The EMERGE framework to measure empowerment for health and development.

RATIONALE: Women's empowerment is a UN Sustainable Development Goal and a focus of global health and development but survey measures and data on gender empowerment remain weak. Existing indicators are often disconnected from theory; stronger operationalization is needed. OBJECTIVE: We present the EMERGE Framework to Measure Empowerment, a framework to strengthen empowerment measures for global health and development. METHOD: We initiated development of this framework in 2016 as part of EMERGE - an initiative designed to build the science of survey research and availability of high-quality survey measures and data on gender empowerment. The framework is guided by existing theories of empowerment, evidence, and expert input. We apply this framework to understand women's empowerment in family planning (FP) via review of state of the field measures. RESULTS: Our framework offers concrete measurable constructs to assess critical consciousness and choice, agency and backlash, and goal achievement as the empowerment process, recognizing its operation at multiple levels-from the individual to the collective. Internal attributes, social norms, and external contexts and resources create facilitators or barriers to the empowerment process. Review of best evidence FP measures assessing empowerment constructs, social norms, and key influencers (e.g., partners and providers) show a strong landscape of measures, including those with women, partners, and providers, but they are limited in assessing translation of choice to agency to achievement of women's self-determined fertility or contraceptive goals, instead relying on assumption of contraceptive use as the goal. We see no measures on collective empowerment toward women's reproductive choice and rights. CONCLUSION: The EMERGE Framework can guide development and analysis of survey measures on empowerment and is needed as the current state of the field shows limited coverage of empowerment constructs even in areas which have received more study, such as family planning.

Tolerance for corruption and descriptive social norm: An experimental study of embezzlement.

Public tolerance for corruption within a society significantly influences the prevalence of corrupt practices, but less is known about how this tolerance evolves with social norms. This paper presents experimental evidences demonstrating that the descriptive social norm indicating widespread corruption can lead to increased tolerance for corruptive acts. We introduce an asymmetric information ultimatum game to simulate the interactions between embezzlers and citizens. Game theoretical analysis reveals that victims anticipating corruption will exhibit greater compliance with embezzlement when the offers are evaluated based on descriptive norms. To test the hypothesis, we employ a framing effect to induce variations in descriptive norms within a behavioral experiment. Although the treatment effect is significant only in the subgroup of student cadres, this subgroup demonstrated increased beliefs about embezzlement, greater tolerance for corruption, and a heightened propensity to embezzle when exposed to framings with hierarchical implications. This paper contributes to the corruption literature by examining the effects of descriptive norms on victims' responses to embezzlement. It offers a more comprehensive perspective on how social standards shape public opinions and corrupt actions, enhancing our understanding of the self-reinforcing nature of corruption.

Professional's Views on the 'Nordic Paradox' in a Low Intimate Partner Violence Prevalence Country.

The apparently contradictory co-existence of high levels of gender equality and intimate partner violence against women (IPVAW) found in Nordic countries has been termed the Nordic Paradox. The aim of this study was to examine how the Nordic Paradox is discussed and explained by Spanish professionals working in the IPVAW field. Five focus groups (n = 19) and interviews with key informants (n = 10) were conducted. Four main categories of possible explanations for the Nordic Paradox were identified: Macro-micro disconnect (i.e., discordance between individual beliefs and behaviors and macro-social norms of gender equality), IPVAW as multicausal (i.e., IPVAW defined as a multicausal phenomenon that does not necessarily have to be associated with gender equality), cultural patterns of social relationships (i.e., the role of social relationships and the way people relate to each other in the Nordic countries), and backlash effect (i.e., men's reaction to greater equality for women). Although this study does not provide a final explanation for the Nordic paradox, its results provide us with a better understanding of the phenomenon and can help to advance research in this field.

Media Influence on Bystander Intervention for Health Protective Norms: The Integrative Model of Behavioral Prediction Perspective.

Drawing upon the Integrative Model of Behavioral Prediction (IM) and the Bystander Intervention Model, this study investigates the impact of media health information on individuals' intentions to address violations of health norms, specifically noncompliance with mask-wearing during the COVID-19 pandemic. Our survey results (n=1,426) indicate a positive correlation between seeking health information from the media and the intention to confront norm violators regarding mask-wearing. This correlation is mediated through three intermediary pathways: attitudes, normative beliefs, and perceived behavioral control. These discoveries address a previously unexplored area concerning pro-social health behaviors, bystander intervention, and contribute to the field of health communication by linking them to research on media influences. Combining media and peer interventions could lead to more effective health outcomes. The discussion covers both theoretical and practical implications.

