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To document the use of performance-enhancing substances (PES) by young athletes and to identify associated factors.Retrospective survey.Self-reported anonymous questionnaire.Three thousand five hundred seventy-three athletes (mean age, 15.5 years) from Quebec provincial teams run by organizations recognized by the Government of Quebec.All subjects filled out a validated questionnaire on factors associated with the use of and the intention to use PES.The use of and intention to use PES.In the 12 months before filling out the questionnaire, 25.8% of respondents admitted having attempted to improve their athletic performance by using 1 or more of 15 substances that were entirely prohibited or restricted by the International Olympic Committee. Multiple regression analyses showed that behavioral intention (β = 0.34) was the main predictor of athletes' use of PES. Attitude (β = 0.09), subjective norm (β = 0.13), perceived facilitating factors (β = 0.40), perceived moral obligation (β = −0.18), and pressure from the athlete's entourage to gain weight (β = 0.10) were positively associated with athletes' behavioral intention to use PES.This study provides evidence that supports the predicting value of the theory of planned behavior. Results suggest that the athlete's psychosocial environment has a significant impact on the decision to use PES and support the need to integrate this factor into the development and implementation of prevention interventions.