Caffeinated Cocktails: Energy Drink Consumption, High-Risk Drinking and Alcohol-Related Consequences Among College Students.

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Caffeinated Cocktails Energy Drink Consumption,
High-Risk Drinking and Alcohol-Related
Consequences Among College Students.

• Mary Claire OBrien, MD
• NIDA/ODS Caffeine Symposium
• July 8, 2009

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Acknowledgements

• Supported by Grants Number RO1 AA14007-2 and
  2R01AA014007-06A1 from the National Institute on
  Alcohol Abuse and Alcoholism, and North Carolina
  DHHS/ OJJDP EUDL Award Number 2004-AH-FX-0014.

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Co-authors

• Thomas P. McCoy
• Scott D. Rhodes
• Ashley Wagoner
• Mark Wolfson

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Presenter Disclosure
Mary Claire OBrien, M.D.

• The following personal financial relationships
  with commercial interests relevant to this
  presentation existed during the past 12 months

No relationships to disclose
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Yes!It really is like the TV show.
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Youth and alcohol

• Underage drinkers consume almost 20 of all
  alcohol in the U.S.
• 6th, 7th, and 8th graders 31.5 reported
  drinking all types of alcohol
• 4 out of 5 college students drink ½ binge
• 18-25 yr olds highest rate of binge drinking
  among all U.S. adults

• Risk taking
• Independence seeking
• Experimentation

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Study to Prevent Alcohol-Related
ConsequencesAmong College Students (SPARC)

• Randomized group trial
• Community organizing approach
• Environmental strategies
• Availability (e.g. keg restrictions, compliance
  checks, responsible beverage service policies)
• Price/ marketing (e.g. regulation of happy
  hours, limits on alcohol industry presence on
  campus)
• Social norms (e.g. substance free housing,
  parental notification)
• Harm minimization (e.g. Safe Ride programs)
• PrincipaI investigator Mark Wolfson, Ph.D.

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SPARC The Evaluation

• College Drinking Survey (CDS)
• Resident Advisor Survey
• Alcohol Incident and Injury Reports
• Campus Police, Student Affairs, Campus Health,
  Campus EMS
• Coalition Member Survey
• Environmental Strategies and Implementation
  Survey (ESIS)
• Coalition Activity Tracking

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Annual Consequences of College Drinking

• 1,700 deaths
• 599,000 injuries
• 696,000 assaults
• 97,000 sexual assaults
• 2.8 MILLION DWI

Hingson, 2005
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Effects of Energy Drink Ingestionon Alcohol
Intoxication.

• Ferreira SE, Tulio de Mello M, Pompeia S,
  Oliviera de Souza-Formigoni ML.
• Alcoholism Clinical and Experimental Research.
• Vol 30, No 4, 2006 pp 598-605.

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26 Alcohol Energy drink
26 Alcohol
26 Energy drink
Breath alcohol concentration Motor
coordination Visual reaction time Feelings of
intoxication
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Results

• Alcohol alone
• Dizzy, weak, tired, headache, trouble walking
• Alcohol Energy drink
• Same BAC
• Felt much less intoxicated
• NOTE!
• Performance on motor coordination and visual
  reaction time were the same for both groups!

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Buzz Beer
?
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Caffeinated liquor
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Mix-your-own

• Jager Bomb
• Liquid Viagra
• Crunk Juice
• Bullvodka
• Irish Trash Can
• Bull Blaster
• Up All Night
• Liquid Cocaine 6
• Tucker Death Mix
• Butt Plug
• Dirty Gecko

• Panty Dropper Punch
• Cherry Bomb Shot
• Bazooka 2
• Jacobos Melon Bomb
• Touchdown
• Canadian Bull
• Flaming Liquid Cocaine Blaster
• Flip Passion
• Raging Bull 2
• Heart Attack

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2006 SPARC CDS

• Ten NC Universities
• Stratified random sample
• Email invitation to participate
• Web-based (secure URL)
• Anonymous
• Reminder emails to non-respondents
• 307 items, with skip patterns (20 min)
• Paypal incentive

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SPARC College Drinking Survey Content

• Demographic variables
• Alcohol consumption behaviors
• Alcohol availability
• How obtained (e.g. where, from whom)
• Where consumed
• Attitudes about drinking (ones own, perception
  of other students)
• Perceived campus drinking norms
• Knowledge of university policies
• Perception of enforcement (on campus, in the
  community)
• Consequences of ones own drinking
• Consequences of other students drinking
• Sexual behaviors
• Other substance use behaviors

