Nearly one-third of US adolescents consume high-caffeine energy drinks or "shots," and these teens report higher rates of alcohol, cigarette, or drug use, reports a study in the January/February Journal of Addiction Medicine, the official journal of the American Society of Addiction Medicine. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.

The same characteristics that attract young people to consume energy drinks - such as being "sensation-seeking or risk-oriented" - may make them more likely to use other substances as well, suggests the new research by Yvonne M. Terry-McElrath, MSA, and colleagues of the Institute for Social Research, University of Michigan, Ann Arbor.

High Use of Energy Drinks/Shots by US Teens...

The researchers analyzed nationally representative data on nearly 22,000 US secondary school students (eighth, tenth, and twelfth graders). The teens were participants in the University of Michigan's "Monitoring the Future" study, funded by the National Institute on Drug Abuse.

In response to questionnaires, about 30 percent of teens reported using caffeine-containing energy drinks or shots. More than 40 percent said they drank regular soft drinks every day, while 20 percent drank diet soft drinks daily.

Boys were more likely to use energy drinks than girls. Use was also higher for teens without two parents at home and those whose parents were less educated. Perhaps surprisingly, the youngest teens (eighth graders) were most likely to use energy drinks/shots.

Students who used energy drinks/shots were also more likely to report recent use of alcohol, cigarettes, and illicit drugs. Across age groups and with adjustment for other factors, teens who used energy drinks/shots were two or three times more likely to report other types of substance use, compared to those who didn't use energy drinks.

Soft drink consumption was also related to substance use. However, the associations were much stronger for energy drinks/shots.

...May Have Implications for Risk of Substance Use

Energy drinks and shots are products containing high doses of caffeine, marketed as aids to increasing energy, concentration, or alertness. Studies in young adults suggest that consumption of energy drinks is associated with increased use of alcohol, marijuana, and tobacco.

In young adults, energy drinks have been linked to behavioral patterns of "sensation-seeking or risk orientation." Energy drinks are often used together with alcohol, which may "mask" the intoxicating effects of alcohol. The new study is one of the first to look at consumption of energy drinks by US adolescents, and how they may be related to other types of substance use.

"The current study indicates that adolescent consumption of energy drinks/shots is widespread and that energy drink users also report heightened risk for substance use," Terry-McElrath and colleagues write. They emphasize that their study provides no cause-and-effect data showing that energy drinks lead to substance abuse in teens.

However, the researchers believe that the findings linking energy drinks to substance use in young adults are likely relevant to adolescents as well. They write, "[E]ducation 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."

Even without the possible link to substance use, Terry-McElrath and coauthors note that, with their high caffeine and sugar content, energy drinks and shots aren't a good dietary choice for teens. They cite a recent American Academy of Pediatrics report stating that "[C]affeine and other stimulant substances contained in energy drinks have no place in the diet of children and adolescents."