Background: Caffeine is often used for its benefits, which include increased vigilance. It does have side-effects, however, such as palpitations and withdrawal symptoms that include headaches and drowsiness. Tertiary education often requires students to study for extended hours, especially during periods of increased workload prior to tests and examinations. Medical students, who have to master a very large volume of academic work in a limited period of time, are no exception. This cross-sectional study investigated caffeine use for ‘academic purposes’ by first- to third-year medical students at the University of the Free State in 2006, and their knowledge of its benefits, side-effects and withdrawal symptoms.

Methods: Data were collected by means of an anonymous, self-administered questionnaire that was completed by students during formal class time, arranged in advance with the relevant lecturers. Questionnaires were available in Afrikaans and English. A pilot study was conducted on 20 physiotherapy students to test the questionnaire. Chi-squared and Kruskall-Wallis tests were used to compare categorical and numerical variables, respectively. Ethical approval to perform the investigation was granted by the Ethics Committee of the Faculty of Health Sciences, University of the Free State.

Results: A 90.5% (360/389) response rate was obtained. Ninety-four per cent of participants used caffeine, with academic purposes (62.6%) among the three most frequent reasons given for its consumption. Other reasons included social consumption (70%) and preference for the taste (72.4%). Coffee (88.2%) was the most commonly consumed caffeinated product among these students, followed by energy mixtures and tablets (37.9%), and soft drinks (36%). Third-year students were the heaviest consumers of coffee for academic purposes. An increase in caffeine consumption for academic purpose was directly related to progression from first- to third- year of the medical course. The average scores for questions on the benefits, side-effects and withdrawal symptoms were all below 1.5 out of 5. Misconceptions about caffeine were also identified. With regard to the benefits of caffeine, the most commonly cited misconception was that it could be used as a substitute for sleep (26.7% of respondents). The most common misconception regarding its side-effects was that it caused hot flushes (21.9%), while aggression (27.2%) was cited as the most common misconception regarding caffeine withdrawal.

Conclusions: The high percentage of caffeine usage and low scores in the caffeine knowledge test indicated that most participants were using caffeine without having sufficient knowledge of its benefits, side-effects and withdrawal symptoms. It is recommended that awareness programmes on the side-effects and symptoms of caffeine dissemination of information on this extensively consumed substance.