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College students consume energy beverages (i.e., energy drinks and energy shots) to fight fatigue, heighten concentration, and promote weight loss, raising concerns about adverse stimulant effects experienced with excess caffeine consumption. Since 2007, energy beverage-related emergency department visits increased 74% in those aged 18-25, some with instances of product misuse (e.g., mixing with alcohol and/or other drugs). The purpose of this formative study was to apply the Theory of Planned Behavior better understand behavioral intentions and predictors of energy beverage consumption in college students.
Methods:
Using a mixed method study design, a convenience sample of college students attending a large Midwestern university completed an electronic survey that measured energy beverage consumption behaviors. The survey was comprised of questions designed to measure demographics, energy beverage consumption practices, medical history, sensation-seeking behavior, vitality (fatigue), and caffeine use. Two blocks of questions were developed to examine attitudes, subjective norms, and perceived behavioral control constructs related to energy beverage consumption. One open-ended survey question was asked: Describe reasons why you do or do not drink energy beverages. The quantitative data were analyzed in SPSS version 22.0 and included descriptive, correlational, and a multiple regression analysis to predict intent to consume energy beverages. The qualitative data were analyzed with QSR International NVivo 10 for Windows.
Results:
The mean age of participants was 19 years (n=288). Of those, 90% reported having consumed energy beverages, with two-thirds reporting use for more than one year. The effects experienced as a result of consuming energy beverages were: trouble falling asleep (54%), heart racing (42%), and headaches (39%). More than half of the respondents reported consuming alcohol with energy beverages because “it tastes good.” Eight themes emerged (alcohol mixer/party longer; tastes good; desirable stimulant effects; enhanced sports performance; unpleasant/unhealthy side effects; combat fatigue; enhanced focus; self-management for weight loss).
The regression model explained approximately 75% of the variance in intent to consume energy beverages. After entry of attitudes, subjective norms, and perceived behavioral control, the total variance explained by the model was 74.8%, F(3, 279) = 276.05, p<.001. Attitude made the strongest unique contribution (beta = .79, p<.001) for explaining Intent to consume, followed by Subjective Norms (beta = .15, p<.001). Perceived Behavioral Control made the weakest contribution (beta = -.06, p<.05). The beta values for each independent variable made a statistically significant unique contribution to the dependent variable, intent to consume energy drinks.
Conclusion:
Despite their popularity, the majority of respondents reported they believed energy beverages were unsafe, or were unsure as to their safety. Attitudes and social norms are key factors influencing intention and consumption of energy beverages in these college students. The Theory of Planned Behavior was useful as an organizing framework for this population, and future studies should be considered using larger samples from different populations. Findings from this study can be used to influence clinical practice, education, research, and health policy.