30 Graduate Student Journal of Psychology 2023, Vol. 21 Copyright 2023 by the Department of Counseling and Clinical Psychology Teachers College, Columbia University A Scoping Review on Energy Drink Consumption Among Adolescents and Young Adults Adolescence, defined by the World Health Or- ganization (WHO) as individuals aged between 10 and 19 years, is a pivotal stage characterized by rapid physical, cognitive, and psychosocial devel- opment, laying the crucial foundations for good health (World Health Organization, 2019). Re- cently, there has been a discernible global increase in energy drink consumption among adolescents, which has become a subject of significant health con- cern and professional debate (Miller et al., 2018). Energy drinks (ED) are beverages that typically contain varying amounts of caffeine, taurine, glucu- ronolactone, vitamins, herbal extracts, proprietary blends, and amino acids. They are marketed as prod- ucts capable of enhancing mental alertness and physi- cal endurance (Ahuja et al., 2021; Higgins et al., 2018). These drinks, available in carbonated or non-carbon- ated forms and with or without sugar, are distinct from traditional beverages like coffee, tea, sodas, and sports drinks, even though they may seem similar. A notable difference is in their caffeine content, with energy drinks potentially containing between 40 to 250 milligrams per 8 fluid ounces, as per the U.S. Food and Drugs Administration (FDA, 2018). This range is significantly higher compared to the caffeine content in an 8-ounce cup of coffee, which usually contains 80 to 100 milligrams. Studies also indicate that energy drinks have an average taurine concen- tration of approximately 750 milligrams per 8-ounce serving (Ahuja et al., 2021; Caine & Geracioti, 2016). The rise in the consumption of energy drinks among adolescents can be attributed to a myriad of factors. Targeted advertising, the promise of increased alertness, combating fatigue, aspirations for improved academic and athletic performance, and the trend of mixing these drinks with alcohol are some of the driv- ing forces behind their popularity (Quigley et al., 2019; Reissig et al., 2009). However, this increasing consump- tion has been linked with several adverse health effects, including elevated blood pressure and psychological is- sues such as anxiety (Lisko et al., 2017). Furthermore, due to the addictive properties of caffeine and other similar components in energy drinks, there have been increased reports of anxiety, stress, and depression among consumers (Linden-Carmichael & Lau-Barra- co, 2017; Richard & Smith, 2016). Given these associ- ated risks, some countries have instituted restrictions on the sale of energy drinks, with others contemplat- ing similar regulatory measures (Winston et al., 2005). Therefore, this scoping review aimed to examine the use of energy drinks in adolescents and young adults to provide a synthesized summary of the ev- idence and identify gaps in our knowledge. The re- search question is: Have there been observable trends in the consumption of energy drinks among adoles- cents and young adults (aged 12-25) in the past decade, with particular emphasis on identifying influencing factors and associated health and behavioral risks? This scoping review aimed to identify empirical studies that have explored the use of energy drink consump- tion among adolescents and young adults. Method: A scoping review search was conducted in the following five databases: PubMed, Embase, Lilacs, Scopus, and Psycnet. Some inclusion criteria, such as being published in the last 10 years, and exclusion criteria, such as article type, animal-model usage, and age, were used to se- lect the studies, and 11 were analyzed independently. Results: The results showed that adolescents use ener- gy drinks for many factors, such as connection with peers and family, propaganda, and taste. Some studies have been developed in Australia and the United States of America, and some have explored other variables associat- ed with energy drinks and alcohol use. Conclusion: It is essential to understand how energy drink consumption and behaviors are related to health or risky behavior and its associations with other drugs. More research is need- ed to explore the long-term health impacts of energy drink consumption during the critical developmental peri- ods of childhood and adolescence, as well as its association with alcohol and other substances. The findings un- derline the importance of stringent regulations, public health policies, and educational initiatives to mitigate the risks associated with energy drink consumption among adolescents. Future research is essential to understand the long-term implications and develop effective preventive strategies to safeguard adolescent health and