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.

Department of Educational Psychology and Health Psychology PJ Safarik University Kosice Slovakia

Department of Epidemiology Helmholtz Centre for Infection Research Inhoffenstr 7 33824 Braunschweig Germany

Department of Health Sciences Faculty of Health Sciences Public University of Navarra Avda de Baranain s n 31008 Pamplona Navarra Spain

Department of Psychiatry Marmara University School of Medicine 34899 Istanbul Turkey

Division of Psychology University of Bradford Bradford BD7 1DP United Kingdom

Division of Psychology University of Bradford Bradford BD7 1DP United Kingdom; School of Psychology Sport and Exercise Staffordshire University Science Center Leek Road Stoke On Trent ST4 2DF United Kingdom

Epidemiology and Social Medicine University of Antwerp Campus Drie Eiken Universiteitsplein 1 2610 Wilrijk Antwerp Belgium

Institute of Active Lifestyle Palacky University of Olomouc 771 47 Olomouc Czech Republic

Leeds Institute of Health Sciences School of Medicine University of Leeds 101 Clarendon Road West Yorkshire LS2 9LJ Leeds United Kingdom

Leibniz Institute for Prevention Research and Epidemiology BIPS Achterstr 30 28359 Bremen Germany

Research and Development Occupational Health Services Mensura Italiëlei 2 2000 Antwerp Belgium; Epidemiology and Social Medicine University of Antwerp Campus Drie Eiken Universiteitsplein 1 2610 Wilrijk Antwerp Belgium

Unit for Health Promotion Research University of Southern Denmark Niels Bohrs Vej 9 6700 Esbjerg Denmark

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