Skip to main content

Social Norms and Health Behavior

  • Chapter
  • First Online:
Handbook of Behavioral Medicine

Abstract

Despite the long history of research on social norms in psychology, sociology, and other disciplines, social norms remain relatively underutilized as a mechanism for changing health behaviors. However, normative influence is a powerful motivator of behavior that can and should be brought to bear in health promotion research. Accordingly, research that has examined the role of social norms in characterizing, predicting, and ultimately altering health behaviors is reviewed. First, an important distinction between descriptive and injunctive norms is addressed and a brief review of literature that has examined norms as correlates of health behaviors is provided. The remainder of the chapter focuses on applications of normative information to behavior change, with an emphasis on social norms theory. The social psychological phenomena that form the basis of the theory, as well as a number of applications of the theory to behavior change are discussed. Alternative applications of norms to the promotion of health behavior and influences of the media on health are also addressed.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 429.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 549.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 799.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  • Abroms, L. C., and Maibach, E. W. (2008). The effectiveness of mass communication to change health behavior. Annu Rev Public Health, 29, 213–234.

    Article  Google Scholar 

  • Ajzen, I. (1991). The theory of planned behavior. Organ Behav Hum Decis Process, 50, 179–211.

    Article  Google Scholar 

  • Anderson, C. A., Berkowitz, L., Donnerstein, E., Huesmann, L. R., Johnson, J. D. et al (2003). The influence of media violence on youth. Psychol Sci Public Interest, 4, 81–110.

    Google Scholar 

  • Bandura, A. (2001). Social cognitive theory of mass communication. Media Psychol, 3, 265–299.

    Article  Google Scholar 

  • Berger, J., and Rand, L. (2008). Shifting signals to help health: using identity signaling to reduce risky health behaviors. J Consum Res, 35, 509–518.

    Article  Google Scholar 

  • Bergstrom, R. L., Neighbors, C., and Lewis, M. A. (2004). Do men find “bony” women attractive? Consequences of misperceiving opposite sex perceptions of attractive body image. Body Image, 1, 183–191.

    Article  PubMed  Google Scholar 

  • Borsari, B., and Carey, K. B. (2003). Descriptive and injunctive norms in college drinking: a meta-analytic integration. J Stud Alcohol, 64, 331–341.

    PubMed  Google Scholar 

  • Brown, J., Steele, J., and Walsh-Childers, K. (2002). Sexual Teens, Sexual Media: Investigating Media’s Influence on Adolescent Sexuality. Mahwah, NJ: Lawrence Erlbaum.

    Google Scholar 

  • Browne, K. D., and Himilton-Giachristis, C. (2005). The influence of violent media on children and adolescents: a public-health approach. Lancet, 365, 702–710.

    PubMed  Google Scholar 

  • Carey, K. B., Borsari, B., Carey, M. P., and Maisto, S. A. (2006). Patterns and importance of self-other differences in college drinking norms. Psychol Addict Behav, 20, 385–393.

    Article  PubMed  Google Scholar 

  • Cialdini, R. B. (2003). Crafting normative messages to protect the environment. Curr Dir Psychol Sci, 12, 105–109.

    Article  Google Scholar 

  • Cialdini, R. B., and Trost, M. R. (1998). Social influence: social norms, conformity and compliance. In D. T. Gilbert, S. Fiske, & G. Lindzey (Eds.), The Handbook of Social Psychology, 4th Ed (pp. 151–192). New York: McGraw-Hill.

    Google Scholar 

  • Cialdini, R. B., Reno, R. R., and Kallgren, C. A. (1990). A focus theory of normative conduct: recycling the concept of norms to reduce littering in public places. J Pers Soc Psychol, 58, 1015–1026.

    Article  Google Scholar 

  • Collins, S. E., Carey, K. B., and Sliwinski, M. J. (2002). Mailed personalized normative feedback as a brief intervention for at-risk college drinkers. J Stud Alcohol, 63, 559–567.

    PubMed  Google Scholar 

  • Cunningham, J. A., Wild, T. C., Bondy, S. J., and Lin, E. (2001). Impact of normative feedback on problem drinkers: a small-area population study. J Stud Alcohol, 62, 228–233.

