{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T03:06:50Z","timestamp":1773198410788,"version":"3.50.1"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T00:00:00Z","timestamp":1773100800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Alcohol mixed with energy drinks (AmED) has emerged as a public health concern, particularly among young adults. Evidence shows that combining energy drinks (EDs) with alcohol can mask ethanol\u2019s sedative effects, promoting higher intake and risky behaviors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross-sectional online survey was conducted among university students in the Mazovia region of Poland (July 2025). An anonymous questionnaire assessed sociodemographic characteristics, EDs consumption, AmED use, co-use of psychoactive substances, consumption contexts, and adverse effects. Associations were analyzed using chi-square tests and logistic regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 871 students (mean age = 22.1 \u00b1 3.05 years; 73.2% women) participated. One in four (25.5%) reported at least occasional AmED use. Logistic regression showed that a later age of first energy drink consumption was associated with a higher likelihood of AmED (OR = 1.34; 95% CI: 1.14\u20131.56; p&amp;lt;0.001). Gender was the only significant sociodemographic predictor. Men were more likely to report co-consumption (OR = 1.37; 95% CI: 1.00\u20131.86; p &amp;lt; 0.05). Over half did not mix energy drinks with other substances; when they did, nicotine (e-cigarettes) and caffeine (coffee) were the most common. The main AmED social contexts were parties and studying, differing by gender. About one-third (36.7%) of AmED users experienced reported unspecified self-reported adverse effects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>AmED consumption is common among university students from the Mazovia region of Poland and appears to be associated with contextual factors, while age of ED initiation showed an ordinal association with the likelihood of AmED use. These findings may inform prevention strategies addressing social drinking contexts and promoting responsible attitudes toward stimulant\u2013alcohol co-use among young adults.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpsyt.2026.1772697","type":"journal-article","created":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T06:41:58Z","timestamp":1773124918000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Alcohol mixed with energy drinks among university students in Poland: prevalence, determinants, and health implications"],"prefix":"10.3389","volume":"17","author":[{"given":"Paulina","family":"Mularczyk-Tomczewska","sequence":"first","affiliation":[{"name":"Department of Public Health, Faculty of Health Sciences, Medical University of Warsaw","place":["Warsaw, Poland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tytus","family":"Koweszko","sequence":"additional","affiliation":[{"name":"Department of Community Psychiatry, Faculty of Health Sciences, Medical University of Warsaw","place":["Warsaw, Poland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mariusz","family":"Gujski","sequence":"additional","affiliation":[{"name":"Department of Public Health, Faculty of Health Sciences, Medical University of Warsaw","place":["Warsaw, Poland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u0141ukasz","family":"Czy\u017cewski","sequence":"additional","affiliation":[{"name":"Department of Geriatric Nursing, Faculty of Health Sciences, Medical University of Warsaw","place":["Warsaw, Poland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrzej","family":"Silczuk","sequence":"additional","affiliation":[{"name":"Department of Community Psychiatry, Faculty of Health Sciences, Medical University of Warsaw","place":["Warsaw, Poland"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,10]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"96","DOI":"10.3945\/an.114.007393","article-title":"Can energy drinks increase the desire for more alcohol","volume":"6","author":"Marczinski","year":"2015","journal-title":"Adv Nutr"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.3390\/nu14234985","article-title":"Alcohol mixed with energy drinks (AmED) use among university students: A systematic review and meta-analysis","volume":"14","author":"De Giorgi","year":"2022","journal-title":"Nutrients"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.3389\/fnbeh.2022.968889","article-title":"The implications of alcohol mixed with energy drinks from medical and socio-legal standpoints","volume":"16","author":"Sefen","year":"2022","journal-title":"Front Behav Neurosci"},{"key":"B4","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1111\/nure.12127","article-title":"Energy drinks mixed with alcohol: what are the risks","author":"Marczinski","year":"2014","journal-title":"Nutr