The Role of Sport and Physical Activity in Preventing Substance Use

Youth Sports, Physical Activities, and Substance Use 

The prevailing thought is that by having youth play sports and engage in physical activities, they are protected against using alcohol, tobacco and drugs.  Sports and physical activities are critical to developing healthy bodies and minds, and are associated with many other benefits including school success and the development of positive self-esteem.   

However, research paints a more complex picture of the connection between sports and exercise and youth substance use.  Below is a description of selected research on the associations between youth sports/physical activity and substance use, and studies evaluating the effects of interventions targeting physical activity and sports for preventing substance use among youth.   

Research on Associations Between Youth Sport/Physical Activity Participation and Substance Use 

  1. A study by Moore and Werch published in the Journal of Adolescent Health in 2005 examined the association between participation in school-sponsored sports and out-of-school sports/physical activities and substance use: (http://www.sciencedirect.com/science/article/pii/S1054139X04002605).  Results showed that participation in any one of seven sports/physical activities was associated with increased substance use for one or both genders, while participation in one of four other sports/physical activities was associated with decreased substance use among one or both genders.
  2. A study by Nelson and Gordon-Larsen published in Pediatrics in 2006 examined relationships between physical activity and sedentary behavior patterns and an array of risk behaviors: (http://pediatrics.aappublications.org/content/117/4/1281.short).  The authors concluded that participation in a range of physical activity-related behaviors, particularly those involving high parental sports/exercise involvement, was associated with favorable risk profiles, including reduced likelihood of illegal drug use.
  3. A review of research by Lisha and Sussman published in Addictive Behaviors in 2010 examined high school and college sports participation and drug use: (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3134407/).  A total of 34 papers were reviewed and findings suggest that participation in sports is related to higher levels of alcohol consumption, but lower levels of both cigarette smoking and illegal drug use.
  4. A study by Terry-McElrath, O’Malley, and Johnston published in the American Journal of Preventive Medicine in 2011 examined the relationships between high school student substance use and exercise in general, and school athletic team participation: (http://monitoringthefuture.org/pubs/abstracts/ytmpomldj2011.pdf).  Higher levels of exercise were associated with lower levels of alcohol, cigarette, and marijuana use.  In addition, higher levels of athletic team participation were associated with higher levels of smokeless tobacco use, high school alcohol and steroid use, and lower levels of cigarette and marijuana use.
  5. A paper by Matthew Kwan and colleagues published in Addictive Behaviors in 2014 reviewed 17 longitudinal studies examining the relationship between sports participation and drug and alcohol use among adolescents: http://www.sciencedirect.com/science/article/pii/S0306460313003766.  Results indicated that sports participation was associated with increased alcohol use, but reduced illicit drug use, especially non-marijuana related drugs. 

Research Evaluating Physical Activity-Related Interventions on Youth Substance Use 

  1. A study by Collingwood and colleagues published in the Journal of Drug Education in 2000 evaluated a physical fitness drug prevention program implemented to youth in 22 school and community settings: (http://baywood.metapress.com/app/home/contribution.asp?referrer=parent&backto=issue,4,8;journal,52,171;linkingpublicationresults,1:300320,1).  The physical training program consisted of exercise and educational modules implemented over a 12-week period.  Results indicated significant pre to post increases in physical activity and fitness, and significant decreases in the percentage of youth who used cigarettes, smokeless tobacco, and alcohol.
  2. A study by Goldberg and colleagues published in JAMA Pediatrics in 2000 evaluated the efficacy of a team-centered, sex-specific education program designed to reduce use of anabolic steroids, alcohol, and other illicit drugs: (http://archpedi.jamanetwork.com/article.aspx?articleid=348976).  The intervention consisted of interactive classroom and exercise training sessions for high school football players.  Fewer students receiving the intervention reported using alcohol, illicit drugs, and sport supplements, along with drinking and driving, while nutrition behaviors improved at one-year.
  3. A study by Werch and colleagues published in the Journal of School Health in 2003 evaluated an intervention addressing alcohol prevention in the context of a sports program: (http://onlinelibrary.wiley.com/doi/10.1111/j.1746-1561.2003.tb04181.x/abstract).  A brief health behavior screen and consultation (SPORT Prevention Plus Wellness) tailored to middle school students’ health habits significantly reduced alcohol initiation, quantity of use, heavy drinking, and significantly increased moderate physical activity at three-months post-intervention.
  4. A second study by Werch and colleagues published in Prevention Science in 2005 evaluated the efficacy of a brief, multi-health behavior intervention integrating physical activity and alcohol use prevention messages for high school adolescents: (http://link.springer.com/article/10.1007/s11121-005-0012-3.  Youth receiving the SPORT Prevention Plus Wellness intervention showed significant positive effects at three-months post-intervention on alcohol consumption, drug use behaviors, and exercise habits, and at 12-months on cigarette smoking.  


As mentioned in the introduction, the relationship between youth sport and physical activity and substance use is a complicated one.  One thing is clear.  We can no longer assume that participation in any youth sport or physical activity is associated with less use of all harmful substances.

In fact, research suggests that participation in sports and athletic teams is likely to be related with increased risk for some types of substance use, particularly alcohol consumption.  The good news is that greater sports and exercise participation is generally associated with decreased risk for cigarette smoking and illegal drug use.

The caveat to these broad conclusions is that the association between increased or decreased risk for specific types of substance use is likely to vary with the specific type of sport or physical activity, as well as gender, parental participation, and level of exercise or athletic team participation.

Fortunately, interventions linking sports and physical activity with substance use prevention can be effective in decreasing substance use while also increasing physical activity.  These programs vary and can include either multiple educational and exercise sessions, or screening with brief motivational intervention.

Because youth who participate in sports are likely to be at increased risk for alcohol and in some cases other types of substance use, it would be prudent to ensure all youth participating in sports receive a program which integrates sports/physical activity with substance use prevention.  Such programs hold promise for reducing youth risk for alcohol use while increasing their healthy habits which can enhance both sports performance and overall well-being.

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