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A Cross-sectional Study on Caffeine Dependency by Drinking Tea and Coffee Among Bangladeshi Students

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Too much caffeine consumption might cause physical and mental dependency on the consumer. This study examined the socio-demographic factors, knowledge, behavior and perception of Bangladeshi students about caffeine which is based on drinking tea and coffee. This questionnaire-based study included 1020 respondents from primary level to postgraduate level students. The analysis utilized frequencies, means, percentages, Pearson's chi-square (χ 2) statistic and Spearman's rank correlation coefficients. Pearson's chi-square (χ 2) statistic test was performed to determine the significance at 5% with a p-value < 0.05. Most of the students (94.8%) consume tea or coffee regularly, and 66.1% drink it daily. A total of 87.5% of students knew that tea and coffee have caffeine. Nearly two-thirds (67.1%) of the students were dependent on tea and coffee, and 35.9% experienced psycho-physiological alterations after a day without drinking those items. About 38% of students noticed side effects after consumption of tea or coffee multiple times in a day. This study also reveals that gender did not alter the knowledge or drinking behavior of tea and coffee. Tea and coffee drinking patterns were not significantly dependent upon the participants' educational qualifications.
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A Cross-sectional Study on Caffeine Dependency by
Drinking Tea and Coffee Among Bangladeshi Students
Ashfia Tasnim Munia1, Saif Bin Salam Bondhon2, Md. Raihan Sarkar3,
Rabita Rahman2, K. M. Yasif Kayes Sikdar3 and Md Abdus Samadd2
1Institute of Statistical Research and Training, University of Dhaka, Dhaka-1000, Bangladesh
2Department of Pharmacy, Faculty of Pharmacy, University of Dhaka, Dhaka-1000, Bangladesh
3Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Dhaka
Dhaka-1000, Bangladesh
(Received: April 26, 2023; Accepted: August 14, 2023; Accepted (web): October 25, 2023)
ABSTRACT: Too much caffeine consumption might cause physical and mental dependency on the consumer. This
study examined the socio-demographic factors, knowledge, behavior and perception of Bangladeshi students about
caffeine which is based on drinking tea and coffee. This questionnaire-based study included 1020 respondents from
primary level to postgraduate level students. The analysis utilized frequencies, means, percentages, Pearson's chi-
square (χ2) statistic and Spearman's rank correlation coefficients. Pearson's chi-square (χ2) statistic test was performed
to determine the significance at 5% with a p-value < 0.05. Most of the students (94.8%) consume tea or coffee
regularly, and 66.1% drink it daily. A total of 87.5% of students knew that tea and coffee have caffeine. Nearly two-
thirds (67.1%) of the students were dependent on tea and coffee, and 35.9% experienced psycho-physiological
alterations after a day without drinking those items. About 38% of students noticed side effects after consumption of
tea or coffee multiple times in a day. This study also reveals that gender did not alter the knowledge or drinking
behavior of tea and coffee. Tea and coffee drinking patterns were not significantly dependent upon the participants’
educational qualifications.
Key words: Caffeine, tea, coffee, drinking habit, dependency.
INTRODUCTION
Caffeine, a methyl-xanthine purine alkaloid
derivative, is widely consumed in food and
beverages.1,2 It is a well-known natural central
nervous system (CNS) stimulant that mainly exists in
tea and coffee.3 Coffee is the largest source of
caffeine, making up 54% of global caffeine
consumption, while tea is right behind it at 43%.4
Nowadays, it has turned into an available food
ingredient in the various commercial beverages on
the market, such as chocolate, which carries nearly
1% of the global caffeine consumption.3,4
Caffeine is a controlled substance.5 Excessive
intakes may cause several unwanted consequences.5
Though the human nervous system can tolerate low
to moderate amounts of caffeine, high doses may lead
Correspondence to: K. M. Yasif Kayes Sikdar,
Email: yasif@du.ac.bd; Phone No.: +61450610928
Dhaka Univ. J. Pharm. Sci. 23(2): 00-00, 2023 (December)
