The consumption of alcohol mixed with energy drinks: prevalence and key correlates among Canadian high school students

Abstract

Research CMAJ OPENT he consumption of energy drinks, beverages that contain moderate to high concentrations of caffeine as well as taurine, herbal supplements, and sugar or sweeteners, has risen steadily in the last decade, 1 with sales surpassing those of many other nonalcoholic beverages in North America.2,3 These beverages have become particularly popular among youth and young adults owing to their purported stimulant effects and ability to increase alertness and enhance mental and physical energy. 1,[4][5][6][7] Clinical studies have shown that the consumption of energy drinks increases stimulation, attention and memory; decreases reaction times and mental fatigue; and improves performance on some physical activities. [8][9][10] At the same time, these beverages have been associated with negative health effects, including those typically associated with excess caffeine consumption, such as irritability, arrhythmia, nervousness, nausea and seizures. 7,[11][12][13][14][15][16] Despite warnings to the contrary, a popular practice among consumers of energy drinks is to mix them with alcohol. 17,18The combined effects of alcohol mixed with caffeine produce varied results on cognitive and motor performance. Because of increased feelings of alertness produced by caffeine, subjective estimates of alcohol impairment are typically underestimated, and the perceived rewarding aspects of drinking are enhanced. 5,17,[19][20][21] As such, consumption of alcohol mixed with energy drinks has been associated with greater risk-taking, impaired driving, higher volumes of alcohol consumption per sitting, increased injury susceptibility and higher rates of alcohol dependence. 1,16,[22][23][24][25][26][27][28][29] Other health consequences associatedBackground: An emerging body of research has reported high consumption of alcohol mixed with energy drinks among young adults, particularly college students. However, little is known about adolescents' consumption of these drinks. The purpose of this study was to determine the prevalence of consumption of alcohol mixed with energy drinks and to examine its correlates among Canadian high school students. Methods:We used a nationally representative sample of 36 155 Canadian students in grades 7 to 12 who participated in the 2010/2011 Youth Smoking Survey.Results: About 20% of Canadian high school students reported consuming alcohol mixed with energy drinks in the last year, with considerable variation across provinces. Multivariate logistic regression analyses showed that the odds of consumption of these drinks were higher among students in lower grades (grades 7 and 8) and among students who identified their ethnicity as black or "other." Consumption of alcohol mixed with energy drinks was positively associated with substance use (current smoking [adjusted odds ratio (OR) 1.52, 95% confidence interval (CI) 1. , absence from school, participation in school team sports and having more weekly spending money. Students who felt more connected to school and had an academic average of 70% or h...

Energy Drink Consumption and Associations With Demographic Characteristics, Drug Use and Injury Among Adolescents

“…Energy drinks, because of their high caffeine content, are increasingly being mixed with alcohol, often in an attempt to reduce feelings of alcohol intoxication. 11,29 There is also evidence of mixing energy drinks with cannabis and prescription drugs -13% of overall visits to US emergency departments that related to energy drinks involved the mixing of energy drinks with alcohol and 10% involved mixing with illicit drugs such as cannabis. 16 Current findings that high sensation-seeking (reported by 16% of respondents) and recent injuries (reported by 42%) are associated with energy drink consumption are consistent with research on college students that found greater jock identity and risk-taking behaviours among individuals who consume energy drinks.…”

Use of caffeinated energy drinks among secondary school students in Ontario: Prevalence and correlates of using energy drinks and mixing with alcohol

“…Lose weight, Gain weight, Stay the same weight, I am not trying to do anything about my weight". Spending money, associated with AmED use in a previous Canadian study, 22 presumably because the higher cost of these drinks may serve as a barrier to some youth, was assessed using the question, "About how much money do you usually get each week to spend on yourself or to save?" with responses recoded as 0 = $0, 1 = $1-$20, 2 = $21-$100, 3 = >$100, and 4 = Not stated (Missing/Don't know).…”

“…Intensity of alcohol use was strongly associated with energy drink use: students reporting any level of alcohol use were more likely to use than those who did not drink at all, and the odds increased with increasing intensity of alcohol use. When two-way interactions between sex and the other covariates were tested (individually) in the model for any use of energy drinks, several interactions were significant: sex with age (F (1,22,778) = 14.4, p = 0.0001), spending money (F (4, 22,775) = 4.2, p = 0.002) and weight efforts (F (3,22,776) = 9.3, p ≤ 0.0001), and the interaction of sex and race was of borderline significance (F (5, 22,774) = 2.9, p = 0.012). While any use of CEDs increased consistently with age among males, a contrasting pattern was observed among females: use was highest among the youngest students and decreased with age up until age 17; those aged 18 and older also had high use.…”

“…15,19,20 Consumption of AmEDs has been associated with binge drinking and a range of risk behaviours, including driving while intoxicated, alcohol dependence, increased risk of physical injury and personal harms (such as being taken advantage of sexually). 16,21,22 A high prevalence of drinking AmEDs among college-age and post-secondary students has been reported, with some studies indicating rates above 50%. 13,20,21,23,24 Recent studies of Canadian university students have found that 76% had ever consumed AmEDs 24 and one quarter of past-month alcohol drinkers had consumed AmEDs in that time.…”

Impacts of Alcoholism in Public Health: A Systematic Review

“…Withal, another study showed that Canadian college students who reported drinking AmEDs (alcohol-mixed energy drinks), were significantly inclined to cigarette smoking, heavy drinking, and marijuana use [99,46], suggesting that AmED, as well as ED (energy drinks) consumption, is another expression of a high-risk behavior lifestyle [46], such as marijuana and alcohol use.…”