Misperceptions of Peer Norms for Tobacco Use and Personal Use: Evidence from Students in Grades 6-12 Across 63 Schools in the US 

38th Annual Meeting of the Society of Behavioral Medicine, San Diego

March 30, 2017

Jessica Perkins, Ph.D., Research Fellow, Massachusetts General Hospital, Massachusetts
H. Wesley Perkins, Ph.D., Dept. of Anthropology/Sociology, Hobart and William Smith Colleges, Geneva, New York
David W. Craig, Ph.D., Dept. of Chemistry, Hobart and William Smith Colleges, Geneva, New York


Actual peer social norms and students’ perceptions of those norms within the school context may be an important determinant of tobacco use initiation and frequency among adolescents as youth look to peers for social cues on what to believe and how to behave. This study distinguishes between actual and perceived peer norms regarding tobacco use attitudes and behavior, and examines the independent associations of both actual and perceived norms with personal attitude and personal use among U.S. students in grades 6-12. Data were collected from 27,545 students across 63 schools in 11 states from 1999 to 2014 via anonymous surveys. Even though permissive attitudes about tobacco use and the actual prevalence of tobacco use increased across grade and age levels, believing that tobacco use is okay or actually using tobacco during the year was rarely the norm in any grade level in any specific secondary school. However, dramatic misperception was found across a diversity of schools and students. Although 77% of students said tobacco use was never good, 64% of students thought that most others in their grade thought use was okay. Similarly, although 78% of students reported never using tobacco, 67% of students perceived that students in their grade most typically used tobacco monthly or more often. Although the prevalence of misperceptions of the attitudinal and behavioral norms regarding tobacco use was greater and more inaccurate across increasing grade and age levels, these misperceptions were pervasive across all racial categories of students, socio-economic status levels of schools, size of grade cohort in one’s school, and time periods within this study. In addition, perception of the attitudinal norm was highly predictive of personal attitude about use. Moreover, misperceiving tobacco use as the norm among same-grade peers strongly predicted personal tobacco use even after adjusting for the actual same-grade prevalence of tobacco use, personal attitude about use, and several other individual and school-level factors. Researchers should give increased attention to designing experiments to assess causality while also testing interventions to reduce misperceptions, and presumably reduce permissive attitudes and actual use. Furthermore, practitioners could begin to explore comprehensive ways to promote the awareness of positive actual norms related to tobacco use.