Behavioral Willingness, Descriptive Normative Perceptions, and Prescription Stimulant Misuse among Young Adults 18-20.

Objective: It is critical to gain further understanding of etiologic factors, such as descriptive normative perceptions and behavioral willingness, that are associated with prescription stimulant misuse (PSM) among young adults. Our primary hypotheses were that descriptive normative perceptions for PSM (i.e., perceptions of how much and how often others engage in PSM) and perceived peer willingness (i.e., perceptions of how open others are to PSM under certain circumstances) would be positively associated with higher willingness to engage in PSM, which in turn would account for significant shared variance with self-reported PSM. Method: Data were collected from a U.S. sample of 18-20-year-olds (N = 1,065; 54.5% females; 70.5% White) recruited for a larger study on alcohol-related risky sexual behavior. Results: Findings indicated higher descriptive normative perceptions and higher perceived peer willingness were associated with higher participants' willingness to engage in PSM. Participants' own willingness was positively associated with PSM. Finally, participants' own willingness to use, descriptive normative perceptions, and perceived peer willingness were associated with higher willingness to engage in PSM, which accounted for significant shared variance with self-reported PSM. Conclusions: Findings suggest the potential utility of personalized feedback interventions for PSM that focus on constructs such as descriptive normative perceptions and behavioral willingness.

Drinking Buddies: Who Are They and When Do They Matter?

The present study sought to further examine the role of peers on alcohol use and problems among young adults. In particular, we focused on a specific subset of peers in one's social network mostly for activities related to alcohol use called "drinking buddies." The presence of drinking buddies in one's social network has been shown to predict heavy drinking uniquely over but few studies have focused on potential factors moderating the relationship. Consequently, an aim of present study was to examine the influence of drinking buddies on alcohol outcomes and the extent to which the relationship may be dependent on one's normative perceptions. Another aim was to provide a descriptive examination of drinking buddies. Participants were college students (N = 250; 72.8% women) who completed self-report measures of alcohol use and problems, injunctive norms, descriptive norms, and social network characteristics. Results showed that descriptive norms moderated the relationship between drinking buddies and all alcohol outcomes assessed. Specifically, the influence of drinking buddies was stronger for those who perceived a lower prevalence of peer drinking. Examination of drinking buddies characteristics revealed that these peers tended to be young adults who were moderate social drinkers with whom they felt close and perceived to be available for concrete and emotional support. Several differences emerged between the drinking buddies of heavy versus non-heavy drinkers. The present study contributed to the larger body of work on peer influence and alcohol use by examining a specific subgroup of peers that may promote risky drinking.

Where do heavy drinking college students experience alcohol consequences and where are they perceived to be normative?

High levels of alcohol consumption are common among college students and associated with endorsing negative alcohol-related consequences. Research suggests both drinking norms and location are strong predictors of drinking behavior in college students. Yet, normative perceptions of consequences, and whether they are location-specific, are less well-studied. We tested the hypotheses that college students who drink would have the highest levels of descriptive and injunctive norms for negative consequences, and would self-report the greatest number of negative consequences, at large gatherings/parties relative to someone's home/dorm and/or bars/clubs. Additionally, we explored whether specific acute consequences were more likely in some drinking locations versus others. Participants were 96 full-time undergraduate students who engaged in high-risk drinking. At baseline, participants reported descriptive and injunctive norms for negative consequences in three locations (home/dorm, large gathering/party, bar/club). Over a 28-day period, participants self-reported daily experiences of five alcohol-related consequences in these same locations. With repeated measures analyses of variance, we found that participants perceived their peers experienced more negative consequences and were more approving of negative consequences at large gatherings/parties and small gatherings at someone's home/dorm relative to bars/clubs. Likewise, nonparametric analyses demonstrated that the total number of consequences over the 28-day assessment period also differed by location, with participants reporting more consequences at home/dorm and large gathering/party locations than at bars/clubs. Future research is needed to better understand how the impact of norms on behavior differs across drinking location, and whether location-specific intervention content (e.g., normative correction) would be useful.

The effect of vaping cues in e-cigarette advertisements on normative perceptions about cigarettes among young adults who use cigarettes and e-cigarettes in Boston.

