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\ud Background: Overestimations of non-prescribed stimulant use of peers are well documented in the U.S.A. and have also been identified as predictive of personal stimulant consumption. This study aimed to examine whether overestimations of peer use and approval of the use are associated with personal use and attitude towards the use of non-prescribed stimulants among European university students.\ud Method: The EU funded ‘Social Norms Intervention for the prevention of Polydrug usE (SNIPE)’ study was conducted in seven European countries. In a web-based questionnaire, 4,482 students were asked about their personal use and their attitude towards non-prescribed stimulant use, as well as the perceived peer use and peer attitude.\ud Results: 59% of students thought that the majority of their peers used non-prescribed stimulants more frequently than themselves, and only 4% thought that the use of the majority was lower than their personal use. The perception that the majority of peers had used non-prescribed stimulants at least once was significantly associated with higher odds for personal use of non-prescribed stimulants (OR: 3.30, 95% CI: 2.32-4.71). In addition, the perception that the majority of peers approved of the non-prescribed use of stimulants was associated with a 4.03 (95% CI: 3.35-4.84) times higher likelihood for personal approval.\ud Discussion: European university students generally perceived the non-prescribed use of stimulants of peers to be higher than their personal use. This perception, as well as a perception of higher approval in the peer group, was associated with a higher likelihood of personal non-prescribed stimulant medication use and approval.

Objective: Perceptions of peer behavior and attitudes exert considerable social pressure on young adults to use substances. This study investigated whether European students perceive their peers’ cannabis use and approval of cannabis use to be higher than their own personal behaviors and attitudes, and whether estimations of peer use and attitudes are associated with personal use and attitudes. Method: University students (n = 4131) from Belgium, Denmark, Germany, the Slovak Republic, Spain, Turkey and the United Kingdom completed an online survey as part of the Social Norms Intervention for Polysubstance usE in students (SNIPE) project, a feasibility study of a web-based normative feedback intervention for substance use. The survey assessed students’ (1) personal substance use and attitudes, and (2) perceptions of their peers’ cannabis use (descriptive norms) and attitudes (injunctive norms). Results: Although most respondents (92%) did not personally use cannabis in the past two months, the majority of students thought that the majority of their peers were using cannabis and that their peers had more permissive attitudes towards cannabis than themselves. Controlling for students’ age, sex, study year and religious beliefs, perceived peer descriptive norms were associated with personal cannabis use (OR: 1.42; 95% CI: 1.22, 1.64) and perceived injunctive norms were associated with personal attitudes towards cannabis use (OR: 1.46; 95% CI: 1.09, 1.94). Conclusions: European students appear to possess similar discrepancies between personal and perceived peer norms for cannabis use and attitudes as found in North American students. Interventions which address such discrepancies may be effective in reducing cannabis use. Keywords: cannabis, social norms, student health, social influence

Introduction: Research conducted in North America suggests that students tend to overestimate tobacco use among their peers. This perceived norm may impact personal tobacco use. It remains unclear how these perceptions influence tobacco use among European students. The two aims were to investigate possible self-other discrepancies regarding personal use and attitudes towards use and to evaluate if perceptions of peer use and peer approval of use are associated with personal use and approval of tobacco use. Methods: The EU-funded 'Social Norms Intervention for the prevention of Polydrug usE' study was conducted in Belgium, Denmark, Germany, Slovak Republic, Spain, Turkey and United Kingdom. In total, 4482 students (71% female) answered an online survey including questions on personal and perceived tobacco use and personal and perceived attitudes towards tobacco use. Results: Across all countries, the majority of students perceived tobacco use of their peers to be higher than their own use. The perception that the majority (> 50%) of peers used tobacco regularly in the past two months was significantly associated with higher odds for personal regular use (OR: 2.66, 95% CI: 1.90–3.73). The perception that the majority of peers approve of tobacco use was significantly associated with higher odds for personal approval of tobacco use (OR: 6.49, 95% CI: 4.54–9.28). Conclusions: Perceived norms are an important predictor of personal tobacco use and attitudes towards use. Interventions addressing perceived norms may be a viable method to change attitudes and tobacco use among European students, and may be a component of future tobacco control policy. Funding for this study was provided by the European Commission, Directorate Gener-al Justice, Freedom and Security (grant number: JLS/2009-2010/DPIP/AG). BB has been a recipient of a research grant provided by the European Research Advisory Board (ERAB).

Objective: The objective of this study was to explore perceptions of peer substance use and related attitudes among European students. Challenging perceptions about peer substance use has become the basis of a form of prevention and intervention known as the social norms approach, which can be delivered using personalized online feedback. This article reports baseline alcohol use and attitudes data for university students across Europe collected as part of the Social Norms Intervention for the prevention of Polydrug usE project (Project SNIPE). Method: Students from universities in Belgium, Denmark, Germany, the Slovak Republic, Spain, Turkey, and the United Kingdom were recruited to take part in an online survey by the use of email invitations, social media, classroom announcements, flyers, and stalls in social areas, such as in cafeterias and bars on campus. A total of 4,482 students agreed to participate. Results: Overall, respondents reported both perceived alcohol use and perceived acceptance of alcohol use among their peers that were higher than their own use or acceptance. Perceived peers behaviors and attitudes were found to be predictive of personal behaviors and attitudes, with some variation across countries and by sex. Conclusions: The results suggest that students at the participating institutions across selected European countries exhibit overall similar patterns of perceptions as have been found on American college campuses. In conjunction with the finding that the perceived norm is predictive of personal behavior and attitudes, this research provides support to the view that the social norms approach may be a viable method to reduce alcohol consumption among students at European universities.

Background: Incorrect perceptions of high rates of peer alcohol and tobacco use are predictive of increased personal use in student populations. Correcting misperceptions by providing feedback has been shown to be an effective intervention for reducing licit drug use. It is currently unknown if social norms interventions are effective in preventing and reducing illicit drug use in European students. The purpose of this paper is to describe the design of a multi-site cluster controlled trial of a web-based social norms intervention aimed at reducing licit and preventing illicit drug use in European university students. Methods/Design: An online questionnaire to assess rates of drug use will be developed and translated based on existing social norms surveys. Students from sixteen universities in seven participating European countries will be invited to complete the questionnaire. Both intervention and control sites will be chosen by convenience. In each country, the intervention site will be the university that the local principal investigator is affiliated with. We aim to recruit 1000 students per site (baseline assessment). All participants will complete the online questionnaire at baseline. Baseline data will be used to develop social norms messages that will be included in a web-based intervention. The intervention group will receive individualized social norms feedback. The website will remain online during the following 5 months. After five months, a second survey will be conducted and effects of the intervention on social norms and drug use will be measured in comparison to the control site. Discussion: This project is the first cross-national European collaboration to investigate the feasibility of a social norms intervention to reduce licit and prevent illicit drug use among European university students. Final trial registration number DRKS00004375 on the ‘German Clinical Trials Register’. This study is funded by the European Commission, Directorate General Justice, Freedom and Security (JLS/2009-2010/DPIP/AG)