The associations between sports team participation and adolescent health risk behaviors in the United States

Background Sports team participation is widely regarded as a protective factor for adolescent development. However, current evidence remains inconsistent regarding its association with specific health risk behaviors. This study aimed to characterize the divergent patterns of substance use, risky driving, and sexual behaviors among U.S. adolescents participating in sports teams over a 24-year period. Methods Data from the Youth Risk Behavior Surveillance System (YRBSS) Combined Datasets (1999–2023) were analyzed, comprising a nationally representative sample of high school students (Grades 9–12). The primary exposure was the frequency of sports team participation. Multivariable logistic regression models were utilized to estimate for four domains of risk behaviors (driving, substance use, illicit drug use, and sexual activity), adjusting for covariates such as gender, age, race/ethnicity, and BMI percentile. Results were expressed as predictions with 95% confidence intervals (95% CIs). Results Sports team participation was significantly negatively associated with cigarette smoking and most illicit drug use behaviors. In contrast, it was significantly associated with higher rates of texting while driving and alcohol consumption. With respect to sexual behavior, students who participated in sports teams were more likely to report recent sexual activity; however, they also demonstrated significantly higher compliance with condom use. Conclusions Sports team participation shows distinct associations with adolescent risk behaviors, highlighting the potential importance of interventions. Greater participation was linked to higher engagement in risky driving, alcohol use, and sexual activity, while showing protective associations with cigarette smoking and the majority of illicit drug use, and exhibiting higher compliance with condom use. These findings underscore the necessity of integrating targeted, behavior-specific prevention strategies into sports settings to maximize health benefits while mitigating unintended harms.