    PubMed  CAS  Google Scholar 

  • Darley, J. M., and Latané, B. (1970). Norms and normative behavior: field studies of social interdependence. In J. Macaulay & L. Berkowitz (Eds.), Altruism and Helping Behavior (pp. 83–102). San Diego: Academic Press.

    Google Scholar 

  • Davey-Rothwell, M. A., Latkin, C. A., and Tobin, K. E. (2009). Longitudinal analysis of the relationship between perceived norms and sharing injection paraphernalia. AIDS Behaviour. Advance online publication. doi: 10.1007/s10461-008-9520-z.

    Google Scholar 

  • DeJong, W., Schneider, S. K., Towvim, L. G., Murphy, M. J., Doerr, E. E. et al (2006). A multisite randomized trial of social norms marketing campaigns to reduce college student drinking. J Stud Alcohol, 67, 868–879.

    PubMed  Google Scholar 

  • Durkheim, E. (1951). Suicide: A Study in Sociology. New York: Free Press.

    Google Scholar 

  • Etcheverry, P. E., and Agnew, C. R. (2008). Romantic partner and friend influences on young adult cigarette smoking: comparing close others’ smoking and injunctive norms over time. Psychol Addict Behav, 22, 313–325.

    Article  PubMed  Google Scholar 

  • Far, J. M., and Miller, J. A. (2003). The small groups norms-challenging model: social norms interventions with targeted high-risk groups. In H. W. Perkins (Ed.), The Social Norms Approach to Preventing School and College Age Substance Abuse: A Handbook for Educators, Counselors, and Clinicians (pp. 111–132). San Francisco: Jossey-Bass.

    Google Scholar 

  • Fishbein, M., and Ajzen, I. (1975). Belief, Attitude, Intention, and Behavior: An Introduction to Theory and Research. Reading, MA: Addison-Wesley.

    Google Scholar 

  • Foss, R., Diekman, S., Goodwin, A., and Bartley, C. (2003). Enhancing a norms program to reduce high-risk drinking among first year students. http://www.hsrc.unc.edu/safety_info/alcohol/UNCSocialNormProject.pdf.

  • Godin, G., and Kok, G. (1996). The theory of planned behavior: a review of its applications to health related behaviors. Am J Health Promot, 11, 87–98.

    Article  PubMed  CAS  Google Scholar 

  • Goldstein, N. J., and Cialdini, R. B. (2007). Using social norms as a lever of social influence. In A. Pratkanis (Ed.), The Science of Social Influence: Advances and Future Progress (pp. 167-192). Philadelphia: Psychology Press.

    Google Scholar 

  • Goldstein, N. J., Cialdini, R. B., and Griskevicius, V. (2008). A room with a viewpoint: using social norms to motivate environmental conservation in hotels. J Consum Res, 35, 472–482.

    Article  Google Scholar 

  • Grabe, S., Ward, L. M., and Hyde, J. S. (2008). The role of the media in body image concerns among women: a meta-analysis of experimental and correlational studies. Psychol Bull, 134, 460–476.

    Article  PubMed  Google Scholar 

  • Graham, J., Marks, G., and Hansen, W. (1991). Social influence processes affecting adolescent substance use. J Appl Soc Psychol, 16, 291–298.

    Google Scholar 

  • Hagger, M., and Chatzisarantis, N. (2005). First and higher-order models of attitudes, normative influence, and perceived behavioral control in the theory of planned behavior. Br J Soc Psychol, 44, 513–535.

    Article  PubMed  Google Scholar 

  • Hansen, W. B., and Graham, W. J. (1991). Preventing alcohol, marijuana, and cigarette use among adolescents: peer pressure resistance training versus establishing conservative norms. Prev Med, 20, 414–430.

    Article  PubMed  CAS  Google Scholar 

  • Hesse, B. W., Nelson, D. E., Kreps, G. L., Croyle, R. T., Arora, N. K. et al (2005). Trust and sources of health information: the impact of the internet and its implications for health care providers: findings from the first health information national trends survey. Arch Intern Med, 165, 2618–2624.

    Article  PubMed  Google Scholar 

  • Jackson, K. M., and Aiken, L. S. (2006). Evaluation of a multicomponent appearance-based sun-protective intervention for young women: uncovering the mechanisms of program efficacy. Health Psychol, 25, 34–46.

