Prevalence, knowledge, attitudes, and practices regarding cognitive enhancer use in a convenience sample of university students in Syria: a cross-sectional study.
In this study, 14.6% of university students in Syria reported using cognitive enhancers, with peer influence and permissive attitudes being significant factors.
Where it sits
this study against the rest of the adamax corpusSummary and findings
This study assessed lifetime cognitive enhancer (CE) use among 707 university students in Syria. The findings indicated that 14.6% reported lifetime CE use, with specific categories including 10.9% for supplement/natural-type CE and 2.3% for medication-type CE. Associations with lifetime CE use were linked to self-reported ADHD, knowing a CE user, and permissive attitudes.
Abstract
<h4>Background</h4>Evidence on cognitive enhancer (CE) use among Middle Eastern university students remains limited, and no prior published study has characterized CE use in Syria. We assessed lifetime use, knowledge, attitudes, and use practices in a convenience sample of Syrian university students.<h4>Methods</h4>A cross-sectional online survey was conducted among 707 students recruited using convenience and snowball sampling. The questionnaire used a broad intention-based definition of CE use and assessed factual knowledge, academic pressure, permissive attitudes, and use patterns. Multivariable logistic regression examined factors associated with lifetime use.<h4>Results</h4>14.6% (103/707) reported lifetime CE use. Under the broad intention-based definition, 10.9% of the total sample reported supplement/natural-type CE use, 2.4% high-dose caffeine-product use, and 2.3% medication-type CE use; 2.0% specifically reported prescription stimulant use. Among lifetime users, use was commonly exam-related, and 29.1% reported adverse effects. In adjusted analyses, self-reported ADHD (AOR = 3.70; 95% CI: 1.18-11.55), personally knowing a CE user (AOR = 4.35; 95% CI: 2.73-6.93), and a higher permissiveness attitude score (AOR = 2.42; 95% CI: 1.72-3.41) were associated with lifetime CE use. Knowledge and academic-pressure scores were not independently associated with lifetime use.<h4>Conclusions</h4>In this recruited sample, lifetime CE use was associated with peer exposure and permissive attitudes, whereas measured knowledge and academic pressure were not independently associated. The difference between overall CE use and medication-type use highlights the importance of distinguishing product classes when studying cognitive enhancement. Longitudinal and more representative studies are needed to clarify these associations and their generalizability.
Background
This paper addresses the prevalence and characteristics of cognitive enhancer use among university students in Syria, an area with limited existing research. Prior studies have shown varying rates of CE use in different populations, but specific data from the Middle East, particularly Syria, is lacking. Understanding these patterns can inform future research and potential interventions.
Methods
A cross-sectional online survey was conducted among 707 university students recruited through convenience and snowball sampling. The survey assessed lifetime CE use, knowledge, attitudes, and use practices. Multivariable logistic regression was used to analyze factors associated with lifetime CE use.
Results
14.6% (103/707) of participants reported lifetime CE use. Among these users, 10.9% reported supplement/natural-type CE use, 2.4% reported high-dose caffeine-product use, and 2.3% reported medication-type CE use. The adjusted odds ratios indicated that self-reported ADHD (AOR = 3.70; 95% CI: 1.18-11.55), knowing a CE user (AOR = 4.35; 95% CI: 2.73-6.93), and higher permissiveness attitude scores (AOR = 2.42; 95% CI: 1.72-3.41) were associated with lifetime CE use.
Interpretation
The findings suggest that peer influence and permissive attitudes are significant factors in CE use among students, aligning with previous literature that highlights social factors in substance use. However, the effect sizes, while statistically significant, may not be clinically meaningful. Limitations such as convenience sampling and reliance on self-reported data may confound the results, suggesting caution in generalizing these findings.
Key findings
- 14.6% (103/707) reported lifetime CE use.
- 10.9% reported supplement/natural-type CE use.
- 2.4% reported high-dose caffeine-product use.
- 2.3% reported medication-type CE use.
- 2.0% specifically reported prescription stimulant use.
- 29.1% of lifetime users reported adverse effects.
Limitations
- Convenience sampling limits generalizability.
- Self-reported data may introduce bias.
- Cross-sectional design does not establish causality.
- Limited to one geographic area, reducing broader applicability.
- Potential underreporting of CE use due to stigma.