DOI: https://doi.org/10.3329/dujps.v22i2.69326
to adverse effects.5 Furthermore, relatively few
consumers of caffeine-containing beverages are
aware of the toxicity of excessive caffeine intake.6
The high concentration primarily causes addiction,
which can lead to serious health issues such as
nervous system disturbances and cardiovascular
problems.6
Consumption patterns of caffeine may vary
depending on geographic location.4 For instance, per
capita caffeine consumption is roughly three times
more in the United States and Canada than it is in the
rest of the world, but it is less than half that of nations
that drink a lot of tea, such as the United Kingdom.4
Asia also ranks highly due to its substantial quantity
of caffeine use.6 These trends vary even more
depending on the age group, with adults favoring
carbonated beverages and energy drinks mixed with
coffee-flavored drinks.3 Adolescents drink caffeine
for different purposes such as studying, partying,
2 Munia et al.
driving and for quick energy.6 Students also use
caffeine for the alleviation of stress due to academic
pressure, social or emotional disturbances.7 Usually,
they consume tea, coffee or a combination of these
two to alleviate stress and improve their
concentration and performance which may lead to
addiction in their later life.8,9
The vast majority of students in Bangladesh
regularly drink tea and coffee as a way to relax or
pass the time.10 However, excessive consumption of
tea and coffee may lead to caffeine dependency with
some serious side effects. Therefore, the objective of
this study is to investigate the knowledge and
perception of Bangladeshi students on the habit of
drinking tea and coffee which is correlated with their
consumption of caffeine. This study will also identify
if any of the students have a caffeine dependency that
is related to their withdrawal symptoms. Moreover,
this study will contribute to increase students’
awareness about caffeine dependency and its major
side effects.
MATERIALS AND METHODS
Study design, sample size and data collection.
A structured English questionnaire was prepared and
an online version was generated using “Google form”
to reach a maximum number of respondents (Table
1). This questionnaire-based research was carried out
with the students of Bangladesh from June 2021 to
July 2021. A total of 1020 respondents’ data were
collected via using online social media platforms
such as, Facebook, WhatsApp, Imo and Viber.
Students who participated in this study were from all
over Bangladesh and their educational level ranged
from primary to postgraduate programs. The consent
of each participant was taken before the investigation
and students who were not interested in participating
were excluded from the study.
Sample size determination. To determine this
study's sample size, the prevalence of the condition of
interest from existing literature was initially
attempted. However, since this information was
unavailable, a conservative estimate of 50%
prevalence was adopted as a starting point. Based on
this assumption, a sample size of approximately 385
students would have been considered appropriate
through the Raosoft®.11 However, the sample size
was adjusted after considering the design effect,
which corrects for the clustered nature of our
sampling approach across multiple locations in
Bangladesh. The design effect, calculated as 2.65,
reflects the extent of clustering within the sample. So,
the sample size was increased by multiplying the
initial estimate of 385 by the design effect of 2.65. As
a result, the final sample size was determined to be
1020, which considered the clustering present in the
study design.
Validation of the study. The validation of the
study was conducted. Initially, the questionnaire was
reviewed by two senior public health experts and
then a pilot study was carried out twice for 3 weeks
before starting the original research. From the pilot
study, participants’ response data, the internal
consistency reliability was found good by using
Cronbach’s alpha (0.85) and test-retest reliability
using the intra-class correlation coefficient (0.73).
Study measures. In this study, the socio-
demographic characteristics of the participants were
differentiated into age, sex, current residence and
educational levels. Along with socio-demographic
categories, the questionnaire was divided into three
further categories, such as knowledge, behavior and
perception of tea & coffee. The questionnaire was
mainly developed based on the students' socio-
demographic characteristics, knowledge about
caffeine, drinking tea/caffeine behavior, side effects,
and physio-psychological changes related questions
(perception) (Table 1).
Data analysis. As statistical tools for analysis,
Microsoft Excel 2019 and the Statistical Package for
Social Sciences (IBM SPSS Version 26) were
utilized. The data were entered in Microsoft Excel for
sorting, coding and editing. Later the Excel file was
imported into the IBM SPSS Statistics 26. Pearson's
chi-square (χ2) statistic was applied to figure out the
relationship between dependent and independent
variables. Spearman's rank correlation coefficient
was measured to evaluate the significance of the
A Cross-sectional Study on Caffeine Dependency by Drinking Tea 3
correlated variables. The correlation was deemed to
be significant at the 5% level, with a p-value of <
0.05.