    Article  PubMed  Google Scholar 

  • Juvonen, J., Martino, S. C., Ellickson, P. L., and Longshore, D. (2007). “But others do it”! Do misperceptions of schoolmate alcohol and marijuana use predict subsequent drug use among young adolescents? J Appl Soc Psychol, 37, 740–758.

    Article  Google Scholar 

  • Kumanyika, S., and Brownson, R. (Eds.). (2007). Handbook of Obesity Prevention: A Resource for Health Professionals. New York: Springer.

    Google Scholar 

  • Larimer, M. E., Turner, A. P., Mallett, K. A., and Geisner, I. M. (2004). Predicting drinking behavior and alcohol-related problems among fraternity and sorority members: examining the role of descriptive and injunctive norms. Psychol Addict Behav, 18, 203–212.

    Article  PubMed  Google Scholar 

  • L’Engle, K. L., Brown, J. D., and Kenneary, K. (2006). The mass media are an important context for adolescents’ sexual behavior. J Adolesc Health, 38, 186–192.

    Article  PubMed  Google Scholar 

  • L’Engle, K. L., and Jackson, C. (2008). Socialization influences on early adolescents’ cognitive susceptibility and transition to sexual intercourse. J Res Adolesc, 18, 353–378.

    Article  Google Scholar 

  • Levin, D. E. (2009). So sexy, so soon: the sexualization of childhood. In S. Olfman (Ed.), The Sexualization of Childhood (Childhood in America) (pp. 75–88). Westport, CT: Praeger.

    Google Scholar 

  • Linkenbach, J. W. (2003). The Montana model: development and overview of a seven-step process for implementing macro-level social norms campaigns. In H. W. Perkins (Ed.), The Social Norms Approach to Preventing School and College Age Substance Abuse: A Handbook for Educators, Counselors, and Clinicians (pp. 182–206). San Francisco: Jossey-Bass.

    Google Scholar 

  • Linkenbach, J. W., and Perkins, H. W. (2003a). Most of us are tobacco free: an eight-month social norms campaign reducing youth initiation of smoking in Montana. In H. W. Perkins (Ed.), The Social Norms Approach to Preventing School and College Age Substance Abuse: A Handbook for Educators, Counselors, and Clinicians (pp. 224–234). San Francisco: Jossey-Bass.

    Google Scholar 

  • Linkenbach, J. W., and Perkins, H. W. (2003b, July). Most of us wear seatbelts: the process and outcomes of a 3-year statewide adult seatbelt campaign in Montana. Paper presented at the National Conference on the Social Norms Model, Boston, MA.

    Google Scholar 

  • Marlatt, G. A., Baer, J. S., Kivlahan, D. R., Dimeff, L. A., Larimer, M. E. et al (1998). Screening and brief intervention for high-risk college student drinkers: results from a two-year follow-up assessment. J Consult Clin Psychol, 66, 604–615.

    Article  PubMed  CAS  Google Scholar 

  • Miller, D. T., and McFarland, C. (1987). Pluralistic ignorance: when similarity is interpreted as dissimilarity. J Pers Soc Psychol, 53, 298–305.

    Article  Google Scholar 

  • Montaño, D. E., Thompson, B., Taylor, V. M., and Mahloch, J. (1997). Understanding mammography intention and utilization among women in an inner city public hospital clinic. Prev Med, 26, 817–824.

    Article  PubMed  Google Scholar 

  • Mrazek, P. J., and Haggerty, R. J. (1994). Reducing Risks for Mental Disorders: Frontiers for Preventive Intervention Research. Washington, DC: National Academies Press.

    Google Scholar 

  • Murphy-Hoefer, R., Hyland, A., and Higbee, C. (2008). Perceived effectiveness of tobacco countermarketing advertisements among young adults. Am J Health Behav, 32, 725–734.

    Article  PubMed  Google Scholar 

  • Mutterperl, J. A., and Sanderson, C. A. (2002). Mind over matter: internalization of the thinness norm as a moderator of responsiveness to norm misperception information. Health Psychol, 21, 519–523.