well-being. Keywords: energy drinks, adolescents, health, consumption Filipe Reis Teodoro Andrade1,2, Gabriel Thalheimer1,2, Santiago David Vásquez Hidalgo2,3, & Rosa Maria Martins de Almeida1,2,3 1Department of Developmental and Personality Psychology, Universidade Federal of Rio Grande do Sul, 2Psychology Institute, Universidade Federal of Rio Grande do Sul, 3Basic Health Sciences Institute, Universidade Federal of Rio Grande do Sul 31 ENERGY DRINK CONSUMPTION AMONG ADOLESCENTS AND YOUNG ADULTS With energy drinks gaining popularity due to aggressive marketing strategies, it is imperative to scrutinize the associated risks, thereby laying the groundwork for the development and imple- mentation of prevention programs targeting both the youth and their guardians (Ahuja et al., 2021; Brache & Stockwell, 2011; Zandvliet et al., 2005). Methods A literature review followed the premises pro- posed by PRISMA (Page et al., 2021a; Page et al., 2021b). The scoping review was carried out accord- ing to the following steps: (1) formulation of the re- search question; (2) production and registration of the investigation protocol; (3) definition of inclusion and exclusion criteria; (4) developing of the research strategy and conducting the reference search; (5) screening of studies based on inclusion and exclusion criteria; (6) evaluation of the quality of studies; (7) data extraction (8) data synthesis and evaluation of the quality of the studies (Donato & Donato, 2019). The approach for conducting systematic scop- ing reviews by Levac et al. (2010) guided the re- view based on the five-stage methodological frame- work that Arksey and O’Malley (2005) developed. Stage 1: Identifying the Research Question. The central question guiding this scoping review was: "Have there been observable trends in the consumption of energy drinks among ad- olescents and young adults (aged 12-25) in the past decade, with particular emphasis on identifying influencing factors and as- sociated health and/or behavioral risks?" Stage 2: Identifying Relevant Studies After the initial search in EMBASE and PubMed, five electronic databases were searched: EMBASE, PubMed, PsycNet, Scopus, and Web of Science, with the last searches performed on August 03, 2022. Date limits were set for 10 years, and the search strategy included using descriptors: Energy Drinks AND (Teenagers) AND (Addiction), with neces- sary adaptations to the specifications of each data- base (Table 1). In searches between June 07, 2022, and August 03, 2022, 143 materials were identified. Stage 3: Study Selection Quantitative and qualitative peer-reviewed, original, full-length research papers were included. The reviewers were previously trained for the task according to the following exclusion criteria: (a) re- views and meta-analyses; (b) Theses, dissertations, abstracts, and publications in congresses; (c) studies that are not in English; (d) animal model research; (e) sample with subjects under 12 or over 25 years old. Participants This Review focused on adolescents and young adults aged between 12 and 25 years. The population may have been studied in schools, universities, or through surveys. Concept During the review, the focus was on energy drink consumption by adolescents, specifically on health and relational factors. Studies that solely fo- cused on addiction to sugar were not considered. The PICO strategy was used based on eligibility cri- teria, with P (population) being adolescents, I (inter- vention) lower levels of use, C (comparison) being patterns of use in adolescents, and O (outcome) be- ing energy drink consumption during adolescence. Search Strategy When performing the search strategy in the five different databases, a total of 143 records were iden- tified. These records were exported to Rayyan Soft- ware (Ouzzani et al., 2016). Duplicate records were then removed, resulting in 139 records for screening the title and abstract. The screening was performed by two authors (FRTA and GT), who independent- ly compared the titles and abstracts of each record with the inclusion criteria. FRTA and GT finally agreed to include 11 records as relevant studies for full-text screening. The records considered eligible for full-text screening were then distributed among one other author, RMMA, in addition to FRTA and GT. They independently screened the full-text studies to assess eligibility for inclusion in the review. The research tool Rayyan Software was used to combine all materials, remove duplicates (n=143), and for the independent reviewers (FRTA and GT) to screen the 139 unique titles and abstracts simul- taneously (Ouzzani et al., 2016). FRTA and GT had a concordance rate of 96.8%, and a third re- viewer (RMMA) assessed divergences. With those steps complete, 13 articles were selected for the sec- ond round of