ABSTRACT
Chapter 4 considers the impact of culture, values and ethnicity on PIEDS use. Sufficient evidence leads to the claim that PIEDS use transpires in all cultures and contexts. It occurs in school sport, although most of the available data come from American high schools where inter-school sport is highly valued, and where it contributes significantly to a school’s reputation and financial viability. PIEDS use also seems prevalent in community gyms and fitness centres, with Europe and the US featuring prominently. Substances of all kinds appear liberally in US colleges and universities as well, where both licit and illicit substance use is usually higher amongst athletes than non-athletes. Irrespective of some minor differences, the studies indicate that people of all backgrounds and who play sport regularly hang around sport clubs, and use gyms to build their bodies, and do actually use PIEDS (with a special emphasis on alcohol) more often that those who pursue other leisure activities.
