expectancies included increased chances of losing, making worse decisions, spending too much, and increased risk for addiction or health problems.

When considering gambling while drinking alcohol, one student expected they “won’t know when to quit,” while others thought they might “spend or lose more money than you have, poor decision making!” or simply “lose money.” Regarding gambling while using cannabis, students expected they might “lose focus” or “lose track of time.” For energy drinks, students thought they would have “less self-control” and “could have heart issues,” and for nicotine while gambling, they would “smell bad,” and “lung/mouth harm.”

Many students reported not knowing what to expect from using substances while gambling.

When students were asked what they anticipated would result from using substances while gambling, they frequently wrote, “I don’t know” or “not sure.” This suggests that some students felt uncertain or lack information about what might result from using substances and gambling simultaneously. “Unknown” expectancies were among the top five frequently reported responses for both positive and negative impacts for all substances except alcohol. Interestingly, this uncertainty differs from other areas (like alcohol use), where people often have expectations even without direct experience. For combinations of gambling and substances, expectations may be less developed or less clear.

Research suggests that the use of substances while gambling can affect gambling behavior, typically increasing risk and negative outcomes.

For example, alcohol consumption can lower inhibitions and impair decision-making, leading individuals to take greater risks, wager more money, and become more likely to chase losses. Cannabis use can impair short-term memory, attention, and executive function, which may result in riskier bets, increased mistakes, and a distorted perception of time. Energy drink consumption may heighten alertness and arousal, potentially resulting in longer gambling sessions (which increases the risk of losing more money), elevated heart rate, increased anxiety, and impulsivity. Nicotine use, particularly smoking while gambling, is common and has been shown to enhance the subjective excitement and “high” experienced during gambling sessions, as well as increase the amount of time and money spent gambling.

Action Steps to Consider:

This study highlights a need for education around the combined effects of gambling and substances among college students. Based on these findings, future work can:

  • Study individuals who already combine these behaviors to better understand their experiences and expectations, and how they differ from those who do not engage in both behaviors at the same time.
  • Develop measurement tools to identify students at higher risk by capturing what they expect will happen when engaging in combined gambling and substance use behavior.
  • Use insights about college students’ outcome expectancies to inform prevention and intervention programs intended to reduce risky behaviors among college students.

If we better understand what students expect to happen when they combine gambling with simultaneous substance use, we can provide them with clearer, more accurate information about what may be likely to transpire. This can help students make safer, more informed choices and reduce negative consequences.

Most Frequently Mentioned Expectancies

Alcohol & Gambling

Positive Expectancies
  • Have more fun

  • Increase my chances of winning 

  • Take risks 

Negative Expectancies
  • Increase my chances of losing 

  • Likely to make bad choices 

  • Increase my likelihood of spending money

Cannabis & Gambling

Positive Expectancies
  • Feel relaxed 

  • Increase my chances of winning 

  • Have more fun 

Negative Expectancies
  • Increase my chances of losing

  • Likely to make bad choices 

  • Feel less focused

Energy Drinks & Gambling

Positive Expectancies
  • Feel energized

  • Have more fun

  • Feel more focused

Negative Expectancies
  • High risk to my health

  • Increase my chances of losing

  • Make me more impulsive

Nicotine & Gambling

Positive Expectancies
  • Have more fun

  • Increase my chances of winning

  • Feel relaxed

Negative Expectancies
  • Increase my chances of losing

  • Make me smell bad

  • Likely to make bad choices

When expectations about gambling and substance use don’t align with likely actual outcomes, it can increase risk. Reaching out to The Gambling Clinic for support and information can help you better understand your patterns and make changes if needed, so that you can make more informed choices.

This research brief results from the work of the Tennessee Institute for Gambling Education & Research (TIGER). Based at the University of Memphis and East Tennessee State University, TIGER conducts research on gambling, the treatment of gambling problems, responsible gambling, and related topics. The Gambling Clinic, Tennessee’s provider of gambling treatment services, is TIGER’s clinical service division. TIGER is funded by the Tennessee Department of Mental Health and Substance Abuse Services. All findings and views are the authors’ own, and not necessarily those of the State of Tennessee or the Department of Mental Health and Substance Abuse Services. To inquire about treatment at The Gambling Clinic, contact us at 1-833-842-8600 or tgc@memphis.edu. You can also explore our website at thegamblingclinic.com to learn more about our research, clinical services, and other resources.

This brief is based on a qualitative study involving 31 college students.

Whalen, Shelby, “Understanding College Student Expectancies of Simultaneous Engagement in Multiple Risk Behaviors: A Measurement Development and Model Testing Study” (2026). Electronic Theses and Dissertations. Paper 4650. https://dc.etsu.edu/etd/4650

About the student author:

Shelby Whalen holds a Ph.D. in clinical psychology from East Tennessee State University. Her research focuses on shared risk factors across addictive and risky behaviors, particularly when they occur together, and on improving treatment approaches to support recovery. Dr. Whalen completed her predoctoral internship at James H. Quillen VA Medical Center and served as a Peer Supervisor at The Gambling Clinic. Dr. Whalen will serve as a Graduate Psychologist in the Domiciliary Substance Use Program at James H. Quillen VA Medical Center and will continue her work with The Gambling Clinic as a Postdoctoral Supervisor.