, Volume 12, Issue 3, pp 271–278 | Cite as

Pharmacological Cognitive Enhancement: Examining the Ethical Principles Guiding College Students’ Abstention

  • Niloofar BavarianEmail author
  • Stephanie Sumstine
  • Jocelyne Mendez
  • Kyle Yomogida
  • Wilma Figueroa
  • Cammie Lam
Original Paper



To understand the ethical principles guiding college students’ abstention from pharmacological cognitive enhancement (PCE), and to determine the correlates associated with endorsing different principles.


One-stage cluster sampling was used to implement a paper-based survey among undergraduate students attending one university in the U.S. Thematic analysis was used to explore the ethical principles guiding PCE abstention. Multivariate logistic regression analyses were used to examine sociodemographic correlates associated with endorsed ethical principles.


Of the 499 eligible students who completed the survey (student response proportion: 94.7%), 259 students had a negative attitude towards PCE, did not engage in PCE, and provided reasons for abstention.


The thematic analysis resulted in the identification of eight themes, with respondents often endorsing more than one theme per response. The three themes most endorsed were non-malfeasance (i.e., avoiding PCE to prevent harm), disapproval of drugs (i.e., a moral opposition to substance use) and dosage beneficence (i.e., adhering to dosage guidance to promote health). The sociodemographic correlates associated with endorsing each theme varied across themes.


Students abstain from PCE for a multitude of reasons, many of which are guided by ethical principles. These findings may be incorporated into future prevention programming messages.


Cognitive enhancement Ethics Young adults 



We wish to thank Sheena Cruz, Cassandra Schroeder, and Summer Takeda for their assistance with data collection.

Author Contribution

Niloofar Bavarian: Developed the research question, assisted with data collection and data analysis, and developed first draft of manuscript.

Stephanie Sumstine: Assisted with data collection and data analysis, and made important edits to manuscript.

Jocelyne Mendez: Assisted with data collection and data analysis, and made important edits to manuscript.

Kyle Yomogida: Assisted with data analysis, literature review, and made important edits to manuscript.

Wilma Figueroa: Assisted with literature review and made important edits to manuscript.

Cammie Lam: Assisted with literature review and made important edits to manuscript.


This work was supported by the Ukleja Center for Ethical Leadership Research Stipend. This work was also supported by the National Institute of General Medical Sciences of the National Institutes of Health under Award Numbers UL1GM118979, TL4GM118980, and RL5GM118978. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Compliance with Ethical Standards

Conflict of Interest

We declare that we have no competing interests.

Research Involving Human Participants

This research involved human participants.

Informed Consent

Informed consent was obtained from all individual participants included in the study. Specifically, a waiver of signed informed consent was attained (to protect anonymity).

Ethical Approval

All procedures performed involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.


  1. 1.
    Bell, S., B. Partridge, J. Lucke, and W. Hall. 2013. Australian university students' attitudes towards the acceptability and regulation of pharmaceuticals to improve academic performance. Neuroethics 6 (1): 197–205. Scholar
  2. 2.
    Greely, H., B. Sahakian, J. Harris, R.C. Kessler, M. Gazzaniga, P. Campbell, and M.J. Farah. 2008. Towards responsible use of cognitive-enhancing drugs by the healthy. Nature 456 (7223): 702–705. Scholar
  3. 3.
    Cakic, V. 2009. Smart drugs for cognitive enhancement: Ethical and pragmatic considerations in the era of cosmetic neurology. Journal of Medical Ethics 35 (10): 611–615. Scholar
  4. 4.
    Schelle, K.J., N. Faulmuller, L. Caviola, and M. Hewstone. 2014. Attitudes toward pharmacological cognitive enhancement-a review. Frontiers in Systems Neuroscience 8: 53. Scholar
  5. 5.
    Gould, M.S., B.T. Walsh, J.L. Munfakh, M. Kleinman, N.H. Duan, M. Olfson, L. Greenhill, and T. Cooper. 2009. Sudden death and use of stimulant medications in youths. American Journal of Psychiatry 166 (9): 992–1001. Scholar
  6. 6.
    Nissen, S.E. 2006. ADHD drugs and cardiovascular risk. The New England Journal of Medicine 354 (14): 1445–1448. Scholar
  7. 7.
    Partridge, B., J. Lucke, and W. Hall. 2012. A comparison of attitudes toward cognitive enhancement and legalized doping in sport in a community sample of Australian adults. American Journal of Bioethics - Primary Research 3 (4): 81–86.Google Scholar
  8. 8.
    Bostrom, N., and A. Sandberg. 2009. Cognitive enhancement: Methods, ethics, regulatory challenges. Science and Engineering Ethics 15 (3): 311–341. Scholar
  9. 9.
    Forlini, C., and E. Racine. 2009. Autonomy and coercion in academic "cognitive enhancement" using methylphenidate: Perspectives of key stakeholders. Neuroethics 2 (3): 163–177. Scholar
  10. 10.
    Forlini, C., J. Schildmann, P. Roser, R. Beranek, and J. Vollmann. 2015. Knowledge, experiences and views of German university students toward neuroenhancement: An empirical-ethical analysis. Neuroethics 8 (2): 83–92. Scholar
  11. 11.
    Vagwala, M.K., A. Bicquelet, G. Didziokaite, R. Coomber, O. Corrigan, and I. Singh. 2017. Towards a moral ecology of pharmacological cognitive enhancement in British universities. Neuroethics 10 (3): 389–403. Scholar
  12. 12.
    Miles, M.B., and A.M. Huberman. 1994. Qualitative data analysis: An expanded sourcebook. Thousand Oaks: Sage.Google Scholar
  13. 13.
    Flay, B. R., and J. Petraitis. 1994. The theory of triadic influence: A new theory of health behavior with implications for preventive interventions. Advances in Medical Sociology 4: 19–44.Google Scholar
  14. 14.
    Flay, B. R., F. Snyder, and J. Petraitis. 2009. The theory of triadic influence. 2 Aufl. Emerging theories in health promotion practice and research. New York: Jossey-Bass.Google Scholar
  15. 15.
    Aikins, R., X.X. Zhang, and S.E. McCabe. 2017. Academic doping: Institutional policies regarding nonmedical use of prescription stimulants in U.S. higher education. Journal of Academic Ethics 15 (3): 229–243. Scholar

Copyright information

© Springer Nature B.V. 2018

Authors and Affiliations

  • Niloofar Bavarian
    • 1
    Email author
  • Stephanie Sumstine
    • 2
  • Jocelyne Mendez
    • 1
  • Kyle Yomogida
    • 1
  • Wilma Figueroa
    • 1
  • Cammie Lam
    • 1
  1. 1.Health Science DepartmentCalifornia State University, Long BeachLong BeachUSA
  2. 2.UCLA Global Center for Children and FamiliesUniversity of California, Los AngelesLos AngelesUSA

Personalised recommendations