Self-reported attitudes of elite athletes towards doping: differences between type of sport

Although athletes' beliefs and values are known to influence whether or not an athlete will use banned drugs, little is known about the athletes' beliefs and attitudes in different sports. The aim of this study was to clarify the beliefs and attitudes of elite athletes towards banned substances and methods in sports. A total of 446 athletes (response rate 90.3 %; 446/494) financially supported by the National Finnish Olympic Committee completed a structured questionnaire during their national team camps in 2002. More than 90 % of the athletes reported to believe that banned substances and methods have performance enhancing effects, and 30 % reported that they personally know an athlete who uses banned substances. Of the male athletes 35 %, and 23 % of females reported they personally know an athlete using banned substances. A total of 15 % of the athletes reported that they had been offered banned substances: 21 % of the speed and power athletes, 14 % of the team sport athletes and of the athletes in motor skills demanding events, and 10 % of the endurance athletes. Stimulants were the most often offered substance group (to 7 % of all the athletes) followed by anabolic steroids (4 %). Subjects who regarded doping as a minor health risk seemed to be more often associated with doping users than those regarding doping as a significant health risk. Athletes in different sports have a different approach to doping. Risk of doping appears to be highest in speed and power sports and lowest in motor skills demanding sports. Males are at higher risk than females. Controlling doping only by tests is not sufficient. A profound change in the attitudes is needed, which should be monitored repeatedly.     

Doping prevalence among preadolescent athletes: a 4-year follow-up

Objective

To describe the prevalence of doping and its progression in a cohort of preadolescent athletes during a 4‐year follow‐up.

Design and settings

Prospective cohort study. Self‐questionnaire survey.

Participants

All of the pupils entering the first year of secondary school (sixth grade) in the Vosges Département (east France) and followed for 4 years.

Main outcome measurements

Drug use (prohibited substances, tobacco, alcohol, cannabis), intention to use, reported health hazards, perceived drug effectiveness, self‐esteem, trait anxiety.

Results

At the beginning of the study, 1.2% (95% CI 0.8 to 1.6) stated that they had taken doping agents at least once in the preceding 6 months, and this had risen to 3.0% (95% CI 2.3–3.7) 4 years later (p<0.001). Of those who had used doping agents, 4% reported that they had experienced a health problem related to doping, and 44% reported that they had won at least one sports event as a result of using the drug. Use of doping agents is linked to the number of hours of practice per week, intention to use, use of other drugs, self‐esteem and trait anxiety.

Conclusions

The results show that doping does exist in preadolescent athletes who train every day. This fact should to be taken into account in preventive actions.     

Can we measure accurately the prevalence of doping?

Questionnaires are used in the majority of the studies on doping prevalence in sport. Nevertheless, prevalence is not easy to evaluate and previous epidemiologic studies demonstrated a wide variance. This variance has mostly been explained by sample differences. The way to evaluate doping prevalence in the survey is questioned in this paper. A questionnaire was administered to 1810 amateur athletes (993 males, 817 females). Doping use was ascertained in various ways, using different definitions of doping and types of question in the survey. Depending on the definition of doping and the type of question used, the prevalence of doping obtained can differ enormously, between 1.3 and 39.2% of athletes. Marijuana and drugs for asthma were the two banned substances most used. The majority of athletes often ignored the banned list and did not use prohibited substances to dope. Using various ways to question athletes, observing the usage of substances, cross checking the data, taking into account the aim of substances uses and the various definitions of doping are necessary to give more reliable prevalence of doping. Moreover, doping at an amateur level seems to be less of a sport problem than a social problem.     

Athletes' knowledge and views on OTC medication

A questionnaire was administered to elite athletes from Australia, Canada, the UK, and the USA representing 10 Olympic sports in order to explore knowledge and understanding of over-the-counter (OTC) medication since the removal of many of these substances from the World Anti-Doping Agency (WADA) Prohibited List, in 2004. Athletes demonstrated limited knowledge and understanding. Around half (50.5 %) knew the penalty incurred following a doping violation involving a banned OTC stimulant. The terms Monitoring Program and Specified Substance List were understood by 43.3 % and 67.5 % of respondents, respectively. Overall, the status of substances in relation to the Prohibited List was correctly identified in just 35.1 % of cases. As a whole, athletes were of the opinion that OTC stimulants posed a risk to health, were performance enhancing and that their use was against the spirit of sport. They were undecided as to whether these drugs should be returned to the Prohibited List. Elite athletes require targeted education programmes that will enable them to make informed decisions on the potential of OTC medications for therapeutic or performance enhancing purposes.     

