Prevalence, knowledge, attitudes, and practices regarding cognitive enhancer use in a convenience sample of university students in Syria: a cross-sectional study.
4 affiliations
- 1Faculty of Medicine, Homs University, Homs, Syrian Arab Republic.
- 2Faculty of Medicine, Damascus University, Damascus, Syrian Arab Republic.
- 3Faculty of Pharmacy, Homs University, Homs, Syrian Arab Republic.
- 4Department of Biochemistry and Microbiology, Faculty of Pharmacy, Homs University, Homs, Syrian Arab Republic.
Abstract
Background
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.Methods
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.Results
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.Conclusions
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.
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BibTeX
@article{almansour2026prevalence,
title = {{Prevalence, knowledge, attitudes, and practices regarding cognitive enhancer use in a convenience sample of university students in Syria: a cross-sectional study.}},
author = {Shahd Almansour and Ahmad Bishr Nasra and Mohammad Alaa Aldakak and Bashar Barhoum and Joelle Salloum and Batoul Abidan and Elias Zaghbour and Walid Khaddam},
journal = {Annals of medicine},
year = {2026},
month = oct,
doi = {10.1080/07853890.2026.2751291},
url = {https://europepmc.org/article/MED/42954660},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Prevalence, knowledge, attitudes, and practices regarding cognitive enhancer use in a convenience sample of university students in Syria: a cross-sectional study.
AU - Shahd Almansour
AU - Ahmad Bishr Nasra
AU - Mohammad Alaa Aldakak
AU - Bashar Barhoum
AU - Joelle Salloum
AU - Batoul Abidan
AU - Elias Zaghbour
AU - Walid Khaddam
PY - 2026
DA - 2026/10/29
JO - Annals of medicine
DO - 10.1080/07853890.2026.2751291
UR - https://europepmc.org/article/MED/42954660
AB - Background 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.Methods 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.Results 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.Conclusions 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.
SN - 0785-3890
SN - 1365-2060
ER -