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Cigarette Use Among Greek Athletes Prevention and Control (2005) 1, 229–236 www.elsevier.com/locate/precon Cigarette use among Greek athletes Sofia Spanoudaki a,*, Pavlos Myrianthefs c, Panagiotis Baltopoulos a, Maria Maridaki b, Jerome Talmud d, George Baltopoulos c a Division of Sports Medicine and Biology of Exercise, Laboratory of Functional Anatomy, TEFAA University of Athens (University of Sports Science), 1-5 Iokastis Steet, Byron, 16231 Athens, Greece b Laboratory of Exercise Physiology, TEFAA University of Athens, Ethnikis Antistasis 41, Dafni 17237, Greece c Athens University School of Nursing ICU, Antismoking Outpatient Clinic at KAT Hospital, 14561 Athens, Greece d Centre Medicale Cardio-Respiratoire, 64250 Cambo – Les – Bains, France Received 3 April 2005 Available online 23 November 2005 KEYWORDS Summary Cessation; Background: Cigarette smoking is an important risk factor for cardiovascular dis- Exercise; ease and lung cancer. Exercise improves cardiovascular and pulmonary function Performance; and also may play an important role in encouraging people to give up smoking, when Prevention; appropriate sporting activity is introduced. We investigated smoking habits among Smoking; Greek students participating in sporting activities. Students; Methods: We interviewed 1003 volunteers with a mean age of 17.9 ± 0.2 years. They Sports included 617 (61.5%) men and 386 (38.5%) women, participating in 30 different sporting activities. A specific questionnaire was used. Results: Of the 1003 volunteers, 104 (10.4%) were current smokers who started smoking at the age of 17.3 ± 0.2 years and smoked 13.6 ± 0.7 cigarettes per day. Among males 9.1% and among females 12.4% were current smokers. Two-thirds (66.4%) of the smokers preferred Marlboro (45.2%) and Camel (21.2%) brands, respectively. Among males, volleyball, kickboxing, track & field and handball and among females, volleyball, dance, gymnastics, and basketball were associated with higher rates of smoking. Students involved in national and international competi- tions had significantly lower smoking rates. Conclusions: Exercise may be related to a significantly lower prevalence of smoking among students. Smoking cessation programs should encourage sporting activity. Participation at high levels of competition may be significant in preventing the habit of smoking. c 2005 World Heart Federation. All rights reserved. * Corresponding author. Tel.: +30 2107657791; fax: +30 2109708367. E-mail address: [email protected] (S. Spanoudaki). 1573-2088/$ - see front matter c 2005 World Heart Federation. All rights reserved. doi:10.1016/j.precon.2005.09.002 230 S. Spanoudaki et al. Introduction 1056). The questionnaire took about 35 min to complete. Cigarette smoking is responsible for more than Applying the questionnaire, we identified cur- 400,000 premature deaths annually in the USA. It rent smokers, age of starting smoking, number of is interesting to note that in 1990, one out of every cigarettes smoked per day, Fagerstrom scale score, five deaths was the result of smoking [1]. Cigarette favourite brands, type of sport, and the level of smoking changes both the structure and function of competition engaged in by male and female central and peripheral airways, alveoli and capil- students. laries, and the immune system of the lungs and For the purposes of our analysis, we divided 30% of coronary heart disease are attributable to sports into two main categories: team sports (7 = tobacco [2]. baseball, basketball, handball, football, softball, Tobacco smoke contains more than 4000 chemi- volleyball, water polo) and individual sports (23 = cals, 60 of which are known to be carcinogenic. The archery, boxing, cycling, dance, fencing, gymnas- most dangerous components identified in cigarette tics, horse riding, judo, karate, kayak, kickboxing, smoke are hydrogen cyanide, nicotine and carbon motocross, rowing, sailing, shooting, skiing, swim- monoxide (CO) [3]. In sports, smoking induced ele- ming, tae kwon do, tennis, ping pong, track and vation in the CO content of the blood reduces exer- field, weight lifting, wrestling). cise tolerance and maximal aerobic capacity. It We also divided athletes according to the level also increases the reliance on glycolytic metabo- of competition into three categories: regional level lism during exercise. As a result, these factors con- athletes participating only in sports activities in- tribute to earlier fatigue in smokers compared with cluded in university courses; national level athletes nonsmokers who exercise [4]. participating in national competitions, as well as in Smoking is not only dangerous for human health university sports activities and International level but it also negatively affects the individual’s qual- athletes participating in national and international ity of life. Sport activity is known to promote competitions, as well as in university sports health and reduce the risk of lung cancer and heart activities. diseases [2]. On the other hand, smoking cessation has significant benefits