Attitudes of coaches towards doping

BACKGROUND: Coaches are usually held to be among the main actors of doping prevention campaigns. The aim of this study was to document certain attitudes of professional coaches faced with doping, and to evaluate how they confronted it on an everyday basis. METHODS: Experimental design: prospective study by self-reporting questionnaire. Setting and participants: the questionnaire was mailed to the last 800 graduated coaches (1994-1997) in the Lorraine region, Eastern France. The 260 responding coaches comprised 77 women and 183 men, the average age being 30.8 +/- 8.0 years (mean +/- standard deviation). RESULTS: 10.3% of coaches consider that an athlete may use doping with no health hazard with the help of a physician, and 30.0% that an athlete who declines doping has little chance of succeeding. 5.8% had used doping drugs in the last twelve months (1 to 6 times). 13.5% of coaches mention that athletes (1 to 5 per coach on average) told them they had been prompted to use doping drugs during the previous 12 months. 80.7% consider that the current methods of preventing doping in sport are ineffective, and 98.1% of them consider that they have a role to play within this context, but 80.3% consider themselves badly trained in the prevention of doping. Only 10.4% have organized a doping prevention action during the last 12 months. CONCLUSIONS: In this study, professional coaches do not seem to be efficient in the prevention of doping. Further education and training for coaches on doping is advisable.     

Perspectives in the utilisation of Fourier-transform infrared spectroscopy of serum in sports medicine: health monitoring of athletes and prevention of doping

Doping prevention is mainly directed to providing information on the dangers of doping to young athletes and to every profession concerned with athletic performance. Unfortunately, repression is also necessary in the fight against doping. Measurement of performance-enhancing drugs is complex, partly because of the large number of prohibited substances. A number of sophisticated analytical techniques are increasingly being used to provide the maximum detection time window. However, the effectiveness of methods to separate exogenous from endogenous biological molecules and the cost of antidoping analyses makes controls invalid or impossible. Moreover, most athletes, because of the metabolic and psychological stresses caused, legitimately refuse blood testing. It is becoming crucial to introduce new methods in the form of longitudinal health monitoring, since this is probably the most effective tool to prevent the use of doping agents when athletes become overtrained and/or overstressed. This paper describes new methods using Fourier-transform infrared spectroscopy to analyse serum from 50 microl samples of capillary blood. This technique has been shown to allow determination of the concentration of a wide range of biological molecules in a single microsample with clinically useful accuracy, and to provide a 'discriminatory biomolecular profile' to differentiate individuals on the basis of their physiological status. A specific application of this methodology is to perform longitudinal health monitoring in athletes, allowing prevention of overtraining. It is proposed to apply such methods in longitudinal studies for health monitoring and prevention of doping.     

Dietary supplements and medications in elite sport – polypharmacy or real need?

The aim of this study was to describe qualitatively and quantitatively dietary supplements (DS) and medication use in elite athletes. Athletes (n=912; age 23.9±6 years; 72% male) reported medications and DSs taken within 3 days before doping control. We analyzed data collected from 2006 to 2008, indentified and classified substances. Total of 74.6% athletes reported use of at least one substance, 61.2% took DS (3.17 per user) and 40.6% took medications. Among users, 21.2% reported the use of six and more different products, and one took 17 different products at the same time. Majority of medication users took non‐steroidal anti‐inflammatory drugs (NSAID) (24.7%), and 22.2% used more than one NSAID. We found no gender differences in DS use (P=0.83). Individual sport athletes used more DS (P<0.01). Our study showed widespread use of DS and drugs by elite athletes. Consumption of DS with no evident performance or health benefits, demonstrated the need for specific educational programs focused on DS use. Amount, quantity and combination of the reported products raised concern about the risk of potential side effects.     

Young athletes' awareness and monitoring of anti‐doping in daily life: Does motivation matter?

This study was a preliminarily investigation into the prevention of unintentional doping on the basis of self‐determination theory (SDT). Specifically, we examined the relationship between athletes' motives for doping avoidance and their behavior when offered an unfamiliar food product. Participants were young Australian athletes (n = 410) that were offered a free lollipop prior to completing a questionnaire. It was noted whether participants refused to take or eat the lollipop and whether they read the ingredients of the lollipop. The questionnaire assessed autonomous and controlled forms of motivation, amotivation, doping intentions, and adherence regarding doping avoidance behaviors. The results showed that young athletes who adopted controlled reasons to avoid doping in sport (e.g., not getting caught) tended to report higher adherence to behaviors related to avoiding and monitoring banned substances, whereas those who adopted autonomous reasons (e.g., anti‐doping being consistent with life goals) appeared to be more willing to read the ingredients of the provided food. The significant interaction effect between autonomous and controlled motivation indicated that autonomous motivation was more predictive to doping intention for athletes with low controlled motivation. It is concluded that SDT may help understand the motivational processes of the prevention of unintentional doping in sport.     

