Normative influences on intentions to smoke among Greek adolescents: the moderating role of smoking status

BACKGROUND Social norms influence adolescent smoking intentions, but this effect may differentiate depending on current smoking experiences. The presented study assessed the moderation effects of smoking status on the relationship between social norms and smoking intentions among Greek adolescents. METHODS A cross-section survey-based design was used. Overall, 251 Greek secondary school students (M age = 16.1 years, 61.2% females) completed structured and anonymous questionnaires including demographic characteristics (age, gender), subjective and descriptive social norms towards smoking, self-reported tobacco use, and intentions to smoke in the next 12 months. RESULTS Linear regression analysis showed that social norms overall predicted 36.4% (Adjusted R2) of the variance in intentions. Perceived prevalence of smoking in same age peers and adults, having more close friends who smoke and perceived social approval of smoking predicted intentions to smoke in one year. Moderated regression analysis showed that the effects of social norms on smoking intentions were significantly moderated by smoking status. CONCLUSIONS Social norms predict smoking intentions, but this effect is stronger among ever (than never) smoker adolescents. Adolescents with smoking experiences may selectively attend to pro-smoking social cues and this perpetuates into their motivation to keep up the habit. School-based interventions should target normative beliefs and related cognitive processes, especially among adolescents who have already initiated tobacco use.