{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T01:05:47Z","timestamp":1791594347229,"version":"4.3.4"},"reference-count":198,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,10,12]],"date-time":"2024-10-12T00:00:00Z","timestamp":1728691200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2024,10,12]],"date-time":"2024-10-12T00:00:00Z","timestamp":1728691200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100014631","name":"Chartered Society of Forensic Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100014631","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Tobacco use spreads through social networks influencing social norms around tobacco use. However, the social norms scholarship is extremely diverse and occasionally conflicting, complicating efforts to understand how best to leverage social norms to reduce tobacco use. This study systematically reviewed and meta\u2010analyzed this vast terrain by focusing on social norms measurement and mechanism, and intervention effectiveness and modality aimed at changing social norms around tobacco use and actual tobacco use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We searched Scopus, PubMed, PsycInfo,\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/Clinicaltrials.gov\">Clinicaltrials.gov<\/jats:ext-link>\n                      , ProQuest Dissertations, the Cochrane Trial Registry, as well as the websites of the Society for Research on Nicotine and Tobacco, the Open Science Framework, medrXiv and the Truth Initiative for experimental and quasi\u2010experimental evaluation studies of interventions designed to shift tobacco use. We included studies written in English from inception to 30 May 2024. We only included studies which noted social norms or social influence as part of the intervention design or set of measured variables. We excluded studies with only one time point, without an intervention being evaluated\u00a0and those not published in English. Study screening followed the PRISMA 2020 guidelines, and was conducted by at least two independent reviewers who resolved discrepancies through discussion and consensus. All included studies were analyzed in a narrative synthesis, and those providing sufficient statistics for tobacco and social norms outcomes were included in meta\u2010analyses, which were performed separately for tobacco outcomes and social norms outcomes. Study outcomes were transformed into a standardized mean difference (Hedges'\n                      <jats:italic>g<\/jats:italic>\n                      ) and several meta\u2010regressions were fit to explore sources of heterogeneity using a robust variance estimation specification to handle effect size dependency.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 95 studies met inclusion criteria for the narrative synthesis, 200 effect sizes from 86 studies were included in the tobacco outcomes meta\u2010analysis, and 66 effect sizes from 29 studies were included in the social norms outcomes meta\u2010analysis. Nearly 90% of included studies were conducted in high\u2010income settings, with the remainder conducted in middle\u2010income settings. No studies were conducted in Latin America or on the African continent. Social norms change interventions had a statistically significant effect on reducing tobacco use and pro\u2010tobacco social normative perceptions [\n                      <jats:italic>g<\/jats:italic>\n                      \u2009=\u20090.233, 95% confidence interval (CI)\u2009=\u20090.166, 0.301,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001 and\n                      <jats:italic>g<\/jats:italic>\n                      \u2009=\u20090.292, 95% CI\u2009=\u20090.090, 0.494,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.007, respectively]. Interventions were commonly conducted among schoolchildren in classrooms through multicomponent education sessions, often coupled with regular \u2018booster' sessions over time. Among adult populations, motivational interviewing and other counselling approaches were used in some cases, and few interventions leveraged digital technologies to change social norms.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Social norms change interventions appear to be effective for reducing tobacco use and pro\u2010tobacco social normative perceptions. In particular, leveraging role models appears to be the most effective social norms change mechanisms for tobacco control.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/add.16685","type":"journal-article","created":{"date-parts":[[2024,10,12]],"date-time":"2024-10-12T06:54:28Z","timestamp":1728716068000},"page":"215-235","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Understanding the mechanisms of change in social norms around tobacco use: A systematic review and meta\u2010analysis of interventions"],"prefix":"10.1111","volume":"120","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9797-9566","authenticated-orcid":false,"given":"Shaon","family":"Lahiri","sequence":"first","affiliation":[{"name":"Department of Health and Human Performance, School of Health Sciences College of Charleston  Charleston SC USA"},{"name":"Department of Prevention and Community Health, Milken Institute School of Public Health The George Washington University  Washington DC USA"},{"name":"Center for Social Norms and Behavioral Dynamics University of Pennsylvania  Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey B.","family":"Bingenheimer","sequence":"additional","affiliation":[{"name":"Department of Prevention and Community Health, Milken Institute School of Public Health The George Washington University  Washington DC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W. Douglas","family":"Evans","sequence":"additional","affiliation":[{"name":"Department of Prevention and Community Health, Milken Institute School of Public Health The George Washington University  Washington DC USA"},{"name":"Department of Global Health, Milken Institute School of Public Health The George Washington University  Washington DC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Prevention and Community Health, Milken Institute School of Public Health The George Washington University  Washington DC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ben","family":"Cislaghi","sequence":"additional","affiliation":[{"name":"Makerere University  Kampala Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priyanka","family":"Dubey","sequence":"additional","affiliation":[{"name":"School of Public and Population Health Boise State University  Boise ID USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bobbi","family":"Snowden","sequence":"additional","affiliation":[{"name":"Department of Global Health, Milken Institute School of Public Health The George Washington University  Washington DC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,10,12]]},"reference":[{"key":"e_1_2_10_2_1","volume-title":"Tobacco","author":"World Health Organization","year":"2023"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-022-01978-x"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)01169-7"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/tc-2022-057669"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/tc.2010.039982"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-015-2041-6"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/tobaccocontrol-2013-051110"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.addbeh.2015.01.023"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.21037\/jtd.2020.02.23"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph16193622"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0132401"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/tobaccocontrol-2011-050098"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/CEJ.0b013e3282f75e48"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/tobaccocontrol-2014-051819"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10198-019-01090-x"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/tobaccocontrol-2020-055874"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1080\/19312458.2018.1483017"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/ntr\/ntab216"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjhp.12317"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.a1655"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12160-016-9816-6"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1080\/17437199.2020.1719184"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-023-28161-7"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2020.00377"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2019.08.023"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/add.15427"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/add.13224"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1177\/1745691619866455"},{"key":"e_1_2_10_30_1","volume-title":"What are social norms? 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