Our data show that almost 20% of the motorcycle taxi riders have been involved in sports-betting in the most recent month, and that among those that engage in sports-betting, about one fifth of them engage daily or nearly daily. Our data show that riders who stop work earlier are more likely to engage in gambling, but most importantly, alcohol consumption and cigarette smoking were significantly associated with gambling. Income earned per day is unrelated to the likelihood to get engaged in sports-betting. Our study is one of the few from sub Saharan Africa that have examined the association between alcohol consumption and gambling.
The frequency of sports-betting in our study population is comparable to that from a study in the United States [16], although this was a student population. However, the frequency in our study population is only half of that demonstrated in a South Africa population [17]. This study in South Africa was conducted among a general adult population, mostly low income poor population. Our study population consists of low income earners as well but younger. However, the frequency gambling in South Africa is much higher and may be because gambling is well established there, since the 1990s and with a variety of options unlike in Uganda. In our study population, sports-betting was the only form of gambling available to the riders. Other forms of gambling such as casinos are available in the capital Kampala, but are likely to be accessed by the higher income earners as the costs of gambling in the casinos are likely to be higher.
Our findings of the association between alcohol consumption and gambling are in agreement with those of a study in South Africa among a population of gamblers [18]. The results confirm our primary hypothesis and agree with several other studies outside the African continent. We observed an inverted U association, indication that among the heavy drinkers, there was no association with sports-betting. It is not clear whether alcohol is the chicken or the egg in the pathway and what the causal mechanism may be. Studies suggest alcohol drinking may increase the propensity to gamble [19]. There is a possibility that heavy drinkers lose their income to drinking and have limited resources left to gamble.
Our study also shows a significant association between cigarette smoking and sports-betting. This finding fits our hypothesis and also agrees with findings from other studies [20]. Alcohol and nicotine in the cigarettes are both substances of addiction and their close association with gambling, which is also addictive is not unexpected. Our data adds to the limited existing evidence of the link between the use of alcohol and cigarettes with gambling in sub Saharan Africa [18]. For the continent, these results are significant because of the close association of all these factors with mental health conditions, which are much neglected. Alcohol, substance abuse, anxiety and depression have all been found to be highly prevalent among persons with problem gambling [21]. Marijuana was not commonly used and our data did not provide sufficient opportunity to explore its association with sports-betting.
It is important to note that we conducted our study among motor cycle taxi riders, a sub group of the population that comprises predominantly young male Ugandans. We chose this group because they represent a large proportion of urban male youth who earn a living from a meager daily income. Youth unemployment is very high in Uganda with more than 60% of youth aged between 18 and 35 years facing unemployment. Motorcycle taxis provide an option for them to earn a living. These results are therefore generalizable to a large proportion of out of school youth in Uganda.
Although our study provides unique data from sub Saharan Africa, it has some weaknesses. We did not measure the severity of the gambling. There are well established tools to do this such as the Gambling severity index score. Future studies should consider including the measurement of the grade of severity of gambling. The strength of our study is that it presents data in a field that is under researched in sub Saharan Africa. The finding of an inverted U relationship between alcohol consumption and sports-betting is novel and should be further examined and replicated in other studies. Although several studies have shown the association between substance abuse and gambling [16, 22, 23], very few such studies have been done in resource limited settings.