Prevalence and Risk Factors of Addictive and Potentially Addictive Behaviors in Swiss Adults: A Population-Based Study.

Abstract

Modern environments expose individuals to stimuli that may promote seemingly harmless, yet potentially addictive behaviors. This study investigated the prevalence, co-occurrence, and risk factors of substance and non-substance addictive behaviors in adults to better inform clinical practice and screening strategies. Data were collected from the Specchio digital cohort in Geneva, Switzerland (2023-2024). Addictive and potentially addictive behaviors included smoking, recreational drug use, binge drinking, gambling, excessive leisure screen use, and sugar-sweetened beverage consumption. Analysis included post-stratified prevalence rates, sex- and age-adjusted logistic regression for risk factors, and upset plots for behavioral co-occurrence patterns. Among 4575 participants (mean age 52 years; 59.3% female), smoking had the highest prevalence (15.7%, 95% CI 14.0-17.5), followed by binge drinking (12.3%), gambling (9.9%), excessive screen time (9.7%), sugar-sweetened beverage consumption (9.6%), and recreational drug use (5.8%). While smoking alone was most common (21.1%), substance-related behaviors frequently co-occurred (4.3%). Males showed higher odds across all behaviors, particularly gambling (adjusted odds ratio (aOR) = 2.18, 95% CI 1.76-2.70), binge drinking (aOR = 2.10, 95% CI 1.73-2.55), and recreational drug use (aOR = 2.08, 95% CI 1.55-2.79). Socioeconomic disadvantage strongly correlated with gambling (aOR = 2.34, 95% CI 1.89-2.90) and sugar-sweetened beverage consumption (aOR = 1.83, 95% CI 1.41-2.37). Lower psychological well-being was significantly associated with excessive screen time (aOR = 1.79, 95% CI 1.36-2.36), sugar-sweetened beverage consumption (aOR = 1.46, 95% CI 1.01-2.13), and smoking (aOR = 1.43, 95% CI 1.20-1.71). This study reveals distinct patterns of addictive and potentially addictive behaviors and identifies key risk factors: male sex, lower socioeconomic status, and poor psychological well-being. These findings emphasize the need for targeted prevention strategies and systematic primary care screening, including for new potentially addictive behaviors such as screen time or the consumption of sugar-sweetened beverages.