Effects of physical activity on substance use among college students

Effects of physical activity on substance use among college students

Michael S. Dunn

Abstract: The purpose of this study was to assess the relationship between recreational physical activity and substance use among college students. Students ranging in age from 18 to 23 (n=2,436), from the 1995 National College Health Risk Behavior Survey, were selected for analyses. Recreational physical activity was assessed by the following question: “On how many days did you exercise or participate in sports activity for at least 20 minutes?” Students engaging in 12 substance use behaviors were assessed according to three levels of physical activity (none, low-activity, high-activity). Low-activity was defined as one to two days of activity per seven days; high-activity was defined as three or more days of physical activity per seven days. The substances included in the analysis were alcohol, cigarettes, smokeless tobacco, marijuana, cocaine, crack, inhalants, steroids, and heroin. The results of this study found that recreational physical activity was associated with increased levels of alcohol use and binge drinking, but lower rates of cigarette use among males and females. No practical significance was found for any illegal substance. As such, these findings do no t suggest the usefulness of physical activity as a tool for intervening in the substance use behavior of college students.

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Alcohol and other drug use among college students continue at an alarming rate, even though many prevention programs have targeted this group. According to the Monitoring the Future Study (Johnston, O’Malley, & Bachman, 1998), 87.3% of college students have tried alcohol, 82.4% had used in the past year, 65.8% had used in the last 30 days, and 40.7% had binge drank in the past two weeks. Additionally, 43.6% had smoked in the past year and 28.3% had smoked in the past 30 days. In regards to marijuana and cocaine, this study found that 31.6% and 17.7% of college students had used marijuana in the past year and past 30 days and 3.4% and 1.6% of students had used cocaine in the past year and past 30 days. Thus, substance use is still a major problem in the college population that has yet to be dealt with in a manner that has proven to be highly effective. Trends indicate there has been almost no change in the amount of alcohol, cigarette, marijuana, and cocaine use over the past 10 years (Johnston et al., 1998). Exercise/ athletic participation may be a possible means in which to prevent/reduce substance abuse.

Exercise and sports participation has traditionally been regarded as a means of encouraging development of healthy habits and deterring health risk behaviors (Pate, Heath, Dowda, Trost, 1996), yet the literature to date has not always validated the perception that exercise/athletic participation is a protective factor for risk behavior. Additionally, only a few studies have investigated the relationship between physical activity and substance use among college students and these studies have usually looked at inter-collegiate athletics not recreational physical activity.

A study by Leichliter, et al. (1998) found that both males and females who participated in college athletics consumed more alcohol per week, engaged in binge drinking more often, and suffered more adverse consequences from their substance use compared to non-athletes. Other studies have found similar results in that high level of physical activity was associated with heavy alcohol use among college students (Kokotailo, Henry, Koscik, Fleming, & Landry, 1996; Wechsler, Dowdall, Davenport, & Castillo, 1995; Skolnick & Winker, 1992; Nattiv & Puffer, 1991). Another study found that college students involved in athletics were more likely to binge drink and use smokeless tobacco compared to students not involved in athletics, but were less likely to use cigarettes or marijuana (Wechsler, Davenport, Dowdall, Grossman, & Zanakos, 1997). On the other hand, Koss and Gaines found that alcohol and drug use was lower among college athletes compared to non-athletes (1993). Another study found few differences between athletes and non-athletes regarding their alcohol consumption (Overman & Terry, 1991). A more recent study found that adolescents who participated in organized group activities were less likely to smoke, drink, and use marijuana compared to non-participating peers (Elder, Leaver-Dunn, Wang, Nagy, & Green, 2000). Page, Hammermeister, Scanlan, and Gilbert (1998) found that both male and female adolescents who participated on one or more athletic teams were significantly less likely to use cigarettes, marijuana, cocaine, and other illegal drugs. However, a greater percentage of those engaging in sports participation were more likely to have ever drank, binge drank in the past 30 days, and have ever used steroids than those not engaging in sports participation. Thus, the relationship between physical activity and substance use at this time is uncertain. It is uncertain if exercise/athletic participation is truly a protective factor for substance use. As such, the purpose of this study was to assess the relationship between level of recreational physical activity and substance me among college students.

