Can Energy Drinks Increase the Desire for More Alcohol?

Energy drinks, the fastest growing segment in the beverage market, have become popular mixers with alcohol. The emerging research examining the use of alcohol mixed with energy drinks (AmEDs) indicates that the combination of caffeine-containing energy drinks with alcohol may be riskier than the use of alcohol alone. The public health concerns arising from AmED use are documented in different research domains. Epidemiologic studies reveal that the consumption of AmEDs is frequent among young and underage drinkers, demographic groups that are more likely to experience the harms and hazards associated with alcohol use. In addition, for all consumers, elevated rates of binge drinking and risk of alcohol dependence have been associated with AmED use when compared to alcohol alone. Results from laboratory studies help explain why AmED use is associated with excessive intake of alcohol. When an energy drink (or caffeine) is combined with alcohol, the desire (or urge) to drink more alcohol is more pronounced in both humans and animals than with the same dose of alcohol alone. The experience of drinking alcohol appears to be more rewarding when combined with energy drinks. Given that caffeine in other foods and beverages increases preference for those products, further research on AmEDs may elucidate the underlying mechanisms that contribute to alcohol dependence.     

A survey of energy drink and alcohol mixed with energy drink consumption

Background

Energy drink consumption among youth is increasing despite recommendations by the American Academy of Pediatrics to eliminate consumption by youth. This study provides information on consumption of energy drinks and alcohol mixed with energy drinks (AmED) in a sample of Israeli youth and how consumer knowledge about the risks affects consumption rates.

Methods

The study was conducted in three Tel Aviv public schools, with a total enrollment of 1,253 students in grades 8 through 12. Among them, 802 students completed a 49-item questionnaire about energy drink and AmED consumption, for a 64 % response rate Non-responders included 451 students who were absent or refused to participate. All students in the same school were administered the questionnaire on the same day.

Results

Energy drinks are popular among youth (84.2 % have ever drunk). More tenth through twelfth grade students consumed energy drinks than eighth and ninth grade students. Students who began drinking in elementary school (36.8 %) are at elevated risk for current energy drink (P?<?.001) and AmED (P?=?.002) use. Knowledge about amounts consumed and recommended allowances is associated with less consumption (OR 1.925; 95 %CI 1.18–3.14).

Discussion

The association between current AmED consumption and drinking ED at a young age is important. Boys and those who start drinking early have a greater risk of both ED and AmED consumption. The characteristics of early drinkers can help increase awareness of potential at-risk youth, such as junior and senior high school students with less educated or single parents.

Conclusions

Risks posed by early use on later energy drink and AmED consumption are concerning. We suggest that parents should limit accessibility. Increased knowledge about acceptable and actual amounts of caffeine in a single product might decrease consumption.

     

广州地区高中生饮酒模式及过量饮酒的社会经济地位影响因素

目的 分析广州市高中生饮酒模式,探讨不同社会经济地位指标与青少年过量饮酒行为的关系,为制定控制策略措施提供依据。方法 采用多阶段分层随机整群抽样方法,抽取广州市4个区高一和高二学生共3 282人,采用自填问卷进行调查。结果 75.61%的学生有饮酒经历;过去一年内,60.22%的学生曾饮酒,27.67 %曾醉酒;过去30 d内,22.75%的学生曾饮酒,7.17%曾重度饮酒。总体上,男生五种饮酒行为流行率均高于女生,差异均有统计学意义(P<0.05);采用广义混合线性模型,分析不同社会经济地位指标对青少年过量饮酒的影响。结果显示,与家庭富裕程度低、学业成就高的青少年相比,来自家庭富裕程度高、学业成就低的青少年较可能有重度饮酒及醉酒行为。结论 广州地区高中生饮酒普遍化,提示防治工作的紧迫性,应及早开展健康教育和干预工作来减少酒精的可及性和青少年的饮酒行为。     

Energy Drinks and Alcohol: Links to Alcohol Behaviors and Consequences Across 56 Days

PurposeTo examine short-term consequences associated with consuming alcohol and energy drinks compared with consuming alcohol without energy drinks.MethodsA longitudinal measurement-burst design (14-day bursts of daily surveys in four consecutive college semesters) captured both within-person variation across occasions and between-person differences across individuals. The analytic sample of late adolescent alcohol users included 4,203 days with alcohol use across up to four semesters per person from 508 college students.ResultsAdding energy drink use to a given day with alcohol use was associated with an increase in number of alcoholic drinks, a trend toward more hours spent drinking, elevated estimated blood alcohol content (eBAC), a greater likelihood of subjective intoxication, and more negative consequences of drinking that day. After controlling for eBAC, energy drink use no longer predicted subjective intoxication but was still associated with a greater number of negative consequences.ConclusionsThe consumption of energy drinks may lead to increases in alcohol consumption and, after controlling for eBAC, negative consequences. Use of energy drinks plus alcohol represents an emerging threat to public health.     

