Pharmacological cognitive enhancement (PCE) usually refers to the use of medical substances by healthy individuals to improve mental performance. Given that certain substances have been frequently used for years, the long-term eŠectiveness and safety are essential to know but particularly difficult and costly to determine. Although PCE is a widespread and frequent phenomenon among university students in other countries, PCE prevalence in Japan has not been elucidated. The present study aimed to investigate the prevalence of and the attitude toward PCE among Japanese undergraduates over 3 years (2017-2019). Almost no student had ever used prescription drugs for cognitive enhancement. When asked, ``Would you like to use drugs to enhance your cognitive performance?'' 68.6-72.0％ of the students answered, ``No,'' 25.4-26.7％ answered, ``I couldn't say,'' and 2.5-4.8％ answered, ``Yes.'' These answers were associated with sex (2017-2018) and stress sensitivity (2019) but not with drinking, smoking, or stress of academic performance. Half of the students had used energy drinks for neural enhancement prior to an examination, which is similar to Western usage. The users of soft enhancers, such as energy drinks, are more likely to use other drugs. Given that caŠeine can be a gateway for cognitive enhancement, future education addressing PCE among students should emphasize the side eŠects of prescription drugs as well as health risks of caŠeine products.
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