BACKGROUND: Overestimations of non-prescribed stimulant use of peers are well documented in the USA 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. 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, 4482 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. 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. 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.

Department of Health Sciences Public University of Navarra 31008 Pamplona Navarra Spain

Department of Psychiatry Marmara University School of Medicine 34722 Istanbul Turkey

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

Leibniz Institute for Prevention Research and Epidemiology 28359 Bremen Germany

Leibniz Institute for Prevention Research and Epidemiology 28359 Bremen Germany; Health Sciences Bremen University of Bremen 28359 Bremen Germany

Medical Sociology and Health Policy University of Antwerp 2610 Antwerp Belgium

Medical Sociology and Health Policy University of Antwerp 2610 Antwerp Belgium; Research and Development Occupational Health Services Mensura 2000 Antwerp Belgium

School of Psychology Sport and Exercise Staffordshire University Stoke On Trent ST4 2DF United Kingdom

Unit for Health Promotion Research University of Southern Denmark 6700 Esbjerg Denmark

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