Interest in the relationship between caffeine and alcohol intake among youth has increased recently.  Both psychoactive compounds influence dopaminergic function in a manner that may increase their desirability and subsequent intake.  Beverages containing caffeine, such as energy drinks and sweetened coffees/teas, have gained popularity among youth.  It is estimated that nearly 75% of youth between the ages of 5-17 consume caffeine regularly.

Purpose: The aim of this research was to assess the potential contribution of caffeine to the onset of alcohol use six months later among a sample of middle school students.

Methods:  Findings reported here were from the first two waves of data obtained from the Young Mountaineer Health Study, a longitudinal investigation on the early onset of alcohol use among youth. Participants were recruited from 20 different middle schools in West Virginia.  Caffeine and alcohol consumption were self-reported using online surveys administered approximately six months apart. The results represent the participants (n=1078) who reported never having used any type of alcohol in the first survey at baseline.

Results:  Estimates of daily caffeine intake were computed from reported consumption of specific beverages at baseline.  These results were then used to assign participants to one of three groups; no  caffeine intake (15%), < 100 mg caffeine/day (28%), and 100 mg caffeine/day (57%).   Six months later, 14% of participants reported having consumed alcohol at least once.  After controlling for potential confounding variables, analysis revealed that the highest level of caffeine intake at baseline ( > 100 mg/day) was significantly related to alcohol use six months later (OR=1.79; RR=1.56, p=.037).  The only other variable that was predictive of alcohol use was the youth’s perceived access to alcohol (OR=2.36, RR=1.87, p<.0001).

Study strengths and limitations:  The sample was recruited from a select number of middle schools in West Virginia thus limiting the generalizability.  Caffeine and alcohol intakes were self-reported and  subject to recall bias.  The extent to which social desirability may have influenced the youths’ responses is unknown.  With that said, the use of validated questions to assess caffeine and alcohol intake is a significant strength as is the ability to compare results over time.

Implications for your practice:  The results of this study suggest that exposure to caffeine may increase the risk of early alcohol use among young adolescents. Until further research confirms this relationship,  your young patients and their parents/guardians may benefit from education about the known risks of caffeine (e.g., rapid heart rate, agitation, sleeplessness).  Given the increasing variety of caffeine-containing drinks available, this is likely to remain an area of concern.

Please feel free to encourage parents/guardians to go to and subscribe to our free monthly newsletter.  In addition to tips and suggestions for healthy drinks, they can find information about caffeinated drinks.

Original citation: Kristjansson, AL, Mann, MJ, Smith, ML, Kogan, SM, Lilly, CL, James, JE.  Caffeine consumption and onset of alcohol use among early adolescents. Preventive Medicine, 163 (2022).

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