The multiplicative effect of combining alcohol with energy drinks on adolescent gambling

Alcohol Versus Combined Alcohol and Energy Drinks Consumption: risk behaviours and consumption patterns among European students

INTRODUCTION

Recent research found that mixing energy drinks with alcohol (AmED) could be more risky than drinking alcohol alone. Our aim was to compare rates of risk behaviours in consumers AmED versus exclusive alcohol drinkers, matching them based on their drinking frequency.

METHODS

Data about sixteen-year-old students who reported the number occasions on which they had drunk AmED or alcohol only in the preceding 12 months (n = 32,848) were drawn from the 2019 ESPAD study. After matching for consumption frequency, the sample consisted of 22,370 students (11,185 AmED consumers and 11,185 exclusive alcohol drinkers). Key predictors comprised substance use, other individual risk behaviours and family characteristics (parental regulation, monitoring and caring).

RESULTS

The multivariate analysis showed significantly higher odds of being AmED consumers compared to exclusive alcohol drinkers in the majority of the investigated risk behaviours, including: daily tobacco smoking, illicit drug use, heavy episodic drinking, truancy at school, engaging in physical fights and serious arguments, having troubles with the police and having unprotected sexual intercourse. Instead, lower odds were found for reporting high parents' educational level, medium and low family economic status, perceived possibility to freely talk about problems to family members, spending free time reading books or other hobbies.

CONCLUSIONS

Our study shows that, given the same consumption frequency in the past year, AmED consumers typically reported higher associations with risk-taking behaviours compared to exclusive alcohol drinkers. These findings advance past research that failed to control for the frequency of AmED use versus exclusive alcohol consumption.

Alcohol and energy drinks: individual contribution of common ingredients on ethanol-induced behaviour

Since energy drinks (EDs) were sold to the general public as soft drinks and recreational beverages, mixing EDs with ethanol has grown in popularity, particularly among younger people. Given the research that links these drinks with higher risk behaviors and increased ethanol intake, ethanol combined with EDs (AmEDs) is a particularly worrying combination. EDs generally commonly include a variety of ingredients. Sugar, caffeine, taurine, and B-group vitamins are almost always present. Studies on the combined effect of ethanol and sugar and caffeine on ethanol-induced behaviors are extensive. Not so much in regards to taurine and vitamins. This review briefly summarises available information from research on the isolated compounds on EtOH-induced behaviors first, and secondly, the combination of AmEDs on EtOH effects. The conclusion is that additional research is needed to fully comprehend the characteristics and consequences of AmEDs on EtOH-induced behaviors.

Trends in energy drink and combined alcohol and energy drinks consumption among Italian high school students, 2008-2019

BACKGROUND

Energy Drinks (ED) are caffeinated beverages marketed as attention and endurance enhancers. The main purpose of this study is to provide national estimates of the prevalence of alcohol mixed with energy drink (AmED) and ED use among school-aged adolescents. A secondary objective is to examine the differences in the prevalence of AmED and ED consumption by gender.

METHODS

For this study, we used data from twelve consecutive years, from ESPAD-Italia®2008 to ESPAD-Italia®2019.

RESULTS

From 2008-2019, the prevalence of lifetime consumption of energy drinks increased significantly for male (64.5-75.7%, p < 0.001) and female (46.8-61.8%, p < 0.001). We also observed an increase in both genders for last year prevalence (male: 51.6-63.4%, p < 0.001; female: 32.5-38.3%, p < 0.001), instead prevalence in last month showed an increase only in males (males: 37.5-45.4%, p = <0.001; females: 19.9-20.3%, p = 0.426). Finally, frequent use showed a fluctuating trend, particularly in females (males: 3.2-4.3%, p = 0.422; females: 0.8-0.8%, p = 0.643). From 2013-2019, the prevalence of AmED consumption did not show relevant changes among adolescents. A clear gender gap is evident for both ED and AmED usage prevalence, in all the years considered for lifetime, last year, last month and frequent use.

CONCLUSIONS

The findings suggest that the prevalence of ED consumption among Italian high school students is very high and has grown substantially over the past 12 years. Differently the prevalence of AmED use, although widespread, did not increase overall since 2013.

Alcohol mixed with energy drinks: what about taurine?

RATIONALE

Since energy drinks (EDs) were marketed to the general public as recreational and soft drinks, mixing these with alcohol has become a popular practice, especially in the younger population. Alcohol mixed with EDs (AmEDs) is a particularly alarming combination, given the evidence that consistently associate these drinks with increased risk behaviours and greater alcohol consumption. Caffeine and taurine are commonly found in EDs. In contrast to caffeine, the studies on taurine psychoactive properties and how this amino acid influences ethanol intake alone or in combination with caffeine are not so numerous.

OBJECTIVES

We summarised relevant and available data on the studies focusing on taurine as a psychoactive agent and its influence on ethanol (EtOH)-induced behaviours. Given the increased risk that represents mixing alcohol with energy drinks, we put emphasis on the research exploring the impact of these combinations on motivated behaviour towards EtOH consumption.

RESULTS

The research on taurine properties on motivated behaviour towards EtOH consumption is limited, and mostly all done in combination with caffeine or other molecules. This makes it difficult to elucidate the effect of this amino acid when combined with alcohol.

CONCLUSIONS

Incomplete understanding of the properties and effects of AmEDs is unavoidable until more studies are performed on the influence of taurine on motivation to consume alcohol. Taurine should be further explored, particularly in regard to its potential beneficial applications, motivational properties and synergies with other psychoactive ingredients (i.e. caffeine).