    Article  PubMed  Google Scholar 

  • Neighbors, C., Larimer, M. E., and Lewis, M. A. (2004). Targeting misperceptions of descriptive drinking norms: efficacy of a computer-delivered personalized normative feedback intervention. J Consult Clin Psychol, 72, 434–447.

    Article  PubMed  Google Scholar 

  • Nolan, J. M., Schultz, P. W., Cialdini, R. B., Goldstein, N. J., and Griskevicius, V. (2008). Normative social influence is underdetected. Pers Soc Psychol Bull, 34, 913–923.

    Article  PubMed  Google Scholar 

  • Perkins, H. W. (2003). The promise and challenge of future work using the social norms model. In H. W. Perkins (Ed.), The Social Norms Approach to Preventing School and College Age Substance Abuse: A Handbook for Educators, Counselors, and Clinicians (pp. 280–296). San Francisco: Jossey-Bass.

    Google Scholar 

  • Perkins, H. W. and Berkowitz, A. D. (1986). Perceiving the community norms of alcohol use among students: some research implications for campus alcohol education programming. Int J Addict, 21, 961–976.

    PubMed  CAS  Google Scholar 

  • Perkins, H. W., and Craig, D. W. (2003a). The Hobart and William and Smith Colleges experiment: a synergistic social norms approach using print, electronic media, and curriculum infusion to reduce collegiate problem drinking. In H. W. Perkins (Ed.), The Social Norms Approach to Preventing School and College Age Substance Abuse: A Handbook for Educators, Counselors, and Clinicians (pp. 35–64). San Francisco: Jossey-Bass.

    Google Scholar 

  • Perkins, H. W., and Craig, D. W. (2003b). The imaginary lives of peers: patterns of substance use and misperceptions of norms among secondary school students. In H. W. Perkins (Ed.), The Social Norms Approach to Preventing School and College Age Substance Abuse: A Handbook for Educators, Counselors, and Clinicians (pp. 209–223). San Francisco: Jossey-Bass.

    Google Scholar 

  • Perkins, H. W., Haines, M. P., and Rice, R. (2005). Misperceiving the college drinking norm and related problems: a nationwide study of exposure to prevention information, perceived norms, and student alcohol misuse. J Stud Alcohol, 66, 470–478.

    PubMed  Google Scholar 

  • Prentice, D. A., and Miller, D. T. (1993). Pluralistic ignorance and alcohol use on campus: some consequences of misperceiving the social norm. J Pers Soc Psychol, 64, 243–256.

    Article  PubMed  CAS  Google Scholar 

  • Reno, R. R., Cialdini, R. B., and Kallgren, C. A. (1993). The transsituational influence of social norms. J Pers Soc Psychol, 64, 104–112.

    Article  Google Scholar 

  • Rivis, A. and Sheeran, P. (2003). Descriptive norms as an additional predictor in the theory of planned behaviour: a meta-analysis. Curr Psychol, 22, 218–233.

    Article  Google Scholar 

  • Ross, L. (1977). The intuitive psychologist and his shortcomings: distortions in the attribution process. In L. Berkowitz (Ed.), Advances in Experimental Social Psychology, vol. 10 (pp. 173–220). San Diego: Academic Press.

    Google Scholar 

  • Ross, L., Greene, D., and House, P. (1977). The false consensus phenomenon: an attributional bias in self-perception and social perception processes. J Exp Soc Psychol, 13, 279–301.

    Article  Google Scholar 

  • Sanderson, C. A., Darley, J. M., and Messinger, C. S. (2002). “I’m not as thin as you think I am”: the development and consequences of feeling discrepant from the thinness norm. Pers Soc Psychol Bull, 28, 172–183.

    Article  Google Scholar 

  • Sargent, J. D., Beach, M. L., Adachi-Mejia, A. M., Gibson, J. J., Titus-Ernstoff, L. T. et al (2005). Exposure to movie smoking: its relation to smoking initiation among US adolescents. Pediatrics, 116, 1183–1191.

    Article  PubMed  Google Scholar 

  • Schmiege, S. J., Aiken, L. S., Sander, J. L., and Gerend, M. A. (2007). Osteoporosis prevention among young women: psychosocial models of calcium consumption and weight-bearing exercise. Health Psychol, 26, 577–587.

