Performance in play: stimulant exposure and broader substance-use vulnerability in mass-participation youth esports

Youth esports now extends far beyond professional competition, encompassing ranked online play, school clubs, amateur events, livestreaming, and digitally mediated peer communities. These settings expose adolescents to energy drinks and other stimulant-containing products in contexts where alertness, concentration, and prolonged play are valued. Energy drinks merit particular attention because their prominence in gaming culture combines caffeine exposure with, for many products, substantial added sugar. Potential consequences include disrupted sleep, acute stimulant effects, and adverse nutritional and metabolic profiles. A further concern is behavioral: repeated consumption for gaming-related fatigue or concentration may foster expectations that psychoactive products are useful tools for performance. Research on nonmedical prescription-stimulant use among adolescents demonstrates a comparable performance-oriented motive, while longitudinal studies link energy-drink use with later tobacco, alcohol, and other substance involvement. These associations remain non-causal and have not been established specifically in recreational esports. This Perspective frames mass-participation youth esports as an emerging setting for early public-health intervention. It proposes action across marketing and sponsorship, schools and community programs, beverage and product policy, families and healthcare, and longitudinal surveillance, while emphasizing the need to establish prevalence, temporal ordering, and high-risk patterns directly in nonprofessional adolescent participants across different social and regulatory settings.