Dopage et sport : connaissances et attitudes des pharmaciens de la ville de Yaoundé

Introduction – Fourty-one retail pharmacists (23 females and 18 males) out of 70 that Yaoundé town counts, participated to this study aimed at determining their attitudes towards and knowledge in doping. They answered a questionnaire concerning their knowledge of doping agents, how they face doping and the role of pharmacists in doping prevention.Synthesis – Results suggest that pharmacists (54%) have been confronted to doping, less than once a month for 27% of them and at least once a month for the rest. Six pharmacists (15%) have been offered to provide doping agents to sport men. 51% (mainly females) consider that the use of food supplements could induce consumption of forbidden drugs. The majority (83%) of pharmacists (mainly females) consider that doping is a public health problem. They agree (88%) that pharmacists have a part to play in doping prevention but also agree (58%; mainly females) that they are poorly or very poorly informed to that effect.Conclusion – The requests made to pharmacists suggest the consumption of doping agents by sport men in our region. It is therefore necessary to carry out an epidemiologic study on prevalence and consumption patterns.     

Adolescents sportifs,offre et demande de substances pour améliorer la performance

Introduction. – Little is known about the main methods and means employed to supply adolescents with doping agents and others substances used to improve their sporting performance.Main facts. – A study in France among all the adolescent of the ‘Union nationale du sport scolaire’, using a self-completed questionnaire, furnished 6402 exploitable questionnaires, corresponding to 48.9% for the girls and 51.1% for the boys, both aged on average from 16.1 ± 2.2 years. These adolescents practise on average 10.0 ± 5.2 hours of sport per week. 21.9% participate on a national or international competition level. Of our respondents, 4.0% said they had been enticed into using products, which are prohibited for athletes. 10.3% of the adolescents stated that they had received substances to improve their performance at least once from an average of two different people. It was mostly a friend, their parents and the family doctor. In nearly half the cases (46.6%), the adolescent paid for the product.Conclusion. – It is necessary to better understand the ways in which this black market functions: for example; the initial sources of the products sold, the number and the ‘profiles’ of the dealers, the general organisation of the market and the sums of money involved.     

Use of acetaminophen in young subelite athletes

AIM: The purpose of the present investigation was to look for other drugs besides doping substances in the urine of subelite athletes submitted to heavy training. METHODS: One hundred and forty-one young subelite athletes (in sprint, cycling, middle distance running and handball) were included in the study, with a control group of 89 high school pupils. Drugs were researched by high performance liquid chromatography using a diode array detector. RESULTS: Among the 212 subjects who agreed to give a urine sample, acetaminophen was detected: 9.5% for the subelite athletes versus 1.3% for the control group with a greater difference for sprint and cycling training (26.7% and 20%, respectively). Acetaminophen is used to treat both acute and chronic pains. It relieves pain by elevating the pain threshold. CONCLUSIONS: The use of acetaminophen has to be taken into account by medical staff, trainers and educators.     

Nutritional supplement and doping use in sport: Possible underlying social cognitive processes

There is growing evidence suggesting that nutritional supplement (NS) use is strongly associated to doping use in elite and amateur sports. However, there is a paucity of research on the psychological processes that underlie this association. The present study investigated the cognitive and behavioral components of the association between NS use and doping among adolescent sub‐elite athletes. Six hundred and fifty adolescent athletes completed a questionnaire including measures of doping intentions, attitudes, norms, and beliefs about NS use. The results showed that NS users who did not report doping use had significantly stronger doping intentions and more positive attitudes and favorable beliefs toward doping use, as compared with athletes who did not use NS. In support of the “shared mental representations” hypothesis, the present findings show that NS use is associated with biased reasoning patterns in favor of doping use. This mechanism may explain why some NS users decide to engage in doping.     

Nutritional supplements in Norwegian elite athletes--impact of international ranking and advisors

