Combined Alcohol and Energy Drinks: consumption patterns and risky behaviours among European students

Background With the growing popularity of energy drinks, a new consumption trend has emerged represented by the mixing of alcohol and energy drinks (AmED). The current study sought to examine AmED use among 16-year-old students in Europe, as well as the associations with social and behavioural characteristics. By examining all these potential relationships from a cross-country perspective, we aim to estimate potential cross-national diferences. Method Sixteen-year-old students were drawn from the 2019 European School Survey Project on Alcohol and Other Drugs cross-sectional survey. Self-reported AmED use in the past 12 months was the dependent variable. Key predictors comprised substance use, other individual risk behaviours and family characteristics (parental regulation, monitoring and caring). Results Of the 16-year-old students surveyed in Europe, 33.9% reported AmED use in the past year. The global prevalence observed among male students (37.3%) was higher than among female students (30.6%). Prevalence ranged from 14.9% in Latvia to 53.7% in Slovenia. The multivariate analysis reported signifcantly higher odds of being AmED users in many of the considered risk behaviours, including daily tobacco smoking, illicit drugs use (cannabis, inhalants, cocaine/crack, NPS), heavy episodic drinking, going around with friends, going out in the evening, truancy at school, engaging in physical fghts, damaged or lost objects or clothing, being involved in serious arguments, having trouble with police, practicing sexual intercourse without a condom and deliberately hurting themselves. Conclusions Consistent with previous studies, European students engaged in risk-taking behaviour showed higher odds of being AmED consumers. Youth AmED prevalence across Europe does not seem to follow a well-defned spatial distribution, suggesting that cultural patterns may only partially explain prevalence diferences