Alcohol and Energy Drinks

208 Pages·2014·1.23 MB·English

Alcohol and Energy Drinks: Motivations, Drinking Behaviours and Associated Risks
by
Kristina Brache
M.Sc., University of Victoria, 2009

A Dissertation Submitted in Partial Fulfillment of the
Requirements for the Degree of

DOCTOR OF PHILOSOPHY

in the Department of Psychology

© Kristina Brache, 2014
University of Victoria

All rights reserved. This dissertation may not be reproduced in whole or in part, by
photocopy or other means, without the permission of the author.
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Alcohol and Energy Drinks: Motivations, Drinking Behaviours and Associated Risks
by
Kristina Brache
M.Sc., University of Victoria, 2009

Supervisory Committee

Dr. Timothy Stockwell, Department of Psychology
Supervisor

Dr. Erica Woodin, Department of Psychology
Departmental Member

Dr. Scott Macdonald, School of Health Information Science
Outside Member
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Supervisory Committee

Dr. Timothy Stockwell, Department of Psychology
Supervisor

Dr. Erica Woodin, Department of Psychology
Departmental Member

Dr. Scott Macdonald, School of Health Information Science
Outside Member

ABSTRACT

Introduction: Consuming alcohol mixed with energy drinks (AmED) has become a
growing and popular trend among young adults worldwide. Although there have been
some mixed findings, generally AmED use is associated with heavy drinking, risky
behaviours and more negative outcomes, compared to alcohol use alone. Little research
has been done outside of college samples and few researchers have investigated
motivations for consuming AmED. Purpose: The purpose of the current research was to
expand on previous research by investigating motivations for AmED use and the
associations between AmED use and heavy drinking, alcohol use disorders, risky
behaviours, and negative outcomes in community samples, while controlling for
potentially important third variables, like sensation seeking. Methods: Using multivariate
regression analyses the associations between AmED use and other variables were
investigated in a randomly selected Canadian sample (n = 13,615) and a Canadian
community young adult sample (n = 456). As well, an in-depth qualitative investigation
of university students’ (n = 465) reported motivations for AmED and energy drink use
was investigated using content analysis. Results: Compared to alcohol only, AmED use
was found to be associated with heavy alcohol use, increased risk for alcohol use
disorders, and increased risky behaviours and negative consequences (e.g., being a
passenger in a vehicle with a drunk driver; drinking and driving; being involved in
physical aggression; having harmful effects on relationships, health, employment) in both
the Canadian and community samples. More frequent AmED use (e.g., weekly or more)
was associated with ever having had a sexually transmitted infection. These relationships
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remained significant even after controlling for demographic variables and sensation
seeking personality in the Canadian community sample. The most commonly reported
motivations for AmED use were due to the taste of the beverage, enjoyment of a
particular AmED (e.g., Jagerbomb), for increased stimulation (e.g., wakefulness, energy,
alertness) while drinking, to facilitate “partying” or staying out late when drinking, to
counteract the depressant effects of alcohol, for social purposes, and because of ease of
availability (e.g., purchased by others/ given for free). Conclusions: This research has
contributed to a better understanding of the relationships between AmED use and
personality traits, drinking behaviours, and risk behaviours in two relatively large
community samples. It has contributed to a better understanding of the motivations for
AmED use and how these motivations may be related to heavy drinking and risky
behaviours. Taken together, this research indicates that there may be something about
AmED use which puts people at an increased risk of drinking heavily, engaging in risky
behaviours, and experiencing harms, compared to alcohol use alone. Along with the
accumulating research in this area, the current research could be valuable for directing
and planning future research studies which are designed to investigate causative
relationships and for formulating effective policies and intervention programs.
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Table of Contents