Rev"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.3389\/fnbeh.2023.1213723","article-title":"Editorial: Alcohol and energy drinks: is this a really good mix","volume":"17","author":"Acquas","year":"2023","journal-title":"Front Behav Neurosci"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.drugalcdep.2008.08.001","article-title":"Caffeinated energy drinks--a growing problem","volume":"99","author":"Reissig","year":"2009","journal-title":"Drug Alcohol Depend"},{"key":"B7","doi-asserted-by":"publisher","first-page":"e947124","DOI":"10.12659\/MSM.947124","article-title":"Regulatory efforts and health implications of energy drink consumption by minors in Poland","volume":"31","author":"Mularczyk-Tomczewska","year":"2025","journal-title":"Med Sci Monit"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1111\/j.1745-7599.2011.00689.x","article-title":"Energy drinks: what is all the hype? The dangers of energy drink consumption","volume":"24","author":"Rath","year":"2012","journal-title":"J Am Acad Nurse Pract"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.3390\/nu17091458","article-title":"Patterns of energy drink use, risk perception, and regulatory attitudes in the adult polish population: results of a cross-sectional survey","volume":"17","author":"Mularczyk-Tomczewska","year":"2025","journal-title":"Nutrients"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.3390\/nu17152435","article-title":"The review on adverse effects of energy drinks and their potential drug interactions","volume":"17","author":"Dobrek","year":"2025","journal-title":"Nutrients"},{"key":"B11","unstructured":"Opinion on Caffeine, Taurine and D-Glucurono-\u03b3-Lactone as Constituents of So-Called \u201cEnergy\u201d Drinks\n          \n          \n          Brussels, Belgium: European Commission website\n          \n          1999"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1017\/S1368980019001605","article-title":"Caffeinated energy drinks: adverse event reports to the US Food and Drug Administration and the National Poison Data System, 2008 to 2015","volume":"22","author":"Markon","year":"2019","journal-title":"Public Health Nutr"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.3390\/nu15183922","article-title":"The dark side of energy drinks: A comprehensive review of their impact on the human body","volume":"15","author":"Costantino","year":"2023","journal-title":"Nutrients"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2009-3592","article-title":"Health effects of energy drinks on children, adolescents, and young adults","volume":"127","author":"Seifert","year":"2011","journal-title":"Pediatrics"},{"key":"B15","unstructured":"Monitoring the future study annual report\n          \n          \n            \n              Miech\n              RA\n            \n            \n              Johnston\n              LD\n            \n            \n              Patrick\n              ME\n            \n            \n              O\u2019Malley\n              PM\n            \n          \n          Ann Arbor, MI: Institute for Social Research, University of Michigan\n          National Survey Results on Drug Use, 1975\u20132024: Overview and Detailed Results for Secondary School Students\n          \n          2024"},{"key":"B16","unstructured":"Ustawa z dnia 11 wrze\u015bnia 2015 r. o zdrowiu publicznym (t.j. Dz.U. z 2024 r. poz. 1670 z p\u00f3\u017an. zm.)"},{"key":"B17","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1016\/j.alcohol.2023.02.001","article-title":"Alcohol versus combined alcohol and energy drinks consumption: Risk behaviors and consumption patterns among European students","volume":"110","author":"Scalese","year":"2023","journal-title":"Alcohol"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1016\/j.addbeh.2018.03.022","article-title":"Alcohol mixed with energy drink use during young adulthood","volume":"84","author":"Patrick","year":"2018","journal-title":"Addict Behav"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.3122\/jabfm.2010.04.090261","article-title":"Risks of alcoholic energy drinks for youth","volume":"23","author":"Weldy","year":"2010","journal-title":"J Am Board Fam Med"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.3389\/fnbeh.2023.1057262","article-title":"Alcohol and energy drinks: individual contribution of common ingredients on ethanol-induced behaviour","volume":"17","author":"Tarragon","year":"2023","journal-title":"Front Behav Neurosci"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2011.06.015","article-title":"Adolescents and young adults presenting to the emergency department intoxicated from a caffeinated alcoholic beverage: a case series","volume":"59","author":"Cleary","year":"2012","journal-title":"Ann Emerg Med"},{"key":"B22","unstructured":"Alcohol and Caffeine\n          \n          \n          Ann 2024. Atlanta, GA: Centers for Disease Control and Prevention.