The impact of social norm change strategies on smokers' quitting behaviours.

Objective: Using a social norm change paradigm model that reflects the California Tobacco Control Program's (CTCP) priorities, we compare the strength of the relationship of the social norm constructs to key smoking behavioural outcomes.
Methods: Social norm constructs that correspond to CTCP's priority areas were created from selected California Adult Tobacco Survey knowledge, attitude and belief questions using confirmatory factor analysis. We then examined the relationship between these constructs and quitting behaviours using logistic regression.
Results: The secondhand smoke (SHS) and countering pro-tobacco influences'(CPTI) constructs followed a dose-response curve with quitting behaviours. Respondents who rated high on the SHS construct were about 70% more likely to have made a recent quit attempt in the last 12 months and about 100% more likely to intend to quit in the next 6 months than respondents who rated low on the SHS construct. For CPTI, respondents who rated high on this construct were 67% more likely to have made a recent quit attempt in the last 12 months and 62% more likely to have intentions to quit in the next 6 months than respondents who rated low on the CPTI construct.
Conclusion: Social norm change constructs represent CTCP's priorities and are strongly related to desired individual behaviour outcomes. This analysis provides strong support for the framework underlying CTCP--namely, that changing social norms affects behaviour change at the individual level through changing population-level smoking-related behaviours.