METHODS

SUBJECTS AND DATA COLLECTION

The 1995 National College Health Risk Behavior Survey (NCHRBS) sample contained 7,442 students from 136 institutions. Of the total sample, 4,838 completed the questionnaire (60% response rate). The sample consisted of 55% female and 73% white. Age ranged from 18 to 65 years (complete details of the data set and sampling procedures have been published elsewhere: Douglas, Collins, Warren, Kann, Gold, Clayton, Ross, & Kolbe, 1997. For the purpose of this paper, only students between the age of 18 to 23 years (n = 2,436) were included in the data analysis. Individuals older than 23 were excluded from the analysis because these students are not considered traditional age students.

Students were randomly selected from lists of undergraduate students provided by each university and college. For data collection, the NCHRBS used a questionnaire mailed to each of the selected students. Mail-outs contained a questionnaire booklet, a pencil, a letter explaining the importance of the questionnaire and that it was completely voluntary and confidential, and a postage-paid return envelope. Two weeks after the first mail-out, students who had not returned the questionnaire were mailed a second one. Two weeks after the second mail-out, a third questionnaire was sent by certified mail and phone calls were made to determine willingness to participate. Data collection was began in January 1995 and completed in July 1995.

DATA ANALYSIS

Level of physical activity was assessed by the following question: “On how many days did you exercise or participate in sports activity for at least 20 minutes?” Students engaging in 12 substance use behaviors were assessed according to three levels of physical activity (none, low-activity, high-activity). Low-activity was defined as one to two days of activity per seven days; high-activity was defined as three or more days of physical activity per seven days. Levels of physical activity was classified as such because the U.S. public health sector recommends 3-5 days of exercise per week (Pate, Pratt, Blair, Haskell, Macera, Bouchard, et al., 1995). As such, those individuals participating in less than three days of physical activity per week were classified as low-activity. Logistic regression risk estimates (odds ratios) were used to assess the relationship between level of physical activity and substance use behavior. Students not participating in any physical activity during the past seven days were used as the referent group. The substance use behaviors that were evaluated included: drank alcohol in the past 30 days; binge drank in the past 30 days; ever smoked cigarettes; smoked cigarettes in the past 30 days; ever smoked cigarettes regularly; used smokeless tobacco in the past 30 days; used marijuana in the past 30 days; used cocaine in the past 30 days; ever used crack; ever used inhalants; ever used steroids; and ever used heroin. Substance use variables were recoded into yes/no categories.

RESULTS

Table 1 shows level of recreational physical activity by gender, race, and grade level. For females, a greater percentage of Whites had engaged in high-activity during the past week compared to African-Americans, Hispanic, and other racial category ([X.sup.2] =2.08, df=4, p=.719), although these finding were not statistically significant. For males, a greater percentage of Whites and Hispanics were engaging in high-activity than African-Americans and other racial category ([X.sup.2] =1.90, df=4, p=.928). Physical activity was not significantly associated with grade level for females or males. However, as grade level increased physical activity decreased in males steadily from freshman year through senior year and females showed a decrease after junior year.

Results showed that high-active females were significantly more likely to have drank alcohol in the past 30 days, as well as hinge drank in the past 30 days compared to non-active individuals. Among high-activity females, 68.6% had consumed alcohol in the past 30 days, whereas 62.1% of non-active females had consumed alcohol [RR=1.33 (95% CI=1.02, 1.72)]. Additionally, 39.7% of those in the high-activity category had binge drank compared to 29.6% of non-active individuals [RR= 1.56 (95% CI= 1.20, 2.02).

High-active females were significantly less likely to be a regular smoker and to have used marijuana and cocaine during the past seven days compared to non-active females, although these associations were very minimal for marijuana and cocaine use. Among high-active females, 17.5% were regular smokers, whereas 22.9% of non-active females smoked regularly [RR=1.50 (95% CI=1.03, 1.91)]. Marijuana use over the past 30 days indicated that 12.3% of high-active females used marijuana compared to 17.8% of non-active individuals [RR=0.64 (95% CI=0.45, 0.91)]. Additionally, low-active females (13.6%) were significantly less likely to use marijuana than non-active individuals [RR=0.72 (95% CI=0.50, 0.98).

