Binge Drinking, Tobacco, and Illicit Drug Use and Involvement in College Athletics

Involvement in intercollegiate athletics is an important part of American college life. Student athletes are a special population whose dual roles as athletes and students can create a collegiate experience that may predispose them to substance abuse. A number of researchers and health educators have delineated the distinct concerns that student athletes face^1-3: the maintenance of athletic performance while responding to injuries and stress, ^1-3 academic performance, career or vocational concerns, and social isolation.¹ Injuries are often cited as a major medical and psychological concern.² Although a number of published studies have documented the widespread, heavy use of alcohol by college students and the subsequent problems these students cause for themselves and others,^4-10 much remains to be learned about the use of alcohol and other drugs among student athletes.

Many of the studies on college athletes have been conducted on a single college campus and thus may not be generalizable to the entire population of intercollegiate athletes.^2,11,12 The findings of those studies differ considerably. Nattiv and Puffer¹² found that athletes engage in risky behavior more frequently than nonathletes do, with significantly higher amounts of alcohol use and more episodes of driving while under the influence of alcohol. Selby² found that athletes tend to use alcohol and such drugs as marijuana more frequently, whereas Koss and Gaines¹¹ reported that alcohol and drug use are lower among intercollegiate athletes than among nonathletes.

The reported findings from the few existing multicollege studies may also not be generalizable because the researchers used convenience rather than random samples of students,^13-16 studied only one sport,¹⁵ or used data from colleges in a single state.¹⁴ The findings of those studies are also inconclusive. Studies by Toohey^15,16 revealed few differences in drug use between athletes and nonathletes, and Overman and Terry¹⁴ found that athletes and nonathletes differ only minimally in their alcohol consumption. Anderson¹³ compared athletes' drug use between 1985 and 1989 and found a decrease in the use of cocaine, marijuana , and amphetamines; stable use of alcohol and steroids; and increased use of smokeless tobacco and certain pain medications. However, the sampling design of Anderson's study did not permit direct comparison between athletes and nonathletes.

Much of the research about college athletes has concerned only those students who participate in intercollegiate athletics. In this study, we explored the ways other students participate in intercollegiate sports; that is, we examined the differences among students with little or no involvement, with partial involvement, and with substantial involvement in intercollegiate athletics. In addition, we used representative national data to make those comparisons. An earlier analysis of the data, in which a sex-specific definition of heavy or binge drinking was used,¹⁷ indicated that students who consider athletics important are more likely to binge drink (odds ratio [OR] = 1.81).¹⁸

In examining the role of athletics in the heavy-drinking culture on college campuses, we compared the drinking patterns of students with different degrees of involvement and interest in athletics. We also analyzed whether the specific correlates of binge drinking among students involved in athletics differed from the correlates of binge drinking that have been found for college students in general.¹⁸ In addition, we compared illicit drug and tobacco use in terms of students' various degrees of involvement in athletics.

METHOD

The Sample

We selected a national sample of 179 colleges from the American Council on Education's list of 4-year colleges and universities accredited by one of the six US regional bodies. In the initial sample, we used probability proportionate to enrollment size. To correct for the presence of few women-only colleges and colleges with fewer than 1,000 students, we added an oversample of 10 all-women colleges and 15 additional colleges with enrollments of fewer than 1,000 students. Nine colleges were subsequently dropped because they did not offer general college degrees; 140 (72%) of the final sample of 195 colleges agreed to participate. The inability to provide the names and addresses of a random sample of students within the required time was the primary reason for nonparticipation.

The 140 participating colleges represent a cross-section of American higher education. They are located in 40 states and the District of Columbia: 24% from the Northeast, 32% from the North Central region, 26% from the South, 18% from the West. Two thirds of the colleges are public, and one third are private. Approximately two thirds are located in a suburban or urban setting, and one third are in small towns or rural areas; 6 are women's colleges, and 5 institutions have a predominantly Black enrollment.

