Introduction:
Links between teenage gambling and tobacco and cannabis use have been reported for more than 25 years¹. Less is known about e-cigarette use and gambling. In Ireland, data about teenage smoking, cannabis use and gambling have been available for some time but analyses are lacking². E-cigarettes have been marketed and sold in Ireland for about a decade but, as in other jurisdictions, little is known about e-cigarette use and gambling. This study fills this gap by examining the links between smoking, e-cigarette and cannabis use, and gambling in Ireland.

Material and Methods:
We use data from the 2019 European School Survey Project on Alcohol and other Drugs (ESPAD), a nationally representative, cross-sectional survey of 1,940 15-16-year-old students. Tobacco, e-cigarette, and cannabis use were measured by asking participants if they had used these substances in the previous 12 months (responses re-coded as yes or no). Gambling prevalence was measured by asking participants, if they gambled money in the previous 12 months, to report which games they had played: playing on slot machines, playing cards or dice, playing the lottery, or betting on sports or animal races (responses re-coded as yes or no). Frequencies and regression analyses were carried out using Stata v16.1.

Results:
As shown in Table 1, prevalence of all 4 behaviours among 15-16 year olds in Ireland was high. Of the 4 behaviours, e-cigarette use in the previous year had the highest prevalence (37.2%, n=723), followed by gambling (22.9%, n=447), cannabis use (19.1%, n=370) and smoking (14.4%, n=281). Smoking (OR 1.84), e-cigarette use (OR 1.79), and cannabis use (OR 1.67) were all significant predictors of past-year gambling.

Conclusions:
This study confirms, for Irish teenagers, previously reported links between smoking, cannabis use, and gambling. It also shows that teenager e-cigarette use, which has a high prevalence in Ireland, has a similar relationship with, and comparable odds for, teenager gambling.