Title Page ..............................................................................................................................i
Supervisory Committee ...................................................................................................... ii
Abstract .............................................................................................................................. iii
Table of Contents ................................................................................................................. v
List of Tables .................................................................................................................... vii
List of Figures .....................................................................................................................ix
Acknowledgments................................................................................................................ x
Introduction .......................................................................................................................... 1
Literature Review ................................................................................................................. 4
Prevalence..................................................................................................................... 6
Drinking Patterns........................................................................................................ 10
Risk Behaviours and Alcohol-Related Consequences................................................. 15
Laboratory Investigations ........................................................................................... 31
Energy Drink Industry Funded Reviews of the Literature .......................................... 44
Reasons for Use .......................................................................................................... 47
Understanding the Relationships ....................................................................................... 55
Personality Variables......................................................................................................... 60
A Theoretical Model of AmED use, Personality Traits, and Outcomes ............................ 62
Gaps in Knowledge/Future Directions .............................................................................. 66
The Current Study .............................................................................................................. 67
Research Questions and Hypotheses .......................................................................... 68
Canadian Alcohol and Other Drug Use Monitoring Survey (CADUMS) ......................... 71
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Methods .............................................................................................................................. 71
Results ................................................................................................................................ 76
Discussion .......................................................................................................................... 78
Victoria Healthy Youth Survey (VHYS) ........................................................................... 85
Methods .............................................................................................................................. 85
Results ................................................................................................................................ 92
Discussion .......................................................................................................................... 95
University of Victoria Student Survey (UVSS) ............................................................... 105
Methods ............................................................................................................................ 105
Results .............................................................................................................................. 108
Discussion ........................................................................................................................ 142
General Discussion .......................................................................................................... 151
References ........................................................................................................................ 165
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List of Tables
Table 1. CADUMS: Percentage of Canadians aged 15 years and older mixing alcohol and
energy drinks in the past 30 days among past 30 day drinkers and the total population
aged 15+ in 2010 .............................................................................................................. 184
Table 2. CADUMS: Demographic comparison of Canadians aged 15 years and older
mixing alcohol and energy drinks in the past 30 days among past 30 day drinkers and
total population aged 15+ in 2010 ................................................................................... 185
Table 3 CADUMS: Comparison of drinking behaviors between drinkers who mixed
alcohol and energy drinks and drinkers who did not ....................................................... 186
Table 4 CADUMS: Comparison of risky alcohol drinking patterns between drinkers who
mixed alcohol and energy drinks and drinkers who did not ............................................ 187
Table 5 CADUMS: Comparison of alcohol use disorder indicators between drinkers who
mixed alcohol and energy drinks and drinkers who did not ............................................ 188
Table 6 CADUMS: Comparison of risky behaviours between drinkers who mixed alcohol
and energy drinks and drinkers who did not .................................................................... 189
Table 7. VHYS: Demographic variables of participants mixing alcohol and energy drinks
in the past month among past year drinkers and the total population .............................. 190
Table 8. VHYS: Comparison of alcohol drinking patterns between drinkers who mixed
alcohol and energy drinks and drinkers who did not ....................................................... 191
Table 9. VHYS: Comparison of alcohol use disorder indicators between drinkers who
mixed alcohol and energy drinks and drinkers who did not ............................................ 192
Table 10. VHYS: Comparison of risky behaviours and negative outcomes between
drinkers who mixed alcohol and energy drinks and drinkers who did not ...................... 193
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Table 11. VHYS: Comparison of risky behaviours and negative outcomes in drinkers
with different frequencies of alcohol mixed with energy drink use ................................ 194
Table 12. VHYS: Frequency of reported physical symptoms after the consumption of
AmED .............................................................................................................................. 196
Table 13. UVSS: Frequency counts for each reason for using energy drinks alone ....... 197
Table 14. UVSS Frequency counts for each reason for mixing alcohol and energy
drinks............................................................................................................................... 198
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List of Figures
Figure 1. UVSS: Motivations for combining alcohol and energy drinks ........................ 182
Figure 2. Model of relationships between combined alcohol and energy drink use,
personality traits and outcome variables .......................................................................... 183
Figure 3. VHYS: Percentage of participants who endorsed experiencing physical
symptoms after the consumption of AmED..................................................................... 195
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Acknowledgments
I would like to acknowledge the years of assistance, mentorship, and support
given to me by my PhD research supervisor, Dr. Tim Stockwell. I appreciate all of the
guidance and support he provided me in the design, implementation, analysis, and
preparation of this dissertation. I would also like to acknowledge the support and
guidance provided to me by committee members, Dr. Erica Woodin and Dr. Scott
Macdonald. They provided me with feedback and support throughout the research
process, in making statistical decisions, and in the preparation of this document. Dr. Erica
Woodin has also provided me with support and guidance throughout my graduate work in
the pursuit of becoming a clinical psychologist who is competent and knowledgeable in
the understanding and treatment of individuals with concurrent substance use and mental
health disorders. I would like to recognize the statistical expertise, consultation, and
analyses, provided by Dr. Jinhui Zhao, statistician at the Centre for Addictions Research
of British Columbia (CARBC) in the preparation of this dissertation. Additionally, I
would like to recognize the support CARBC provided throughout my graduate training
and in the execution and completion of my dissertation research. The research centre
provided me with many opportunities for learning, consultation, and support in
understanding substance use and conducting research in this area.
I would like to acknowledge the personal financial support provided to me during
my PhD by the Social Sciences and Humanities Research Council. I would also like to
acknowledge the support provided to me through my participation in the Intersections of
Mental Health Perspectives in Addictions Research Training (IMPART) program. I
would like to acknowledge the Canadian Institutes of Health Research (CIHR) for their
financial support in conducting the University of Victoria Student Survey research for the
current dissertation.
Finally, I would like to acknowledge the support provided by my family members
throughout my PhD and the countless hours they have endured me talking about energy
drinks, alcohol, and Jagerbombs.