    Article  PubMed  Google Scholar 

  • Scholly, K., Katz, A. R., Gascoigne, J., and Holck, P. S. (2005). Using social norms theory to explain perceptions and sexual health behaviors of undergraduate college students: an exploratory study. J Am Coll Health, 53, 159–166.

    Article  PubMed  Google Scholar 

  • Schultz, P. W., Nolan, J. M., Cialdini, R. B., Goldstein, N. J., and Griskevicius, V. (2007). The constructive, destructive, and reconstructive power of social norms. Psychol Sci, 18, 429–434.

    Article  PubMed  Google Scholar 

  • Schwartz, S. H. (1977). Normative influences on altruism. In L. Berkowitz (Ed.), Advances in Experimental Social Psychology, vol. 10 (pp. 221–279). New York: Academic Press.

    Google Scholar 

  • Sheeran, P., Abraham, C., and Orbell, S. (1999). Psychosocial correlates of heterosexual condom use: a meta-analysis. Psychol Bull, 125, 90–132.

    Article  PubMed  CAS  Google Scholar 

  • Sher, K. J., Bartholow, B. D., and Nanda, S. (2001). Short- and long-term effects of fraternity and sorority membership on alcohol use: a social norms perspective. Psychol Addict Behav, 15, 42–51.

    Article  PubMed  CAS  Google Scholar 

  • Sherif, M. (1936). The Psychology of Social Norms. New York: Harper Collins.

    Google Scholar 

  • Smith, J. R., and Louis, W. R. (2008). Do as we say and as we do: the interplay of descriptive and injunctive group norms in the attitude-behaviour relationship. Br J Soc Psychol, 47, 647–666.

    Article  PubMed  Google Scholar 

  • Smith-McLallen, A., and Fishbein, M. (2008). Predictors of intentions to perform six cancer-related behaviours: roles for injunctive and descriptive norms. Psychol Health Med, 13, 389–401.

    Article  PubMed  Google Scholar 

  • Stewart, L. P., Lederman, L. C., Golubow, M., Cattafesta, J. L., Goodhart, F. W. et al (2002). Applying communication theories to prevent dangerous drinking among college students: the R U sure campaign. Commun Stud, 53, 381–399.

    Article  Google Scholar 

  • Stiff, J. B., and Mongeau, P. A. (2003). Persuasive Communication, 2nd Ed. New York: Guilford.

    Google Scholar 

  • Story, M., Kaphingst, K. M., Robinson-O’Brien, R., and Glanz, K. (2008). Creating healthy food and eating environments: policy and environmental approaches. Annu Rev Public Health, 29, 253–272.

    Article  PubMed  Google Scholar 

  • Strasburger, V. C. (2009). Media and children: what needs to happen now? JAMA, 301, 2265–2266.

    Article  PubMed  CAS  Google Scholar 

  • Terry, D., and Hogg, M. (1996). Group norms and the attitude-behavior relationship: a role for group identification. Pers Soc Psychol Bull, 22, 776–793.

    Article  Google Scholar 

  • Trafimow, D., and Finlay, K. A. (1996). The importance of subjective norms for a minority of people: between-subjects and within-subjects analyses. Pers Soc Psychol Bull, 22, 820–828.

    Article  Google Scholar 

  • Trafimow, D., and Fishbein, M. (1994). The moderating effect of behavior type on the subjective norm-behavior relationship. J Soc Psychol, 134, 755–763.

    Article  Google Scholar 

  • Tversky, A., and Kahneman, D. (1973). Availability: a heuristic for judging frequency and probability. Cogn Psychol, 5, 207–232.

    Article  Google Scholar 

  • Wechsler, H., Nelson, T., Lee, J. E., Seiberg, M., Lewis, C. et al (2003). Perception and reality: a national evaluation of social norms marketing interventions to reduce college students’ heavy alcohol use. J Stud Alcohol, 64, 484–494.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Allecia E. Reid .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2010 Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Reid, A.E., Cialdini, R.B., Aiken, L.S. (2010). Social Norms and Health Behavior. In: Steptoe, A. (eds) Handbook of Behavioral Medicine. Springer, New York, NY. https://doi.org/10.1007/978-0-387-09488-5_19

Download citation

Publish with us

Policies and ethics