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Addict Behav. Author manuscript; available in PMC 2011 Jul 12.
Published in final edited form as:
PMCID: PMC3134407

Relationship of high school and college sports participation with alcohol, tobacco, and illicit drug use: A review

1. Introduction

There is substantial evidence that athletes (particularly at an elite level) use drugs more than their non-athlete counterparts (Ambrose, 2004Hoberman, 2002Juhn, 2003Millman & 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 & Rodin, 1990Penedo, 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, 1999Martens, Dams-O’Connor, & Beck, 2006Sussman, Pokhrel, Ashmore, & Bradford, 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).