Keywords
Smoking
Tobacco
Cardiovascular Risk
Sport Type
Abstract
Background. Smoking habits remain prevalent even among competitive athletes, despite their well-documented negative impact on cardiovascular health and athletic performance.
Aim. To assess the prevalence of tobacco use among competitive athletes in a southern Italian region and explore its association with demographic characteristics, sport type, and cardiovascular risk factors.
Materials and methods. A cross-sectional survey was conducted among 1,348 athletes residing in the Salento peninsula (Southern Italy), with a mean age of 38.8±13.9 years. A structured questionnaire collected information on sporting activity, tobacco use, electronic nicotine delivery systems (ENDS), and cardiovascular risk factors.
Results. Overall, 24.4% of athletes reported smoking. Smoking prevalence was significantly higher among athletes with at least one cardiovascular risk factor compared with those without (31.2% vs. 22.1%, p=0.01). Strength athletes showed a higher prevalence of smoking than endurance athletes (31.9% vs. 17.1%, p=0.001), and athletes participating in team sports smoked more frequently than those in individual sports (34.0% vs. 19.7%, p<0.01). Smoking was more prevalent among older athletes than younger athletes (25.9% vs. 21.6%, p=0.023). ENDS were used by 10.3% of athletes; among ENDS users, a higher proportion were younger athletes (65% vs. 39%, p=0.001) and women (55% vs. 43%, p=0.02). Consistent with these findings, multivariable analysis showed that smoking was independently associated with the presence of ≥1 cardiovascular risk factor (OR 2.46), participation in team sports (OR 1.79), and older age (>35 years: OR 1.54), while endurance athletes (OR 0.62) and elite competitors (OR 0.58) exhibited lower odds of smoking.
Conclusion. Tobacco use remains common among competitive athletes and appears comparable to estimates from the general population. Smoking is more frequent among strength athletes and among those with cardiovascular risk factors. ENDS use is particularly widespread among younger athletes and women. These findings highlight the need for targeted cardiovascular prevention strategies even within athletic populations.
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