INTRODUCTION: E-cigarette advertising frequently involves vaping cues-hand to mouth motions and vapor-that physically resemble traditional cigarette smoking cues. There has been concern that these vaping cues could make cigarettes seem more frequently used and acceptable by society. This analysis examined whether exposure to vaping cues in e-cigarette ads influence descriptive and injunctive normative perceptions about cigarettes among young adults who use cigarettes and e-cigarettes (dual use). METHOD: Secondary analysis was conducted on an experiment that randomly exposed young adults living in Boston who dual used in the past-week to either 1) E-cigarette ads with vaping cues; 2) E-cigarette ads that edited out vaping cues; or 3) Beverage ads. Descriptive and injunctive normative perceptions about cigarettes were compared across participants who viewed e-cigarette ads with vaping cues versus those who viewed ads without vaping cues. RESULTS: Those who viewed e-cigarette ads with vaping cues had decreased perceptions that cigarette smoking was common compared to those who viewed e-cigarette ads without vaping cues. Exposure to e-cigarette ads with vaping cues also led to increased perceptions of other peoples' unfavorable views toward cigarette smoking in general and their own cigarette smoking. CONCLUSION: Contrary to renormalization concerns, vaping cues in e-cigarette ads increased anti-smoking normative perceptions among people who dual used in the past week. Further research is needed to examine the impact of vaping cues in e-cigarette ads on normative perceptions among those who don't smoke or quit smoking cigarettes.

An in-school social norms approach intervention for reducing unhealthy snacking behaviours amongst 11-12-year-olds.

OBJECTIVES: Adolescents tend to overestimate the extent of peers' unhealthy snacking consumption and such misperceptions have been associated with increased personal unhealthy snacking. This study aims to test whether a Social Norms Approach (SNA) intervention which challenges these misperceptions of peers' unhealthy snacking will have a positive effect on students' personal unhealthy snacking behaviours, related attitudes, and behavioural intentions. DESIGN: A quasi-experimental study tested the effectiveness of an in-school SNA intervention (n = 163) compared to a control condition (n = 95) among 11-12-year-old students. METHOD: Both conditions received healthy eating information, while students in the SNA intervention received additional normative feedback (outlining the discrepancies between perceived and actual unhealthy snacking of the majority based on baseline data) delivered through an interactive poster-making session. Students completed self-reported measures of personal unhealthy snacking, related-attitudes, behavioural intentions, and normative perceptions (descriptive and injunctive) at baseline, post-intervention, and at a 3-month follow-up. RESULTS: Students who received SNA feedback were significantly less likely to overestimate peers' unhealthy snacking attitudes post-intervention (F(1,232) = 16.405, p < .001), and at 3-month follow-up consumed fewer unhealthy snacks (F(1,232) = 6.133, p = .014) and had less positive attitudes towards unhealthy snacking (F(1,198) = 8.779, p = .003). The changes in personal snacking attitudes at 3-month follow-up were mediated by changes in normative misperceptions about peers' unhealthy snacking attitudes post-intervention, which indicated that the reductions in normative misperceptions following SNA messages mediated the effect of the intervention. CONCLUSION: The results indicate that in-school SNA interventions which challenge normative misperceptions constitute a promising strategy for reducing unhealthy snacking in young adolescents.

JUUL in school: JUUL electronic cigarette use patterns, reasons for use, and social normative perceptions among college student ever users.

BACKGROUND: JUUL electronic cigarettes have surged in popularity since their emergence on the market in 2015. JUUL is slim and simple in design and is capable of delivering cigarette-like levels of nicotine. However, little research has examined JUUL use patterns, reasons for use, and normative perceptions of JUUL among young adults. METHODS: Participants were college students (N = 243) who reported ever using a JUUL electronic cigarette. Eligible participants completed a survey assessing JUUL use patterns, reasons for JUUL use, and normative perceptions of JUUL. RESULTS: Most participants reported using JUUL once or twice (47.7%) and almost one-third reported using JUUL daily or monthly (29.6%). Overall, participants reported a low level of nicotine dependence (Melectronic cigarette HONC = 0.93, SD = 2.04). Cool Mint was the most preferred flavor (35.8%) followed by Mango (12.0%). The top reasons for use were because "friends were using it" (27.0%) and "curiosity" (19.4%). Nearly half (49.8%) of participants reported that they would tell all five of their five closest friends that they use JUUL. Only 10.7% reported a belief that none of their friends would approve of their JUUL use. CONCLUSIONS: The high percentage of daily and monthly JUUL users coupled with the relatively high rates of perceived acceptability of use indicates the possibility of high uptake among college students. Findings also suggest college students perceive JUUL as highly acceptable and that their friend's use and curiosity were primary motivators of their initial use, indicating the importance of peer influence in college student JUUL use.

