The Relative Roles of Types of Extracurricular Activity on Smoking and Drinking Initiation Among Tweens

  • Anna M. Adachi-Mejia
    Address correspondence to Anna M. Adachi-Mejia, PhD, HB 7925, Cancer Control Research Program, Dartmouth-Hitchcock Norris Cotton Cancer Center, Lebanon, NH 03756.
    Department of Pediatrics, Geisel School of Medicine at Dartmouth, Lebanon, NH

    Cancer Control Research Program, Norris Cotton Cancer Center, Lebanon, NH

    Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, NH
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  • Jennifer J. Gibson Chambers
    University of New England College of Osteopathic Medicine Medical School, Biddeford, Me
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  • Zhigang Li
    Section of Biostatistics and Epidemiology, Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, Lebanon, NH

    Cancer Epidemiology and Chemoprevention Research Program, Norris Cotton Cancer Center, Lebanon, NH
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  • James D. Sargent
    Department of Pediatrics, Geisel School of Medicine at Dartmouth, Lebanon, NH

    Cancer Control Research Program, Norris Cotton Cancer Center, Lebanon, NH
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      Youth involvement in extracurricular activities may help prevent smoking and drinking initiation. However, the relative roles of types of extracurricular activity on these risks are unclear. Therefore, we examined the association between substance use and participation in team sports with a coach, other sports without a coach, music, school clubs, and other clubs in a nationally representative sample of US tweens.


      We conducted telephone surveys with 6522 US students (ages 10 to 14 years) in 2003. We asked participants if they had ever tried smoking or drinking, and we asked them about their participation in extracurricular activities. We used sample weighting to produce response estimates that were representative of the population of adolescents aged 10 to 14 years at the time of data collection. Logistic regression models that adjusted for appropriate sampling weights using jackknife variance estimation tested associations with trying smoking and drinking, controlling for sociodemographics, child and parent characteristics, friend/sibling/parent substance use, and media use.


      A little over half of the students reported participating in team sports with a coach (55.5%) and without a coach (55.4%) a few times per week or more. Most had minimal to no participation in school clubs (74.2%); however, most reported being involved in other clubs (85.8%). A little less than half participated in music, choir, dance, and/or band lessons. Over half of participants involved in religious activity did those activities a few times per week or more. In the multiple regression analysis, team sport participation with a coach was the only extracurricular activity associated with lower risk of trying smoking (adjusted odds ratio 0.68, 95% confidence interval 0.49, 0.96) compared to none or minimal participation. Participating in other clubs was the only extracurricular activity associated with lower risk of trying drinking (adjusted odds ratio 0.56, 95% confidence interval 0.32, 0.99) compared to none or minimal participation.


      Type of extracurricular involvement may be associated with risk of youth smoking and drinking initiation. Future research should seek to better understand the underlying reasons behind these differences.


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