Social norms that sustain transactional sex and associations with sexual health outcomes: A mixed-methods study in the Comarca Ngäbe-Buglé, a rural-Indigenous region of Panama.

The Comarca Ngäbe-Buglé (CNB), home to >200,000 Indigenous people, is one of the poorest regions in Panama. We describe transactional sex (TS) behaviours, normative beliefs and factors associated with TS among Indigenous adolescents(14-19years) in the CNB. We conducted a mixed-methods study in the CNB between January and November 2018, which included a qualitative study with participant observation and semi-structured interviews that focused on descriptive norms related to TS; and a cross-sectional study among public-school-going adolescents using self-administered questionnaire to report sexual behaviour and injunctive norms related to TS. Participants in the epidemiological study were also asked to submit samples for HIV, syphilis, chlamydia, and gonorrhoea testing. Qualitative thematic analysis was used to organise and analyse field notes and semi-structured interviews. Quantitative analysis included four models: TS experience and acceptance of a TS offer and the associations of these outcome variables with demographic and behavioural variables and HIV/STI infections. In the qualitative study among 20 adolescents, we found that people offering TS were reported to be from within and outside of the community, and included older men and women, and disturbingly, teachers. Participants reported feeling individual and collective agency in the decision to engage in TS and described little social sanctions for participation. In the quantitative study among 700 adolescents(309 girls[45.1%],379 boys[54.9%]), we found that girls(18.8%;58/309) and boys(15.5%;58/379) reported similar levels of having been offered TS, and of acceptance among those offered(girls 81.4% [35/43]; boys 77.8% [35/45]). TS was found to be associated with the reported forced sex and HIV/syphilis seropositivity. Due to widespread acceptance and feelings of agency, interventions would not be effective if they focused on eliminating the transactional component of sexual encounters. Instead, interventions should focus on individual and household economic stability, increasing violence reporting, bringing perpetrators to justice, and adopting condom use during all sexual encounters.

Compliance with COVID-19 Physical Distancing Mandates in Oman: The Role of Health Literacy and Internal Health Locus of Control.

BACKGROUND: Research indicates that the effectiveness of coronavirus disease 2019 (COVID-19) physical distancing mandates is influenced by several individual factors, including health literacy; internal health locus of control (IHLOC), the belief that physical distancing can reduce COVID-19 risk; social norms; self-efficacy; and perceptions of the benefits and barriers associated with distancing. However, further investigation is needed to understand the links between these factors and compliance intentions. OBJECTIVE: This study investigates the mechanism linking these factors with the intentions to comply with physical distancing mandates. METHODS: A total of 759 participants (Mean age = 29.13, standard deviation [SD] = 8.33; 68.5% women) were surveyed online from September 2020 to October 2020. Data were analyzed using ANOVA (analysis of variance) and structural equation modeling. KEY RESULTS: Health literacy was associated with more perceived benefits (ß = .175, p = .001), greater self-efficacy (ß = .193, p < .001), and less perceived barriers (ß = -.391, p < .001). IHLOC was significantly associated with greater perceived benefits (ß = .156, p = .007) and self-efficacy (ß = .294, p < .001). Family descriptive norms were significantly associated with fewer perceived barriers (ß = -.276, p < .001), while injunctive norms were associated with more perceived benefits (ß = .202, p = .001) and higher self-efficacy (ß = .299, p < .001). Intentions to adhere to physical distancing mandates were significantly associated with past compliance (ß = .427, p < .001) and perceived barriers (ß = -.205, p < .001) and benefits (ß = .295, p < .001). Post-hoc mediation analyses revealed several small yet significant indirect effects, highlighting the complex pathways shaping adherence intentions. CONCLUSIONS: This study identifies how health literacy, IHLOC, social norms, perceived benefits and barriers, and self-efficacy intricately shape intentions to comply with physical distancing mandates. These findings offer valuable implications for public health policy and interventions. [HLRP: Health Literacy Research and Practice. 2024;8(2):e69-e78.].

PLAIN LANGUAGE SUMMARY: This study examined the factors associated with Omanis' intentions to comply with physical distancing mandates during COVID-19. Results revealed that individuals with higher health literacy perceived fewer barriers and more benefits to physical distancing, making them more willing to comply with mandates. Those who believed their actions could reduce the risk of contracting the virus also reported greater benefits and were more likely to comply.