Table 1. Questionnaire form of the study.
Questionnaire Option
What is your gender?
Male
Female
How old are you?
<18
18– 23
24-29
What is your current educational
level?
Primary
Secondary
Higher secondary
Undergraduate
Postgraduate
Other:__________
Following which region do you live
in?
Metropolitan
Municipality
Suburb
Rural
Do you drink tea/coffee?
Yes
No
Which one is more preferable to you
between tea and coffee?
Coffee
Tea
Both
None
Is drinking tea or coffee a part of
your daily routine?
Yes
No
How many cups of tea/coffee on
average do you consume daily?
1
2
3
4
5 or more
Do you know that tea or coffee
contains caffeine?
Yes
No
May be
Caffeine is a central nervous system
(CNS) stimulant.
Yes
No
May be
I don't know
Have you experienced any types of
side effects after taking tea or coffee
multiple times a day?
Yes
No
If you don't take tea or coffee in a
day, do you experience any psycho-
physiological change?
Yes
No
Do you classify yourself as a
tea/coffee addict?
Yes
No
Do you think that tea/coffee
addiction or withdrawal problems
are psychological disorders?
Yes
No
May be
I don’t know
Ethical clearance. The study was carried out in
accordance with the Helsinki Declaration (World
Medical Association).12 It was solely online
questionnaire-based research that had no risk of harm
to humans or animals and was not part of any clinical
research. So, there was no need to take ethical
approval. However, the consent of each respondent
was taken in writing before participating in the
research. The participant’s personal information was
kept confidential.
RESULTS AND DISCUSSION
Socio-demographic characteristics. In a total
of 1020 respondents, both genders were nearly the
same in frequency (51.6% male vs. 48.4% female).
The age of the respondents was categorized into
several groups. The majority (70%) belonged to the
age group 18-23 years, while >23 years had the least
frequency (7.5%) and <18 years were only in 22.5%
(Table 2). Most of the respondents (68.6%) reported
themselves to be an inhabitant of a metropolis, while
the least (4.8%) was recorded from the suburbs area
and 19.6% were from municipal. However, only 7%
of the participants in this study were inhabitants of
rural areas. The data analysis revealed that most
respondents (60.9%) belonged to the undergraduate
level, followed by higher secondary (21.6%) and
secondary (12.7%), while the least were primary
(0.8%) students (Table 2).
Table 2. Socio-demographic characteristics of the respondents
(n=1020).
Socio-demographic characteristics Frequency Percentage
(%)
Age 18 years or below 229 22.5
Between 18-23 years 714 70
Above 23 years 77 7.5
Gender Male 526 51.6
Female 494 48.4
Current
Residence Metropolitan 700 68.6
Municipality 200 19.6
Suburb 49 4.8
Rural 71 7
Educational
Level Primary 8 0.8
Secondary 130 12.7
Higher secondary 220 21.6
Undergraduate 621 60.9
Knowledge, behavior and perceptional
patterns of the respondents. In the questionnaire
form, most of the respondents answered correctly the
two knowledge-based questions, “Do you know tea
4 Munia et al.
or coffee contains caffeine?” and “Do you know
caffeine is a central nervous system (CNS)
stimulant?” (92.7% and 86.5%, respectively). In
contrast, more than half of the respondents correctly
answered another knowledge-related question, “Do
you know tea or coffee addiction is a psychological
disorder” (53.8% correct vs. 46.1% incorrect). The
behavioral assessment showed that most students
were tea or coffee consumers (94.8%), while they
preferred tea, coffee or both in near frequencies
(33%, 27.8% and 35.5%, respectively). Most of them
(66%) drink tea or coffee as a part of their daily
routine. Among the respondents, 45.5% population
took at least 1 cup of tea or coffee, followed by 2
cups (35%), 3 cups (11.6%), 4 cups (4.5%) and 5
cups or more (3.4%). A considerable number of
respondents were not regular consumers of tea or
coffee (30.8%). The result of the perception section
revealed that most participants were free from any
side effects or physio-psychological effects (61.6%
and 64.1%, respectively), while two-thirds of them
did not consider themselves tea or coffee addicts.
