Determinants of harmful substance use and harmful gambling

Harmful substance use and harmful gambling describe behaviour that is related to material harms of social, mental, or physical nature for either the user or those around them—harm that would not have occurred in the absence of the substance use or gambling. This chapter presents a broad range of determinants of harmful substance use and harmful gambling, clustered into domains such as marginalization, marketing, economic cycles, intra-individual factors, and biological vulnerabilities. There is much interaction between determinants operating within different domains. In comparison to the determinants of transitions to risky substance use and gambling, where the balance of evidence was stronger for factors at the level of the social, economic, and political environment, the balance of evidence for determinants of transitions to harmful substance use and gambling is predominantly at the individual and cellular and molecular levels of analysis.