title: Environmental contexts of combined alcohol and energy drink use: Associations with intoxication in licensed venues.
abstract: Environmental factors inside licensed venues have been found to influence the intoxication levels and consumption practices of patrons. The consumption of alcohol mixed with energy drinks (AmED) occurs primarily at or prior to attending licensed venues, however there is a lack of in situ research investigating AmED use in these contexts. Given that AmED use has been linked with increased alcohol consumption, intoxication, illicit substance use, and risk taking behaviours, this paper explores the environmental correlates and levels of intoxication associated with AmED use in licensed venues.
  
  
  
  Structured observations were undertaken in five Australian cities on Friday and Saturday nights. Covert teams spent 4-5h in venues and recorded hourly observations on patron, venue, and staff characteristics, alcohol, illicit drug and AmED consumption patterns and intoxication levels.
  
  
  
  898 hourly observations were recorded across 68 venues. All but one venue served energy drinks, and patron AmED use was observed during 34.9% of hourly records. AmED use was more prevalent after 12am and in nightclub venues compared to bars and pubs, and was positively associated with high intoxication levels, illicit drug use, and younger crowds. After controlling for environmental factors (i.e. venue crowding, service practices, venue characteristics, patron demographics and behaviour) AmED use did not predict high intoxication at a venue level in multivariable models.
  
  
  
  AmED consumption is ubiquitous in the licensed venues of Australian night-time entertainment districts, particularly busy nightclub venues where intoxication and risky consumption are heightened. However, AmED use was not associated with high patron intoxication when environmental factors were considered.
authors: School of Psychology, Deakin University, Level 3, 27 Brougham St, Geelong, Victoria, Australia. Electronic address: nic.droste@deakin.edu.au.
authors: Nicolas
authors: N
authors: Droste
authors: School of Psychology, Deakin University, Level 3, 27 Brougham St, Geelong, Victoria, Australia.
authors: Peter
authors: P
authors: Miller
authors: Centre for Alcohol Policy Research, La Trobe University, 215 Franklin Street, Melbourne, VIC 3000, Australia.
authors: Amy
authors: A
authors: Pennay
authors: School of Psychology, Deakin University, Level 3, 27 Brougham St, Geelong, Victoria, Australia.
authors: Lucy
authors: L
authors: Zinkiewicz
authors: Turning Point, Eastern Health, 54-62 Gertrude St, Fitzroy, Victoria 3065, Australia; Eastern Health Clinical School, Monash University, Clayton, Victoria 3168, Australia.
authors: Dan I
authors: DI
authors: Lubman
mesh_terms: D000367:Age Factors; D000428:Alcohol Drinking / Q000009:adverse effects* / Q000331:legislation & jurisprudence; D000434:Alcoholic Beverages / Q000009:adverse effects*; D000435:Alcoholic Intoxication / Q000453:epidemiology*; D001315:Australia / Q000453:epidemiology; D016009:Chi-Square Distribution; D061215:Energy Drinks / Q000009:adverse effects*; D004777:Environment; D006801:Humans; D007899:Leisure Activities; D008004:Licensure; D016015:Logistic Models; D015999:Multivariate Analysis; D016017:Odds Ratio; D012307:Risk Factors; D013997:Time Factors
keywords: Alcohol; Energy drinks; Intoxication; Licensed venues; Nightlife; Observational research; Stimulants