assessments, this time analyzing full text according to the same criteria previously stated. Based on the analysis of the complete texts, 13 ar- ticles were selected for the data extraction phase. After this second exclusion phase, data extraction began, con- 32 ANDRADE ET AL. girls. In contrast, Ludden & Wolfson (2010) found that girls were likelier than boys to report expecta- tions around appetite suppression. Patterns of use ac- cording to age were less clear-cut, with some studies showing that consumption levels increased with age and others demonstrating that the converse was true. Martz et al. (2015) showed that cross-racial and ethnic patterns were also identified; black students were less likely to consume energy drinks than their white counterparts or Latins. Other studies have sug- gested that consumption levels are highest among Aboriginal, Hispanic, and/or Black students (Martz et al., 2015; Visram et al., 2016; Xu et al., 2020). Higher consumption levels were positively associ- ated with being underweight or obese, being from a single-parent family, receiving complimentary school meals, having special educational needs, and having higher spending (Reid et al., 2015; Scalese et al., 2017). Young people with higher scholastic averages, a higher sense of coherence, higher levels of parental monitoring, and more educated parents were less like- ly to consume and consistently associated with ener- gy drink consumption was the use of alcohol and/or binge drinking, smoking, or susceptibility to smok- ing and other substance energy drinks (Miller, 2008). One survey of Australian college students ob- served that premixed alcohol-mixed energy drinks (AMEDs) included the ability to drink more, sensa- tions of being more awake or in control, the symbolic attractiveness of AMEDs, and the ease of obtaining and concealing the beverages for underage drinkers. The survey also identified several negative aspects of AMEDs, including difficulty speaking, hang- overs, and increased aggression (Jones et al., 2012). A study on the appropriateness of caffeinated drinks for children found that high caffeine intakes (>5 mg/kg body weight per day) were associated with an increased risk of apprehension (anxiety) and with- drawal symptoms. Nevertheless, evidence from young adult studies and expert discussions was used to sug- gest that relatively small quantities of caffeine may benefit cognitive function and sports performance, as well as contribute to daily liquid intake (Jones et al., 2012; Kemps et al., 2019; Sanchis-Gomar et al., 2015). Views Regarding the Consumption of Energy Drinks Our analysis of mixed method studies and rele- vant survey results revealed two significant themes: sidering as inclusion criteria in the study: (a) articles that had energy drinks in their title; (b) studies that evaluated the effect of energy drinks on adolescents; (c) research that made comparisons between groups or intragroup; At this stage, two articles were excluded (see Figure 1). Stage 4: Charting the Data Three authors (FRTA, GT, and RMMA) ana- lyzed energy drink use in adolescence, including three main phases: preparation, organizing, and writing. One author (FRTA) extracted study characteristics, which were also reviewed by GT and included in an agreement between RMMA. As this was a review, study quality (e.g., risks of bias, study strength) was considered, but not for a meta-analysis. Tables 1 and 2 show the systematization and categorization of relevant topics from the results of the studies in- cluded in this review, reflecting the review questions. Stage 5: Collating, Summarizing, and Reporting the Results The main characteristics of the eleven includ- ed studies are presented in Table 2. The studies were grouped by year of publication. Studies pub- lished in the same year were grouped alphabetical- ly by first authors’ surnames. The extracted data were: (1) citation; (2) country; (3) Study design; (4) outcome measures; (5) sample; (6) main findings. Findings The f indings of the review are present- ed according to the review questions. Table 2 reports the general information and signif- icant f indings of the reviewed publications. Results Concerning the overall number of articles, there were 119.796 participants from different countries, most of them from China, the United States of Ameri- ca, and Italy, aged 12 to 19 years, who completed various surveys. The average is 11.979,6 adolescents. The most predominant type of test was the socio-demograph- ic questionnaire, covering 50% of the total articles. Several studies indicated that boys were more like- ly to report consumption than girls and in a more sig- nificant amount (Choi et al., 2016; Koivusilta et al., 2016; Magnezi et al., 2015). In this scoping review, cross-sectional survey data suggested that the use of energy drinks is patterned by gender. Larson et al. (2014) found a significant connection between reg- ular consumption and lower breakfast frequency for 33 ENERGY DRINK CONSUMPTION AMONG ADOLESCENTS AND YOUNG ADULTS ergy drinks by children and young people is associated with several adverse outcomes and health-damaging behaviors. 