A new scoping review of 25 studies finds that people who play more video games tend to be somewhat more likely to use cannabis, but the research is too inconsistent and early-stage to draw firm conclusions about why or for whom this link exists. All evidence is associational, meaning no study has established that one behavior causes the other, and shared risk factors like impulsivity and depression may explain much of the overlap.

Video gaming and cannabis use are both increasing in prevalence worldwide, particularly among adolescents and young adults, raising questions about whether the two behaviors are linked and, if so, what that means for prevention and screening efforts. Clinicians regularly encounter patients who report both heavy gaming and cannabis use, yet there has been no comprehensive effort to understand what the published literature actually says about their co-occurrence. This review provides the first systematic map of that evidence base, and its findings highlight how far the field still needs to go before clinical recommendations can be grounded in solid data.

Both video gaming and cannabis use have expanded dramatically in the 21st century, with researchers beginning to ask whether the two behaviors share common risk factors or even reinforce each other. Theoretical overlap exists: both can serve as stress-relief strategies, both engage reward and impulse-control circuitry in the brain, and both are disproportionately prevalent among younger males. This scoping review, conducted according to the Arksey and O’Malley framework and PRISMA-ScR guidelines, searched multiple databases for original research published between 2000 and February 2025 that examined the relationship between any form of video gaming and cannabis use. From 646 initial records, the authors identified 25 studies meeting their inclusion criteria, spanning adolescents, young adults, and mixed-age populations.

The majority of included studies reported a positive association between gaming frequency or gaming disorder and cannabis use, but the picture was far from uniform. Several studies found no statistically significant relationship, and a small number found a negative association, where more gaming was linked to less cannabis use. Critically, neither video gaming nor cannabis use was measured consistently across studies, with definitions ranging from casual screen time to clinical gaming disorder, and from lifetime cannabis use to current daily consumption. Almost all studies were cross-sectional and relied on convenience samples, which means no temporal sequence can be established and confounding by factors like impulsivity, depression, and male sex cannot be ruled out. The authors conclude that the field requires standardized measurement, longitudinal designs, and more attention to diverse populations before any causal or clinical conclusions can be drawn.

This review does something valuable by honestly demonstrating how little we actually know about the video gaming and cannabis overlap. It resists the temptation to overstate what a small, methodologically inconsistent body of research can tell us, and I respect that restraint. At the same time, the “majority of studies found a positive association” framing is essentially a vote count of unweighted, heterogeneous studies, which should not be mistaken for strong evidence of a meaningful link. The signal is real enough to warrant further investigation, but it is nowhere near actionable.

In my practice, I already ask about screen habits and gaming when patients describe patterns of cannabis use that concern them, not because the literature mandates it, but because understanding the full behavioral context of a patient’s day is basic good medicine. If a young adult is using cannabis heavily during gaming sessions and reporting that both feel compulsive, that is clinically relevant regardless of whether a population-level association has been proven. This review does not change my approach, but it does confirm that better research tools are needed to serve these patients well in the future.

This scoping review sits very early in the research arc. It is a mapping exercise, not a synthesis, and it explicitly does not assess study quality or pool effect sizes. For clinicians, this means the findings should be understood as a landscape description rather than evidence for a clinical guideline. The review does usefully extend beyond prior work that focused only on gaming disorder by including the full continuum of gaming behavior, which better reflects the range of patients clinicians actually see. However, the absence of longitudinal data means we cannot distinguish whether gaming leads to cannabis use, cannabis use leads to more gaming, both are driven by the same underlying vulnerabilities, or the association is largely an artifact of unmeasured confounding.

From a pharmacological and safety standpoint, the review does not address dose, product type, route of cannabis administration, or interactions between cannabis effects and gaming performance or gaming-related decision-making. These are all areas where future research could be clinically informative. At present, there is no evidence-based protocol linking gaming assessment to cannabis screening or vice versa. The most concrete actionable step for clinicians is simply to maintain curiosity about behavioral co-occurrence in young patients: when a patient reports heavy cannabis use, asking about screen time and gaming habits may reveal patterns worth exploring, even if the evidence base has not yet caught up to practice intuition.