Each participating institution provided a random sample of undergraduates: 215 students at each of 127 colleges and 108 at each of 13 colleges (12 of which were in the oversample). The final student sample included 28,709 students.

Questionnaire

The 20-page questionnaire asked students about their drinking behavior and a number of other variables that could be important predictors of binging. For this study, we defined binge drinking as consuming five or more drinks in a row for men and four or more drinks in a row for women during the 2 weeks immediately before the survey.¹⁷ The answers to two questions enabled us to determine students' involvement in athletics. First, we asked, "How important is it for you to participate in the following activities at college?" Athletics was one of nine listed activities; for the analysis, responses were grouped as very important or important versus somewhat important or not at all important.

The second question was, "In the past 30 days, how many hours per day on average have you spent on each of the following activities? Average number of hours per day: 0, 1, 2, 3, 4, 5, 6, 7, 8+." Intercollegiate athletics was one of the nine listed activities; for the analysis, responses were grouped as 0 versus 1+ hours.

We determined the level of drug and tobacco use by asking students whether they had used each of a list of substances (not including anything used by prescription): responses were never used, used but not in past 12 months, used but not in past 30 days, and used in past 30 days. The substances covered were marijuana (or hashish); crack cocaine; cocaine; barbiturates; amphetamines; tranquilizers; heroin; other opiate-type drugs; LSD and other psychedelics or hallucinogenics, such as PCP; anabolic steroids; cigarettes, and chewing tobacco.

The Mailing

Questionnaires were mailed to 28,709 students, beginning in February 1993. We used four separate mailings, usually 10 days apart-a questionnaire, a reminder postcard, a second questionnaire, and a second reminder postcard. For various reasons (eg, incorrect address, withdrawal from school, leave of absence), 3,082 students could not be reached, reducing the target sample to 25,627. A total of 17,592 students returned questionnaires, yielding on overall response rate of 69%. At 104 of the colleges, response rates ranged between 60% and 80%, and only 6 colleges had response rates less than 50%. Response rate was not associated with the binging rate (ie, the Pearson correlation coefficient between the binge drinking rate at the college and response rate was .06, p = .46).

In the case of the 11,557 students who could be classified as early or late responders, we found no significant difference in binge drinking (43% for the early responders, compared with 42% for the late responders). We mailed an additional short form of the questionnaire to a segment of students who had failed to return the questionnaire. The rate of binge drinking for these nonresponders did not differ from the rate for those who responded to the original student survey.

Data Analysis

We divided the students into three groups to describe their involvement in athletics: students who spent 1 or more hours per day in intercollegiate sports and thought participation in athletics was important were defined as being involved in athletics; students who spent 1 or more hours per day in intercollegiate sports or thought participation in athletics was important were labeled as partly involved; and students who spent no time in intercollegiate sports and did not think participation in athletics was important were considered to be not involved in athletics. We conducted chi-square analyses for men and women separately to compare alcohol, tobacco, and other drug use in the three groups.

To determine individual correlates of binge drinking among the three groups, we used the Statistical Analysis System (SAS) Proc Logistic, Version 6.07, to fit the logistic model 19; and we used thesteps and model to determine the individual correlates of binge drinking among all the college students in the survey.¹⁸ Odds ratios (ORs) are presented in the text of this article, and both odds ratios and 95% confidence intervals (CIs) are shown in the tables.

Because some students failed to answer the athletic questions, our data were based on 17,251 students at 140 institutions. Of this number, 2,113 (12%) were involved in athletics (8% of women, 18% of men); 3,932 (23%) were partly involved in athletics (18% of women, 30% of men); and 11,206 (65%) were not involved in athletics (74% of women, 52% of men).

RESULTS

Alcohol Use

The majority (61%) of the men involved in athletics engaged in binge drinking; 55% of those partly involved and 43% of those not involved were binge drinkers. Among women, more of those involved in athletics engaged in binge drinking (50%) than those not involved, one third of whom (36%) had engaged in binge drinking (Table 1).

