Sports participation, smoking risk factors, and cigarette smoking among adolescents: Implications for prevention

Background: Smoking remains the leading preventable cause of death in the U.S., and preventing smoking among adolescents is a priority for comprehensive tobacco control. Sports participation positively contributes to youth development, but our understanding of how adolescent sports participation is related to cigarette smoking remains limited, including knowledge of potential smoking risk factors within this population. Methods: We investigated the relationship between sports participation and smoking behaviors in a sample of adolescents (n = 322) age 12 – 21 presenting for well-visit appointments at an adolescent medicine clinic in Washington, DC. Participants completed self-reported assessments of sports participation, smoking behaviors, and tobacco-related attitudes and exposure to family and peer smoking. Results: In bivariate analyses, sports participants were significantly less likely than nonparticipants to have ever smoked, smoked at age 13 or younger, been exposed to family and friends who smoked, and had less positive views towards the social effects of smoking (p < 0.01). In multivariate analyses, after accounting for demographics and smoking risk factors, sports participants were significantly less likely to have smoked at age 13 or younger (OR = 0.50, p < 0.05). Older age and exposure to family/friends who smoked were consistently the strongest predictors of smoking risk behaviors across multivariate models. Conclusions: Sports participants are less likely to report smoking risk behaviors, which may in part be explained by differential exposure to family/friends who smoke. Additional research to examine how the social contexts of sports participants and nonparticipants can be leveraged for smoking prevention is warranted.