Descriptive and injunctive norms of waterpipe smoking among college students.

INTRODUCTION: Smoking tobacco via a waterpipe (WP) is on the rise, particularly among college students. One reason for this may be normative perceptions of WP tobacco smoking (WTS) among this population. The current study examined the perceived and actual descriptive and injunctive norms of WTS among a college student sample. METHODS: Participants were 894 college students enrolled at a large, Midwestern university. Participants completed measures of WTS frequency and quantity and perceived/actual descriptive and injunctive norms of WTS. RESULTS: Over one-third of the sample reported ever trying WTS, while only 2% reported current (past month) use. When comparing ever and never WP smokers, ever smokers reported greater perceived peer approval of WTS. Both males and females overestimated WTS frequency of same-sex students at their university. DISCUSSION: The current study is one of the first to investigate descriptive and injunctive norms of WTS among college students. Students who report WTS are more likely to overestimate descriptive norms of WTS among their peers, suggesting corrective normative feedback regarding actual use by peers may be an important target for WTS intervention among college students. Future research should investigate the temporal association between normative perceptions and WTS behaviors among college students.

Characteristics of drinking events associated with heavy episodic drinking among adolescents in the United States.

PURPOSE: To examine associations between characteristics of drinking events and the quantity of alcohol consumed by adolescents in the United States. METHODS: Analyses relied on 2011-2015 data from the National Survey on Drug Use and Health (NSDUH). The study sample included 8110 adolescents, ages 12-17years old, who drank alcohol in the past 30days. A logistic regression model, weighted for national estimation, was constructed to examine factors associated with heavy episodic drinking (HED; 5+ drinks for males, 4+ drinks for females) during the underage drinker's most recent drinking event. These models were adjusted for study year and individual characteristics, including past year drinking frequency, age of drinking onset, and demographic variables. RESULTS: Buying alcohol off-premise or from another person and being given alcohol from non-parent social sources were associated with greater odds of HED compared to being given alcohol by one of their parents. Drinking alcohol at someone else's house or multiple locations were associated with heavier alcohol consumption compared to drinking at one's own home. Being older and an earlier age of alcohol onset were associated with greater odds of HED. CONCLUSIONS: This study identifies contextual factors associated with HED by adolescents. Compared to global association studies, the findings from these event-specific analyses provide strong evidence of the environmental conditions that contribute to HED in American adolescents. Although no level of alcohol consumption is safe for adolescents, knowledge of event-level risk factors can inform targeted interventions.

The impact of normative perceptions on alcohol consumption in military veterans.

BACKGROUND AND AIMS: Perceptions of both descriptive norms (prevalence of drinking) and injunctive norms (others' approval of drinking) relate to alcohol consumption, but mechanisms for these associations have received little attention, especially in military samples. This study tested the direct and indirect associations between perceived descriptive and injunctive norms on drinking through personal attitudes (i.e. personal approval) in a veteran sample. DESIGN: Data were collected as part of a longitudinal randomized controlled alcohol intervention study. The study involved two time-points: baseline/intervention (time 1) and 1-month follow-up (time 2). SETTING: A national sample of veterans was recruited from Facebook to participate in an online study between June and October 2015. PARTICIPANTS: Data included responses of 621 adult military veterans (age 18-34; 83% male). MEASURES: Respondents reported on their weekly alcohol consumption (primary outcome), perceptions of typical drinking and approval by other same-gender veterans. Covariates included gender, intervention condition and combat experience. FINDINGS: Regression results found no significant effects of perceived descriptive or injunctive norms on time 2 drinking when accounting for the effects of personal attitudes, time 1 drinking and covariates. However, mediation analyses found support for personal attitudes as a mediator of the relationship between perceived descriptive norms and time 2 drinking [indirect effect = 0.003, standard deviation (SD) = 0.001, P = 0.001] and between perceived injunctive norms and time 2 drinking (indirect effect = 0.004, SE = 0.001, P < 0.001). CONCLUSIONS: Attitudes to drinking appear to mediate the association between descriptive and injunctions norms about alcohol and subsequent level of alcohol consumption in US military personnel.

Normative perceptions of alcohol-related consequences among college students.