139 studies were located, with 11 meeting our inclusion criteria. A total of 99.740 participants were included in the 11 articles. In which we have ob- tained the gender data of 28.326 participants (28.4%), amongst 47.2% were males and 52.7% were females. Three randomized controlled trials demonstrated that pre-exercise ingestion of an energy drink positively impacted some aspects of sports performance (O’Dea, 2003; Pennay & Lubman, 2012; Sanchis-Gomar et al., 2015). Nevertheless, the referred studies involved small numbers of athletes, and the results should thus be treated with some vigilance. Several cross-section- al studies indicated that energy drink consumption by adolescents was strongly and positively associated with higher rates of impulsivity, risk behavior, smok- ing, alcohol, and other substance use, as well as being linked to physical health manifestations such as head- aches, loss of vigor, stomach aches, insomnia, fatigue, and hyperactivity (Azagba et al., 2014; O’Dea, 2003). Two studies provided evidence of a dose-response effect, although none of the investigations could de- fine the reason (Jones et al., 2012; Pennay & Lubman, 2012). Typically, boys consume more energy drinks than girls. Usage was found to be patterned by gender and age, although there was some variance between studies on the direction of the association. The high- est consumption levels have been observed in sed- entary and physically active people, suggesting a link between sports and screen-based relaxation activities. An exciting finding among the analyzed studies is in a Hungarian study by Toth et al. (2020) where he examined 631 high school students and their re- lationships with energy drinks that corroborate the hypothesis of this review. The social environment of respondents and the amount of time they spend with friends were also factors influencing ED use. Parents supporting or forbidding education use have a signifi- cant influence on their children. Those with a weaker sense of coherence and a tendency toward depression were much more likely to become addicted, those who were active in sports were significantly less like- ly to report symptoms of depression, and their sense of coherence was also more potent than young people who did not engage in sporting activities at the same time, ED consumption was widespread among young people who were active in sports (Tóth et al., 2020). motivations for usage and convincing on usage. Motivations for Use Many individuals, particularly boys involved in sports, consume energy drinks to enhance their athlet- ic performance. Others may opt for energy drinks as an occasional substitute for soft drinks, but only when they have extra funds available, as they tend to be pric- ier (Abian-Vicen et al., 2014; Costa et al., 2014; Gal- lo-Salazar et al., 2015). Participants in studies have com- monly reported that energy drinks "wake you up, make you feel alert, and taste good," "make me hyper," and "keep me energized for soccer matches" (Abian-Vicen et al., 2014; O'Dea, 2003). A research study conduct- ed by Jones explored the perceptions of alcohol-energy drinks (AEDs) among 12-17-year-olds and found that young people enjoyed them because they increased the fun at parties and acted as a pick-me-up (Jones, 2011). Convincing on Use The use of energy drinks among young people is influenced by advertising and brand loyalty, accord- ing to a study that involved participants from three different age groups (16-21, 22-28, and 29-35 years). The study found that energy drinks were advertised on various platforms such as TV, the internet, games promotions, sports sponsorship, and shops. Industry marketing targeted specific drinks to men or wom- en using sexualized imagery, humor, and social me- dia (Bunting et al., 2013). The younger age group seemed more aware of their projected social image and more influenced by their peers when making purchasing decisions. Social situations, particularly spending time with friends, were identified as famil- iar contexts for energy drink consumption. Parents also played a significant role in influencing their chil- dren's use of energy drinks. They either discouraged or prohibited the consumption of energy drinks or encouraged and endorsed their use. The study found that energy drinks were easily accessible from conve- nience stores or supermarkets, provided by parents, shared by siblings or friends, or obtained free at spon- sored events. (Bunting et al., 2013: Costa