The Canadian Medical Association Journal has vioced alarm over the increasing popularity of highly caffeinated energy drinks among kids and teens. (THE CANADIAN PRESS/Paul Chiasson)

A new study says one in four high school students in Nova Scotia has consumed energy drinks mixed with alcohol, one of the highest rates in the country.

The study is in an online journal of the Canadian Medical Association. Overall it found one in five Canadian high school students reported mixing the two.

The study says the highest rates were among aboriginal and black students and in British Columbia and Nova Scotia. It also showed students in lower grades were more likely to consume the mixed drinks.

Doctors say energy drinks mask the symptoms of intoxication and can lead to more risk-taking behaviour like drunk driving. The authors of the study called it "an emerging public health concern."

Researchers at Dalhousie University in Halifax who compiled the study said students who felt "connected to school" were less likely to drink alcohol mixed with energy drinks.

It used a nationally representative sample of 36,155 students between grades 7 and 12.