Prevalence, determinants and trends of anabolic-androgenic steroid use among 93,437 high-school students: Repeated cross-sectional studies in Italy.

Authors

Sabrina Molinaro, Angelo Vigani, Chiara Stival, Alessandra Lugo, Sonia Cerrai, Michela Franchini, Francesca Denoth, Thomas Zandonai, Anna Odone, Silvano Gallus

Published in

Public health. Volume 259. Pages 106470. Aug 28, 2026. Epub Aug 28, 2026.

Abstract

Limited information is available on anabolic-androgenic steroids (AAS) use among young people. This study aims to fill this knowledge gap using a large Italian dataset.
Repeated representative cross-sectional study.
We used data from the ESPAD®Italia surveys annually conducted between 2017 and 2023 (excluding 2020) on 93,437 adolescents aged 15-19 years. Odds ratios (OR) of lifetime AAS use were estimated using unconditional multiple logistic regression models.
Lifetime AAS use prevalence was 1.9%, current use was 0.8%. Lifetime use declined from 2.4% (2017) to 1.2% (2021), then rose to 3.3% (2023). AAS use was more frequent among males (OR = 1.94; 95% Confidence Interval, CI: 1.75-2.15), those preferring not to disclose their gender (OR = 4.18; 95% CI: 3.00-5.81), overweight/obese (OR = 1.27; 95% CI: 1.10-1.46), subjects doing daily (OR = 1.21; 95% CI: 1.02-1.45), moderate (OR = 1.22; 95% CI: 1.00-1.49), intense (OR = 1.74; 95% CI: 1.41-2.15), agonistic (OR = 1.29; 95% CI: 1.15-1.45) physical activity, users of slimming substances (OR = 15.61; 95% CI: 13.01-18.73), supplements (OR = 4.59; 95% CI: 4.07-5.19), cigarettes (OR = 2.26; 95% CI: 2.04-2.51), cannabis (OR = 3.16; 95% CI: 2.83-3.52), alcohol (OR = 1.71; 95% CI: 1.53-1.91), energy drinks (OR = 4.25; 95% CI: 3.81-4.74), gamblers (OR = 1.98; 95% CI: 1.72-2.28), with low school performance (OR = 1.49; 95% CI: 1.17-1.90) and self-satisfaction (OR = 1.57; 95% CI: 1.36-1.82), and social problems (OR = 1.61; 95% CI: 1.40-1.84).
After a declining trend until 2021, AAS use subsequently rose among Italian teens, especially in vulnerable groups, including gender minorities, and adolescents with addictive behaviours or compromised social and psychological well-being. Awareness efforts are needed to address this emerging concern.

PMID:
42664874
Bibliographic data and abstract were imported from PubMed on 29 Aug 2026.

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