Factors influencing young people's use of alcohol mixed with energy drinks

Prevalence of energy drink consumption world-wide: A systematic review and meta-analysis

BACKGROUND AND AIMS

The increasing market for energy drinks (EDs) in recent years, as well as the health risks caused by their consumption, prompt calls to estimate the prevalence of ED use among different countries. This systematic review and meta-analysis aimed to synthesize the prevalence of ED use in different continents and age groups.

METHOD

We searched two databases (i.e. PubMed and PsycInfo) on 31 March 2023 to identify studies reporting the prevalence of ED use. A total of 192 studies (196 distinct samples; n = 1 120 613; 53.37% males) from the United States, Europe, Asia, Oceania and Africa were included in the analysis. A random-effects model was applied to estimate the overall pooled prevalence at several time-periods. Subgroup analyses were performed to provide prevalence based on continent and age group. The quality of articles was assessed using Joana Brigg's Institute (JBI) critical appraisal checklist. Measurements included prevalence of ED use (i.e. life-time, past 12 months, past 30 days, past 7 days and daily use), continent and age group (i.e. children, adolescents, young adults and adults).

RESULTS

The life-time ED use world-wide-pooled prevalence was estimated to be 54.7% [95% confidence interval (CI) = 48.8-60.6; I2  = 99.80], 43.4% (95% CI = 36.1-50.6; I2  = 99.92) in the past 12 months, 32.3% (95% CI = 28.8-35.8; I2  = 99.82) in the past 30 days, 21.6% (95% CI = 18.7-24.5; I2  = 99.95) in the past 7 days and 8.82% (95% CI = 6.3-11.4; I2  = 99.95) daily ED use. Subgroups analyses showed significant differences in ED life-time use within age groups (P = 0.002) and continents (P = 0.035).

CONCLUSIONS

The world-wide prevalence of energy drink use appears to be high, particularly among adolescents and young adults.

Dimensions of the diet-exercise relationship in later life: A qualitative study

OBJECTIVE

Diet and physical activity are two lifestyle behaviours that are critical for healthy ageing. The aim of this study was to explore how older adults negotiate dietary and physical activity decisions to identify areas of intersection between these two behaviours and inform health promotion interventions targeting both diet and exercise.

METHODS

This exploratory study utilised a novel data collection approach that involved lay interviewers recruiting their peers to (i) participate in two interviews over a period of six months and (ii) make notes on their thoughts relating to diet and physical activity. Participants were 75 adults aged 60+ years in Western Australia (n = 64 females).

RESULTS

Three primary themes were identified: (i) the importance but difficulty of achieving energy balance; (ii) issues relating to managing food intake before, during, and after physical activity; and (iii) reciprocal opportunities for eating and physical activity.

CONCLUSIONS

Diet and physical activity are linked in complex ways, highlighting the need for multi-factorial interventions.

IMPLICATIONS FOR PUBLIC HEALTH

When developing communications strategies designed to encourage older people to both improve their diets and increase their physical activity, consideration could be given to leveraging existing perceived alignments between healthy eating and being active.

Alcohol mixed energy drink usage and risk-taking among college students in Western New York State

Alcohol mixed energy drinks (AmED) may promote excessive alcohol intake and risk-taking among college students. Objective: To understand the relationship between AmED use and risky behavior as well as attitudes and motivations for AmED use. Participants: Undergraduate college students N = 422 (Study 1), N = 37 (Study 2). Methods: Using a mixed-methods approach, we first surveyed undergraduate students about their AmED and alcohol consumption and a series of risk behaviors, self-efficacy, and beliefs (Study 1). We then conducted focus groups within the same population to better understand attitudes, knowledge, and motivations for using AmED (Study 2). Results: Recent AmED use was significantly associated with an increased number of reported binge drinking occasions and self-reported driving while intoxicated events. Our qualitative data analyses revealed two major themes associated with AmED consumption: factors encouraging AmED use and decisions about driving while under the influence of alcohol. Conclusions: These findings add to the literature of beliefs and motivations for AmED use among college students.

Use of Alcohol Mixed with Energy Drinks Increases the Prevalence of Driving Violations among Brazilian Truck Drivers

Background: The use of alcohol mixed with energy drinks (AmED) has been reported to be associated with a variety of unsafe driving practices. Truck drivers are vulnerable to driving violations, particularly because of their engagement in drug use. The use of AmED among these professionals remains unknown. Aim: To estimate the prevalence of AmED use and its association with driving violations among truck drivers. Methods: 684 drivers were recruited in Sao Paulo, Brazil. The use of drugs was reported. Drivers were split into three groups: (a) alcohol abstainers (AA); (b) alcohol-only users (AO); and (c) users of AmED. Intergroup comparisons were performed by polynomial logistic regression (the reference category was AO). We also performed Poisson regression analysis to obtain the prevalence ratio; the significance level was stipulated at 5%. Results: The prevalence of drivers reporting the use of AmED was 16.8%. Users of AmED (a) were younger, (b) were less experienced drivers, (c) had a heavier pattern of alcohol use, (d) used illicit drugs more frequently, and (e) had poorer sleep quality than AO subjects. A higher prevalence of drivers who had arguments or fights while driving (PR = 1.71) and of drivers who drove unbelted (PR = 1.66) ingested AmED than of AO subjects. Conclusions/importance: The use of AmED increased the prevalence of driving violations beyond the risks commonly attributed to alcohol use. We suggest additional investments in preventative measures based on the beverage category and a revision of the work organization of truck drivers to reduce their health and social risks.