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2006 Additional Goals

• Estimate the prevalence of mixing alcohol with
  energy drinks (AmED) among past 30-day drinkers
• Examine the association of AmED and high-risk
  drinking
• Examine the association of AmED with
  alcohol-related consequences, after adjusting for
  drinking behaviors

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2006 Sample characteristics

• N 4,271
• Average age 20.4 2.8 yrs
• 61 Female
• 78 Non-Hispanic White
• 26 Fr 25 So 25 Jr 20 Sr
• 12 Greek society member or pledge
• 22 intramural athlete 5 varsity
• 57 on-campus resident

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2006 SPARC CDS
4,271 students
4,237 answered drinking questions (99.2)
1,385 non past 30-day drinkers (32)
2,886 past 30-day drinkers (68)
697 past 30-day AmED (24)
AmED Alcohol mixed with energy drinks
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Reasons given for consuming AmED

• To hide the flavor of the alcohol
• To drink more and not feel as drunk
• To drink more and not look as drunk
• To not get a hangover
• Because it was being served at a party
• Because it was the only mixer available
• Because thats how you make Jagerbombs

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AmED more likely

• Male (p lt 0.001)
• White (p lt 0.001)
• Intramural athletes (p lt 0.001)
• Greek society members or pledges (p lt 0.01)
• Younger (plt0.01)
• Average age of first drink 15.1 yrs
• (vs. 16.0 yrs for non-AmED p lt0.001)
• More drinking during last year of high school (p
  lt 0.001)
• More non-medical use of prescription stimulants
  (p lt 0.001)

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High-Risk Drinking
Drinking Behavior Non-AmED N2,189 (76) AmED N697 (24) b 95 CI z statistic p-value
Typical drinks in single episode 4.5 ? 0.15 5.8 ? 0.17 1.4 (1.1, 1.6) 11.69 lt0.001
days with 5/4 heavy episodic drinking past 30 days 3.4 ? 0.17 6.4 ? 0.23 2.9 (2.5, 3.3) 14.21 lt0.001
days drunk in a typical week 0.73 ? 0.04 1.4 ? 0.05 0.70 (0.61, 0.79) 15.44 lt0.001
Most drinks single episode past 30 days 6.1 ? 0.15 8.3 ? 0.19 2.2 (1.9, 2.5) 14.28 lt0.001
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Alcohol-Related Consequences
Consequence Non-AmED N2,189 (76) AmED N697 (24) AOR 95 CI z statistic p-value
Was taken advantage of sexually 3.7 (2.9, 4.8) 6.4 (4.7, 8.7) 1.77 (1.23, 2.55) 3.05 0.002
Took advantage of another sexually 1.7 (1.2, 2.4) 3.7 (2.5, 5.4) 2.18 (1.34, 3.55) 3.13 0.002
Rode with a driver who was under the influence of alcohol 22.5 (18.6, 26.9) 38.9 (32.7, 45.6) 2.20 (1.81, 2.68) 7.83 lt0.001
Was hurt or injured 5.9 (4.8, 7.2) 12.3 (9.9, 15.3) 2.25 (1.70, 2.96) 5.74 lt0.001
Required medical treatment 1.2 (0.8, 1.8) 2.6 (1.7, 4.1) 2.17 (1.24, 3.80) 2.70 0.007
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Buzz Beer
?
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2007 SPARC CDS
3, 783 answered drinking questions (99.2)
3,813 students
1,114 non-drinkers (30)
2,669 past 30-day drinkers (70)
704 past 30-day AmED (26)
393 MYO only (55.8)
249 Pre-mix MYO (35.4)
59 Pre-mix only (8.4)
AmED Alcohol mixed with energy drinks Pre-mix
Pre-mixed alcoholic energy drinks (e.g. Sparks,
Tilt) MYO Mix-your-own alcoholic energy drinks
(e.g. Jagerbomb, Red Bull and vodka)
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AME Availability

• BOUGHT IT THEMSELVES 65.5
• Of these, 48.3 were under age 21
• (223 of 462)
• GIVEN THE ED FOR FREE 13.4
• Of these, 79.8 were under age 21
• (75 of 94)
• SOMEONE ELSE BOUGHT FOR THEM 13.9
• Of these, 71.4 were under age 21
• (80 of 112)

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Questions?