2008年烟台市部分高等学校大学生饮酒行为及其相关因素调查

[目的]了解烟台市大学生饮酒行为及其影响因素,为制定有针对性的饮酒行为干预措施提供依据。[方法]2008年,对烟台市3所高等学校的862名大学生进行问卷调查。[结果]调查862人,饮酒率为68．45％,男女生分别为85．09％、55．98％（P〈0.01）。饮酒者中,45．93％首次饮酒年龄低于18岁,首次饮酒的原因是朋友劝饮的占41.19％;饮酒首选啤酒的占68．98％;在家庭聚会和同学朋友聚会时饮酒的分别占73．22％、66．95％;醉酒率为54．41％,其中3．90％经常醉酒;17．97％因酒误过事,其中没完成学习任务占52．83％。多因素非条件Logistic回归分析结果,男生、吸烟者、月平均生活费用高、酒相关知识认知度高、对饮酒持积极期望是大学生饮酒的危险因素,父母反对其饮酒、父母不饮酒是大学生饮酒的保护因素,OR值分别为3．559、1．664、3．931、1．615、15．677、0．435、0．547。[结论]烟台市大学生饮酒行为较为普遍。男生、吸烟者、月平均生活费用高、酒相关知识认知度高、对饮酒持积极期望、父母支持其饮酒、父母双方都饮酒的大学生饮酒行为较多。     

Evaluating the believability and effectiveness of the social norms message "most students drink 0 to 4 drinks when they party"

In an effort to reduce dangerous drinking levels among college students, university health educators have initiated social norms campaigns based on the rationale that students will be more likely to reduce their own drinking behaviors if they think that most students on campus are not heavy or binge drinkers. Within the framework of social comparisons theory, this study reports the findings of a survey of 277 college students and explores the correlates of accuracy and bias in students' estimates of whether or not most other students think that binge drinking on campus is a problem and whether or not most other students believe the campaign message. The overwhelming majority (72.6%) of students did not believe the norms message that most students on campus drink "0 to 4" drinks when they party, and 52.7% reported drinking "5 or more" drinks in a sitting. The social norms campaign was effective in motivating 61% of the respondents to think about binge drinking as a problem. For the most part, group or social network norms were more influential on students' own drinking behavior than were their estimates of the campus drinking norm. The findings also clarify that accuracy in estimating the campus social norm in and of itself does not necessarily lead to an increase or reduction in alcohol consumption. The social comparisons approach underscores the complex and social nature of human interaction and reinforces the need for the development of multiple approaches to alcohol education with messages that are designed to target the specific needs of students based on their orientations toward alcohol consumption.     

北京市2014年高中生饮酒行为及其影响因素分析

了解北京市高中生饮酒相关行为现状及其影响因素,为预防青少年过早饮酒和过量饮酒提供依据.方法 2014年3-5月,采用分层整群随机抽样方法,抽取北京市18个区县的15 726名高中生进行健康危险行为自填问卷调查.结果 北京市高中生曾饮酒率为67.9%,13岁前饮酒率为35.2%,现在饮酒率为41.0%,过量饮酒率为16.6%.“与家人朋友喝”是北京市高中生饮酒的最主要原因.职业技术学校、男生、高二、母亲高中文化水平、重组家庭、人均月收入高和学习成绩差的高中生各项饮酒率均较高.有健康危险行为的高中生更容易出现饮酒相关行为,如有吸烟行为的学生更容易发生现在饮酒行为(OR=4.41,95%CI=3.90~4.98),有打架行为的学生更容易出现过量饮酒行为(OR=2.00,95%CI=1.77~2.26),有性行为的学生更容易出现13岁前饮酒行为(OR=1.58,95%CI=1.36~1.84),有尝试自杀行为的学生更容易出现过量饮酒行为(OR=1.67,95%CI=1.27~2.19).结论 在预防青少年饮酒相关行为时,应考虑年龄、家庭、性别等因素,并重视其他健康危险行为因素的影响,家庭和学校需尽早积极开展预防青少年饮酒行为的综合性健康教育.     

DSM-IV alcohol dependence and drinking in the U.S. population: A risk analysis

PURPOSE: This paper examines the relationship between alcohol dependence according to the criteria found in the 4th edition of the Diagnostic and Statistical Manual (DSM-IV) of the American Psychiatric Association and drinking in the U.S. general population.