on health status including Statistics exercise tolerance. The extensive literature on the health benefits of cessation has been summa- Data collected on smoking habits were subjected rised by the US Surgeon General [5]. to descriptive statistics including mean, standard The purpose of this study was to investigate the error and percentages. Categorical data were com- epidemiological characteristics of tobacco use pared using the v2 test. Each type was then divided among Greek students participating in sporting according to the average duration of daily training activities, who were not professional athletes. (<3 and P3 h) and according to the level of compe- Also, we set out to examine possible relations be- tition in which they participated. tween smoking and the type of sport, sex, and level of competition. Results Material and methods Of the 1003 students-athletes interviewed, 617 (61.5%) were men and 386 (38.5%) were women. From July 2001 to February 2003, we surveyed The mean age was 17.9 ± 0.2 years (range: 17–31 male and female students from Athens University years). There were 104 current smokers (10.4%) participating in 30 different sporting activities. A including 56 men (9.1%) and 48 women (12.4%). 26 item, multiple-choice questionnaire was applied The difference was not statistically significant (v2 (Appendix). Testing was anonymous and on a volun- test). Table 1 summarizes the characteristics of teer basis. Only Greek students participated in the all the participants in the study. Males participat- survey; those from other racial and ethnic groups ing in the study were significantly younger and were excluded. All students participating in the started smoking at a significantly younger age study were amateurs and not professional athletes. (P < 0.01). Most males were participating in team The questionnaire was distributed by informed sports while most females were participating in personnel to student-athletes at the Athens Univer- individual sports. A significantly higher proportion sity of Sport Science. We recruited 1056 students of females was involved in national and interna- with a response rate of approximately 95% (1003/ tional sports activities (P < 0.05). Cigarette use among Greek athletes 231 Table 1 Demographics and descriptive statistics of all study participants Males (617, 61.5%) Females (386, 38.5%) Total (1003) Smokers 56 (9.1%) 48 (12.4%) 104 (10.4%) Non-smokers 561 338 899 Age (years) 16.9 ± 0.2*** 19.3 ± 0.2*** 17.9 ± 0.2 NS 16.5 ± 0.2*** 18.9 ± 0.3*** 17.4 ± 0.2 S 21.9 ± 0.6** 22.5 ± 0.3** 22.2 ± 0.4 Type of sport Individual 180 (29.2%)**** 247 (63.9%)**** 427 (42.6%) Team 437 (70.8%)**** 139 (36.1%)**** 576 (57.4%) Competition level Regional 478 (77.5%)**** 237 (61.4%)**** 715 (71.3%) National 105 (17.0%)**** 116 (30.1%)**** 221 (22.0%) International 34 (5.5%)* 33 (8.5%)* 67 (6.7%) S, smokers; NS, non-smokers. * Statistically significant difference, P < 0.05. ** Statistically significant difference, P < 0.01. *** Statistically significant difference, P < 0.001. **** Statistically significant difference, P < 0.0001. Table 2 Smokers vs. non-smokers: age, competition level and type of sport in males and females Males (n = 617) Females (n = 386) Total (n = 1003) S (%) NS S (%) NS S (%) NS Age 21.9 ± 0.6 16.5 ± 0.2 22.5 ± 0.3 18.9 ± 0.3 22.2 ± 0.4 17.4 ± 0.2 Competition level Regional (n = 715) 37 (6.0) 441 25 (6.5) 212 62 (6.2) 653 National (n = 221) 9 (1.5)* 96 15 (3.9)* 101 24 (2.4) 197 International (n = 67) 10 (1.6) 24 8 (2.1) 25 18 (1.8) 49 Type of sport Individual (n = 427) 23(3.7)** 157 30(7.8)** 217 53 374 Team (n = 576) 33 (5.4) 404 18 (4.6) 121 51 525 S, smokers; NS, non-smokers. * Statistically significant difference, P < 0.05. ** Statistically significant difference, P < 0.01. Table 2 shows the characteristics of the smokers compared to females. The most popular brands vs. non-smokers with respect to age, level of com- were Marlboro and Camel in both sexes. The level petition and type of sport in males and females. A of addiction to nicotine measured by the Fager- significantly higher proportion of females partici- strom scale score was 5.2 ± 0.2 for males and pating at a national level (P < 0.05) and in individ- 5.1 ± 0.3 for females. The difference was not sta- ual sports (P < 0.01) were smokers compared to tistically significant. males. Table 4 shows the numbers and percentage of Table 3 shows the characteristics of smokers, smokers per specific sports activity. Percentages including the numbers and percentages of smokers, were calculated if the total number of participants of cigarettes smoked per day, the Fagerstrom scale as P10 per sports activity. Among males, volley- score, the starting age of smoking, and the most ball, kickboxing, track & field and handball and popular cigarette brands. It also shows the smoking among females, volleyball, dancing, gymnastics, rates according to the type of sports activity, level and basketball were associated with the highest of competition and the duration of training per ses- smoking rates.
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