Among males, results showed that low-active and high-active individuals were significantly more likely to binge drink than non-active individuals. Among those in the low-active category, 47.9% had binge drank in the past 30 days, whereas 36.8% of non-active individual had binge drank [RR=1.57 (95% CI=1.09, 2.26)]. For high-active individuals, 50.7% had binge drank in the past 30 days [RR= 1.76 (95% CI=1.25, 2.46). High-active and low-active males were significantly less likely to use cigarettes regularly. For cigarette use, 15.0% of high-active, 22.2% of low-active, and 24.5% of non-active males were regular smokers [high-active, RR= 1.84 (95% CI=2.00, 2.78); low-active, RR=1.13 (95% CI=0.74, 0.98)].

DISCUSSION

The results of this study indicated that physical activity might serve as a protective factor for cigarette use but not alcohol use among college students. Additionally, no practical significance was found for any other substance use behavior, thus indicating that recreational activity level may not reduce one’s likelihood of engaging in substance use behavior.

Females classified as high-active were more likely to have used alcohol over a 30 day period and to have binge drank over a 30 day period compared to non-active individuals. Among males, both low-active and high-active individuals were more likely to have binge drank over a 30 day period than non-active individuals. Previous studies of physical activity and alcohol use have indicated similar results with physically active students using alcohol to a greater extent (Wechsler et al., 1997; Wechsler et al., 1995; Aaron, Dearwater, Anderson, Olsen, Kriska, & LaPorte, 1998; Skolnick & Winker, 1992). The reason why physical activity is associated with alcohol use has yet to be fully explained. Possibly it has to do with socialization and the mass media.

Recreational physical activity level was shown to be a protective factor for regular use of cigarettes for both males and females. It may be that engaging in activities that promote health can have an effect on one’s cigarette use behavior. It seems plausible to conclude that individuals who value the benefits of regular exercise would be less likely to smoke because of the effects it has on one’s heart and lung functioning. As such, smoking could limit one’s ability to engage in high-impact physical activity by limiting one’s oxygen intake which in-turn reduces cardiovascular endurance and stamina. Previous studies have indicated similar results with high-active individuals being less likely to smoke (Baumert, Henderson, &Thompson, 1998; Page et al., 1998; Rainey, McKeown, Sargent, & Valois, 1996; Pate et al., 1996; Escobedo et al., 1993). It may be that three or more days of physical activity is the optimal amount of activity needed to prevent the use of cigarettes. On the other hand, greater amounts of physical activity resulted in greater uses of smokeless tobacco. It has been suggested that individuals who value athletic performance my use other forms of tobacco that will not reduce their cardiovascular endurance (Shilts, 1991; Gingiss & Gottlieb, 1991).

The present findings suggest that participation in physical activity does not provide much protection in term of alcohol and drug use, in that those individuals who participated in recreational physical activity were just as like to use drugs as non-participators and more likely to use alcohol. On the other hand, recreational activity level was associated with lower levels of cigarette use. Other studies assessing adolescent or inter-collegiate athletes have tended to find that participation is a protective factor against illegal drug and cigarette use but not necessarily alcohol use (Wechsler et al., 1997; Pate et al., 1996. In terms of the present sample of college students, it may be that no level of recreational participation would reduce one’s drug use. It may be that during the college years some students may not be all that interested in their health in terms of functioning. It could be that some college students workout for the sole reason of the outward signs of physical activity (i.e., lean body, physical beauty). Additionally, the college years are usually a time of experimentation and freedom away from parental influence, which may account for the few differences between those who participate in recreational physical activity and those who did not. As such, these findings do nor suggest the usefulness of physical activity as a tool for intervening in the substance use behavior of college students.

Table 1. Level of Recreational Physical Activity by Gender, Race, and

Grade Level

Female

low-activity high-activity

None (1) (2)

% N % N % N

Race

White 32.9 296 28.1 253 38.9 350

African American 49.3 106 20.5 44 30.2 65

Hispanic 36.2 72 30.7 61 33.2 66

Other 37.9 44 32.8 38 29.3 34

Grade Level

Freshmen 35.3 145 29.7 122 35.0 144

Sophomore 32.5 151 28.4 132 39.0 181

Junior 41.3 119 25.7 74 39.0 181

Senior 39.1 109 25.4 71 35.5 99

Male

low-activity high-activity

None (1) (2)