College students in the U.S. continue to drink in hazardous ways and experience a range of alcohol-related consequences. Personalized feedback interventions (PFIs), which often include normative components comparing personal drinking to that of similar peers, have been effective in reducing alcohol outcomes among college students. Though normative perceptions of the quantity and frequency of alcohol use have been examined in many studies, norms for alcohol-related consequences have received less attention. The current study examined self-other discrepancies (SODs) for alcohol-related consequences among college students. Participants overestimated how often alcohol-related consequences are experienced by other same-sex students on campus and rated consequences as more acceptable for others to experience than themselves. No differences in SODs were found between those who did and did not report alcohol use. Future studies should examine the efficacy of PFIs that incorporate normative feedback on alcohol-related consequences.

Normative perceptions of non-medical stimulant use: associations with actual use and hazardous drinking.

UNLABELLED: Approximately 10% of US college students are engaged in non-medical use of prescription stimulants (NMUPS) and that use is linked to concerning health, educational, and societal consequences. Few studies have assessed normative perceptions surrounding NMUPS. Accordingly, we examined self-reported use and normative perceptions for NMUPS and demographic factors that may be associated with them. We also investigated whether higher normative perceptions for NMUPS were related to the most commonly used and abused substance among college students (alcohol). METHOD: 1106 undergraduates participated in an online survey of normative perceptions of NMUPS and students' own drinking and stimulant use habits. RESULTS: Students overestimated NMUPS by other students and those normative estimates were associated with higher NMUPS. Living in a fraternity or sorority was related to higher NMUPS and perceived norms. Finally, higher normative perceptions of NMUPS were associated with higher hazardous drinking. CONCLUSION: The large discrepancy between actual use (generally low) and students' perceptions (generally high), and the relationship of these perceptions to both one's own use of NMUPS and alcohol suggests that interventions aimed at correcting norms may be useful.

FIRST-YEAR COLLEGE WOMEN'S MOTIVATIONS FOR HOOKING UP: A MIXED-METHODS EXAMINATION OF NORMATIVE PEER PERCEPTIONS AND PERSONAL HOOKUP PARTICIPATION.

This study used content analysis techniques to explore 221 first-year college women's perceptions of female peers' reasons (i.e., normative perceptions) for hooking up. Data on personal participation in hooking up were also collected. The well-established Drinking Motives Questionnaire (Cooper, 1994) was used as a framework for coding positive (enhancement or social) and negative (coping or conformity) normative hookup motivations. Participants most commonly indicated that enhancement reasons motivated peers' hookup behaviors (69.7%). Coping (23.5%), external (21.7%), social (19.5%), and conformity (16.3%) motives were cited less frequently. Furthermore, women who had hooked up since matriculating into college (61.5%, n = 136) were significantly more likely to state that their female peers hook up for enhancement reasons (a positive motive), but they were significantly less likely to perceive that typical female peers hook up for coping or conformity reasons (negative motives) (ps < .001). Findings indicate not only that college women uphold overwhelmingly positive perceptions for peers' hooking up, but there appears to be a strong relationship between college women's own hooking up participation and the positive versus negative attributions they ascribe to hooking up among their peers. This study extends the understanding of college women's perceptions and potential influences of hooking up and provides implications for harm reduction efforts.

Normative perceptions and past-year consequences as predictors of subjective evaluations and weekly drinking behavior.

Problem drinking during the college years continues to be an important area of study. Subjective evaluations of consequences have recently been demonstrated to predict future drinking behavior; however, what predicts those evaluations is yet unknown. Social Learning Theory (SLT) provides a guiding framework in this study. Primary aims are to investigate whether individual differences in past experience with alcohol consequences and normative perceptions of alcohol consequences predict subjective evaluations (i.e., the extent to which consequences are perceived as negative, aversive, or severe) and weekly drinking behavior. We also test whether evaluations mediate the influence of past consequences and norms on weekly drinking behavior. Following a baseline assessment, participants (N = 96 regularly drinking college students, 52% female) completed ten weekly web-based surveys on previous week alcohol use, consequences, and subjective evaluations of those consequences. A series of hierarchical linear models were used to test hypotheses. Most mediational pathways were not supported - weekly level evaluations do not appear to fully explain the effect of norms or past experience on weekly level drinking behavior. However, results demonstrated that normative perceptions of and past experience with consequences were associated with both weekly drinking behavior and subjective evaluations, and evaluations remained significant predictors of alcohol use behavior after accounting for these important between-person influences. Findings support the importance placed by SLT on cognition in drinking behavior, and suggest that norms for consequences and subjective evaluations may be appropriate targets of intervention in college students.