et al., 2014). Discussion This review set out to examine evidence of any asso- ciations between adolescents and young adults’ health and consumption of energy drinks. It also sought to ex- plore consumer experiences and attitudes toward these drinks. The evidence demonstrates that the use of en- 34 ANDRADE ET AL. group at risk. That said, an experimental study devel- oped in Canada provided evidence that current warnings in caffeinated energy drinks (CEDs) could be enhanced to increase the salience of messages, with a more signif- icant impact from clear, descriptive, front-of-package ‘high source of caffeine’ labels, eliciting lower prod- uct appeal and perceived safety ratings in young adults aged 12–24 years (Reid et al., 2015). As caffeine is the primary psychoactive ingredient in energy drinks and is responsible for the vast majority of toxicity, energy drink labels that present high levels of caffeine associ- ated with 'danger' could reduce the number of poison- ings through indiscriminate use (Zandvliet et al., 2005). Advertisements for energy drinks are often target- ed towards adolescents through popular TV shows and websites, which could potentially encourage them to consume such drinks (Harris et al., 2015). It is important to note that while the average amount of caffeine con- sumed by teenagers has decreased over the past 20 years, there has been a significant increase in energy drink con- sumption among adolescents over the past decade (Tran et al., 2016). This is a cause for concern due to the numer- ous reported adverse effects of excessive caffeine, rang- ing from minor sleep disturbances to mortality. High consumption of energy drinks among young people in recent years is a worrying trend (Mesirow et al., 2015). The need to understand adolescents' consumption of energy drinks is justified primarily by a range of imme- diate risk behaviors that are associated. Regarding future health, recent reviews have pointed out that standards adopted during this period have a potentially lasting in- fluence and can extend into adulthood, with repercus- sions on physical and psychological health (Rice & Klein, 2019). Different behaviors of children and adolescents can negatively affect health and well-being, with short or long-term impacts. Regarding energy drinks, there is evidence that the age at first use predicts future risks. A longitudinal study with young American military offi- cers pointed to the age range between 13 and 16 years as critical, suggesting that adolescents who begin con- sumption during this period become more likely to con- sume larger quantities of the product in isolated episodes than those who started consumption after the 20 years (Sather et al., 2016). Furthermore, new associations have been found between frequent ED consumption with alcohol by adolescents and a greater risk of developing alcohol dependence in adulthood (Arria et al., 2011). ED does not present therapeutic benefits, contains The studies mentioned above have reported perceived beneficial effects on young people’s bod- ies and sports performance, with slight mention of any adverse effects and limited knowledge of ener- gy drink ingredients among participants (Frank- lin et al., 2013; Pennay & Lubman, 2012; Sam- pasa-Kunyinga et al., 2020; Visram et al., 2016). Other literature findings show that energy drinks can significantly increase the likelihood of negative mental health conditions, such as stress, anxiety, and depression. These adverse outcomes are particular- ly prevalent in adolescents and young consumers (Richards et al., 2016). Although energy drinks may positively impact mood in the short term, long-term consumption is more likely to harm mental health (Trapp et al., 2014). However, there is a lack of com- prehensive data regarding the potential link between energy drink consumption and mental health issues in young people (Kaur et al., 2020). Consequently, it is plausible that the components of energy drinks could contribute to the development or aggrava- tion of mental health problems (Babu et al., 2008). As for the appeal of energy drinks among the young, taste and energy-seeking were identified as critical drivers for consumption. Advertising and brand loyalty have been highlighted as significant influences on young people’s attitudes toward ener- gy drinks, and peers, family, and friends also played an important role. A few studies found that more than half of young energy drink consumers (53%) reported using energy drinks to continue partying and drinking alcohol over a more extended period and may experience adverse effects ranging from dif- ficulty sleeping to addiction to alcohol (Franklin et al., 2013; Park et al., 2012; Wiggers et al., 2020). A study by Leal and Jackson (2019) used sam- ples for monitoring students between 2010 