Relationship of high school and college sports participation with alcohol, tobacco, and illicit drug use: A review
Introduction
There is substantial evidence that athletes (particularly at an elite level) use drugs more than their non-athlete counterparts (Ambrose, 2004, Hoberman, 2002, Juhn, 2003, Millman and Ross, 2003). Generally, the drugs studied are performance enhancing substances (Kutscher, Lund, & Perry, 2002). However, it is unclear where persons who engage in athletics use other substances such as alcohol, tobacco, marijuana, or other illicit drugs. Research on this topic is sparse. Only one systematic review has been completed in this domain (Martens, Watson, & Beck, 2006), and it focused solely on alcohol consumption in athletes at the college level. Currently, there is a strong interest in the relationship between sport participation and drug abuse. The recent revitalization of this priority area is highlighted by the National Institute of Health's recent call for proposals (RFA DA 09-013 and 014). The present review seeks to elucidate the relationship between sport participation and use of alcohol, cigarettes, and illicit drugs among high school and college athletes.
Traditionally, participation in sports has been viewed as a protective factor against drug use and abuse (Pate, Heath, Dowda, & Trost, 1996). There is a well demonstrated link between physical activity, positive health outcomes, functional capacity, positive mood, and general wellbeing (Plante and Rodin, 1990, Penedo, 2005, Warburton et al., 2006). Exercise is specifically found to be one of the seven indicators of healthy aging (Vaillant, 2003). One may speculate that participation in sports quells recreational drug use or abuse. However, there is a substantial gap in the current literature on sports participation and substance use and therefore no conclusive evidence that such a relationship exists.
High school and college athletes appear to enjoy positions of higher social status or privilege than most non-athletes (Harvey, 1999, Martens et al., 2006a, Sussman et al., 2007). However, increased social standing does not come without challenges. Student athletes are expected to balance full course loads, practice, work outs, and social life. Heyman (1986) suggested that the pressures associated with this multitude of obligations may be overwhelming; thus, at the collegiate level athletes are often subject to developmental, emotional, and psychological problems (Heyman, 1986).
The current review is the first systematic examination of the relationship between participation in sport (at high school and college levels) and drug use or abuse. Presently, it is unknown (1) how many data-based peer-reviewed studies on high school and college athletes and drug use/abuse exist, (2) what the relationship is between sports participation and drug use/abuse, and (3) if that relationship changes with substance. The present review attempts to address these questions by first identifying all the data-based peer-reviewed studies that identify the relationship between athletes versus non-athletes and drug use. We expected that lower levels of cigarette smoking should be found among sports participants because cigarette smoking shows immediate physical ramifications on athletic performance (Penderson, Poulin, Lefcoe, Donald, & Hill, 1992). Tentatively we also expected that sports participation would also be inversely related to alcohol use and illicit drug use as well, assuming that alcohol and illicit drug use would be used primarily by “at risk” youth who were marginalized within school environments (Sussman et al., 2007).
Section snippets
Selection of studies
Electronic databases (Google Scholar, PubMed, Ovid, Web of Science, and Cochrane Reviews Database) were searched to identify empirical articles relevant to sports participation and substance use among youths (accessed February 3rd, 2009 to March 5th, 2009). The database was searched by crossing the terms “sports types,” and “sport type,” with “substance abuse,” “drug addiction,” and “drug abuse.” Only studies published in the English language that included some type of number count or survey to
Alcohol
Twenty-nine of the 34 total studies examined the relationship between participation in sport and alcohol consumption. In 22 of the studies participation in sports was positively associated with alcohol; that is, those who participated in sports reported higher levels of drinking than those who did not participate. Seven of the studies did not fit this type of relationship. Among these, two found an inverse relationship (Elder et al., 2000, Thorlindsson and Bemburg, 2006); involvement in sports
Discussion
The relationship between athletic participation and substance use differs by type of drug. As expected, it appears that both cigarette smoking and illicit drug use are inversely related to participation in athletics. However, we found a generally positive association between participation in sports and alcohol consumption. No differences were found in relation to level of sport activity (i.e., high school versus college level). Indeed, 22 of the 29 studies on alcohol found that drinking was
Role of funding sources
This paper was supported by grants from the National Institute on Drug Abuse (#s DA13814, DA016090, and DA020138).
Contributors
Nadra Lisha conducted literature searchers and provided summaries of previous research, conducted the statistical analysis and wrote the first draft of the manuscript. Steve Sussman provided guidance throughout the paper writing process, edited the paper, and made changes to the content. All authors contributed to and have approved the final manuscript.
Conflict of interest
All other authors declare that they have no conflicts of interest.
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