Health risk behaviours, obesity, and gambling severity: findings from a nationwide population study

Prior research on the relationship between health risk behaviours (HRBs), obesity, and gambling has primarily focused on problem gambling, while studies focusing on lower severity levels are scarce. Moreover, this relationship has rarely been analysed separately for women and men. This study aimed to investigate the association between HRBs, obesity, and the full spectrum of gambling severity in women and men. Cross-sectional population-based data from Healthy Finland Survey 2022-23 was exploited, including adults aged 20+ years (n = 28 154, response rate 46%, mean age 52 years). The Problem Gambling Severity Index (PGSI) was used as the dependent variable, both in continuous (score 0-27) and categorical (non-problem, low-risk, moderate-risk, and problem gambling) form. Independent variables included HRBs (daily smoking, excessive drinking, low fruit and vegetable (F & V) consumption, low physical activity, and insufficient sleep) and obesity. Sociodemographic factors, suboptimal self-rated health, and psychological distress were adjusted for. Daily smoking, excessive drinking, low F & V consumption, and insufficient sleep were less prevalent in the non-problem gambling category (PGSI score = 0) compared to the low-risk (score 1-2), moderate-risk (score 3-7), and problem gambling (score ≥8) categories. After adjusting for potential confounding variables, all HRBs and obesity, except for physical inactivity, were significantly associated with higher PGSI scores. These findings highlight the need for public health strategies that address gambling across the entire risk spectrum. Moreover, a holistic approach that considers the individual's broader life context could strengthen both research and prevention efforts.