A cross cultural comparison of negative alcohol-related consequences when mixing alcohol with energy drinks compared to other drinking occasions

Purpose: Previous research has reported an increased prevalence of negative-alcohol related consequences among those who consume alcohol mixed with energy drinks (AMED). However, limited research has compared these outcomes on different drinking occasions within the same participants. Therefore, the aim of this within-subject survey was to compare negative alcohol-related consequences on AMED occasions with other occasions on which the same individuals consumed alcohol only (AO) or combined alcohol with other non-alcoholic beverages (AMOB). Methods: Data from the UK (n = 1873), The Netherlands (n = 6002) and Australia (n = 1056) were pooled to compare negative alcohol-related consequences on AMED occasions with other occasions on which participants consumed AO (n = 2205). In addition, data from the UK compared negative alcohol-related consequences and alcohol consumption across AO, AMED and AMOB occasions (n = 550). Results: Overall, negative alcohol-related consequences were significantly (p <0.001) higher on AO occasions (6.6) compared to AMED (4.4) occasions. For example, significantly (p <0.001)more students reported 'getting themselves into sexual situations they later regretted' on AO occasions (21.9%) compared to AMED occasions (14.5%). Cross cultural comparisons revealed that the prevalence of negative alcohol-related consequences is significantly (p <0.001) lower in The Netherlands, on both AO (4.9) and AMED occasions (2.6), compared to the UK (9.0, 7.1) and Australia (8.7, 6.3). However, there were no significant differences, on both drinking occasions, between the UK and Australia. In line with the pooled results, separate analysis of the UK data showed that negative alcohol- related consequences were significantly higher (p <0.05) on AO occasions (9.0) compared to AMED (7.2) and AMOB (7.0) occasions. There were no significant differences in the number of reported negative alcohol-related consequences between AMED and AMOB occasions. Furthermore, alcohol consumption was significantly (p <0.05) higher on AO occasions (9.0), compared to AMED (6.1) and AMOB (6.7) occasions. Conclusion: In contrast to previous research these within-subjects analyses suggests that, when compared with consuming AO or AMOB, AMED is not associated with an increased risk of alcohol related harm. In fact, the likelihood of engaging in negative alcohol-related consequences is reduced on AMED and AMOB occasions compared to AO occasions. Furthermore, the risks for AMED and AMOB were similar.