Research article
Exercise and Substance Use Among American Youth, 1991–2009

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Background

The National Institute on Drug Abuse has called for increased research into the use of physical activity in substance abuse prevention, specifically research into physical activity type and context.

Purpose

This paper examines the relationships between (1) secondary school student substance use and (2) exercise in general and school athletic team participation, and examines such relationships over time.

Methods

Nationally representative cross-sectional samples of 8th-, 10th-, and 12th-grade students were surveyed each year from 1991 to 2009. Substance use measures included past 2-week binge drinking and past 30-day alcohol, cigarette, smokeless tobacco, marijuana, and steroid use. Analyses were conducted during 2009–2010.

Results

Across grades, higher levels of exercise were associated with lower levels of alcohol, cigarette, and marijuana use. Higher levels of athletic team participation were associated with higher levels of smokeless tobacco use and lower levels of cigarette and marijuana use across grades and to higher levels of high school alcohol and steroid use. Exercise helped suppress the undesired relationship between team participation and alcohol use; exercise and athletic team participation worked synergistically in lowering cigarette and marijuana use. Observed relationships were generally stable across time.

Conclusions

There appear to be substantive differences between exercise and team sport participation in relation to adolescent substance use. These findings from cross-sectional data suggest that interventions to improve levels of general physical activity should be evaluated to determine if they help delay or reduce substance use among youth in general as well as among student athletes.

Introduction

The costs of tobacco, illicit drug, and alcohol abuse are staggering1, 2, 3, 4; improved prevention methods are needed. Support for exercise in preventing substance use is well grounded in theory and neurobiology.5, 6, 7, 8, 9, 10, 11, 12, 13, 14 However, the National Institute on Drug Abuse has identified important knowledge gaps in the relationship between physical activity and substance use including “type, amount, context (including access), and persistence of physical activity.”15 The current study focuses on relationships between physical activity type and adolescent substance use.

Adolescence is a key developmental stage for prevention; most substance initiation occurs at ages <18 years.16, 17 Early onset associates with heavier, problematic substance use18; delaying onset results in substantially less lifetime use and dependence.19, 20 Effective strategies to increase physical activity among adolescents do exist.21, 22 Thus, utilizing physical activity in substance use prevention among adolescents is promising if relationships between adolescent physical activity and substance use can be further explored.15

Youth substance use and poor exercise are interrelated.23, 24 However, studies indicate no single relationship between adolescent exercise and substance use. Alcohol has associated positively to exercise in some studies,25, 26, 27, 28, 29 negatively in others,30, 31 and has been unassociated in others.32, 33 For cigarettes, exercise primarily associates with lower levels of use25, 34, 35; however, some studies have shown no or inconsistent findings.36, 37 Relationships between exercise and illegal drug use are generally negative,25, 30, 38, 39 but positive with smokeless tobacco.25, 35, 39

Such inconsistencies may associate with how exercise is defined. Team or competitive sport participation associates positively with alcohol for adolescents overall,25, 28, 29 or men/boys only.26 Among highly athletic youth and young adults (aged 16–24 years), team sports associated with higher levels of alcohol use than non-team-based sports.40 In contrast, exercise frequency and intensity has associated with lowered prevalence of being drunk and driving after drinking.30 Both team sports and exercise frequency and intensity associate with decreased cigarette and illicit drug use.25, 30, 39 Hypotheses associated with team sports participation and adolescent substance use include both protective and risk-related factors.41 Knowledge of differences in how adolescent substance use associates with physical activity based on type of exercise could strengthen available approaches to reduce or delay adolescent substance use as well as identify at-risk populations.

Two studies have compared adolescent substance use based on interacting team sport participation and exercise level/frequency: Rainey and colleagues28 used 1991 and 1993 high school South Carolina data; Kulig et al.38 used nationally representative 1999 high school data. Rainey found highly active athletes more likely to use alcohol than low-activity and sedentary nonathletes. Kulig found that lower levels of cigarette use was seen among physically active female sports team members compared with nonactive women who are not members of sports teams. Neither study included middle school students nor did they examine if findings held over time.

The current study (1) examines relationships between general exercising and school athletic team participation and substance use among U.S. middle and high school students from 1991 to 2009; (2) explores interactions between exercise and team participation; and (3) investigates relationship stability over time. Hypotheses are that (1) higher levels of exercise will associate with lower levels of alcohol, cigarette, and marijuana use and will have mixed relationships with smokeless tobacco and steroid use; (2) higher levels of athletic team participation will associate with higher levels of alcohol, smokeless tobacco, and steroid use but lower levels of cigarette and marijuana use; (3) results will be similar across grades; and (4) results will be stable across time.

Section snippets

Methods

Analyses utilize Monitoring the Future (MTF) study data; detailed methodology is available elsewhere.17 MTF annually surveys nationally representative cross-sectional samples of approximately 45,000 8th-, 10th-, and 12th-grade students in the coterminous U.S. Informed consent was obtained; the University of Michigan Behavioral Sciences IRB approved the study. Classroom surveys were administered by study personnel. From 1991 to 2009, student response rates averaged 90%, 87%, and 83% for 8th,

Results

Mean exercise participation was 4.09 in middle school and 3.94 in high school. Mean athletic team participation was 3.14 for middle school and 2.85 for high school. Among middle school students, the Pearson correlation between these two measures was 0.51 (p<0.001); among high school students, the correlation was 0.57 (p<0.001). Thus, though overlapping, the terms each retain a unique measure of the exercise spectrum. Including both terms in analytic models showed variance inflation factors of

Discussion

This paper examined relationships among substance use, exercise, and athletic team participation among U.S. middle and high school youth from 1991 to 2009. Exercise was associated with lower prevalence of middle and high school use of several substances. In contrast, school athletic team participation had mixed results with substance use. Results were generally stable across time.

Conclusion

The current study supports the possible preventive effects of physical exercise on adolescent substance use and indicates important differences exist between general exercise and team sports participation. Frequent exercise appears to be associated strongly with lowered levels of adolescent alcohol, tobacco, and marijuana use for the general student population and school athletic team participants.

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