Energy Drink Consumption: A Unique Predictor of Risk for Alcohol Use Among Pre-Adolescents?

Introduction: Energy drink consumption is associated with alcohol and drug use and other externalizing behaviors among adolescents and young adults (Arria et al., 2010; Krisjansson et al., 2013). In addition, energy drink consumption predicts later alcohol use among early adolescents (Miyake & Marmorstein, 2015). However, this longitudinal prediction may be due to the co-occurrence of energy drink consumption with other risk factors for alcohol use. The goal of this study was to examine whether energy drink consumption among pre-adolescents predicted later alcohol use over and above the effects of established risk factors for alcohol use. We also examined whether energy drink consumption predicted alcohol use only among youth with high levels of externalizing symptoms.

Method: Participants were drawn from the Camden Youth Development Study, a longitudinal study of middle-school students (N=144; 50% female; 65% Hispanic, 30% African-American, 5% Native American, 2% White, 1% Asian; 81% qualifying for free lunch). They were initially assessed during 6^th and 7^th grades (mean age=11.9 (SD=.8)) and followed-up 16 months later (participation rates 94% and 96%). Self-reports of frequency of energy drink and alcohol consumption, conduct disorder symptoms, beliefs about peer and best friend’s substance use, social behavior alcohol expectancies, sensation-seeking, and parental monitoring were used. Missing data were imputed. Multiple regression analyses were conducted, with frequency of energy drink use at the initial assessment as the independent variable and frequency of alcohol use at the final assessment as the dependent variable. Other risk factors adjusted for were: age, gender, race, alcohol use frequency at the first assessment, conduct disorder symptoms, beliefs about peer and best friend’s substance use, social behavior alcohol expectancies, sensation-seeking, and parental monitoring. To address the second goal, a term representing the interaction between conduct disorder symptoms and energy drink consumption was added to the model.

Results: Energy drink use at the first assessment predicted frequency of alcohol use 16 months later, net the effect of known risk factors for adolescent alcohol use (parameter estimate=.16, SE=.06, p=.01). Conduct disorder symptoms did not interact with energy drink use at the initial assessment to significantly predict later alcohol use.

Conclusions: Energy drink consumption predicts future alcohol consumption among early adolescents, over and above the effects of previously-identified risk factors for alcohol use. This effect is not limited to youth with pre-existing conduct problems. Future research examining mediators and moderators of this effect will be important in informing prevention and/or intervention efforts.