Prevalence and correlates of youth poly-substance use in the COMPASS study

BACKGROUND AND AIMS

Youth poly-substance use, associated with long-term negative health and social outcomes, is of increasing concern following the rise of e-cigarette vaping and cannabis legalization in Canada. This work aimed to investigate current evidence on correlates of this behaviour to inform effective prevention and harm reduction programming.

DESIGN

Cross-sectional sample taking part in a cohort study.

SETTING

Canadian high schools (AB, BC, ON, QC) PARTICIPANTS: 74,501 Canadian high school students who completed the COMPASS student questionnaire in 2018/2019.

MEASUREMENTS

Self-report data on use of five substances (alcohol, cigarettes, e-cigarettes, cannabis, and opioids) alongside demographic factors, social and school support, and mental health-related measures.

RESULTS

Of the 39% of youth who reported current substance use, 53% reported using two or more. E-cigarette vaping was most prevalent (28%) and most often combined with other substances. Feeling supported by friends and having no problem with seeking help at school were associated with higher levels of poly-substance use. Family support, school connectedness, and school support to resist drugs decreased the risk of substance co-use.

CONCLUSIONS

The evidence presented here suggests that interventions for youth poly-substance use should rely on joint efforts between parents, schools, and communities to focus on structural factors rather than problematizing the individual.

Prevalence of gambling behaviours and their associations with socioemotional harm among 11-16 year olds in Wales: findings from the School Health Research Network survey

BACKGROUND

Gambling opportunities are increasingly available and acceptable to many adolescents. Adolescent problem gambling has been associated with poor outcomes, such as lower reported physical and mental health. While much research has focussed on 'problem' gambling, analysing the distribution and determinants of experimentation with gambling is important in order to understand its normalization and population level consequences. This study describes the distribution of inequalities and socioemotional harms associated with adolescent gambling.

METHODS

Data were drawn from a subsample of students (N = 37 363) who completed gambling questions as part of the 2017 School Health Research Network Student Health and Wellbeing Survey, representing 193 secondary schools in Wales. Using imputations, we estimated a series of single-predictor and multi-predictor regressions for count of gambling behaviours, any gambling in the past 12 months and socioemotional harms of gambling.

RESULTS

Approximately two-fifths (41.0%) of respondents reported gambling in the past 12 months, of whom 16.2% reported feeling bad as a result of their own gambling. We found significant sex differences in gambling, with boys gambling more frequently than girls. Adolescents from more affluent families reported a higher count of gambling behaviours and socioemotional harms, although paradoxically, increasing affluence was also associated with lower prevalence of gambling in the last year. Non-White British ethnicities and students who felt less connected to school were more likely to engage in gambling and experience socioemotional harms.

CONCLUSIONS

Our findings provide important new insights regarding risk factors in adolescence associated with gambling behaviours and socioemotional harms.

Psychosocial risk factors in disordered gambling: A descriptive systematic overview of vulnerable populations

BACKGROUND

Gambling is a behaviour engaged in by millions of people worldwide; for some, gambling can become a severely maladaptive behaviour, and previous research has identified a wide range of psychosocial risk factors that can be considered important for the development and maintenance of disordered gambling. Although risk factors have been identified, the homogeneity of risk factors across specific groups thought to be vulnerable to disordered gambling is to date, unexplored.

METHODS

To address this, the current review sought to conduct a systematic overview of literature relating to seven vulnerable groups: young people and adolescents, older adults, women, veterans, indigenous peoples, prisoners, and low socio-economic/income groups.

RESULTS

Multiple risk factors associated with disordered gambling were identified; some appeared consistently across most groups, including being male, co-morbid mental and physical health conditions, substance use disorders, accessibility and availability of gambling, form and mode of gambling, and experience of trauma. Further risk factors were identified that were specific to each vulnerable group.

CONCLUSION

Within the general population, certain groups are more vulnerable to disordered gambling. Although some risk factors are consistent across groups, some risk factors appear to be group specific. It is clear that there is no homogenous pathway in to disordered gambling, and that social, developmental, environmental and demographic characteristics can all interact to influence an individual's relationship with gambling.

Problem gambling among Czech adolescents: An exploration of its relationship to early initiation of tobacco smoking

BACKGROUND AND AIMS

Gambling in adolescence is often related to licit and illicit substance use. Some evidence shows that teenage smokers gamble more than non-smokers. The aim of the study is to analyze the relationship between problem gambling and smoking among Czech adolescents.

METHODS

Data on 6,082 adolescents (50.1% boys and 49.9% girls) aged 15-19 years were collected as part of the ESPAD study in the Czech Republic in 2015. Logistic regression and linear regression models were used to test the hypothesis that the early onset of daily smoking increases the risk of problem gambling.

RESULTS

The age of initiation of daily smoking seems to be a more reliable marker of the risk of problem gambling than smoking status or intensity of smoking. More than 20% of smokers who started smoking daily at the age of 12 years or earlier are at risk of problem gambling, which shows a significantly increased probability compared to non-smokers (OR = 2.7). Other factors that increase the chances of becoming a problem gambler include being male, of higher age, and a student of a secondary school.

DISCUSSION AND CONCLUSIONS

The relationship between adolescent smoking and gambling is complex and is likely to be influenced by other underlying factors. Early daily smokers and at-risk gamblers tend in a similar way to risky behavior as a result of impulsivity. Interventions targeting early smoking and other substance-use behavior should not only aim at quitting smoking but could also include preventing smokers from developing problem gambling.