\n          Centers for Disease Control and Prevention"},{"key":"B23","volume-title":"Statistica. Version 13.3","year":"2017"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.23736\/S0026-4946.16.04492-3","article-title":"Energy drinks consumption in Italian adolescents: preliminary data of social, psychological and behavioral features","volume":"71","author":"Cofini","year":"2019","journal-title":"Minerva Pediatr"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.20344\/amp.9403","article-title":"Consumption patterns of energy drinks in Portuguese adolescents from A city in Northern Portugal","volume":"31","author":"Martins","year":"2018","journal-title":"Acta Med Port"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1177\/1757913914565388","article-title":"Energy drink consumption is associated with unhealthy dietary behaviours among college youth","volume":"135","author":"Poulos","year":"2015","journal-title":"Perspect Public Health"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1017\/S1368980015000191","article-title":"Sports and energy drink consumption are linked to health-risk behaviours among young adults","volume":"18","author":"Larson","year":"2015","journal-title":"Public Health Nutr"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.17269\/cjph.106.4684","article-title":"Use of caffeinated energy drinks among secondary school students in Ontario: Prevalence and correlates of using energy drinks and mixing with alcohol","volume":"106","author":"Reid","year":"2015","journal-title":"Can J Public Health"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2021.109061","article-title":"Trends in energy drink and combined alcohol and energy drinks consumption among Italian high school students, 2008-2019","volume":"228","author":"Scalese","year":"2021","journal-title":"Drug Alcohol Depend"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1080\/15389588.2012.755261","article-title":"The effects of alcohol mixed with energy drinks (AmED) on traffic behaviors among Brazilian college students: a national survey","volume":"14","author":"Eckschmidt","year":"2013","journal-title":"Traffic Inj Prev"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1007\/s00431-019-03342-7","article-title":"Energy drinks in children and adolescents: demographic data and immediate effects","volume":"178","author":"Mansour","year":"2019","journal-title":"Eur J Pediatr"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1089\/caff.2018.0008","article-title":"Gender differences in any-source caffeine and energy drink use and associated adverse health behaviors","volume":"9","author":"Dillon","year":"2019","journal-title":"J Caffeine Adenosine Res"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.26444\/aaem\/214352","article-title":"Legal regulations and consumption of energy drinks in the European Union and selected member states","author":"Mularczyk-Tomczewska","year":"2025","journal-title":"Ann Agric Environ Med"},{"key":"B34","doi-asserted-by":"publisher","first-page":"298","DOI":"10.24095\/hpcdp.39.11.02","article-title":"Age at first alcohol use predicts current alcohol use, binge drinking and mixing of alcohol with energy drinks among Ontario Grade 12 students in the COMPASS study. Utiliser l\u2019\u00e2ge de la premi\u00e8re consommation d\u2019alcool pour pr\u00e9dire la consommation d\u2019alcool, la consommation excessive d\u2019alcool et le m\u00e9lange d\u2019alcool et de boissons \u00e9nergisantes chez les \u00e9l\u00e8ves de 12e ann\u00e9e en Ontario dans le cadre du projet COMPASS","volume":"39","author":"Holligan","year":"2019","journal-title":"Health Promot Chronic Dis Prev Can"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1016\/j.addbeh.2017.03.016","article-title":"Energy Drink and Alcohol mixed Energy Drink use among high school adolescents: Association with risk taking behavior, social characteristics","volume":"72","author":"Scalese","year":"2017","journal-title":"Addict Behav"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.3390\/nu17213430","article-title":"Energy drink knowledge, consumption, and regulation support among polish medical and non-medical students: A cross-sectional study","volume":"17","author":"Mularczyk-Tomczewska","year":"2025","journal-title":"Nutrients"}],"container-title":["Frontiers in Psychiatry"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyt.2026.1772697\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T06:42:00Z","timestamp":1773124920000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyt.2026.1772697\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,10]]},"references-count":36,"alternative-id":["10.3389\/fpsyt.2026.1772697"],"URL":"https:\/\/doi.org\/10.3389\/fpsyt.2026.1772697","relation":{},"ISSN":["1664-0640"],"issn-type":[{"value":"1664-0640","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,10]]},"article-number":"1772697"}}