METHODS: The data set under analysis is the 1988 National Health Interview Survey, which interviewed a probability sample of 22,102 adult drinkers in the U.S. household population. The response rate was 86%.

RESULTS: Results indicate that there is a linear relationship between DSM-IV dependence and the mean number of drinks consumed per day, or the number of days drinking five or more glasses of alcohol in the past 12 months. Respondents who reported consuming five or more drinks in a day have about six times more chances of being dependent than respondents who did not report such pattern of drinking. Older drinkers are less at risk than younger drinkers.

CONCLUSIONS: There is a risk of alcohol dependence at relatively low volumes of consumption. The risk increases gradually with the volume of consumption. An added and higher risk exists when drinkers engage in a pattern of consumption involving the ingestion of five or more drinks per day.     

Is alcohol mixed with energy drinks consumption associated with susceptibility to smoking?

ObjectiveThis paper examines whether adolescent students in Canada who have never smoked but who drink alcohol mixed with energy drinks (AmED) are more susceptible to smoking than those who do not consume AmED.MethodsA nationally representative sample of 15,875 never-smoking students in grades 9 to 12 from the 2010–2011 Canadian Youth Smoking Survey is used. The association between AmED and susceptibility to smoking is examined using a logistic regression.ResultsAbout 28% of the never-smoking adolescents in grades 9 to 12 are susceptible to smoking, and 13% report using AmED. Results of the adjusted logistic regression analysis show a statistically significant positive association between consuming AmED and susceptibility to smoking. Never-smoking students who reported using AmED are more susceptible to smoking when compared with those who have not consumed AmED (OR = 1.89; 95% CI = 1.71–2.10). Similar results are obtained when the analysis is stratified by gender.ConclusionsThe consumption of AmED is associated with higher odds of smoking susceptibility among Canadian adolescents. AmED use could be a potential marker for smoking susceptibility among never-smoking adolescents.     

Encouraging responsible drinking among underage drinkers

Public Service Announcements tailored to specific college drinking rituals (Treise, Wolburg and Otnes 1999) were tested on 133 underage undergraduate drinkers. More significant reductions in drinking intentions were found when using appeals focusing on drinking rituals pertaining to Maturity/Order (older students drink moderately: "Don't drink like a freshman.") than to Transformation (desired personality and mood changes), Community (social bonding and camaraderie), or a no-message Control. Gender did not moderate this effect. Underage drinkers may drink, in part, to feel more "grown up." Emphasizing that more senior students actually drink responsibly may diminish this belief and result in reduced alcohol consumption among underage students.     

At-risk drinking among patients making routine primary care visits

BACKGROUND: Addressing non-alcoholic, at-risk patterns of alcohol consumption that are associated with increased morbidity and mortality is an important health care priority. OBJECTIVE: The objective was to describe the prevalence and characteristics of at-risk drinkers in a population-based sample of adults with routine primary care visits. Methods: Three thousand four hundred thirty-nine patients with advance appointments in 23 primary care practices completed a health survey prior to their visit. At-risk drinking was defined as consuming an average of two or more drinks per day (chronic drinking), or two or more occasions of consuming five or more drinks in the past month (binge drinking), or, in the past month, one or more occasion of driving after consuming three or more drinks (drinking and driving). RESULTS: Prevalence was: 11% at-risk drinking; 63% light to moderate drinking; 26% abstinence. Abstainers differed from alcohol users on demographics (older, fewer Caucasian, lower income, more unemployed), other health behaviors (less exercise, lower rates of smoking, and marijuana and cocaine use), and family history of alcohol problems (lower). Abstainers also reported poorer physical and psychological health. Compared to light to moderate drinkers, at-risk drinkers were more likely to be male, unmarried, and to use other substances (tobacco, marijuana, and cocaine). Among at-risk drinkers, those with two or more risk factors were more likely male, consumed more alcohol per week, had higher AUDIT scores and were more motivated to change their drinking. Among those with only one risk factor, binge drinkers reported high rates of tobacco and marijuana use, relatively poor perceived health, and the highest proportion of negative consequences from drinking. CONCLUSIONS: At least 1 in 10 patients making routine primary care visits have drinking practices that place them at risk for negative consequences from drinking. Three drinking patterns that can be used to define at-risk drinking are relatively distinct.     

Patterns of alcohol consumption in the Seychelles Islands (Indian Ocean).

