What do we know about alcohol mixed with energy drink (AmED) use in Australia? Expanding local evidence.

OBJECTIVES: Despite continued health concerns associated with the practice of consuming alcohol mixed with energy drinks (AmED), few Australian studies have examined the popularity of this combination or attempted to characterise AmED consumers. The purpose of this paper is to replicate two previously used survey approaches to consolidate a national picture of AmED consumption in Australia. METHODS: The survey approaches used were: an online survey with a convenience sample of New South Wales (NSW), Australia, residents (n = 1931; 63.7% female; median age 23.0 years); and street intercept surveys in regional and metropolitan entertainment precincts in NSW (n = 1265; 58.2% male; median age 21.0 years). Analyses explored the rates and frequency of AmED use across both samples, and the sociodemographic and substance use predictors of AmED consumption in the past 12 months. RESULTS: More than 90% of participants in both samples reported alcohol consumption in the past 12 months, with approximately 40% of current drinkers also reporting AmED use in the past 12 months. Three-quarters of participants interviewed in entertainment precincts reported alcohol consumption in the previous 12 hours, with one in six of these also reporting AmED consumption in the past 12 hours. AmED users across both samples were more likely than alcohol-only consumers to be younger and male, and to report riskier substance use practices. CONCLUSIONS: Health promotion activities are warranted to promote awareness of energy drink guidelines, and the potential harms of exceeding these guidelines, among alcohol consumers. In addition, health workers should consider enquiring about AmED use as an indicator of risk related to substance use.

Homicides with direct and indirect links to the night-time economy.

INTRODUCTION AND AIMS: Alcohol use and homicide are a wide community concern with particular interest in understanding and preventing attacks (e.g. 'one punch' male on male attacks) in commercial nightlife settings with high levels of collective drinking. There is insufficient knowledge of the long-term patterns in this violence or the relationship between public drinking and flow on violence in other social settings. DESIGN AND METHODS: Alcohol-related homicides were those in which alcohol consumption was a contributing factor. Those also linked to purchase or consumption in locations where alcohol is sold after dark were classified as night-time economy related. The study comprised a first-hand analysis of files in the archive of the Australian National Homicide Monitoring Program in 2 years with a decade gap (1998/1999-2007/2008), and it classified 73 of all 238 alcohol-related incidents by direct or indirect relation to public nightlife settings. RESULTS: Related homicides in these years were not highly concentrated in developed night-time economies, but more spread outside major nightlife zones. Indirectly related killings were even more dispersed and included more women victims killed in domestic settings. DISCUSSION AND CONCLUSIONS: There is a consistent though dispersed relationship between heavy public drinking at night and homicide. Concerns about homicide and night-time drinking leisure with mostly male victims attacked in well-known areas of busy city nightlife, must also consider the broader gendered patterns of 'flow on' nightlife-related incidents, including fatal semi-private and domestic violence that is indirectly but importantly related to drinking and alcohol purchase in public commercial nightlife.

The need for accuracy and validity in research on nightlife and drinking: A commentary on Devilly et al. and recommendations for future research.

Research on nightlife and drinking faces many unique challenges, and validity in research is an important concern. A recent publication by Devilly et al. entitled "SmartStart: Results of a large point of entry study into preloading alcohol and associated behaviours" contains definitions and assumptions about prior work that require more careful consideration. Important issues include: using a definition of pre-drinking which is the same as previous work so that valid comparison can be made, reporting of blood alcohol concentration (BAC) levels that comply with other work, accurate reporting of response rates, and careful consideration of sampling approaches to maximise ethical integrity. Ensuring consistency of definition and accurate representation of previous literature regarding BAC, pre-drinking and energy drink use, is important for supplying the broader community with reliable information on which policy decisions can be made.

A comparative study of blood alcohol concentrations in Australian night-time entertainment districts.

INTRODUCTION AND AIMS: There is little research describing how intoxication levels change throughout the night in entertainment districts. This research aims to describe levels of alcohol intoxication across multiple Australian metropolitan and regional nightlife districts. DESIGN AND METHODS: This study was conducted in the night-time entertainment districts of three metropolitan cities (Sydney, Melbourne and Perth) and two regional cities (Wollongong and Geelong) in Australia. Data collection occurred approximately fortnightly in each city on a Friday or Saturday night between 8 pm and 5 am. Brief structured interviews (3-10 min) and breathalyser tests were undertaken in busy thoroughfares over six months. RESULTS: Of the 7037 individuals approached to participate in the study, 6998 [61.8% male, mean age 24.89 years (standard deviation 6.37; range 18-73)] agreed to be interviewed. There was a linear increase in blood alcohol concentration (BAC) levels throughout the night. Post hoc testing revealed significantly more highly intoxicated participants (i.e. BAC above 0.10 mg of alcohol per 100 mL of blood) after midnight (P < 0.05). The overall mean BAC was 0.06 mg/100 mL. Men were more intoxicated than women earlier in the night, but gender differences disappeared by 3 am. There was no age differences in intoxication earlier in the night, but after midnight, patrons over the age of 21 showed increasing BAC levels. DISCUSSION AND CONCLUSIONS: There is a consistent trend across the cities of high to very high levels of intoxication later in the night, with trends after midnight being significantly different to those before.