Sports-team participation and risk behaviors among US high school students: behavior-specific and sex-heterogeneous associations in the national YRBS, 2011–2023

Sports-team participation is often regarded as a favorable adolescent context, but whether its associations are consistent across distinct risk behaviors and across sex remains unresolved. We conducted a repeated cross-sectional analysis of seven U. S. National Youth Risk Behavior Survey cycles (2011–2023; 110,409 records) using survey-weighted regression and marginal standardization. Participation in one or more sports teams was associated with higher adjusted prevalence of alcohol use (PD, +4.46 percentage points; 95% CI, +3.38 to +5.55) and physical fighting (+2.53; 95% CI, +1.62 to +3.43), but lower prevalence of cigarette smoking (−3.46; 95% CI, −4.10 to −2.82) and marijuana use (−1.49; 95% CI, −2.33 to −0.66); all Holm-adjusted p < 0.001. Sex heterogeneity was observed for all four outcomes (all interaction p < 0.001): positive associations with fighting and alcohol were more pronounced among males, whereas inverse associations with cigarette smoking and marijuana use were more evident among females. The overall behavioral pattern was retained in participation-level and prespecified sensitivity analyses, although alcohol showed evidence of survey-cycle heterogeneity. Sports-team participation therefore corresponded to a behavior-specific and sex-heterogeneous, rather than uniformly lower- or higher-risk, behavioral profile. These findings may inform prevention science and intervention development in U. S. high school settings by supporting behavior-specific, context-sensitive strategies that address the social conditions surrounding sports participation rather than treating participation itself as uniformly protective or harmful.