Self-reported drinking habits were examined in a random sample of 1067 persons aged 25-64 years in the Seychelles, a country in epidemiological transition where consumption of home-brewed, mostly unregistered beverages has been traditionally high. Alcohol consumption was calculated from respondents reporting at least one drink per week ('regular drinkers'). Among men, 51.1% were regular drinkers and had average intake of 112.1 ml alcohol a day. Among women, 5.9% were regular drinkers and had 49.7 ml alcohol a day. Frequency of drinking, but not amount per drinker, was slightly less in the 25-34-year than older-age categories. Home-brews (mostly palm toddy and fermented sugar cane juice) were consumed by 52% of regular drinkers and accounted for 54% of the total alcohol intake reported by all regular drinkers. Based on the reported consumption by regular drinkers only, the average annual alcohol consumption amounted respectively to 20.7 litres and 1.2 litres per man and woman aged 25-64 years, or, using extrapolation, 13.2 litres and 0.8 litres per man and woman respectively of the total population. These values may underestimate the true figures by half, since reported beer consumption accounted for 53% of beer sales. Socio-economic status was associated strongly and inversely with home-brew consumption, but slightly and positively with consumption of commercially marketed beverages. Alcohol intake was associated with smoking, high-density lipoprotein cholesterol, carbohydrate-deficient transferrin and blood pressure, but not with age and body mass index. In conclusion, these data show high alcohol consumption in the Seychelles with an important gender difference, a large proportion of alcohol derived from home-brews, and opposite tendencies for the relationships between socio-economic status and home-made or commercially marketed beverages.     

The relationship between alcohol use, eating habits and weight change in college freshmen

PURPOSE: This study aims to improve understanding of how alcohol consumption in college freshmen affects eating patterns before, during, and after drinking, as well as its relation to body weight change. METHODS: Two hundred eighty-two college freshmen (61% female; 59% Caucasian) completed measures of alcohol use, measured body mass index (BMI), and eating and activity habits before, during and following drinking episodes. Students were categorized by drinking status (non-drinker, low-risk, and moderate/high-risk) in order to explore group differences. RESULTS: Seventy-five percent of the sample reported past-month alcohol consumption, with 65% (N=134) of these categorized as "low-risk" drinkers and 35% (N=72) as "moderate-risk" drinkers. Moderate-risk drinkers were more likely than low-risk drinkers to report increases in appetite after drinking, with nearly half of students reporting overeating and making unhealthy food choices following drinking. Moderate-risk drinkers also demonstrated significant increases in 1st semester BMI change, relative to non-drinkers and low-risk drinkers. CONCLUSIONS: Eating patterns for a significant number of college students are altered before, during, and following drinking episodes, which related to change in freshman year BMI.     

Experiences of alcohol-related harassment among medical students

Medical Education 2010: 44 : 1213–1223 Objectives Although fatal accidents caused by alcohol‐related harassment occur frequently among college students, this issue has not been adequately examined. This study set out to investigate the prevalence of alcohol‐related harassment among medical students in Japan. Methods A multi‐institutional, cross‐sectional survey was carried out across seven medical schools in Japan. A self‐report anonymous questionnaire was distributed to 1152 medical students; 951 respondents (82.6%) satisfactorily completed it. From the responses, we determined the reported prevalences of the following types of alcohol‐related harassment among medical students by senior medical students or doctors: (i) being coerced into drinking alcohol; (ii) being compelled to drink an alcoholic beverage all at once (the ikki drinking game); (iii) being deliberately forced to drink until unconscious, and (iv) being subjected to verbal abuse, physical abuse or sexual harassment in relation to alcohol. The prevalence of becoming a harasser among medical students was also measured. Multivariate regressions were used to assess the associations between experiences of alcohol‐related harassment and student characteristics. Results A total of 821 respondents (86.3%) had experienced alcohol‐related harassment and 686 (72.1%) had harassed others. Experiences of the ikki drinking game were frequently reported by both victims (n = 686, 72.1% of all respondents) and harassers (n = 595, 62.6% of all respondents). In multivariate regression, having an experience of alcohol‐related harassment correlated with both being harassed (odds ratio [OR] 14.22, 95% confidence interval [CI] 8.73–23.98) and being a harasser (OR 13.19, 95% CI 8.05–22.34). The pres‐ence of senior members of medical college clubs who were regular drinkers also correlated with both being harassed (OR 2.96, 95% CI 1.88–4.67) and being a harasser (OR 2.97, 95% CI 2.06–4.27). Conclusions Alcohol‐related harassment among medical students is common and tends to occur at drinking parties with senior college club members. Hence, one of the most important strategies for preventing alcohol‐related harassment may be to disrupt this vicious cycle.     