(67.1%) (Table 3).
Table 3. Knowledge, behavior and perception of the respondents (n=1020).
Aspect Related questions Response Frequency Percentage (%)
Knowledge Tea or coffee contains caffeine Yes 946 92.745
No 74 7.255
Caffeine is a central nervous system (CNS) stimulant Yes 883 86.569
No 137 13.431
Tea or coffee addiction is a psychological disorder Yes 549 53.824
No 471 46.176
Behavior Tea or coffee consumer Yes 967 94.8
No 53 5.2
Preference between tea and coffee Tea 337 33
Coffee 280 27.5
Both 365 35.8
None 38 3.7
Drink tea or coffee as a part of daily routine Yes 674 66.1
No 346 33.9
Average daily consumption of tea or coffee (cups) 1 464 45.5
2 357 35
3 118 11.6
4 46 4.5
5 or more 35 3.4
Nothing 314 30.8
Perception Side effects experienced after taking tea or coffee multiple times
in a day Yes 392 38.4
No 628 61.6
Physio-psychological changes experienced if tea or coffee is not
taken in a day Yes 366 35.9
No 654 64.1
Tea or coffee addict Yes 336 32.9
No 684 67.1
Strength and association between socio-
demographic characteristics and the knowledge,
behavior & perceptions regarding caffeine
consumption. Analysis revealed that the age variable
was significantly associated (p < 0.05) with the
knowledge-based questions, “Do you know tea or
A Cross-sectional Study on Caffeine Dependency by Drinking Tea 5
coffee contains caffeine?” and “Do you know
caffeine is a central nervous system (CNS)
stimulant?” (Table 4). In contrast, another question
“Do you know tea or coffee addiction can lead to a
psychological disorder” was statistically insignificant
(p-value > 0.05) in respect to age (Table 4). The
association between the gender variable and the two
knowledge questions, including “Do you know tea or
coffee contains caffeine?” and “Do you know tea or
coffee addiction can lead to a psychological
disorder?” were also significant (p-value < 0.05)
(Table 4). However, the second question “Do you
know that caffeine is a central nervous system (CNS)
stimulant?” was significant in the respect of gender at
a 5% significance level (p-value > 0.05). Simul-
taneously, the “current residence” of the students was
associated with the first two knowledge questions,
“Do you know tea or coffee contains caffeine?” and
“Do you know caffeine is a central nervous system
(CNS) stimulant?”, while insignificant with the third
question, “Do you know tea or coffee addiction can
lead to a psychological disorder?” (p-value > 0.05)
(Table 4). The “educational qualification of the
students” was significantly correlated with the first
two knowledge questions, “Do you know tea or
coffee contains caffeine?” and “Do you know
caffeine is a central nervous system (CNS)
stimulant?” of the knowledge category (Table 4).
However, there was a lack of association between the
educational qualification of the students and the third
question of knowledge, “Do you know tea or coffee
addiction can lead to a psychological disorder?” (p-
value > 0.05) (Table 4).
Table 4. Association and strength between socio-demographic characteristics and the knowledge, behavior & perceptions regarding
caffeine consumption.