Nudge-based misinformation interventions are effective in information environments with low misinformation prevalence.

Nudge-based misinformation interventions are presented as cheap and effective ways to reduce the spread of misinformation online. However, despite online information environments typically containing relatively low volumes of misinformation, most studies testing the effectiveness of nudge interventions present equal proportions of true and false information. As the effectiveness of nudges can be highly context-dependent, it is imperative to validate the effectiveness of nudge-based interventions in environments with more realistic proportions of misinformation. The current study (N = 1387) assessed the effectiveness of a combined accuracy and social-norm nudge in simulated social-media environments with varying proportions of misinformation (50%, 20%, and 12.5%) relative to true and non-news-based (i.e., "social") information. The nudge intervention was effective at improving sharing discernment in conditions with lower proportions of misinformation, providing ecologically valid support for the use of nudge-based interventions to counter misinformation propagation on social media.

Social norms and young adults' self-reported meat and plant-based meal intake: Findings from two online cross-sectional studies.

Plant-based eating is beneficial for human and planetary health. It is important to identify factors which may encourage people to reduce meat, and increase plant-based meal intake. Perceived social norms are associated with meat and plant-based meal intake in adults, however, less is known about the relationship between perceived social norms and young adults' own self-reported meat and plant-based eating in general, and in different social contexts. Across two online studies we examined this. In Study 1 (n = 217 young adults, aged 18-25 years, mean age = 19.50 years, SD = 1.37 years, mean BMI = 24.21, SD = 5.45, 91% cisfemale, 92.0% omnivores), perceived descriptive (the perceived behaviour of others) and injunctive (the perceived approval of others) norms were measured in general. In study 2 (n = 151 young adults aged 18-25 years, mean age = 19.62 years, SD = 1.50 years, mean BMI = 24.32, SD = 4.99, 88.8% cisfemale, 71.1% omnivore), perceived descriptive and injunctive norms were examined in a variety of social contexts. In Study 1, perceived descriptive norms about friends were associated with self-reported meat, and descriptive norms about peers and friends, and injunctive norms about friends were positively associated with self-reported plant-based meal intake. In Study 2, descriptive norms about friends were associated with self-reported meat intake in fast-food restaurants and at friends' houses, and injunctive norms about friends were associated with meat intake in restaurants. There were no other significant associations between either type of social norm and meat or plant-based meal intake. We provide the first evidence that peers and friends may be relevant for plant-based meal intake, and only friends may be relevant for meat intake. Further research is needed to examine people's actual food intake, and in longitudinal studies to rule out reverse causality.

German population norms of the preference to solitude scale and its correlates.

AIM: Our first aim was to present norm values for the Preference for Solitude Scale by sex, age, and other sociodemographic groups. Our second aim was to evaluate the correlates of preference for solitude. METHODS: Data were collected in August/September 2023 from a sample of individuals (N = 5000) living in Germany aged 18 to 74 years (ensuring representativeness in terms of sex, age group and federal state for the German general adult population). The established and valid Preference for Solitude Scale (range 0 to 12, with higher values reflecting a stronger preference for solitude) was used to quantify the preference for solitude. Norm values were provided by sex and age groups. Multiple linear regressions were used to examine the correlates of preference for solitude. RESULTS: Average preference for solitude score was 7.6 (SD = 3.0; 0 to 12). The average score was 7.3 (SD = 3.0) among males and 7.9 (SD = 2.9) among females. Regressions showed that a stronger preference for solitude was associated with being female (ß = .51, p < .001), being older (e.g., being 40 to 49 years compared to 18 to 29 years, ß = .85, p < .001), being single (e.g., divorced compared to being single, ß = -.78, p < .01), higher level of education (secondary education compared to primary education, ß = .43, p < .01), never been a smoker (e.g., daily smoker compared to never smokers, ß = -.61, p < .001), absence of alcohol consumption (e.g., drinking once a week compared to never drinking, ß = -1.09, p < .001), no sports activity (e.g., 2-4 hours per week compared to no sports activity, ß = -.60, p < .001), poorer self-rated health (ß = .28, p < .001) and more depressive symptoms (ß = .05, p < .001). Sex-stratified regressions yielded similar results. CONCLUSION: Norm values provided in this study can be used as a benchmark for comparison with other countries and can guide further research dealing with preferences for solitude. We demonstrated the importance of several sociodemographic factors (e.g., marital status), lifestyle-related factors (e.g., sports activity), and health-related factors (e.g., depressive symptoms) for the preference for solitude. Such knowledge about the correlates of preference for solitude may help to characterize them. This is essential to ensure a good balance between social interaction and being alone. This is important because preference for solitude is associated with poor self-rated health and depression, but also with healthy behaviors such as abstaining from smoking and drinking.

