Sports participation increases vaping risk among high school students


High school students in sports teams were less likely to use cigarettes, but more likely to use electronic vapor products, according to a recent study.

Participation in sports teams increases the risk of using electronic vapor products (EVPs) among high school students, according to a recent study published in Pediatrics.

An increase in EVP use among high school students has been observed in recent years, potentially because of an assumption that nicotine vaping does not cause similar levels of harm and addiction as tobacco products. However, longitudinal studies have indicated an increased risk of cigarette use among youths using e-cigarettes.

Cases of morbidity because of vaping have been reported, and suspected carcinogens released by EVP liquids indicate potential, unknown health consequences. With these outcomes in mind, studies have been conducted on how adolescent behaviors affect the risk of EVP use.

Participation in sports teams has been associated with decreased cigarette use, but some studies have associated sports team participation with increased e-cigarette use. However, this data was limited.

To determine the association between participation in sports teams and EVP use, investigators conducted an analysis of data from the Youth Risk Behavior Survey (YRBS), a survey of high school students in the United States.

Data was gathered from the 2015, 2017, and 2019 YRBS cycles. Questions in the survey asked students on their use of EVPs and cigarettes in the previous 30 days. 

Exclusive users of EVP, referred to as EVP users, were students who had not used cigarettes but had used EVPs in this time. Exclusive users of cigarettes, referred to as cigarette users, were students who had used cigarettes and not EVPs. Students who used both products were referred to as dual users, and those who used neither were referred to as nonusers.

Intermittent use of EVPs or cigarettes was defined as 1 to 19 days of use in the past 30 days, while frequent use was 20 days or more in the past 30 days. Sports participation was determined through a question asking how many sports teams students played in during the past 12 months.

There were 30,762 high school students who met the inclusion criteria for the study throughout the 3 YRBS cycles. About half of participants were female. Of participants, 75.1% were nonusers, 2.3% cigarette users, 16.1% EVP users, and 6.5% dual users.

No participation in sports teams was seen in 43.7% of participants, while 25.4% were on 1 team, 17.4% on 2 teams, and 13.5% on 3 or more teams. Of students participating on 1 or more sports team, 74.5% were nonusers, 1.7% cigarette users, 18.3% EVP users, and 5.5% dual users.

Among students not participating in sports teams during the prior 12 months, 75.9% were nonusers, 3.1% cigarette users, 13.4% EVP users, and 7.6% dual users. These students used EVPs less than those participating in sports teams but used cigarettes more.

Participation in sports teams reduced the odds of frequent versus intermittent use for cigarettes and EVPs among cigarette and EVP users respectively.

Based on these results, investigators recommended student athletes be educated on the health risks of EVP use.


Rapoport E, Zhu M, Pham D, Keim SA, Adesman A. Sports team participation and vaping among high school students: 2015–2019. Pediatrics. 2023;151(1):e2021055565. doi:10.1542/peds.2021-055565

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