More of the men involved in athletics than those not involved also engaged in a frequent heavy drinking lifestyle (Table 1). One quarter of the involved men were drunk three or more times in the past month, compared with 17% of those not involved in athletics. One fifth (21%) of the athletically involved men intentionally drank to get drunk, compared with 15% of those not involved in athletics. Similarly, more women involved in athletics drank heavily, compared with those who were uninvolved, although the difference was not as great among women as it was among men (Table 1).

Tobacco Use

Approximately one-fifth (16%) of the men involved in athletics had used chewing tobacco in the last 30 days, in contrast to 12% of those partly involved and 7% of those not involved in athletics. Virtually no women used chewing tobacco (1% or fewer across all three groups; see Table 2).

Among men, 15% of those who were involved in athletics had smoked cigarettes in the last 30 days, in contrast to 20% of those partly involved and 26% of the students who were not involved in athletics. Results were similar, but the differences were smaller among women, with one fifth (20%) of those involved in athletics having used cigarettes in the last 30 days, compared with 23% of those not involved. Patterns of chewing tobacco and cigarette use in the last year were similar to use in the past 30 days for both men and women (Table 2).

Illicit Drug Use

Fewer of the students involved in athletics than those not involved reported having used marijuana. Slightly more than one tenth (12%) of the men who were involved in athletics used marijuana, compared with 16% of those not involved and 14% of those partly involved. Results were similar for the women: 10% of those involved in athletics used marijuana , compared with 11% of those partly involved or not involved. Little if any other drug use in the last 30 days was reported across all three groups. The term other drugs included cocaine, barbiturates, amphetamines, tranquilizers, heroin, other opiates, LSD, PCP, and steroids.

The Older Student

Overall, the earlier Harvard School of Public Health College Alcohol Study found that younger students (under 24 years of age) were more likely to binge drink than were students in older age groups.¹⁸ A majority (93%) of students involved in athletics are in this younger age group. The greater concentration of younger students in the involved and partly involved groups may influence the relationship of substance use and athletic activity. For this reason, we conducted a separate analysis for students 24 years old or younger. The results were essentially the same as for all students.

Correlates of Binge Drinking

We first examined correlates of binge drinking across the three categories of involvement with athletics (involved, partly involved, and not involved), using a previously developed model of the most important correlates of binge drinking for all college students.¹⁸

The same variables that strongly predicted binge drinking among those involved in athletics were also significant for those partly involved, for those not involved, and for all students. Among the athletes, those variables included residence in a fraternity or a sorority house (OR = 7.07); partying (OR = 4.61); and using marijuana (OR = 7.64). Smoking cigarettes was also a strong predictor (OR = 3.82). Whether the student typically binged during a drinking episode in the last year of high school was a very strong predictor of college binging (OR = 6.03) among these students.

Two other variables that were associated with binging to a greater extent among students involved in athletics than among all students, those not involved, and those partly involved were being less than 24 years old (OR = 2.68) and being single (OR = 4.34). Living in a coeducational dormitory, which was a significant predictor of binging among all three groups, was not significant among those who were involved in athletics.

Not being Hispanic was not significantly related to heavy episodic drinking among athletes or those partly involved in athletics, but had a slight effect on binging among all students and those not involved in athletics. Working for wages 2 hours or fewer daily, watching TV for more than 2 hours a day, and spending more than 1 hour daily participating in other physical activities were not significant predictors of binging among the students involved in athletics.

The ORs for other individual predictors of binging that we considered were similar across all three categories of students involved with athletics and among all students. Those predictors included being White; being male; having a parent who was a college graduate; having a parent who did not abstain from alcohol; having a family that approved of alcohol; thinking that religion, community service, arts, and academic work were not very important; living with a roommate; having five or more friends; having a grade point average of less than B; not having a faculty confidant; majoring in business; having two or more sexual partners in a month; socializing on a daily basis for more than 2 hours, studying less than 4 hours per day, or sleeping more than 6 hours per night; and being uninvolved in volunteer work or social organizations.

