title: Energy Drinks, Alcohol, Sports and Traumatic Brain Injuries among Adolescents.
abstract: OBJECTIVE
  The high prevalence of traumatic brain injuries (TBI) among adolescents has brought much focus to this area in recent years. Sports injuries have been identified as a main mechanism. Although energy drinks, including those mixed with alcohol, are often used by young athletes and other adolescents they have not been examined in relation to TBI.
  
  
  OBJECTIVE
  We report on the prevalence of adolescent TBI and its associations with energy drinks, alcohol and energy drink mixed in with alcohol consumption.
  
  
  METHODS
  Data were derived from the Centre for Addiction and Mental Health's 2013 Ontario Student Drug Use and Health Survey (OSDUHS). This population-based cross-sectional school survey included 10,272 7th to 12th graders (ages 11-20) who completed anonymous self-administered questionnaires in classrooms.
  
  
  METHODS
  Mild to severe TBI were defined as those resulting in a loss of consciousness for at least five minutes, or being hospitalized for at least one night. Mechanism of TBI, prevalence estimates of TBI, and odds of energy drink consumption, alcohol use, and consumption of energy drinks mixed with alcohol are assessed.
  
  
  RESULTS
  Among all students, 22.4% (95% CI: 20.7, 24.1) reported a history of TBI. Sports injuries remain the main mechanism of a recent (past year) TBI (45.5%, 95% CI: 41.0, 50.1). Multinomial logistic regression showed that relative to adolescents who never sustained a TBI, the odds of sustaining a recent TBI were greater for those consuming alcohol, energy drinks, and energy drinks mixed in with alcohol than abstainers. Odds ratios were higher for these behaviors among students who sustained a recent TBI than those who sustained a former TBI (lifetime but not past 12 months). Relative to recent TBI due to other causes of injury, adolescents who sustained a recent TBI while playing sports had higher odds of recent energy drinks consumption than abstainers.
  
  
  CONCLUSIONS
  TBI remains a disabling and common condition among adolescents and the consumption of alcohol, energy drinks, and alcohol mixed with energy drinks further increase the odds of TBI among adolescents. These associations warrant further investigation.
authors.affiliation: Injury Prevention Research Office, St. Michael's Hospital, Toronto, Canada; Department of Psychology, University of Toronto, Toronto, Canada.
authors.forename: Gabriela
authors.initials: G
authors.lastname: Ilie
authors.affiliation: Social and Epidemiological Research, Centre for Addiction and Mental Health, Toronto, Canada.
authors.forename: Angela
authors.initials: A
authors.lastname: Boak
authors.affiliation: Social and Epidemiological Research, Centre for Addiction and Mental Health, Toronto, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
authors.forename: Robert E
authors.initials: RE
authors.lastname: Mann
authors.affiliation: Social and Epidemiological Research, Centre for Addiction and Mental Health, Toronto, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
authors.forename: Edward M
authors.initials: EM
authors.lastname: Adlaf
authors.affiliation: Social and Epidemiological Research, Centre for Addiction and Mental Health, Toronto, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
authors.forename: Hayley
authors.initials: H
authors.lastname: Hamilton
authors.affiliation: Dalhousie University, Halifax, Canada.
authors.forename: Mark
authors.initials: M
authors.lastname: Asbridge
authors.affiliation: Social and Epidemiological Research, Centre for Addiction and Mental Health, Toronto, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Rehm
authors.affiliation: Dalla Lana School of Public Health, University of Toronto, Toronto, Canada; Division of Neurosurgery, University of Toronto, Toronto, Canada.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Cusimano
mesh_terms: D000293:Adolescent; D000428:Alcohol Drinking / Q000009:adverse effects*; D001930:Brain Injuries / Q000453:epidemiology*; D002648:Child; D003430:Cross-Sectional Studies; D061215:Energy Drinks / Q000009:adverse effects* / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D015995:Prevalence; D013177:Sports / Q000706:statistics & numerical data*; D055815:Young Adult