and 2016 and found that energy drink consumers are significantly more likely to intend to initiate mari- juana use. Youth who heavily use energy drinks have substantially higher odds of having the intention to use marijuana (Snipes & Benotsch, 2013). Oth- er studies in Table 2 show that adolescents may have associations with depressive symptoms when they ingest energy drinks with alcoholic beverages (Cot- ter et al., 2013; Tóth et al., 2020; Xu et al., 2020). Aggressive marketing campaigns by manufac- turers toward adolescents and young adults put this 35 ENERGY DRINK CONSUMPTION AMONG ADOLESCENTS AND YOUNG ADULTS tor, in combination with the gendered marketing and perceived links to sports performance. More re- search is required to explore the longer-term health impacts, given that childhood and adolescence are critical yet understudied periods in developing health-related behaviors and use of energy drinks as- sociated with alcohol or types of consumption. The potential effects of heavy and long-term energy drink consumption on child development, behavior, and educational outcomes also warrant further study. Furthermore, the findings have important practical implications for public health policies and laws governing the sale of energy drinks to mi- nors on a prevention level. The results highlight the significance of imposing more stringent regu- lations and education efforts to block adolescents' access to these drinks, promoting healthy habits. Dealing with the problem of children and teens consuming energy drinks requires acknowledging the complexity of their choices. While educating them about health may have little impact, healthcare pro- fessionals and others should provide clear informa- tion about the safety of consuming energy drinks. They may need guidance from organizations like the Food and Drug Administration (FDA- U.S.A), the Brazilian Health Regulatory Agency (Anvi- sa), and the European Medicines Agency (EMA). It's essential to conduct further research to explore the long-term health impacts, particularly during child- hood and adolescence, which are critical yet under- studied periods in developing health-related behaviors. Strengths and Limitations Three authors thoroughly and systematically screened titles and abstracts, followed by full-text stud- ies and reference lists. Discussions were held to ensure that no appropriate studies were lost. We attempted to use various search terms such as "stimulant drink," "energy strip," "energy shot," and "energy mint," as well as "youth," "young adults," and "teen" for the popula- tion. However, these terms yielded little results in the research bases. This was a limitation of our study. Ad- ditionally, we only included studies in the English lan- guage, which may have caused us to miss some relevant papers. We searched five databases, but this is a partial number. However, we followed the recommendations of experienced academics to cast as wide a net as pos- sible regarding the context, concept, and population. understudied ingredients, is not fully regulated, and has no safe consumption levels yet established for chil- dren and adolescents (Curran & Marczinski, 2017; Howland & Rohsenow, 2013; Seifert et al., 2011). The context is one of uncertainty regarding the acute and chronic safety of these products. Thus, it is neces- sary to understand the patterns of ED consumption by adolescents in our reality, the motivations that have led them to consume, and the factors that may be as- sociated, both protective factors against consumption and risk factors, due to eventual or regular use. Spe- cial attention to this stage of development, character- ized by lower assessment and self-protection capabil- ities, can prevent global health and well-being issues, with consequences in different areas of adult life. Conclusion The data collected covered several significant bias- es to be considered; however, regarding the use of en- ergy drinks for adolescents, it is essential to have more studies to understand that energy drink consumption might increase risk behaviors associated with alcohol, which can be seen through competition, or impulsive risk, and depression (Table 2). Adolescence is a phase of significant biological and social changes. It is cru- cial to be aware of these aspects, primarily regarding social support, for a greater possibility of dealing with new situations. This review contributes to the growing body of evidence regarding the health effects of consuming energy drinks. For young people, the negative im- plications may outweigh the positive ones. Despite this, factors like the brand, relationships with energy drink users, taste, and perceived benefits increase their popularity among young consumers. The advertising for these products worldwide often features ideas of