Multivariate Analyses

The next step was to run a final logistic regression model to determine what predicts binge drinking among the groups of students with various degrees of involvement with athletics. We had previously developed a model of the most important correlates of binge drinking for all college students.¹⁸ The only change in this model was the removal of the variable describing athletics as important or very important because it is part of the definition of the three groups (see Table 3 for the three groups, as well as the findings for all students).

Among those involved with athletics, the strongest predictor of binge drinking was living in a fraternity or a sorority residence (OR = 4.80); other important predictors were engaging in such risky behaviors as using marijuana (OR = 3.22) and smoking cigarettes (OR = 2.82). Binging in high school was also an important predictor (OR = 3.46), along with believing that parties were important (OR = 2.85), being White (OR = 2.75), and being male (OR = 1.45). Having had two or more sexual partners in the past month was not statistically significant. Several variables that were moderately predictive of binging among all students and among those not involved in athletics were not statistically significant predictors among the students involved in athletics. They included viewing community service as being somewhat important or not very important, living in a coed dormitory, and studying less than 4 hours daily.

DISCUSSION

Students who are involved in athletics contribute more than their share to the binge drinking atmosphere at their colleges. A greater percentage of college men and women involved in athletics are binge drinkers than are students who are not involved in athletics. On the other hand, students involved in athletics more often abstain from smoking cigarettes than do students who are not involved. This suggests that when students can understand that a behavior will hamper their performance, they can forego it. Only about half as many men involved in athletics as men not involved in athletics are smokers. Similarly, fewer men involved in athletics than uninvolved men use marijuana.

Educational campaigns aimed at students who are involved in athletics need to stress the incompatibility of binge drinking and athletic performance. Such alcohol education should also include a detailed examination of those alcohol-related problems that interfere with optimal performance.

We found that the strongest predictors of binge drinking among college students involved in athletics included living in a fraternity or a sorority, viewing parties as important, and having binged in high school. Those are the same factors that were important for all students. This suggests that comprehensive campuswide interventions may also influence students who are involved in athletics.

The role of coaches in discouraging all substance use, including binge drinking, has not been sufficiently reviewed. Coaches should be enlisted in campuswide drug prevention efforts because they are very influential with all students involved in athletics, not just the team members. Students who are active participants in athletics are students as well as athletes, and their "athletic educators" are also part of the greater college educational community, yet few college alcohol education programs make use of coaches and athletic directors.

Despite our findings that involvement in athletics is related to binge drinking in a national representative sample of colleges and students, a number of important questions remain unanswered. Do students involved in athletics drink more heavily during the off seasons of their sport, but cut down their drinking during the playing season? If so, this behavior would suggest that their heavy drinking could be controlled. Do students involved in team sports binge drink more than those involved in nonteam or individual sports? If so, such conduct is in line with the highly social nature of college binge drinking.¹⁸ It also suggests that a peer-group approach is indicated. Future research should address these and other questions.

In this study, we explored the broad issue of involvement in athletics, but future research might be directed toward examining involvement in even more depth , because involvement takes many forms. For some students, involvement means being only a spectator at events or includes participation in only one sport for a very limited season and nothing more. For others, involvement might even mean participating in one or several sports throughout the year, combined with being a spectator at other events. For some students, intercollegiate athletics remain a minor part of their college experience; for others, it is by far the most important part of their lives. Researchers might examine both the quantity and quality of students' involvement in intercollegiate athletics and employ a far more elaborate set of questions to survey the various styles of involvement.

NOTE

This study was supported by the Robert Wood Johnson Foundation.

For further information, please write Henry Wechsler, PhD, Director, College Alcohol Studies, Harvard School of Public Health, Department of Health and Social Behavior, 677 Huntington Avenue, Boston, MA 02115.

REFERENCES