Socio-demographic
characteristic
Statistical
tools and
results
Knowledge, behavior and perceptions regarding caffeine consumption
Knowledge Behavior Perceptions
Tea or
coffee
contains
caffeine
Caffeine is
a central
nervous
system
(CNS)
stimulant
Tea or
coffee
addiction
is a psy-
chological
disorder
Tea or
coffee
consu-
mer
Preference
between
tea and
coffee
Drinks tea
or coffee
as a part of
daily
routine
Average
daily
consump-
tion of tea
or coffee
(cups)
Side effects
experienced
after taking tea
or coffee
multiple times
in a day
Physio-
psychological
changes
experienced if
tea or coffee is
not taken in a
day
Tea or
coffee
addict
Age
Spearman rank
correlation
coefficient (r)
-0.140 -0.122 -0.015 -0.038 0.050 -0.061 0.174 -0.056 -0.092 -0.124
2 -statistic 22.681 17.959 1.846 3.628 13.076 3.803 32.612 5.592 8.597 15.867
df 2 2 2 2 6 2 8 2 2 2
p-value 0.000 0.000 0.397 0.163 0.042 0.149 0.000 0.061 0.014 0.000
Sex
Spearman rank
correlation
coefficient (r)
0.097 0.019 0.067 0.006 0.051 0.044 0.000 0.118 0.167 0.114
2 -statistic 9.617 0.379 4.625 0.36 2.817 1.958 2.485 14.096 28.320 13.215
df 1 1 1 1 3 1 4 1 1 1
p-value 0.002 0.538 0.032 0.850 0.421 0.162 0.647 0.000 0.000 0.000
Current residence
Spearman rank
correlation
coefficient (r)
0.060 0.131 0.016 0.013 0.038 0.058 -0.029 0.009 0.044 0.034
2 -statistic 28.019 44.945 3.748 3.258 26.064 12.646 18.951 0.814 5.198 4.845
df 3 3 3 3 9 3 12 3 3 3
p-value 0.000 0.000 0.290 0.354 0.002 0.005 0.090 0.846 0.158 0.183
Educational level
Spearman rank
correlation
coefficient (r)
-0.205 -0.189 -0.026 -0.022 0.014 -0.045 0.154 -0.057 -0.062 -0.116
2 -statistic 69.119 67.265 7.953 2.259 29.886 6.448 40.225 5.865 12.603 16.353
df 4 4 4 4 12 4 16 4 4 4
p-value 0.000 0.000 0.093 0.688 0.003 0.168 0.001 0.209 0.013 0.003
6 Munia et al.
Except for “Do you consume tea or coffee?” and
“Do you drink tea or coffee as a part of your daily
routine?” respectively, the age variable was
statistically correlated with the behavior questions at
the 5% significance level (Table 4). In contrast, none
of the behavior questions were significantly
associated with the gender variable. The “current
residency of the students” variable was related to the
questions of the behavior category, “Any preference
between tea and coffee?” and “Do you drink tea or
coffee as a part of your daily routine?”, with p-values
of 0.002 and 0.005, respectively. At a 5% level of
significance, the educational level variable was
significantly correlated with behavior categories
concerning the second and fourth behavior questions
“Any preference between tea and coffee?” and “Any
preference between tea and coffee?” (Table 4). In
perception categories, except for the, “Do you
experience any side effects after taking tea or coffee
multiple times in a day?”, age was statistically
significant with the rest of the two questions, “Have
you experienced any physio-psychological change if
tea or coffee is not taken in a day?” and “Any
addiction for tea or coffee?” (p < 0.05). However, the
gender variable was associated with all the
perception-based questions. Furthermore, none of the
perception-based questions was associated with the
current residence variable (p-value > 0.05). The
educational level variable was significant (p < 0.05)
with the second and third perception category
questions, “Have you experienced any physio-
psychological change if tea or coffee is not taken in a
day?” and “Any addiction to tea or coffee?”. The
educational level had a weak negative correlation
with the knowledge regarding the first question, “Do
you experience any side effects after taking tea or
coffee multiple times in a day?”. Except for this, all
other correlations were negligible (Table 4).
Association and strength between behavior
and perceptions regarding caffeine consumption.
At a 5% level of significance, the third and fourth
questions, “Do you drink tea or coffee as a part of
your daily routine?” and “Any preference between
tea and coffee?” of the behavior category were not
statistically related to the first question of the
perception category “Do you experience any side
effects after taking tea or coffee multiple times in a
day?” (Table 5). At the same time, they were
significantly associated with the second question,
“Have you experienced any physio-psychological
change if tea or coffee is not taken in a day?” of the
perception category (Table 5). From the analysis, it is
clear that drinking tea or coffee as a part of daily
routine positively correlates with physio-
psychological changes experienced if tea or coffee is
not taken in a day. In contrast, there is no correlation
with side effects experienced after taking tea or
coffee multiple times daily. On the other hand, the
average daily consumption of tea or coffee (cups) is
negatively correlated with physio-psychological
changes experienced if tea or coffee is not taken in a
day. In contrast, there is no correlation with side
effects experienced after taking tea or coffee multiple
times daily (Table 5).
