International Journal of Public Health

, Volume 62, Issue 3, pp 379–386 | Cite as

Young adolescents who combine alcohol and energy drinks have a higher risk of reporting negative behavioural outcomes

  • Jana Holubcikova
  • Peter Kolarcik
  • Andrea Madarasova Geckova
  • Eva Joppova
  • Jitse P. van Dijk
  • Sijmen A. Reijneveld
Original Article



To explore whether young adolescents consuming alcohol and energy drinks combined were more likely to report negative behavioural outcomes than their peers who drink only one type of these beverages or are abstinent.


We analysed data on a representative sample of Slovak adolescents 8502 adolescents (mean age 13.21, 49.4 % boys) from the 2014 Health Behaviour in School-aged Children cross-sectional study. We assessed the associations of alcohol and energy drinks consumption with negative outcomes and their potential synergy, as measured by the synergy index (SI).


Adolescents consuming both alcohol and energy drinks were at higher risk of negative behavioural outcomes than their peers who drank only alcohol or energy drinks or were non-consumers. Consumers of alcohol and energy drinks were highly prone to be involved in fighting—the joint association of alcohol and energy drinks consumption was greater than sum of its associations separately in relation to fighting (SI 1.49; 95 % confidence interval 1.03–2.16).


Preventive strategies should aim at increasing awareness of negative behavioural outcomes—especially aggressive behaviour associated with alcohol and energy drinks consumption among young adolescents.


Young adolescents Alcohol Energy drinks Negative behavioural outcomes 



This work was partially supported by the Research and Development Support Agency under Contract No. APVV 0032-11 and APVV-15-0012, by the Scientific Grant Agency of the Ministry of Education, science, research and sport of the Slovak Republic, the Slovak Academy of Sciences, reg. no. 1/0895/14, and was also partially funded within the framework of the project “Social determinants of health in socially and physically disadvantaged and other groups of population” of the Ministry of Education, Youth and Sports in Czech Republic CZ.1.07/2.3.00/20.0063’.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.


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Copyright information

© Swiss School of Public Health (SSPH+) 2016

Authors and Affiliations

  • Jana Holubcikova
    • 1
    • 2
  • Peter Kolarcik
    • 1
    • 2
    • 3
  • Andrea Madarasova Geckova
    • 1
    • 2
    • 3
  • Eva Joppova
    • 4
  • Jitse P. van Dijk
    • 1
    • 3
    • 5
  • Sijmen A. Reijneveld
    • 1
    • 5
  1. 1.Department of Health Psychology, Faculty of MedicineGraduate School Kosice Institute for Society and Health, P. J. Safarik UniversityKosiceSlovakia
  2. 2.Department of Health Psychology, Faculty of MedicineP. J. Safarik UniversityKosiceSlovakia
  3. 3.Olomouc University Society and Health Institute, Palacky University OlomoucOlomoucCzech Republic
  4. 4.Department of Paediatrics and Adolescent Medicine, Faculty of Medicine, Clinical Educational Bases in Associated HospitalsP. J. Safarik UniversityKosiceSlovakia
  5. 5.Department of Community and Occupational MedicineUniversity Medical Centre Groningen, University of GroningenGroningenThe Netherlands

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