Negative Outcomes and Expectances Associated with Consumption of Alcohol Mixed with Energy Drinks in a Collegiate Sample

Background & Purpose: Energy drinks—whose active ingredient is usually caffeine—may contribute to the risks of heavy drinking among college students.  Prior research, for example, found that consuming alcohol mixed with energy drinks (AmED) was associated with having engaged in unprotected sex compared to non-mixing heavy drinkers (heavy drinking defined as 4 or more drinks per occasion for women, 5 or more for men). The goals of this study were to attempt additional confirmation of AmED amplifying the risks of alcohol in collegiate samples and to build on this work by identifying expectancies associated with AmED consumption and testing if these expectancies had a relationship with AmED consequences.    

Method: This cross-sectional study surveyed a nonrandom sample of 73 undergraduates at a midsized, Midwestern university. Point prevalence estimated the frequency AmED use, negative consequences and expectancies; chi-square tested for associations with post-hoc Cramér V to measure association strength. Fisher’s exact test was used where the assumptions of chi-square were violated.

Results: Ninety percent of the sample was aged 18-25. Most (79.2%) respondents described themselves as Caucasian; 52.8% identified as male, 47.2% as female.  Nearly half (49.3%) had consumed AmED in the last twelve months, being the most prevalent proportionally among female (70.6%) and racial majority respondents (55.4%). AmED was significantly associated (p<0.05) with driving under the influence, unprotected sex and verbal arguments, all with a moderate-strong strength of association. Heavy drinking alone was not significantly associated with driving under the influence and had a weaker strength of association with unprotected sex and verbal arguments vs. AmED. 

The most common expectancies reported by respondents who had ever used AmED were improving the taste of alcohol (62.3%), having more energy while drinking (44.8%), having a better time while drinking (39.7%) and increasing sociability (32.8%). Among those who had consumed in the past 12 months, AmED was significantly and strongly associated with improving the taste of alcohol and having more energy while drinking, and moderately with improving alertness while drinking and increasing sociability. There were no statistically significant associations between the identified expectancies and negative consequences.

Conclusion & Implications: This study adds to the literature regarding AmED and increased alcohol risk among college students and identifies several expectancies associated with AmED consumption. Within this sample, AmED consumption proved popular and problematic, associated with driving under the influence, unprotected sex and verbal arguments. Four expectancies were associated with AmED use, though none of these had a statistically significant link to AmED consequences. Because only those who had consumed AmED in the last year were included in this portion of the analysis, the non-finding may be a result of limited sample size. Another limitation is that this study was cross-sectional, therefore only associations were examined.

These results suggest that AmED consumption may be an identifier of high-risk students. The results also suggest a need to inform students of the possible negative consequences that may occur in association with AmED use above and beyond those of alcohol use alone.