ATLANTA — High school athletes who play on sports teams smoke tobacco products at a lower rate than non-athletes, but use smokeless tobacco at a higher rate, according to a study published by the Centers for Disease Control & Prevention (CDC) in the latest issue of Morbidity & Mortality Weekly Report (MMWR).

Data from national Youth Risk Behavior Surveys (YRBS) show that while current use of combustible tobacco products (cigarettes and cigars) dropped dramatically from 2001 to 2013 among all high school students (31.5% to 19.5%), current use of smokeless tobacco remained unchanged among non-athletes (5.9%) and increased among athletes (10% to 11.1%).

The lower use of combustible tobacco products might result from athletes’ awareness of how smoking can hurt athletic performance, the report said. The higher use of smokeless tobacco suggests athletes may perceive these products as harmless, socially acceptable or perhaps even as a way to boost athletic performance, the CDC speculated.

The data show a relationship between the number of sports teams on which an athlete plays and his or her tobacco use. Athletes who play on multiple sports teams use smokeless tobacco more and combustible tobacco less. During 2013, prevalence of smokeless use was 5.9%, 10.2%, 11.5% and 12.5% among students participating in zero, one, two, or three or more sports teams, respectively. But combustible tobacco use was 21.3%, 19.6%, 17.1% and 15.8% among students participating in zero, one, two or three or more sports teams, respectively.

The tobacco industry has marketed smokeless products as an alternative to cigarettes in situations where smoking is prohibited, which might further promote their use among athletes, said the CDC.

Although Minor League Baseball prohibits use of smokeless products, Major League Baseball restricts but does not prohibit their use. San Francisco has adopted a policy, which becomes effective Jan. 1, 2016, that would prohibit the use of smokeless tobacco and all other tobacco products at all city professional and amateur athletic venues. On Sept. 2, 2015, Boston enacted a similar policy that goes into effect April 1, 2016.

Smokeless tobacco use among professional athletes is concerning, said the CDC, because youth may view them as role models. Tobacco-free policies that prohibit all tobacco use by players, coaches, referees and fans on school campuses and at all public recreational facilities—including stadiums, parks and school gymnasiums—might help make smokeless tobacco use less socially acceptable and reduce its use among student athletes, said the report.