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Objective  To investigate the attitudes, beliefs and behavior related to performance enhancing substances (PES) use in elite Saudi football players.    Method  A cross-sectional survey was conducted. Using a systematic random sample of elite Saudi male football players, the standard World Anti-doping Agency (WADA) Social Science Research Package questionnaire was distributed to 408 players.    Results  The overall prevalence rate of PES use was 3.9%, with the overall prevalence rate of doping susceptibility 17.1%. PES use or doping susceptibility is strongly correlated but negatively associated with morality and cheating measures ( p  <  0.011, the estimate is − 0.139), threat or deterrence appraisal ( p  <  0.001, the estimate is − 0.301) and beliefs about the reference group’s endorsement ( p  < 0.001, the estimate is − 0.213) but not with legitimacy perceptions ( p  = 0.513) and beliefs about the benefits of doping ( p  = 0.678). The strongest relationship was found between threat or deterrence appraisal ( p  < 0.001), and beliefs about the reference group’s endorsement of PES use ( p  < 0.001).    Conclusion  Morality and cheating measures, threat or deterrence appraisal and beliefs about the reference group’s endorsement are the main predictors for PES use in Saudi Arabia.

Attitudes and behavior related to performance-enhancing substance use among elite Saudi football players