Energy drinks, soft drinks, and substance use among United States secondary school students

Abstract

Objectives: Examine energy drink/shot and regular and diet soft drink use among United States secondary school students in 2010-2011, and associations between such use and substance use.

Methods: We used self-reported data from cross-sectional surveys of nationally representative samples of 8th-, 10th-, and 12th-grade students and conducted multivariate analyses examining associations between beverage and substance use, controlling for individual and school characteristics.

Results: Approximately 30% of students reported consuming energy drinks or shots; more than 40% reported daily regular soft drink use, and about 20% reported daily diet soft drink use. Beverage consumption was strongly and positively associated with past 30-day alcohol, cigarette, and illicit drug use. The observed associations between energy drinks and substance use were significantly stronger than those between regular or diet soft drinks and substance use.

Conclusions: This correlational study indicates that adolescent consumption of energy drinks/shots is widespread and that energy drink users report heightened risk for substance use. This study does not establish causation between the behaviors. Education for parents and prevention efforts among adolescents should include education on the masking effects of caffeine in energy drinks on alcohol- and other substance-related impairments, and recognition that some groups (such as high sensation-seeking youth) may be particularly likely to consume energy drinks and to be substance users.

Figure 1

Predicted probabilities of any past 30-day substance use by grade and type of beverage consumption among secondary students, 2010–2011 Notes: All models simultaneously included all three beverage consumption measures as well as gender, white race/ethnicity, if both parents resided in the home, average parental education, region (using a dichotomy for South), population density (using a dichotomy for SMSA vs. other), and year (using a dichotomy for 2011). Post-hoc contrasts utilized to examine equality of beverage consumption estimates on substance use. Bar heights show the estimated probability of use of the indicated substance (alcohol, cigarettes, marijuana, or amphetamines) by type of beverage use (energy drinks/shots, regular soft drinks, or diet soft drinks), based on models that included all three beverage use measures and all control variables. Asterisks above each bar indicate the significance of difference between the specific beverage type and the relevant substance. Alphabetic characters (a,b,c) below each grade indicator show which specific contrasts were significant. ^aSignificant (p<.05 or lower) difference between estimate for regular soft drinks and diet soft drinks ^bSignificant (p<.05 or lower) difference between estimate for regular soft drinks and energy drinks/shots ^cSignificant (p<.05 or lower) difference between estimate for diet soft drinks and energy drinks/shots *p<.05; **p<.01; ***p<.001 for associations between beverage consumption and substance use in multivariate logistic regression models.