Caffeine use by children: the quest for enhancement.

Fair play, both in academics and sports, is a concept that is challenged by the notion of performance enhancement. Both cognitive and physical performance can be viewed as potentially enhanceable, and arguments can be made that enhancement can serve two purposes: gaining an edge or keeping up with others (who may or may not have used performance-enhancing substances). Caffeine, a central nervous system and cardiac stimulant, is frequently used by children for both academic and athletic performance enhancement. In fact, the marketplace contains a plethora of caffeinated products marketed directly to children. This article examines safety and ethical issues associated with the use of caffeine by children and explores the question: Can cognitive performance enhancement be ethically permissible if sports performance enhancement is not?