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...