The aims of this study were to investigate (a) the use of nutritional supplements (NS) (vitamins, minerals, Omega 3, antioxidants, ginseng, amino acids, Creatine and energy supplements) in elite athletes of different international ranking (b) why athletes are using NS, and (c) who recommends the elite athletes to use NS. The total population of elite athletes in Norwegian National Teams (n = 1620, 960 males and 660 females aged 15-39 years) and randomly selected (n = 1681) (916 males and 765 females) controls from the general population, were given a questionnaire including questions about use of nutritional supplements (NS), and from whom athletes had received information about nutrition and recommendations to use NS. The response rate was 76% for male and 92% for female athletes and 75% and 81% for male and female controls, respectively. A similar percentage of female athletes (54%) and controls (52%) reported use of one or more NS, but more male athletes (51%) than male controls (32%) used NS (P < 0.001). However, independent of gender, more athletes as compared to controls used minerals (males 26% vs. 8%; females 42% vs. 20%), amino acids (males 12% vs. 4%; females 3% vs. 0), and Creatine (males 12% vs. 2%; females 3% vs. 0). A lower percentage of NS users were observed in the best female athletes (52%) as compared to female athletes with less experience of international competition (73%) (P < 0.01). In male athletes, NS use was independent of international ranking (49%-53%). The coach was the main advisor for use of NS for both male (58%) and female athletes (52%). For male and female athletes, the main reason for using NS was that they felt it was needed in addition to their daily intake (56% and 67%, respectively). Forty one percent of the male and 37% of the female athletes using NS felt they were well informed about nutrition in general and NS. However, 8% of the NS users did not know whether the NS they used was doping classified or not. In conclusion: we found that a similar percentage of female elite athletes and controls, but a higher percentage of male elite athletes than controls, reported the use of NS. There was a lower percentage of NS use among the top female athletes, but not the top male athletes as compared to the less successful elite athletes. The coach was the main advisor for NS use both for male and female elite athletes.     

Doping and supplementation: the attitudes of talented young athletes

There is evidence of a small but significant proportion of adolescents engaging in doping practices. Young athletes face very specific pressures to achieve results as they strive for a career at an elite level. This study used an anonymized questionnaire to survey 403 (12-21 years old) talented young athletes' attitudes toward performance-enhancing substances and supplements. Two-thirds of the sample comprised males. Athletes were generally against the use of doping substances to enhance sporting performance. Within this generally unfavorable view, males tended to express a more permissive attitude toward performance-enhancing methods than females. Those convinced of the necessity of supplementation for sporting success were also more likely to express permissive attitudes. When asked whether they would take a "magic" drug that, while undetectable, would significantly enhance performance, the overwhelming majority of athletes said "no," but many thought others would take the substance. Interestingly, there was a significant association between the projected use of the hypothetical drug by competitors and the individual respondent's willingness to take the hypothetically "magic" substance. The study offers an insight into young athletes' attitudes toward specific forms of performance enhancement, and the strength of their beliefs in the face of a tempting hypothetical scenario.     

Gateway to doping? Supplement use in the context of preferred competitive situations,doping attitude,beliefs, and norms

Nutritional supplement (NS) use is widespread in sport. This study applied an integrated social cognitive approach to examine doping attitudes, beliefs, and self‐reported doping use behavior across NS users (n = 96) and nonusers (n = 116). Following ethical approval, 212 competitive athletes (age mean = 21.4, s = 4.5; 137 males) completed self‐reported measures of doping‐related social cognitions and behaviors, presented in an online format where completion implied consent. Significantly more NS users (22.9%) reported doping compared with nonusers (6.0%; U = 4628.0, P < 0.05). NS users presented significantly more positive attitudes toward doping (U = 3152.0, P < 0.05) and expressed a significantly greater belief that doping is effective (U = 3152.0, P < 0.05). When presented with the scenario that performance‐enhancing substances are effective and increase the possibility of winning, NS users were significantly more in favor of competing in situations that allow doping (U = 3504.5, P < 0.05). In sum, doping use is three‐and‐a‐half times more prevalent in NS users compared with nonusers. This finding is accompanied by significant differences in doping attitudes, norms, and beliefs. Thus, this article offers support for the gateway hypothesis; athletes who engage in legal performance enhancement practices appear to embody an “at‐risk” group for transition toward doping. Education should be appropriately targeted.     

Self‐admitted behavior and perceived use of performance‐enhancing vs psychoactive drugs among competitive athletes

The relationships between projected use, self‐reported behavior and attitudes to performance‐enhancing (PED) and recreational (RD) drugs were investigated among 82 competitive Hungarian athletes, with 14.6% admitting using PED and 31.7% using RD. Both the observed doping estimations (even those made by non‐users) and self‐admitted use were considerably higher than the average rate of positive doping tests (2% of all tests). The notable overestimation by PED users (34.6% vs 16.9%) was in keeping with the false consensus effect. A prediction model with attitude and projection to the likelihood of PED use suggested at least a 70% chance of self‐involvement of athletes, with responses at or above the median scores (Performance Enhancement Attitude Scale≥60 and estimation≥50%) on the two independent measures. Users overestimated the prevalence of doping in their sport (P=0.007) but not RD use, with the converse holding for RD users' views of doping (P=0.029). PED users also showed a significantly more lenient attitude toward doping (P<0.001). This domain‐specific characteristic adds new information to the ongoing research effort in understanding drug‐doping co‐morbidity. The reasons for elevated in‐group projection are discussed, along with the potential application of this phenomenon in doping epidemiology studies.