Int J High Risk Behav Addict. 2017 September; 6(3):e59989. Published online 2017 August 19. doi: 10.5812/ijhrba.59989. Research Article Survey on Energy Drink Consumption Among the Adult Population in Sicily: Do New Drinking Habits Associate with the Risk of Alcoholism in the Crib of Mediterranean Diet? Alessandra Casuccio, 1,* Palmira Immordino, 1 Rossella Falcone, 1 Fanny Pojero, 1 and Sara Palmeri 1 1 Department of Sciences for Health Promotion and Mother-Child Care “G. D’Alessandro” University of Palermo, Italy * Corresponding author: Alessandra Casuccio, Via del Vespro 133, 90127, Palermo, Italy. Tel: +39-916553613, Fax: +39-916553641, E-mail: alessandra.casuccio@unipa.it Received 2016 March 21; Revised 2016 October 09; Accepted 2016 November 29. Abstract Background: The market for and the level of energy drinks (EDs) consumption are increasing every year, and while only a few have a comprehensive knowledge about the potential harmful physiological and psychological effects of EDs, the number of publications that have documented the potential adverse risks associated with the use of these beverages remains small. Objectives: The present study aim to evaluate the prevalence of EDs consumers among the adult population and to verify the factors associated with its consumption and onset of adverse events. Patients and Methods: A cross-sectional survey was conducted using a knowledge, attitudes, and practices (KAP) semi-structured questionnaire, administered to adult population of central Sicily, Italy. Results: In this study, 217 adults were interviewed. Of the respondents, 77.9% were current EDs consumers. A significant difference was observed in the level of education (P = 0.022), with particular preponderance of ED-drinking individuals among those with middle school education compared to those with higher education levels, and with a habit of consuming alcohol more frequently than nonusers (P = 0.031). For 73% of the respondents, ED consumption was associated with consumption of alcohol, and 21% of the interviewed participants stated they had suffered from disorders caused by drinking EDs. With regards to differences between sexes, males had drunk EDs for a longer period than females (OR 1.74 (1.15 - 2.97); P = 0.041). The predominant motivation was sports for males (OR 6.5 (1.88 - 22.48); P = 0.003), and studying for females (OR 4.25 (1.25 - 14.4); P = 0.020). The females also claimed to drink EDs particularly on weekends and to have suffered more symptoms than males (OR 2.429 (1.14 - 5.18), P = 0.021). Conclusions: The results of this study confirm a large use of EDs among the adult population and the side effects reported may represent a health risk. The use of EDs may influence ingestion of large amount of alcohol. This result indicates the need for a thorough evaluation of this social phenomenon. Keywords: Adult, Alcoholism, Energy Drink, Risky Behavior 1. Background Energy drinks (EDs) are non-alcoholic beverages mar- keted as improving energy, alertness, concentration, and athletic performance due to the presence of high doses of stimulants, mainly caffeine, taurine, glucuronolactone, carnitine, and a combination of other ingredients (such as guarana, ginseng, and vitamins among others) (1). Most EDs contain enormous quantities of sugar (up to a quar- ter of a cup per can); the sugar-free version contains aspar- tame and acesulfame K in place of sugar. While often consumed by athletes in the hope of im- proving performance, consumption of energy drinks is on the rise in the general population, particularly among ado- lescents and young adults (2, 3). Marketing campaigns fo- cused on improving performance, attention, and strength are, in fact, aimed mainly at these 2 age groups, and this can increase the risk of caffeine intoxication from energy drink consumption (4). The energy drink industry is booming, with sales esti- mated to be over 12.5 billion USD in 2012, an increase of 60% from 2008 to 2012 (5, 6). In Italy, ED consumption rose from 2.67 million litres in 2006 to 2.97 million litres in 2009 (an increase of 11%), registering a prevalence rate of 28% in the adult population (6). In 2011, the European Food Safety Au- thority (EFSA) commissioned a study to gather data on the consumption of energy drinks in 16 countries of the Euro- pean Union. The report revealed that 68% of the adoles- cents (aged 10 - 18 years), 30% of adults, and 18% of children (< 10 years old) consumed energy drinks (6). However, the excessive consumption of EDs is not con- sidered free from risk to human health. The possible ad- verse effects of this habit were associated with particularly high caffeine content (> 300 mg/day) and the fact that EDs facilitate contingent alcohol consumption. Caffeine con- tent can vary from about 50 to 500 mg; the caffeine content Copyright © 2017, International Journal of High Risk Behaviors and Addiction. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.