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Study Objective To estimate the 12-month prevalence of cognitive-enhancing drug use. Design Paper-and-pencil questionnaire that used the randomized response technique. Setting University in Mainz, Germany. Participants A total of 2569 university students who completed the questionnaire. Measurements and Main Results An anonymous, specialized questionnaire that used the randomized response technique was distributed to students at the beginning of classes and was collected afterward. From the responses, we calculated the prevalence of students taking drugs only to improve their cognitive performance and not to treat underlying mental disorders such as attention-deficit-hyperactivity disorder, depression, and sleep disorders. The estimated 12-month prevalence of using cognitive-enhancing drugs was 20%. Prevalence varied by sex (male 23.7%, female 17.0%), field of study (highest in students studying sports-related fields, 25.4%), and semester (first semester 24.3%, beyond first semester 16.7%). To our knowledge, this is the first time that the randomized response technique has been used to survey students about cognitive-enhancing drug use. Conclusion Using the randomized response technique, our questionnaire provided data that showed a high 12-month prevalence of cognitive-enhancing drug use in German university students. Our study suggests that other direct survey techniques have underestimated the use of these drugs. Drug prevention programs need to be established at universities to address this issue. [ABSTRACT FROM AUTHOR]

Aims Recent studies have suggested that the use of doping substances and particularly of anabolic androgenic steroids (AAS) is often practised by fitness centre visitors. These studies employed direct interview techniques and questionnaires to assess the estimated number of unreported cases of doping. Because people hesitate to provide compromising information about themselves, these techniques are subject to response errors. In this study we applied an alternative interview technique to assess more accurately unreported cases of doping in fitness centres. Design and participants The present investigation employed the randomized response technique (RRT) to reduce response errors. A cohort of 500 people from 49 fitness centres participated in this study. Finding The RRT revealed a high prevalence of doping (12.5%). In addition, and most importantly, the present RRT study revealed an alarmingly high prevalence of illicit drug use, specifically of cocaine use, that has been severely underestimated by previous studies. Conclusions The RRT confirmed previously estimated rates of AAS use assessed by direct interview techniques and voluntary questionnaires, but uncovered a much higher usage rate of illicit drugs among fitness centre visitors. This outcome enabled us to construct a ‘probability’ rating for the use of doping substances in fitness centre visitors. Given its high prevalence and the predominant use of AAS, doping among fitness centre visitors is an issue of extreme relevance for the health care system. Our study may help to characterize further doping substance users and to develop and apply prevention and intervention programmes specifically to individuals at high risk. [ABSTRACT FROM AUTHOR]