% N % N % N

Race

White 22.1 133 29.2 176 48.8 294

African American 22.6 26 29.6 34 47.8 55

Hispanic 21.7 28 29.5 38 48.8 63

Other 24.0 29 33.9 41 42.1 51

Grade Level

Freshmen 19.5 62 29.2 93 51.3 163

Sophomore 21.0 58 29.0 80 50.0 138

Junior 25.4 46 26.0 47 48.6 88

Senior 26.3 51 33.5 65 40.2 78

(1) Low-activity = 1 to 2 days of recreational physical activity per

week

(2) High-activity = 3 or more days of recreational physical activity

per week

Table 2. Percentage of Female Substance Use by Level of Recreational

Physical Activity

None low-activity (1)

Drank alcohol in past 30 days 62.1 66.0

Drank 5 or more drinks, past 30 days 29.6 31.3

Ever tried cigarettes 68.2 66.5

Smoked cigarettes in past 30 days 29.2 28.2

Ever smoked cigarettes regularly 22.9 21.1

Used smokeless tobacco in past 30 days 0.2 0.8

Used marijuana in past 30 days 17.8 13.6

Used cocaine in past 30 days 1.4 0.5

Ever used crack 1.9 0.8

Ever used inhalants 9.6 7.7

Ever used steroids 0.4 0.5

Ever used heroin 0.4 0.0

high-activity (2)

Drank alcohol in past 30 days 68.6

Drank 5 or more drinks, past 30 days 39.7

Ever tried cigarettes 67.4

Smoked cigarettes in past 30 days 25.6

Ever smoked cigarettes regularly 17.5

Used smokeless tobacco in past 30 days 1.0

Used marijuana in past 30 days 12.3

Used cocaine in past 30 days 0.0

Ever used crack 0.8

Ever used inhalants 6.4

Ever used steroids 0.0

Ever used heroin 0.0

(1) Low-activity = 1 to 2 days of recreational physical activity per

week

(2) High-activity = 3 or more days of recreational physical activity

per week

Table 3. Percentage of Male Substance Use by Level of Recreational

Physical Activity

None low-activity (1)

Drank alcohol in past 30 days 64.6 72.1

Drank 5 or more drinks, past 30 days 36.8 47.9

Ever tried cigarettes 67.5 71.6

Smoked cigarettes in past 30 days 32.7 26.0

Ever smoked cigarettes regularly 24.5 22.2

Used smokeless tobacco in past 30 days 9.0 13.4

Used marijuana in past 30 days 14.8 20.8

Used cocaine in past 30 days 1.9 0.3

Ever used crack 4.2 1.5

Ever used inhalants 13.4 11.6

Ever used steroids 0.9 1.7

Ever used heroin 1.5 1.0

high-activity (2)

Drank alcohol in past 30 days 70.1

Drank 5 or more drinks, past 30 days 50.7

Ever tried cigarettes 66.0

Smoked cigarettes in past 30 days 24.2

Ever smoked cigarettes regularly 15.0

Used smokeless tobacco in past 30 days 14.2

Used marijuana in past 30 days 18.3

Used cocaine in past 30 days 0.9

Ever used crack 0.3

Ever used inhalants 10.1

Ever used steroids 2.1

Ever used heroin 0.9

(1) Low activity = 1 to 2 days of recreational physical activity per

week.

(2) High activity = 3 or more days of recreational physical activity

per week.

Table 4. Odds Ratio (3) of Females Not Engaging in Health Risk Behavior

by Level of Recreational Physical Activity

low-activity (1)

Drank alcohol in past 30 days 1.18 (0.89, 1.55)

Drank 5 or more drinks, past 30 days 1.08 (0.81, 1.44)

Ever tried cigarettes 1.08 (0.81, 1.42)

Smoked cigarettes in past 30 days 1.05 (0.78, 1.40)

Ever smoked cigarettes regularly 1.11 (0.80, 1.52)

Used smokeless tobacco in past 30 days 3.94 (0.40, 3.80)

Used marijuana in past 30 days 0.64 (0.50, 0.98) *

Used cocaine in past 30 days 0.36 (0.07, 1.77)

Ever used crack 0.38 (0.10, 1.40)

Ever used inhalants 1.27 (0.80, 2.03)

Ever used steroids 1.31 (0.18, 9.37)

Ever used heroin 0.99 (0.99, 1.00)

high-activity (2)

