The consumption of alcohol mixed with energy drinks: prevalence and key correlates among Canadian high school students.

Background: 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) 1.19-1.95], past-year heavy drinking [adjusted OR 3.41, 95% CI 2.84-4.09] and marijuana use [adjusted OR 2.29, 95% CI 1.90-2.76]), 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 higher were less likely to consume alcohol mixed with energy drinks.

Interpretation: The consumption of alcohol mixed with energy drinks is an emerging public health concern. Consumption of these drinks is substantial among Canadian high school students and can lead to many potential harms, both acute (e.g., injury) and long term (e.g., increased alcohol dependence). Our findings highlight the need for further research into the long-term effects of consumption of alcohol mixed with energy drinks among young people, as well as the development of interventions aimed at reducing consumption of these drinks.