{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T13:48:06Z","timestamp":1792590486625,"version":"4.5.0"},"reference-count":54,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T00:00:00Z","timestamp":1781654400000},"content-version":"unspecified","delay-in-days":16,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Tobacco-Related Disease Research Program (TRDRP) of the University of California, Office of the President","award":["T31IR-1584, T32IR-4988, T32CF4745"],"award-info":[{"award-number":["T31IR-1584, T32IR-4988, T32CF4745"]}]},{"DOI":"10.13039\/100005002","name":"California Department of Public Health","doi-asserted-by":"publisher","award":["Contract #22-10341"],"award-info":[{"award-number":["Contract #22-10341"]}],"id":[{"id":"10.13039\/100005002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["bmjph"],"accepted":{"date-parts":[[2026,5,26]]},"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Changing social norms on cigarette smoking are proposed as a primary strategy to reduce smoking behaviour.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using core questions in 30 years of tobacco use supplements (TUS) to the Current Population Survey (CPS), we develop a state-specific, injunctive social norm scale of Willingness to Restrict Smoking (WTRS) and test its association with smoking behaviours. Respondents (n=1 462 050) to US national and state representative TUS-CPS conducted at nine regular intervals from 1992 to 2022.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Respondents were queried on their WTRS in 10 different settings, which varied somewhat over time. Psychometric analyses of 10 items supported a single primary dimension that accounted for 74% (SD: 7.3%) of estimated common variance. Using item response theory methods, we calibrated scores across different years and demonstrated consistency of measurement over time (differential test functioning (DTF) across adjacent years = &lt;1% difference in scores). The resulting WTRS scale had good reliability (omega-h\n                      <jats:sub>mean<\/jats:sub>\n                      = 0.75, SD=0.04 and alpha\n                      <jats:sub>mean<\/jats:sub>\n                      =0.81, SD=0.03). Construct and concurrent validity of the scale were shown with regression analyses with outcomes of current cigarette smoking (p&lt;0.001) and presence of home smoking restrictions (p&lt;0.001). An 87% correlation between state-averaged smoking prevalence and WTRS score was observed over the 30-year period. The adjusted OR (AOR) of being a person who smokes for people in states with the lowest versus highest quartiles of states for the WTRS score was 0.74 (95% CI 0.69 to 0.76) which can be compared with the same OR between the lowest and highest quartiles of cigarette prices. (AOR=0.84, 95%\u2009CI 0.84 to 0.92).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This WTRS social norm scale was likely influenced by state tobacco control programmes targeting social norms and appears to be a strong indicator of declining smoking prevalence across 30 years of US data.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjph-2024-002389","type":"journal-article","created":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T09:10:11Z","timestamp":1781687411000},"page":"e002389","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Social norms and the decline in US cigarette smoking: evidence from 30 years of US representative surveys"],"prefix":"10.1136","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5383-9032","authenticated-orcid":false,"given":"David R","family":"Strong","sequence":"first","affiliation":[{"name":"Moores Cancer Center, University of California San Diego, La Jolla, California, USA"},{"name":"Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John P","family":"Pierce","sequence":"additional","affiliation":[{"name":"Moores Cancer Center, University of California San Diego, La Jolla, California, USA"},{"name":"Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"Messer","sequence":"additional","affiliation":[{"name":"Moores Cancer Center, University of California San Diego, La Jolla, California, USA"},{"name":"Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Dang","sequence":"additional","affiliation":[{"name":"Moores Cancer Center, University of California San Diego, La Jolla, California, USA"},{"name":"Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"McMenamin","sequence":"additional","affiliation":[{"name":"Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew D","family":"Stone","sequence":"additional","affiliation":[{"name":"Moores Cancer Center, University of California San Diego, La Jolla, California, USA"},{"name":"Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dennis R","family":"Trinidad","sequence":"additional","affiliation":[{"name":"Moores Cancer Center, University of California San Diego, La Jolla, California, USA"},{"name":"Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,6,17]]},"reference":[{"key":"2026061702100611000_4.2.e002389.1","unstructured":"Swanson GE , TM N , Hartley EL , eds. 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