Table 5. Association and strength between behavior and perceptions regarding caffeine consumption.
Behavior Statistical tools and results Perception
Side effects experienced after
taking tea or coffee multiple times
in a day
Physio-psychological changes
experienced if tea or coffee is not taken in
a day
Drinks tea or coffee
as a part of daily
routine
Spearman rank correlation
coefficient (r) -0.004 0.428
2 -statistic 0.020 186.903
Df 1 1
p-value 0.889 0.000
Average daily
consumption of tea
or coffee (cups)
Spearman rank correlation
coefficient (r) -0.027 -0.442
2 -statistic 1.718 202.324
Df 4 4
p-value 0.787 0.000
A Cross-sectional Study on Caffeine Dependency by Drinking Tea 7
As the investigation was conducted over the
phone and online media, the results revealed that
urban youth were more engaged in online social
media than those from other socio-demographic
groups. The male-to-female ratio was nearly equal,
showing that both sexes were equally involved in
mobile and online activities. Students <18 years may
have fewer opportunities to connect to the internet
whereas students >23 years were likely less
accessible via the internet (Table 2).
By correctly answering the knowledge-based
questions, the outcome demonstrates that the majority
of Bangladeshi students may have a basic
understanding of tea or coffee as a caffeine source as
well as its pharmacological activity. However, many
of the respondents were unaware of the psychological
risks that are associated with caffeine consumption.
The results also revealed that tea, coffee and a
combination of the two are very popular among
Bangladeshi students, while tea is a little bit more
popular than coffee. This finding pattern is nearly the
same as in a previous study, where the majority of the
population chose tea (83.7%), followed by coffee
(14.7%) and a few (1.6%) took both tea and coffee.13
Kabir et al. mentioned in their study that the food
style of Bangladeshi students depends on their
campus environment, living, social influences,
educational work, food costs and supply as well as
their ambient environment.10 Drinking tea and coffee
is not an exception to that. The study showed that for
various surrounding factors such as educational level,
residency, age and sex, the popularity of tea and
coffee may vary from person to person.
As a student's life is very tough, the students feel
stress that may originate from a variety of sources,
including academic pressures, personal lives and the
environment. Undergraduate students, in particular,
require regular caffeine intake to cope with academic,
mental and emotional stress.14 Furthermore, the
depression, stress and anxiety level of the students
also significantly increased during examination
time.15 Champlin et al.14 and Majori et al.16 indicated
in their studies that energy drinks and tea are the first
options for students to improve concentration and
feel less weary during the exam period. It may be the
reason why a huge number of students in Bangladesh
consume caffeine-containing drinks such as, tea or
coffee.
Caffeine may assist students to deal with stress
and perform efficiently because of the harried and
weary life in the metropolis.17,18 Some people may
become addicted to excessive consumption as well as
build a tolerance to it over time. Rajaseharan et al.
