Social Norms Approach Study: examining the effects of normative constructs as well as outcome expectancies on adolescent alcohol use

Despite growing evidence of the negative health effects of alcohol use, many adolescents engage in underage drinking, and binge drinking, in particular (Fuller-Thomson et al., 2013; Bewick et al., 2013; Dieterich et al., 2013). Evidence suggests that binge drinking among adolescents is associated with car accidents, physical fighting and alcohol poisoning (Fuller-Thomson et al., 2013, Viner and Taylor, 2007, Swahn et al., 2004). Adolescent who use alcohol are also likely to be involved in unprotected sex, are more tended to have multiple sexual partners, and are often female drinkers who experience higher rates of sexual victimization and teen pregnancy (Champion et al., 2004; Ramisetty-Mikler et al., 2004; Dieterich et al., 2013). Apart from this, prevalence is high among some ethnic groups in the UK and elsewhere. A study found that Black African people in the UK have higher rates of drinking compared to most South Asian ethnicities, but lower rates of alcohol use than the general population and people from white backgrounds (Hurcombe, Bayley and Goodman, 2010).

Several interventions such as self-efficacy, fear-based and social norms approach (SNA) have been used to reduce substance abuse and heavy drinking especially among young people (Bruvold, 1993; Dieterich et al., 2013). Increasingly, social norms interventions are being used mainly because of the impressive emerging data on reduction in substance use and other problem behaviours (McAlaney et al., 2007, 2010, 2011; Bewick et al., 2013; Dieterich et al., 2013; Bruvold, 1993; Perkins, 2003). The demand for SNA is also due to the pervasive lack of impact of traditional substance abuse strategies (Hansen, 1992; Perkins, 2003). SNA is based on the notion that an individual’s behaviour is partly influenced more by what people do or say (descriptive norm), and by what are approved behaviours (injunctive norms) (Cialdini, Reno, and Kallgren, 1990). Past research shows that normative perceptions shape behaviours mainly because of the rewards associated with conforming to the referent group behaviour and punishment for non-compliance (Bosari and Carey, 2003; Dejong et al., 2006). Individuals, especially adolescents, tend to conform to erroneously perceived group norms as they wish to or feel pressured to follow imaginary peers (Perkins, 2003). For instance, studies have shown that young people tend to overestimate the permissiveness of peer attitudes and undesirable behaviour (descriptive norm) such as alcohol and tobacco use, or underestimate the extent to which peers engage in healthy behaviour (Bewick et al., 2013; Turner, Perkins, and Bauerle, 2008; Borsari and Carey, 2003). Oftentimes, overestimations of problem behaviour will increase these problem behaviours while underestimations of healthy behaviours will discourage individuals from engaging in them (Neighbors, Geisner, and Lee, 2008; Beck and Treiman, 1996). Worryingly, available data show that individuals use their perceptions of peer norms as a standard (approved behaviour – injunctive norm) against which to compare their own behaviours (Baer et al., 2001; Larimer et al., 2001; Neighbors et al., 2008).

Although social norms interventions have been successfully used in college settings to influence health behaviour (McAlaney et al., 2007, 2010; Dieterich et al., 2013; Bruvold, 1993; Neighbors, Geisner and Lee, 2008; Turner et al., 2008), some studies suggest that social norms interventions may fail to achieve the desired behaviour change (Wechsler et al., 2003; Clapp et al., 2003). Consequently, efforts to understand the mechanisms of SNA approaches have led to the conceptualisation of the Theory of Normative Social Behaviour (TNSB; Rimal and Real, 2005). The TNSB model suggests that influence of descriptive norms on behavioural intentions is moderated by injunctive norms, outcome expectancies and group identity. Rimal and Real (2005) defined outcome expectancies as beliefs that ones’ behaviour will lead to a certain outcome. However, perceived similarity was postulated as the extent to which individuals perceive similarity between themselves and the social group. According to Rimal and Real (2005) such normative mechanisms might amplify the effects of descriptive norms on behaviours. Therefore, to understand the mechanism underlying alcohol use (or heavy drinking), this study examines the effects of normative constructs (i.e. injunctive and descriptive norms) as well as outcome expectancies on adolescent alcohol use. We aim at assessing the effect of outcome expectancies rather than group identity on account that the former is a robust predictor of alcohol use than the later (Zamboanga et al., 2006). Our intent is to explore how these constructs may be used in a normative campaign to reduce adolescent alcohol use.