Physical activity interventions for young people with increased risk of problematic substance use: A systematic review including different intervention formats

Objective: This systematic review investigates physical activity (PA) interventions for (1) reducing substance use and associated outcomes, (2) increasing physical activity, and (3) improving mental health in young people aged 12-25 years at increased risk for problematic substance use. Method: Four databases (PsycINFO, CINAHL, SPORTDiscus, and Medline) and grey literature, including hand searches, were searched (2021-2022). Non-randomized controlled or randomized controlled trials of a) multimodal or unimodal, short or long-term physical activity interventions in young people at increased risk of problematic substance use that b) investigated substance use outcomes were included. PA and mental health outcomes were explored where possible. Results: Sixty-one percent of the studies (k = 17/28) reported a significant improvement in outcomes related to tobacco (e.g., abstinence, cravings, withdrawal symptoms, smoking pattern), alcohol (e.g., quantity, frequency), or other substance use (e.g., frequency, quantity, recent use). Eight studies reported an increase in PA participation; two reported a beneficial effect on depression symptoms. The certainty of the evidence, i.e., the confidence in the reported effect estimates, was downgraded based on the risk of bias assessment. Findings should therefore be interpreted cautiously. Conclusions: A range of physical activity intervention formats and modalities may decrease substance use and associated outcomes and increase physical activity participation among people at risk for problematic substance use. Future research is warranted to better establish efficacy and investigate the effectiveness of implementing physical activity as part of treatment for substance use in young people.