Abstract
OBJECTIVES: To understand the ethical principles guiding college students' abstention from pharmacological cognitive enhancement (PCE), and to determine the correlates associated with endorsing different principles. DESIGN: 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. PARTICIPANTS: 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. RESULTS: 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. CONCLUSIONS: 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.