Ethnic differences in meat consumption attitudes, norms and behaviors: A survey of White, South Asian and Black ethnic groups in the UK.

A reduction in meat consumption is necessary to mitigate negative impacts of climate change and adverse health outcomes. The UK has an increasingly multi-ethnic population, yet there is little research on meat consumption habits and attitudes among ethnic groups in the UK. We ran a survey (N = 1014) with quota samples for ethnic groups and analyzed attitudes, behaviors and norm perceptions of White, South Asian and Black British respondents. Most respondents believe overconsumption of red and processed meat has negative impacts on health (73.3%) and the environment (64.3%).South Asian respondents were statistically significantly less likely to be meat eaters than White respondents (OR = 0.44, 95% CIs: 0.30-0.65, t = -4.15, p = 0.000), while there was no significant difference between White and Black respondents (OR = 1.06, 95% CIs: 0.63-1.76, t = 0.21, p = 0.834). Both South Asian (OR = 2.76, 95% CIs: 1.89-4.03 t = 5.25, p = 0.000) and Black respondents (OR = 2.09, 95% CIs: 0.1.30-3.35, t = 3.06, p = 0.002) were significantly more likely to express being influenced by friends and family in their food choices than White respondents. South Asian (OR = 3.24,95% CIs: 2.17-4.84, t = 5.74, p = 0.000) and Black (OR = 2.02,95% CIs: 1.21-3.39, t = 2.69, p = 0.007) respondents were also both significantly more likely to report they would want to eat similarly to their friends and family than White respondents. Statistical analyses suggested some gender and socioeconomic differences across and among ethnic groups, which are reported and discussed. The differences in meat consumption behaviors and norm conformity between ethnic groups raises the prospect that interventions that leverage social norms may be more effective in South Asian groups than Black and White groups in the UK.

The model of norm-regulated responsibility for proenvironmental behavior in the context of littering prevention.

Previous research suggests that descriptive norms positively influence proenvironmental behavior, including littering prevention. However, in some behavioral contexts, a weak descriptive norm may increase individuals' feelings of responsibility by signaling a need for action. We examined this effect in the context of litter prevention by conducting structural equation modeling of survey data from 1400 Singapore residents. The results showed that descriptive norms negatively predicted ascription of responsibility and were negatively related to littering prevention behavior via ascription of responsibility and personal norms. It also showed that strong injunctive norms can reduce the inhibitory effect of descriptive norms on ascription of responsibility. These findings were consistent with several hypotheses constituting the model of norm-regulated responsibility, a novel explanatory framework offering new insights and a more nuanced and comprehensive understanding of social norms' influence on proenvironmental behavior.

Neural Tracking of Perceived Parent, but Not Peer, Norms Is Associated with Longitudinal Changes in Adolescent Attitudes about Externalizing Behaviors.

Adolescents' perceptions of parent and peer norms about externalizing behaviors influence the extent to which they adopt similar attitudes, yet little is known about how the trajectories of perceived parent and peer norms are related to trajectories of personal attitudes across adolescence. Neural development of midline regions implicated in self-other processing may underlie developmental changes in parent and peer influence. Here, we examined whether neural processing of perceived parent and peer norms in midline regions during self-evaluations would be associated with trajectories of personal attitudes about externalizing behaviors. Trajectories of adolescents' perceived parent and peer norms were examined longitudinally with functional neuroimaging (n = 165; ages 11-16 years across three waves; 86 girls, 79 boys; 29.7% White, 21.8% Black, 35.8% Latinx, 12.7% other/multiracial). Behavioral results showed perceived parent norms were less permissive than adolescents' own attitudes about externalizing behaviors, whereas perceived peer norms were more permissive than adolescents' own attitudes, effects that increased from early to middle adolescence. Although younger adolescents reported less permissive attitudes when they spontaneously tracked perceived parent norms in the ventromedial and medial pFCs during self-evaluations, this effect weakened as they aged. No brain-behavior effects were found when tracking perceived peer norms. These findings elucidate how perceived parent and peer norms change in parallel with personal attitudes about externalizing behaviors from early to middle adolescence and underscore the importance of spontaneous neural tracking of perceived parent norms during self-evaluations for buffering permissive personal attitudes, particularly in early adolescence.