stated in their study that consumption within a
limited range of caffeine has no detrimental
consequences, while extended intake may cause
addiction.19 Another two studies' results revealed that
caffeine intake should be recommended up to 4 cups
per day (a cup of coffee can contain 80-175 mg of
caffeine).20,21 So, those students who drink 5 or more
cups may develop caffeine addiction and withdrawal
symptoms. However, using within the recommended
range, the regular consumer may have experienced
beneficial effects of the caffeine such as better
reaction time, wakefulness, focus and motor
coordination.22,23 They may also get some benefits
because moderate intake of caffeine has no
association with harmful events. Furthermore, it may
be beneficial for cardiovascular diseases such as
arrhythmias, coronary artery disease and heart
failure.24
Though which side effects our respondents
suffered were not considered in our study, according
to the questionnaire, many of the individuals in our
study reported experiencing side effects and
psychological changes because of their tea or coffee
consumption. Caffeine affects gastrointestinal
motility and gastric acid output; therefore, these
alterations could be linked to the gastrointestinal
tract.25 Due to a diuretic and natriuretic action, acute
caffeine consumption promotes urination in patients
who have been devoid of caffeine for several days.26
They have the risk of being dehydrated. Due to
tolerance, chronic users may not experience this
effect.27 Minor psycho-physiological changes in
students may not necessitate a clinical diagnosis for
8 Munia et al.
psychiatric problems. Mild anxiety, jitteriness,
sleeplessness, increased sleep latency, and decreased
coordination are some of the symptoms.22 Those who
suffer from anxiety or panic disorders may require
medical attention. Some students may experience and
aggravate anxiety as a result of excessive tea or
coffee consumption,28 while some people may feel
less anxious once they stop drinking tea or coffee.29
However, moderate doses of tea or coffee may be
beneficial to depressed students and may reduce the
risk of depression in others.30 In general, the students
might label themselves as tea or coffee addicts.
Furthermore, clinical diagnosis is required in the case
of caffeine addiction.
The outcomes of this study show that students'
knowledge of tea or coffee, as well as its
pharmacology, may improve as they get older, as
there was no substantial gender bias in the
knowledge-based questions (Table 4). Norton et al.
also stated the same patterns in their study in 2011.31
The residential area and educational level are also
important to determine the student's knowledge of tea
and coffee as well as caffeine. However, age, gender,
place of residence and education may not have an
impact on all areas of knowledge. In particular, the
psychological relevance of tea or coffee requires a
great deal of attention. None of the variables are
significantly associated with side effects connected to
tea or coffee consumption. As a result, everyone,
regardless of age, gender, location or educational
level, could be affected. Age, gender and place of
residence may all influence how people perceive
drinking tea and coffee. In this scenario, the current
residence is an exception.
There were no significant association between
the two question “Do you drink tea or coffee as a part
of your daily routine?” and “How many cups of
tea/coffee on average do you consume daily?” (Table
5). This can be explained by the findings of the study
of Evans and Griffiths.32 The regular intake of
caffeine develops a tolerance; thus, the chronic
consumer of tea and coffee generally does not face
any such effects.33 However, daily consumption and a
higher number of cups may also lead to caffeine
dependence, as a result, physio-psychological
changes might be experienced if tea or coffee is not
taken in a day.33 The significant association of "Have
you experienced any physio-psychological change if
tea or coffee is not taken in a day?" with the "Do you
drink tea or coffee as a part of your daily routine?"
and "How many cups of tea/coffee on average do you
consume daily?" –can be explained by their findings.
To the best of our knowledge, this study is one
of the few that offers perspective on the knowledge,
behavior and perception of caffeine consumption
among Bangladeshi students. The study form was
disseminated to the entire Bangladesh. According to
the findings of this study, students in Bangladesh
may consume tea and caffeine in moderation and
should be aware of the negative consequences of
excessive caffeine use.
Although this study provides precise data on
caffeine knowledge, behavior and perception among
Bangladeshi students based on tea and coffee intake,
it has several drawbacks. Because it is an online
investigation, students who are uncomfortable with
the internet may choose to skip it. Furthermore, the
students' knowledge, behavior and perception levels
were self-perspective data that may be skewed.
Cross-sectional research cannot prove causality.
Finally, each of this information was related to the
individual providing it and it might have been
influenced by the social desirability of a person.
CONCLUSION
In Bangladesh, students consume caffeine-
containing drinks like coffee and tea in significant
amounts, but they mainly prefer tea over coffee. With
excessive caffeine intake, students may also have the
risk of developing a caffeine dependency, which
could exacerbate the symptoms of caffeine
withdrawal. Students may have a decent
understanding of the general facts and possible
negative effects of caffeine in tea and coffee, but the
present results showed that students lack an accurate
perception of caffeine dependency and withdrawal
symptoms. Additional studies are required to
determine whether more participants are addicted to
A Cross-sectional Study on Caffeine Dependency by Drinking Tea 9
tea and coffee. Therefore, there must be a link
between caffeine consumption and the drinking of tea
and coffee. However, further clinical study is
required to confirm the findings of the study.
ACKNOWLEDGMENT
The authors acknowledge all respondents who
participated in the study. The research was funded by
the University of Dhaka and the University Grants
Commission of Bangladesh (UGC) to author K. M.
Yasif Kayes Sikdar.
DISCLOSURE STATEMENT
The authors declare that there is no conflict of
interest.
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