power, strength, energy, and explosion, using imag- es and product names that allude to these concepts. It is crucial to explore the effects of high levels of in- gredients like caffeine, taurine, and sugar in energy drinks on young people's bodies. More education is needed about energy drink patterns for this de- mographic. However, addressing this issue through policies and interventions is complex due to the choices adolescents and young people make. While individual health education is unlikely to have a sig- nificant impact, healthcare and other professionals can play a role in promoting safe consumption habits. Young men were identified as an essential fac- 36 ANDRADE ET AL. emerging adolescent health risk: Caffeinated en- ergy drink consumption patterns among high school students. Preventive Medicine, 62, 54-59. https://doi.org/10.1016/j.ypmed.2014.01.019 Babu, K. M., Church, R. J., & Lewander, W. (2008). Energy drinks: The new eye‐opener for ado- lescents. Clinical Pediatric Emergency Medi- cine, 9(1), 35–42. https://doi.org/10.1016/j. cpem.2007.12.002 Bonar, E. E., Cunningham, R. M., Polshkova, S., Cher- mack, S. T., Blow, F. C., & Walton, M. A. (2015). Alcohol and energy drink use among adolescents seeking emergency department care. Addictive Behaviors, 43, 11–17. https://doi.org/10.1016/j. addbeh.2014.11.023 Brache, K., & Stockwell, T. (2011). Drinking patterns and risk behaviors associated with combined al- cohol and energy drink consumption in college drinkers. Addictive Behaviors, 36(12), 1133-1140. https://doi.org/10.1016/j.addbeh.2011.07.003 Bryant Ludden, A., & Wolfson, A. R. (2010). Under- standing adolescent caffeine use: connecting use patterns with expectancies, reasons, and sleep. Health Education & Behavior, 37(3), 330-342. https://doi.org/10.1177/1090198109341783 Bunting, H., Baggett, A., & Grigor, J. (2013). Ado- lescent and young adult perceptions of caffein- ated energy drinks. A qualitative approach. Ap- petite, 65, 132-138. https://doi.org/10.1016/j. appet.2013.02.011 Caine, J. J., & Geracioti, T. D. (2016). Taurine, ener- gy drinks, and neuroendocrine effects. Cleveland Clinic Journal of Medicine, 83(12), 895–904. https://doi.org/10.3949/ccjm.83a.15050 Costa, B. M., Hayley, A., & Miller, P. (2014). Young adolescents’ perceptions, patterns, and contexts of energy drink use. A focus group study. Appe- tite, 80, 183-189. https://doi.org/10.1016/j.ap- pet.2014.05.013 Choi, H. J., Wolford-Clevenger, C., Brem, M. J., El- mquist, J., Stuart, G. L., Pasch, K. E., & Temple, J. R. (2016). The temporal association between energy drink and alcohol use among adolescents: a short communication. Drug and Alcohol Depen- dence, 158, 164-166. https://doi.org/10.1016/j. drugalcdep.2015.11.009 Cotter, B. V., Jackson, D. A., Merchant, R. C., Babu, K. M., Baird, J. R., Nirenberg, T., & Linakis, J. Recommendations for Further Research The findings have considerable and varied implica- tions in the context of this research. This study reveals the increasing concern over adolescent energy drink intake and its potential connection to other drugs, especially alcohol. Theoretically, our findings add to the field by verifying and deepening our knowledge of the dangers that alcoholic drinks pose to adolescents. Our research indicates that further long-term studies are required to track adolescents and better un- derstand how their behavior may be affected as they ap- proach adulthood through energy drinks. Additional- ly, this study highlights the need for more investigation into the development and effectiveness of preventive and educational programs targeting adolescents. 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W., Hendriks, V. M., Van Den Brink, W., Van Ree, J. M., & Beijnen, J. H. (2005). Population pharmacokinetics of caffeine and its metabolites theobromine, paraxanthine and theophylline after inhalation in combination with diacetylmorphine. Basic & Clinical Phar- macology & Toxicology, 96(1), 71-79. https://doi. org/10.1111/j.1742-7843.2005.pto960111.x 41 ENERGY DRINK CONSUMPTION AMONG ADOLESCENTS AND YOUNG ADULTS Table 1 Search Strategies Used for EMBASE, PsychNet, PubMed, Scopus, and Web of Science 42 ANDRADE ET AL. Table 2 Summary of the Information and Characteristics of Each Study (n =11) 43 ENERGY DRINK CONSUMPTION AMONG ADOLESCENTS AND YOUNG ADULTS 44 ANDRADE ET AL. 45 ENERGY DRINK CONSUMPTION AMONG ADOLESCENTS AND YOUNG ADULTS 46 ANDRADE ET AL. Note. Some of the studies utilized abbreviation words. ST: Screen time, FFs; Fast foods; SSBs: Sugar-sweetened beverages; ED: Energy drink; EDs: Energy drinks; MTF: Monitoring the Future; ARCs: Alcohol-related conse- quences; AmED: Alcohol mixed with energy drink. 47 ENERGY DRINK CONSUMPTION AMONG ADOLESCENTS AND YOUNG ADULTS Figure 1 Flow Chart of Steps Performed During a Scoping Review