Alcohol mixed with energy drink (AMED): A critical review and meta-analysis

The purpose of this systematic review and meta-analysis was to critically review the (1) prevalence of alcohol mixed with energy drink (AMED) consumption, (2) motives for AMED consumption, (3) correlates of AMED consumption, and (4) whether AMED consumption has an impact on (a) alcohol consumption, (b) subjective intoxication, and (c) risk-taking behavior. Overall a minority of the population consumes AMED, typically infrequently. Motives for AMED consumption are predominantly hedonistic and social. Meta-analyses revealed that AMED consumers drink significantly more alcohol than alcohol-only (AO) consumers. Within-subject comparisons restricted to AMED consumers revealed that alcohol consumption does not significantly differ between typical AMED and AO occasions. On past month heaviest drinking occasions, AMED users consume significantly less alcohol on AMED occasions when compared to AO occasions. AMED consumers experience significantly fewer negative consequences and risk-taking behavior on AMED occasions compared with AO occasions. Meta-analyses of subjective intoxication studies suggest that AMED consumption does not differentially affect subjective intoxication when compared to AO consumption. In conclusion, when compared to AO consumption, mixing alcohol with energy drink does not affect subjective intoxication and seems unlikely to increase total alcohol consumption, associated risk-taking behavior, nor other negative alcohol-related consequences. Further research may be necessary to fully reveal the effects of AMED.

Combined use of alcohol and energy drinks: Dose relationship with self-reported physiological stimulation and sedation side effects

BACKGROUND

Negative physiological stimulation and sedation side effects are experienced by a significant proportion of consumers who consume alcohol mixed with energy drinks (AmED). Few studies have compared the frequency of side effects between sessions of AmED and sessions of alcohol only within-subject, and none have explored a dose relationship.

OBJECTIVES

Explore the occurrence of self-reported physiological stimulant and sedative side effects between sessions of AmED and alcohol only, and at varying ED dosage levels within AmED sessions.

METHODS

A convenience sample of 2953 residents of New South Wales, Australia completed an online survey. N=731 AmED users reported daily caffeine intake, typical alcohol and AmED consumption, and past 12-month experience of physiological stimulation and sedation side effects during AmED and alcohol only sessions. Within-subject analyses compared occurrence of side effects between session types. Hierarchical binary logistic regression analyses explored the association of ED dose during AmED sessions with the experience of physiological side effects.

RESULTS

There were greater odds of most stimulant side effects, and lower odds of sedation side effects, during AmED sessions compared to alcohol only sessions. Compared to one ED, consumption of three or more EDs was significantly associated with the majority of both stimulant and alcohol intoxication side effects after controlling for demographics and consumption covariates.

CONCLUSIONS

AmED is associated with perceived changes in physiological stimulant and sedation side effects of alcohol. Experience of side effects is positively associated with ED dosage. Future research should account for varying ED dosage, and reflect real world consumption levels.

Reverse engineering a 'responsible drinking' campaign to assess strategic intent

BACKGROUND AND AIMS

The alcohol industry produces 'responsible drinking' advertising campaigns. There is concern that these may promote drinking while persuading governments and the general public that the industry is acting responsibly. This paper examined young people's thoughts and feelings in response to one of these campaigns in Australia.

DESIGN

A qualitative analysis of introspection data provided by young drinkers after exposure to a responsible drinking advertisement produced by DrinkWise called 'How to Drink Properly'.

SETTING

Perth, Western Australia.

PARTICIPANTS

Forty-eight 18-21-year-old drinkers.

MEASUREMENTS

The qualitative data were imported into NVivo10 and coded according to the various stages of advertising effects frameworks. A thematic analysis approach was used to identify patterns in the data relating to (i) perceptions of the source and purpose of the advertisement and (ii) any resulting attitudinal or behavioural outcomes.

FINDINGS

Despite the sample comprising mainly high-risk drinkers, participants were generally unable to relate to the heavy drinkers depicted in the DrinkWise advertisement. This disassociation resulted in a perceived lack of need to modify their own drinking behaviours. Instead, the study participants found the advertisement to be entertaining and supportive of existing social norms relating to heavy drinking among members of this age group.

CONCLUSIONS

The 'How to Drink Properly' advertisement by Drinkwise in Australia may reinforce existing drinking attitudes and behaviours among young drinkers.