Alcohol use beliefs and behaviors among high school students

Purpose: To identify specific alcohol use beliefs and behaviors among local high school students; to determine whether relationships exist between alcohol use and various sociodemographic and lifestyle behaviors; and to assist in the development and implementation of alcohol abuse prevention programs.Methods: This cross-sectional study involved the completion of a questionnaire by 1236 Grade 9–13 students (86% response rate) from 62 randomly selected classrooms in three Canadian urban schools. Data analyzed here are part of a larger lifestyle survey.Results: A total of 24% of students reported never having tasted alcohol, 22% have tasted alcohol but do not currently drink, 39% are current moderate drinkers, 11% are current heavy drinkers (five or more drinks on one occasion at least once a month), and 5% did not answer. Reasons stated most often for not drinking were “bad for health” and “upbringing,” while reasons stated most often for drinking were “enjoy it” and “to get in a party mood.” Student drinking patterns were significantly related to gender, ethnicity, grade, and the reported drinking habits of parents and friends. Older male adolescents who describe their ethnicity as Canadian are at higher risk for heavy drinking than students who are younger or female, or identify their ethnicity as European or Asian. Current heavy drinkers are at higher risk than other students for engaging in other high-risk behaviors such as drinking and driving, being a passenger in a car when the driver is intoxicated, and daily smoking.Conclusions: Heavy alcohol use in adolescents remains an important community health concern. Older self-described Canadian and Canadian-born male adolescents are at higher risk for heavy drinking. Current and heavy drinking rises significantly between Grades 9 and 12. Students who drink heavily are more likely to drink and drive, to smoke daily, and to have friends and parents who drink alcohol.     

大学生对饮酒所致脸红反应社会学涵义的认知

目的了解大学生对饮酒所致脸红反应的理解,以及对饮酒脸红者的行为反应,为探讨饮酒所致脸红反应的遗传-环境联系提供线索。方法以自行设计的问卷对中国中部某大学医学院和教育学院的442名大学生进行匿名调查。以Epi Data 3.02录入数据,利用SPSS 13.0完成数据分析。结果71.0%的学生在过去一年里饮过酒。50.4%的学生认为脸红反应是表示脸红者不应再继续饮酒,有此认知的非饮酒学生和饮酒学生比例分别为63.6%和44.9%。55.4%的学生表示饮酒群体中的其他人将劝阻脸红者继续饮酒。针对饮酒场合中男生的脸红反应,41.9%的男生和49.2%的女生认为饮酒群体中的男生仍会鼓励男生脸红者继续饮更多的酒;如果出现脸红反应者是女生,此比例分别为7.8%和10.5%。结论大学生对饮酒所致脸红反应的社会学涵义缺乏正确认知,这种缺乏不仅影响其对脸红反应者、尤其是对不同性别脸红者的行为反应,而且有可能影响其自身的饮酒经历。     

Is the Consumption of Energy Drinks Associated With Academic Achievement Among College Students?

Despite widely reported side effects, use of energy drinks has increased among college students, who report that they consume energy drinks to help them complete schoolwork. However, little is known about the association between energy drink use and academic performance. We explored the relationship between energy drink consumption and current academic grade point average (GPA) among first-year undergraduate students. Participants included 844 first-year undergraduates (58.1 % female; 50.7 % White). Students reported their health behaviors via an online survey. We measured energy drink consumption with two measures: past month consumption by number of drinks usually consumed in 1 month and number consumed during the last occasion of consumption. We used multiple linear regression modeling with energy drink consumption and current GPA, controlling for gender, race, weekend and weekday sleep duration, perceived stress, perceived stress management, media use, and past month alcohol use. We found that past month energy drink consumption quantity by frequency (p < 0.001), and energy drinks consumed during the last occasion (p < 0.001), were associated with a lower GPA. Energy drinks consumed during the last occasion of consumption (p = 0.01) remained significantly associated with a lower GPA when controlling for alcohol use. While students report using energy drinks for school-related reasons, our findings suggest that greater energy drink consumption is associated with a lower GPA, even after controlling for potential confounding variables. Longitudinal research is needed that addresses whether GPA declines after continued use of energy drinks or if students struggling academically turn to energy drinks to manage their schoolwork.     

大学生饮酒行为及动因研究

了解大学生的饮酒行为，饮酒动机与心理，探讨它们之间的相互关系，为干预问题饮酒，开展以学校为中心的社区预防工作提供必要的资料和依据。方法：采用不记名问卷对４４８名大学生进行了饮酒状况。支机与心理以及对饮酒危害性认识等方面的调查研究，结果男生的饮酒率为９２．９０％，女生饮酒率为８６．８２％，男女饮酒行为类型，饮酒情境和饮酒种类之间均有高度显著性差异；第一次饮酒动机主要是好奇心、家人同意和朋友劝；生活压