I'll have what She's having (but not what They're having): The moderating role of group membership in the effect of social norms on food choice in an online environment.

The modern food-rich environment has contributed to the rise of unhealthy diets linked to noncommunicable diseases. Previous in-person research has found that the effect of social norms on food intake is greater when set by a perceived in-group member relative to an out-group member. Given recent increased social media use, we investigated whether this effect of group membership extends to food choices and to normative information presented remotely online. Participants (N = 179 female university students, 18-32 years) viewed a Facebook page pertaining to either their university (in-group) or a rival university (out-group). They were presented with either a healthy or an unhealthy norm via a post in which a student discussed their order at a café on the relevant campus. Food choice was assessed through an online menu where participants were asked to order one main, side, and dessert dish. As predicted, participants who viewed the healthy norm ordered a higher percentage of healthy items (especially in the desserts category) relative to those who viewed the unhealthy norm. However, this effect was significant only for those in the in-group condition; there was no such pattern for participants in the out-group condition. These findings provide insight into the role of group membership in the effect of social norms, and have practical implications regarding the design of identity-based social media health campaigns to promote healthier eating behaviours.

Exploring the influence of context on social norms around Australian parents' food provision using story completion.

OBJECTIVE: To explore the differences in social norms around parents' food provision in different provision contexts and by demographics. DESIGN: Qualitative study using story completion methodology via an online survey in September 2021. Adults 18+ with or without children were randomised to one of three story stems focusing on food provision in different contexts; food provision at home (non-visitor), with visitors present and with the involvement of sport. Stories were coded and themed using thematic analysis. A content analysis was performed to determine count and frequency of codes in stories by participant demographics and story assumptions. SETTING: Australia. PARTICIPANTS: Adults (n 196). RESULTS: Nine themes were identified from the data resulting in four social norms around providing healthy foods and justifying non-adherence to healthy eating guidelines, evolution of family life and mealtime values, the presence of others influencing how we engage with food provision and unhealthy foods used as incentives/rewards in sport. Following content analysis, no differences of themes or norms by participant demographics or story assumptions were found. CONCLUSIONS: We identified pervasive social norms around family food provision and further identified how contextual factors resulted in variations or distinct norms. This highlights the impact context may have on the social norms parents face when providing food to their children and the opportunities and risks of leveraging these social norms to influence food choice in these contexts. Public health interventions and practitioners should understand the influence of context and social environments when promoting behaviour change and providing individualised advice. Future research could explore parents' experiences of these norms and to what extent they impact food choice.

One step too far: social cerebellum in norm-violating navigation.

Social norms are pivotal in guiding social interactions. The current study investigated the potential contribution of the posterior cerebellum, a critical region involved in perceiving and comprehending the sequential dynamics of social actions, in detecting actions that either conform to or deviate from social norms. Participants engaged in a goal-directed task in which they observed others navigating towards a goal. The trajectories demonstrated either norm-violating (trespassing forbidden zones) or norm-following behaviors (avoiding forbidden zones). Results revealed that observing social norm-violating behaviors engaged the bilateral posterior cerebellar Crus 2 and the right temporoparietal junction (TPJ) from the mentalizing network, and the parahippocampal gyrus (PHG) to a greater extent than observing norm-following behaviors. These mentalizing regions were also activated when comparing social sequences against non-social and non-sequential control conditions. Reproducing norm-violating social trajectories observed earlier, activated the left cerebellar Crus 2 and the right PHG compared to reproducing norm-following trajectories. These findings illuminate the neural mechanisms in the cerebellum associated with detecting norm transgressions during social navigation, emphasizing the role of the posterior cerebellum in detecting and signaling deviations from anticipated sequences.

Pornography Use and the Acceptance of Gender Norm Violation in a School Context.

