The use of caffeinated alcoholic beverages among underage drinkers: results of a national survey

Addict Behav. 2014 Jan;39(1):253-8. doi: 10.1016/j.addbeh.2013.10.006. Epub 2013 Oct 8.


Objective: The mixing of alcoholic beverages with caffeine has been identified as a public health problem among college students; however, little is known about the consumption of such drinks among younger adolescents. We estimated the prevalence of caffeinated alcoholic beverage (CAB) use among a wide age range of underage drinkers, examined differences in traditional (i.e. self-mixed alcoholic beverages with soda, coffee and tea) and non-traditional CAB use (pre-mixed caffeinated alcoholic beverages or self-mixed alcoholic beverages with energy drinks or energy shots) among underage drinkers by age and other demographic characteristics, and examined differences in hazardous drinking behavior between CAB and non-CAB users.

Methods: We used an existing Internet panel maintained by Knowledge Networks, Inc. to assess the use of pre-mixed and self-mixed CABs in the past 30 days among a national sample of 1031 youth drinkers age 13-20. We conducted logistic regression analyses to estimate the relationship between traditional and non-traditional CAB use and risky drinking behavior as well as adverse outcomes of drinking, while controlling for age, gender, race/ethnicity, income, and general risk-taking (seat belt use).

Results: The overall prevalence of CAB use in the sample of underage drinkers was 52.4% (95% confidence interval [CI], 47.4%-57.4%). CAB prevalence was 48.4% among 13-15 year-old drinkers, 45.3% among 16-18 year-old drinkers, and 58.4% among 19-20 year-old drinkers. After controlling for other variables, we found a continuum of risk with non-traditional CAB use most significantly associated with binge drinking (odds ratio [OR]=6.3), fighting (OR=4.4), and alcohol-related injuries (OR=5.6).

Conclusions: The problem of caffeinated alcoholic beverage use is not restricted to college-aged youth. The prevalence of CAB use among underage drinkers is higher than previously thought and begins in early adolescence. Adolescents who consume CABs, and particularly non-traditional CABs, are at increased risk of adverse outcomes.

Keywords: Adverse outcomes; Alcohol drinking pattern; Alcohol use; CAB; Energy drink; Youth; caffeinated alcoholic beverage.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Alcohol Drinking / epidemiology*
  • Alcoholic Beverages / statistics & numerical data*
  • Binge Drinking / epidemiology*
  • Caffeine*
  • Carbonated Beverages / statistics & numerical data
  • Central Nervous System Stimulants*
  • Coffee
  • Energy Drinks / statistics & numerical data*
  • Female
  • Humans
  • Male
  • Surveys and Questionnaires
  • Tea
  • Young Adult


  • Central Nervous System Stimulants
  • Coffee
  • Tea
  • Caffeine