Factors associated with potential doping behavior among Swedish combat sport athletes: a cross-sectional study

The global growth and commercialism in combat sports have resulted in practitioners using performance-enhancing substances such as androgenic anabolic steroids, diuretics, hormone modulators, or stimulants. To gain a competitive edge, pressure often makes experienced athletes more prone to doping. Despite global trends of doping in combat sports, there is an evident lack of knowledge on protective and risk factors related to doping behavior in combat sports athletes. This study aimed to investigate (i) the prevalence of potential doping behavior (PDB) in Swedish combat sport athletes, (ii) sexbased differences in PDB, and (iii) factors associated with PDB.

A crosssectional observational study was conducted using a digital survey approach. The study population consisted of 120 active male (age: 40.6 ± 13.0 years) and 45 female members (age: 40.6 ± 9.2 years) of combat sport clubs in Sweden. Two standardized questionnaires were used: (1) Knowledge of Doping Questionnaire (KD), and (2) Questionnaire on Substance Use (QSU). The data were analyzed using Binomial Logistic Regression analysis and Fisher's Exact Test.

The prevalence of PDB was 9.7%. The logistic regression analysis showed "Training load" (OR = 1.005) and "Occasional tobacco use" (OR = 7.178) were positively associated with PDB. In other words, occasional tobacco users had over seven times higher odds of PDB compared to non-users. Also, each unit increase in training load slightly elevated the risk for PDB. Additionally, sexbased differences showed males as more prone to PDB compared to their female counterparts (p = 0.007). All other covariates, including "Doping knowledge," "Daily tobacco use," "Trust in coach expertise in doping" and "Competitive results" were not significantly associated with PDB.

In conclusion, for Swedish combat sport athletes, PDB was associated with higher training load and occasional tobacco use. Consequently, future antidoping interventions should address these identified associations in doping prevention programs.