Effects of Caffeine and Nicotine Gum on Balance Performance in Athletes

No Significant Alterations in Balance Performance After Acute Caffeine and Nicotine Gum Intake in Trained Athletes

This randomized, single-blind, placebo-controlled, four-condition crossover study evaluates the acute effects of caffeine gum (~3 mg/kg) and nicotine gum (4 mg) on balance performance in healthy, trained adults. Each participant completes four test visits (caffeine gum, nicotine gum, xylitol-based placebo gum, and no-gum control) separated by ≥24 hours. Static and dynamic balance are assessed using the ProKin 252 system under standardized procedures. The primary outcomes are postural sway (ellipse area) and center-of-pressure path length over predefined test trials/time frames. The objective is to determine whether acute administration of these stimulants alters balance-related performance relative to placebo and control.

Study Overview

• Status: Completed
• Conditions: Athletic Performance; Postural Stability; Healhty
• Intervention / Treatment: Dietary supplement: Caffeine Gum 3mg/kg; Dietary supplement: Nicotine Gum (4 mg); Other: Placebo Gum (Xylitol)

Detailed Description

This study evaluates the acute effects of two commonly used stimulants-caffeine and nicotine administered in chewing-gum form-on static and dynamic balance performance in healthy, trained adults. The trial uses a randomized, single-blind, placebo-controlled, four-condition crossover design. Twenty participants complete four laboratory visits scheduled at the same time of day and separated by a washout interval of at least 24 hours. The order of the four conditions is randomized.

Interventions are: (1) caffeine gum at approximately 3 mg/kg, (2) nicotine gum at 4 mg, (3) sugar-free xylitol-based placebo gum, and (4) a no-gum control condition. Pre-testing exposure is standardized across conditions: caffeine gum is chewed for 5 minutes, nicotine gum for 30 minutes, and placebo gum for 20 minutes prior to balance assessments. The control condition involves no gum exposure. All procedures are conducted under uniform laboratory conditions.

Balance performance is assessed immediately after the pre-specified exposure period using the ProKin 252 balance platform. Standardized static and dynamic balance tasks are administered according to device guidelines and site procedures. Primary outcomes are postural sway quantified as ellipse area and center-of-pressure path length over predefined trials/time frames. Additional procedural details (e.g., task sequence, rest intervals, and device settings) are maintained in the study manual to ensure consistency across visits.

The objective is to determine whether acute administration of caffeine or nicotine, relative to placebo and control, alters balance-related performance indices in healthy, physically active individuals.

• Study Type: Interventional
• Enrollment (Actual): 20
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Izmir, Turkey (Türkiye)
    • Ege University, Faculty of Sport Sciences

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

1. Be healthy, with no diagnosed neurological or musculoskeletal disorders
2. Be physically active and have at least 3 years of regular training history
3. Be between 18 and 30 years of age
4. Have no balance impairments or vestibular issues
5. Be non-smoker or not using tobacco during study days
6. Able to comply with the intervention protocols and attend all test sessions
7. Provide written informed consent

Exclusion Criteria:

1. Training age less than three years,
2. Having a disease or sports injury that will affect balance performance,
3. Using a drug or substance that affects balance,
4. Not being able to comply with or continue the study measurements.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Basic Science
• Allocation: Randomized
• Interventional Model: Crossover Assignment
• Masking: Single

Number of Arms

4

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: caffeine gum	Dietary supplement: Caffeine Gum 3mg/kg; Participants chewed 2-3 pieces of 100 mg caffeine gum (~3 mg/kg total) for 5 minutes prior to balance testing.
Active Comparator: Nicotine Gum	Dietary supplement: Nicotine Gum (4 mg); Participants chewed one piece of 4 mg nicotine gum for 30 minutes before undergoing balance testing.
Placebo Comparator: Placebo Gum	Other: Placebo Gum (Xylitol); Participants chewed xylitol-based sugar-free gum with no active substance for 20 minutes prior to testing.
No Intervention: Control; No chewing gum administered; participants completed balance testing without any intervention.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Static Postural Sway Ellipse Area - ProKin 252 Stabilometric Platform	Center of pressure (COP) 95% ellipse area during quiet bipedal stance (eyes open; standardized foot position) measured with the ProKin 252. Higher values indicate poorer balance. Unit of Measure: mm^2	At each visit: 5 minutes after start of chewing (caffeine gum), 30 minutes after start of chewing (nicotine gum), 20 minutes after start of chewing (xylitol placebo gum), and 0 minutes (no gum) for the control condition; single 30-second trial per visit

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Static Center of Pressure (COP) Path Length - ProKin 252 Stabilometric Platform	Total COP excursion length during quiet bipedal stance (eyes open; standardized foot position) measured with the ProKin 252. Higher values indicate poorer balance. Unit of Measure: mm	At each visit: 5 minutes after start of chewing (caffeine gum), 30 minutes after start of chewing (nicotine gum), 20 minutes after start of chewing (xylitol placebo gum), and 0 minutes (no gum) for the control condition; single 30-second trial per visit

Collaborators and Investigators

• Sponsor: Gülbin Rudarlı

Study record dates

Study Major Dates

• Study Start (Actual): January 8, 2024
• Primary Completion (Actual): April 5, 2024
• Study Completion (Actual): July 2, 2024

Study Registration Dates

• First Submitted: July 8, 2025
• First Submitted That Met QC Criteria: November 20, 2025
• First Posted (Estimated): November 28, 2025

Study Record Updates

• Last Update Posted (Estimated): December 4, 2025
• Last Update Submitted That Met QC Criteria: November 26, 2025
• Last Verified: November 1, 2025

More Information

Terms related to this study

• Keywords: Nicotine; Caffeine; Dynamic balance; Postural control; Caffeinated chewing gum; Nicotine chewing gum; Ellipse area; Perimeter length; Trained athletes
• Additional Relevant MeSH Terms: Organic Chemicals; Therapeutics; Food; Diet, Food, and Nutrition; Physiological Phenomena; Food and Beverages; Carbohydrates; Polymers; Macromolecular Substances; Alcohols; Polysaccharides; Biopolymers; Plant Gums; Candy; Sugar Alcohols; Chewing Gum; Tobacco Use Cessation Devices; Nicotine Chewing Gum; Xylitol
• Other Study ID Numbers: EGE-24-3.1T-81

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: Yes