Social Norms Research Articles

The prohibitions against murder and incest: transgressions and consequences

The link between incest and domestic violence is explored. Violence is an inherent characteristic of humanity, but its expression is supposed to be channeled by family and societal norms, notably the fundamental prohibitions of murder and incest. The aggressor's act lies outside these common norms, while the victims are often made vulnerable by a family past marked by violence.

Barriers and Facilitators in Lactation Support for the Preterm Mother-Infant Dyad: An Integrated Approach.

Breastfeeding offers significant health benefits for both mothers and infants, particularly preterm infants, where it serves as a therapeutic strategy to reduce mortality and morbidities. However, breastfeeding practices are threatened globally by societal norms and systemic barriers at both micro and macro levels. This paper explores the complex interplay of these barriers and facilitators, focusing on the Neonatal Intensive Care Unit (NICU) setting. Preterm infants face specific feeding challenges due to immature physiological functions, yet evidence supports that strategies like cue-based feeding and individualized care can enhance feeding success and health outcomes. For mothers, initiating and maintaining lactation after preterm birth is critical but challenging, with early lactation support and achieving sufficient milk volume being key predictors of success. Partner support significantly influences lactation outcomes, although more inclusive research is needed for diverse family structures. In the NICU, a multidisciplinary approach to lactation care is vital, emphasizing the need for experienced staff and family-centered practices. NICU design, policies promoting parental presence, and adherence to Baby-friendly Hospital Initiative guidelines further support breastfeeding. This paper aims to provide directives for local breastfeeding policies through an integrated approach, considering societal attitudes and healthcare practices. The findings advocate for improved lactation support in NICUs, inclusive language and policies, and further research into diverse familial and gender roles in breastfeeding.

Sustainable Steps in the Snow: Exploring factors associated with active school commuting in Finland

Physical inactivity of children and youth is a major health problem. Active commuting could increase the amount of physical activity and be a more environmentally friendly traffic mode choice compared with motorized vehicles. Parents have an integral role in determining the options a child has for commuting. We explored parental barriers and motivators associated with the active commute of their children.This cross-sectional study used the CLIMATE NUDGE Survey data of parents with school-aged children. A set of 25 possible influencing factors included demographic factors, social aspects, and pro-environmental attitudes, and questions about the motivating role of journey characteristics and health effects. The data were analyzed with two multinomial logistic regression analyses (N = 320): first, comparing those who either never or sometimes commute actively to those who always do so, and second, those who always or sometimes commute actively to those who never do so.Results indicated the strongest determinants to differentiate those who always and those who never use active commute, were commute distance and parental beliefs about social commute norms. The longer the commute distance was, the more likely the child was to belong to the never active commuter group and less likely to belong to the always active commuter group. The more parents believed their child’s peers commuted actively, the more likely it was that their child always commuted actively and less likely they never did so.We found several factors associated with active commuting, yet somewhat surprisingly neither environmental attitudes nor climate change related reasons were significantly associated with active commuting. To conclude, instead of highlighting environmental aspects to promote active commute, we recommend highlighting social norms and perception of the commute distance, and addressing weather-related barriers and health related motivators.

Disposable Bodies

This article examines figures of disability in the poetry of D. M. Aderibigbe to illuminate the fate of disabled Nigerians. It considers the connections between disability and social norms, showing how normative masculinity is implicated in the killings of persons with disabilities. It draws on Chielozona Eze’s discussion of disability and Judith Butler’s concept of grievability to analyze Aderibigbe’s critique of normative culture, while situating the analysis of his poetry within the critical scholarship on disability, gender, masculinities, and social justice. In the poems “Olumo’s Face” and “Ode to My Father’s Childhood,” Aderibigbe represents disabled bodies as disposable, which underscores the need to continue advocating for disability justice.

Interventions involving nudge theory for COVID-19 vaccination: A systematic review and meta-analysis.

