Binge-watching and substance use in adolescents: a cross-sectional study of behavioral risk factors and gender differences

Abstract Background Problematic binge-watching, defined as the compulsive consumption of audiovisual content for prolonged periods of time, has increased in prevalence, especially among adolescents. However, its relationship with the development of risk behaviors, such as the consumption of psychoactive substances, has been scarcely studied. These substances use behaviors could result in negative outcomes, such as health problems, interpersonal conflicts, and academic difficulties. The objective of the present study is to analyze the relationship between binge-watching, substance use and problem behaviors in a sample of Spanish adolescents. Methods A total of 940 Spanish adolescents (aged 14–18 years, M = 15.44, SD = 0.77; 57% boys, 43% girls) were recruited from public (68%) and private (32%) high schools. Substance use and problem behaviors were assessed using the Spanish Survey on Drug Use in Secondary Education (ESTUDES), while binge-watching was assessed using the Spanish version of the Binge-Watching Engagement and Symptoms Questionnaire. Associations were examined using Mann-Whitney U test and logistic regression models controlling for gender. Results Mann-Whitney U analyses revealed that adolescents reporting alcohol use, tobacco use, energy drinks, or energy drinks mixed with alcohol scored significantly higher on multiple binge-watching dimensions, particularly “Dependency” and “Loss of Control”. Arguments with parents were associated with higher binge-watching levels, whereas the findings for trouble concentrating at school were less consistent across analyses. Gender-stratified analyses showed that these associations were stronger among female adolescents. Logistic regression models controlling for gender confirmed that higher scores on “Dependency” and “Loss of Control” significantly predicted psychoactive substance use, supporting the presence of overlapping risk patterns between problematic dimensions of binge-watching and substance-related behaviors. No significant associations were found with bullying victimization, which may reflect that binge-watching is primarily related to individual coping and internalizing behaviors, rather than peer-directed aggression. Conclusions The combined influence of psychoactive substance use and problematic binge-watching behavior could be explained by factors such as immediate gratification, emotional avoidance, or disruptive coping strategies to manage stress or anxiety, which would be related to other problem behaviors. These findings underline the need to develop preventive strategies that include a gender perspective in order to promote responsible consumption of audiovisual content among adolescents.