Drank alcohol in past 30 days 1.33 (1.02, 1.72) *

Drank 5 or more drinks, past 30 days 1.56 (1.20, 2.02) *

Ever tried cigarettes 1.03 (0.79, 1.34)

Smoked cigarettes in past 30 days 0.87 (0.66, 1.15)

Ever smoked cigarettes regularly 1.50 (1.03, 1.91) *

Used smokeless tobacco in past 30 days 5.00 (0.58, 4.29)

Used marijuana in past 30 days 0.72 (0.45, 0.91) *

Used cocaine in past 30 days 0.98 (0.97, 0.99) *

Ever used crack 0.39 (0.12, 1.28)

Ever used inhalants 0.82 (0.51, 1.33)

Ever used steroids 0.99 (0.98, 3.45)

Ever used heroin 0.99 (0.99, 1.00)

(1) Low-activity = 1 to 2 days of recreational physical activity per

week

(2) High-activity = 3 or more days of recreational physical activity

per week

(3) This table list relative risk estimates (odds ratio). 95%

confidence intervals are included in (). An odds ratio is considered

significant if the confidence interval does not include 1.00. The

referent group for calculating odds ratios was not participating in

any exercise over the past 7 days.

* Statistically significant

Table 5. Odds Ratio (3) of Male Students Not Engaging in Health Risk

Behaviors By Level of Recreational Physical Activity

low-activity (1)

Drank alcohol in past 30 days 1.42 (1.00, 2.09)

Drank 5 or more drinks, past 30 days 1.57 (1.09, 2.26) *

Ever tried cigarettes 0.82 (0.55, 1.21)

Smoked cigarettes in past 30 days 1.06 (0.72, 2.00)

Ever smoked cigarettes regularly 1.13 (0.74, 0.98) *

Used smokeless tobacco in past 30 days 1.56 (0.87, 2.79)

Used marijuana in past 30 days 1.51 (0.94, 2.42)

Used cocaine in past 30 days 0.18 (0.02, 1.65)

Ever used crack 0.34 (0.12, 0.94) *

Ever used inhalants 0.84 (0.49, 1.44)

Ever used steroids 0.93 (0.24, 3.51)

Ever used heroin 1.12 (0.18, 6.80)

high-activity (2)

Drank alcohol in past 30 days 1.28 (0.90, 1.82)

Drank 5 or more drinks, past 30 days 1.76 (1.25, 2.46) *

Ever tried cigarettes 1.06 (0.75, 1.51)

Smoked cigarettes in past 30 days 0.65 (0.45, 0.93) *

Ever smoked cigarettes regularly 1.84 (2.00, 2.78) *

Used smokeless tobacco in past 30 days 1.67 (0.97, 2.86)

Used marijuana in past 30 days 1.28 (0.82, 2.00)

Used cocaine in past 30 days 0.45 (0.11, 1.83)

Ever used crack 0.07 (0.00, 0.62) *

Ever used inhalants 0.72 (0.44, 1.19)

Ever used steroids 1.15 (0.35, 3.73)

Ever used heroin 1.63 (0.33, 7.94)

(1) Low-activity = 1 to 2 days of recreational physical activity per

week

(2) High-activity = 3 or more days of recreational physical activity

per week

(3) This table list relative risk estimates (odds ratio). 95%

confidence intervals are inluded in (). An odds ratio is considered

significant if the confidence interval does not include 1.00. The

referent group for calculating odds ratios was not participating

in any exercise over the past 7 days.

* Statistically significant

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HEALTH EDUCATION RESPONSIBILITY AND COMPETENCY ADDRESSED

Responsibility I–Assessing Individual and Community Needs for Health Education

Competency B–Distinguish between behaviors that foster and those that hinder well-being.

Sub-competency 2–Identify behaviors that tend to promote or compromise health.

Michael S. Dunn, Ph.D. is an Assistant Professor in the Department of Public Health at East Tennessee State University. Min Qi Wang, Ph.D. is a Professor in the Department of Public and Community Health at the University of Maryland. Address all correspondence to Michael S. Dunn, Ph.D., Department of Public Health, East Tennessee State University, P.O. Box 70674 Johnson City, TN 37614-0674, PHONE: 423.439.4458, E-MAIL: dunn@etsu.edu

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