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Background and Aims: 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-analyzed 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., Methods: We searched Scopus, PubMed, PsycInfo, Clinicaltrials.gov, 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-experimental 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 and 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-analyses, which were performed separately for tobacco outcomes and social norms outcomes. Study outcomes were transformed into a standardized mean difference (Hedges' g) and several meta-regressions were fit to explore sources of heterogeneity using a robust variance estimation specification to handle effect size dependency., Results: 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-analysis, and 66 effect sizes from 29 studies were included in the social norms outcomes meta-analysis. Nearly 90% of included studies were conducted in high-income settings, with the remainder conducted in middle-income 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-tobacco social normative perceptions [g = 0.233, 95% confidence interval (CI) = 0.166, 0.301, P < 0.001 and g = 0.292, 95% CI = 0.090, 0.494, P = 0.007, respectively]. Interventions were commonly conducted among schoolchildren in classrooms through multicomponent education sessions, often coupled with regular 'booster' 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., Conclusions: Social norms change interventions appear to be effective for reducing tobacco use and pro-tobacco social normative perceptions. In particular, leveraging role models appears to be the most effective social norms change mechanisms for tobacco control., (© 2024 The Author(s). Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.)

Background and Aims: Family history of substance use disorder (SUD) affects a child's risk of the disorder through both genetic and shared environmental factors. We aimed to estimate the association between parental or older sibling SUD history with the risk of adolescent SUD diagnosis., Design, Setting and Participants: We conducted a population-based cohort study using administrative health-care databases in the Province of Manitoba, Canada, which has a universal and publicly funded health-care system. We included all children born from 1984 to 2000 who have linkages to both parents and were followed until age 18 years. We used generalized estimating equation models to produce unadjusted and adjusted relative risk (RR) estimates of adolescent SUD risk. The study cohort included 134 389 children and 31 307 full sibling pairs; 51.3% were male and 35.4% first-born., Measurements: The exposure was SUD diagnosis in a mother or father in either hospitalization or outpatient physician visit records before the children's age of 13 years. The secondary exposure was an adolescent SUD diagnosis in an older full sibling. The outcome was SUD diagnosis during adolescence (13 and 18 years of age) identified in either hospitalization or physician visit records. Children demographics and characteristics associated with SUD diagnosis were included in the models., Findings: Of the 134 389 children, 9.5% had a mother with a history of SUD, 11.3% had a father and 1.3% had an older sibling with a history of SUD diagnosis; 2566 (1.9%) had an adolescent SUD diagnosis. An increased risk of adolescent SUD was observed with SUD history in mothers [adjusted RR (aRR) = 2.50; 95% confidence interval (CI) = 2.26, 2.79], fathers (aRR = 2.15; 95% CI = 1.95, 2.37), both parents (aRR = 3.74; 95% CI = 3.24, 4.31) and older sibling (aRR = 3.85; 95% CI = 2.53, 5.87)., Conclusions: A family history of substance use disorder in parents or older siblings appears to be associated with increased SUD risk in adolescents., (© 2022 Society for the Study of Addiction.)

Background and Aims: The growing body of research evidence on substance use and substance use disorder (SU/SUD) prevention could be leveraged to strengthen the intended impact of policies that address SU/SUD. The aim of the present study was to explore how research was used in United States federal legislation that emphasized SU/SUD prevention., Design: Using a mixed-methods approach, we assessed whether the use of research predicted a bill's legislative progress. We randomly sampled 10 bills that represented different types of research keywords to examine how research was used in these bills, applying content analysis., Setting: United States Congress., Participants/cases: Federal legislation introduced between the 101st and the 114th Congresses (1989-2017; n = 1866)., Measurements: The quantitative outcome measures were bills' likelihood of passing out of committee and being enacted. Qualitative outcomes included the ways research was used in legislation., Findings: Bills that used any research language were 2.2 times more likely to pass out of committee (OR = 2.18; 95% CI, 1.75, 2.72) and 82% more likely to be enacted (OR = 1.82; 95% CI, 1.23, 2.69) than bills not using research language. Bills using dissemination words were 57% more likely to pass out of committee (OR = 1.57; CI, 1.08, 2.28) and analysis words were 93% more likely (OR = 1.93; 95% CI, 1.51, 2.47) than bills not using dissemination or analysis words. Research was used to (i) define the problem to justify legislative action, (ii) address the problem by providing funding, and (iii) address the problem through industry regulations. However, there was a lack of research use that targets underlying risk and protective factors., Conclusions: In the US Congress, substance use and substance use disorder prevention bills that use research language appear to be more likely to progress in the legislative cycle than bills that do not, suggesting that legislation using research may be viewed as more credible., (© 2022 Society for the Study of Addiction.)