Background: The aim of this study was to explore the associations of physical activity with smoking and alcohol consumption. It examined whether these associations are due to people participating in organized sports (the sport hypothesis), and/or reflect the concentration of drinking and smoking in manual occupational groups (the occupation hypothesis).
Methods: Data from the 2003 Health Survey for England (n=11,617) were analyzed from a multilevel perspective. Four models were specified to examine the variation of heavy drinking, smoking, sports activity, and occupational activity across different sociodemographic groups; and four sets of analyses further explored the associations of sports and occupational activity with heavy drinking and smoking.
Results: Some support was found for both the sport and occupation hypothesis. Sports activity and heavy drinking were more prevalent among sportsclub members, and occupational activity and heavy drinking were more prevalent among manual occupational groups. Sportsclub membership accounted for some of the association between sports activity and heavy drinking; and occupational position partly accounted for the association between occupational activity and heavy drinking. The occupation hypothesis is the more likely explanation for the association between physical activity and smoking.
Conclusions: This study shows that it is worthwhile to distinguish between different types of physical activity; and that multiple processes underlie the clustering of health behaviors.