# Substance Use in Sports: A Cross‐Sectional Study Among Professional Footballers in Accra, Ghana

## TL;DR

This study finds that professional footballers in Accra, Ghana, commonly use caffeine for energy but have low dependence on alcohol, cannabis, and tobacco, with pleasure being the main reason for use.

## Contribution

The study provides novel insights into substance use patterns among professional footballers in Ghana, a region with limited prior research on this topic.

## Key findings

- Caffeine use was highest (30.2%), followed by alcohol (15.8%), cannabis (2.9%), and tobacco (2.2%).
- Pleasure was the main motivation for alcohol, cannabis, and tobacco use, while caffeine was used primarily for energy.
- Longer tenure at a club was associated with lower substance use (OR = 0.81).

## Abstract

Substance use in sports, though harmful, is common but with little evidence from Africa. This study aims to assess the prevalence and self‐reported motivations for substance use, as well as to characterize the patterns of alcohol, tobacco, and cannabis use among professional footballers in Accra.

This cross‐sectional study included 139 professional footballers from nine teams competing in the Ghana Premier League and Division One League within the Greater Accra Region. Participants were selected using convenience sampling. Substance use was assessed with the Alcohol Use Disorders Identification Test (AUDIT), Fagerström Test for Nicotine Dependence (FTND), and Cannabis Use Disorders Identification Test–Revised (CUDIT‐R) to evaluate alcohol, tobacco, and cannabis use patterns, respectively.

The prevalence of substance use was 44.6%, with caffeine prevalence highest (30.2%), followed by alcohol (15.8%), 2.9% for cannabis, and 2.2% for tobacco. The mean AUDIT score amongst alcohol users was 3.6 ( ± 3.7), representing low‐risk consumption. The mean CUDIT‐R score was 6.3 ( ± 4.6), consistent with low‐risk cannabis use, while the mean FTND score was 0 ± 0, reflecting low nicotine dependence. Pleasure was the most frequently reported reason for alcohol, cannabis, and tobacco use, whereas energy enhancement was the main reason for caffeine use. Knowledge of performance‐enhancing drugs was low (2.2%), and no participant reported their use. A negative association was observed between the number of years spent at the current club and substance use (OR = 0.81; 95% CI 0.65–0.99; p = 0.042).

Participants in this study reported high usage of caffeine and low usage of alcohol, cannabis, and nicotine. There was also low dependence on these substances. Pleasure or recreational use was the commonest reason for substance use. Caffeine was most popularly used for energy. Health education, counselling, and scheduled substance use monitoring of athletes are necessary to prevent inadvertent use, maintain low levels and prevent progression to high‐risk use.