Although media effect studies have quite extensively investigated the association between pornography use and gendered attitudes, some questions remain. The present study aimed to address two of these questions by exploring how gendered attitudes and gender beliefs may be influenced by gender typicality and pornography use. First, the literature has not yet accounted for individual differences based on gender typicality. Second, the influence of pornography use on gender beliefs going beyond pornography's script application is understudied. This online cross-sectional study (N = 1,440, Mage = 23.86, SD = 4.79) contributes to the field by investigating the indirect association between pornography use and acceptance of gender norm violation through gendered attitudes and the moderating role of gender typicality. Acceptance of gender norm violation was measured via vignettes describing a school context in which a teacher and a student violated gender norms. Findings indicated that gendered attitudes negatively relate to the acceptance of gender norm violation. Moreover, compared to women, men's pornography use indirectly relates to lower acceptance rates through gendered attitudes. Additionally, for men, specific levels of gender typicality and atypicality form a strengthening and buffering role, respectively. This applies to the association between pornography use and gendered attitudes as well as to the indirect relationship of pornography use with acceptance of gender norm violation. These findings suggest that pornography use may also affect gender beliefs that are unrelated to the scripts present in pornography. Future studies should take into account the type of preferred pornography and unravel the specific impact of women's pornography use.

Persistent interaction patterns across social media platforms and over time.

Growing concern surrounds the impact of social media platforms on public discourse1-4 and their influence on social dynamics5-9, especially in the context of toxicity10-12. Here, to better understand these phenomena, we use a comparative approach to isolate human behavioural patterns across multiple social media platforms. In particular, we analyse conversations in different online communities, focusing on identifying consistent patterns of toxic content. Drawing from an extensive dataset that spans eight platforms over 34 years-from Usenet to contemporary social media-our findings show consistent conversation patterns and user behaviour, irrespective of the platform, topic or time. Notably, although long conversations consistently exhibit higher toxicity, toxic language does not invariably discourage people from participating in a conversation, and toxicity does not necessarily escalate as discussions evolve. Our analysis suggests that debates and contrasting sentiments among users significantly contribute to more intense and hostile discussions. Moreover, the persistence of these patterns across three decades, despite changes in platforms and societal norms, underscores the pivotal role of human behaviour in shaping online discourse.

Source-credibility information and social norms improve truth discernment and reduce engagement with misinformation online.

Misinformation on social media is a pervasive challenge. In this study (N = 415) a social-media simulation was used to test two potential interventions for countering misinformation: a credibility badge and a social norm. The credibility badge was implemented by associating accounts, including participants', with a credibility score. Participants' credibility score was dynamically updated depending on their engagement with true and false posts. To implement the social-norm intervention, participants were provided with both a descriptive norm (i.e., most people do not share misinformation) and an injunctive norm (i.e., sharing misinformation is the wrong thing to do). Both interventions were effective. The social-norm intervention led to reduced belief in false claims and improved discrimination between true and false claims. It also had some positive impact on social-media engagement, although some effects were not robust to alternative analysis specifications. The presence of credibility badges led to greater belief in true claims, lower belief in false claims, and improved discrimination. The credibility-badge intervention also had robust positive impacts on social-media engagement, leading to increased flagging and decreased liking and sharing of false posts. Cumulatively, the results suggest that both interventions have potential to combat misinformation and improve the social-media information landscape.

Electronic cigarette social norms among adolescents in New South Wales, Australia.

The use of electronic cigarettes (e-cigarettes) is common and increasing, especially among youth. In 2022/2023, 30% of 12- to 17-year-olds reported ever using e-cigarettes in Australia-a >50% increase from 2017 (14%). Several adverse e-cigarette health effects have been identified and most effects remain unknown. Social norms, rules that govern social behaviours, are associated with current and future adolescent e-cigarette use. Understanding social norms in Australian adolescents is critical to the development of targeted and effective e-cigarette prevention activities. This study aims to explore e-cigarette social norms among adolescents living in New South Wales, Australia. A total of 32 online single or paired semi-structured qualitative interviews were conducted involving 46 participants aged 14-17 years, as part of the Generation Vape project. Reflexive thematic analysis was applied within a constructivist perceptive. Adolescents perceived e-cigarettes use as prolific among their peers, with use considered common, acceptable and normal. Fuelled by social exposure to e-cigarettes, 'everyone' was generally thought to be using them (descriptive norms). E-cigarette use was considered so entrenched that it was part of adolescent identity, with abstinence regarded as atypical. Use was driven by an internalised desire to fit it (injunctive norm), rather than being attributed to overt/external 'peer-pressure'. Positive e-cigarette norms exist among Australian adolescents with norm formation strongly influenced by social exposure, including e-cigarette promotion. Prevention efforts should include limiting adolescent exposure to e-cigarette marketing to help redefine existing pro-e-cigarette social norms and protect health.