New approaches to mitigate vaccine hesitancy and improve vaccine uptake are urgently needed. Nudging has shown effective results in several health areas. However, the effectiveness of interventions involving nudge theory in increasing COVID-19 vaccination remains unclear. We searched PubMed, Web of Science, and Scopus for randomized controlled trials published before December 31, 2022, to determine whether interventions involving nudge theory improved COVID-19 vaccination behavior and intent. Risk ratio (RR) and a 95% confidence interval (CI) were used as pooled measures to assess vaccination behavior. Intention to vaccinate was reported in a narrative synthesis. Sixteen randomized controlled trials involving 176,125 participants were included. Interventions involving nudge theory weakly boosted the COVID-19 vaccine uptake rate (RR = 1.21, 95% CI [1.07, 1.36], p < .01). Subgroup analysis showed a weak positive effect of social norms (RR = 2.04, 95% CI [1.61, 2.57]), defaults (RR = 1.32, 95% CI [1.03, 1.69]), and salient reminders (RR = 1.19, 95% CI [1.04, 1.36]). Nudge interventions integrating multiple components were more efficacious in increasing vaccination rates compared to nudge alone. The effect of nudging interventions weakened over time (p < .001). Most studies (10 of 11) involving vaccination intention outcomes showed positive or partially positive results. Interventions involving nudge theory can promote COVID-19 vaccination behavior and intentions. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

WASH recommendations for improving disaster preparedness and recovery in schools in Indonesia

Access to functional and clean toilets which maintain privacy and dignity and support girls’ Menstrual hygiene management (MHM) plays a crucial role to getting girls back to school post-disaster. This could also help in managing feelings of shame and disgust experienced when using toilets in schools in post disaster settings. In this paper, we report on our assessment of water, sanitation and hygiene (WASH) facilities in schools three-years post the 2018 multi-hazard event in Indonesia. We used a mixed-methods approach using visual observations, interviews with school principals, surveys with schoolgirls and focus group discussions with schoolgirls and teachers to understand the lived experiences of students using toilets at school. Our results highlight that across schools descriptive and injunctive social norms were supportive of littering, inadequate toilet facilities for girls to manage their menstruation and bullying and antisocial behaviour by opening toilet doors while the facilities were occupied. Based on these results, we developed two types of interventions, physical and behavioural, piloted in three schools to increase WASH and MHM awareness and the safety of sanitation facilities. Our interventions showed that approaches for WASH interventions in schools can only be designed if we understand the local barriers to carrying out interventions that integrate maintenance plans. We provide recommendations to support practitioners in mitigating risk and improving circumstances for girls in schools in Indonesia, which have the potential to address SDG 4 on inclusive and equitable education and SDG 5 on gender equality and girls’ empowerment.

An empirical evidence on the impact of social customer relationship management on the small and medium enterprises performance

Social media has swiftly established itself as a primary source of products’ information for customers. Nowadays, Small and Medium-size Enterprises (SMEs) can use social media to develop Customer Relationship Management platforms (social CRM). Firms, particularly SMEs in developing countries need to understand the factors affecting their performance by implementing social CRM. However, there is a dearth of awareness on the impact of social CRM on the performance of SMEs. This study proposes an integrated model that aims to investigate the effects of social CRM on SMEs’ performance. The model is constructed by incorporating three dominant theoretical frameworks: the Fit-Viability Model (FVM), Network Externalities, and the Resource-Based View (RBV). A cross-sectional survey was used to gather data from 149 SMEs managerial staff. Findings revealed that almost 50% of the variability in the performance of SMEs is explained by the fitness and viability of social CRM. In addition, network externalities of social media significantly impact the social CRM fitness in the context of SMEs with path coefficient 0.617. Furthermore, the internal financial resources factor makes sCRM viable for SMEs as the results show significant relationship between the internal financial resources and the sCRM viability with 0.536 path coefficient. Manager innovativeness, IT knowledge, top management support, and government assistance, on the other hand, do not contribute significantly to the viability of social CRM for SMEs. The model aids SMEs in making well-informed decisions regarding the adoption of social CRM by evaluating both the suitability of social media for CRM tasks and the enterprise preparedness to implement social CRM, leading to enhanced performance.

HUBUNGAN MODAL SOSIAL PETANI TERHADAP KEBERLANJUTAN USAHATANI JAGUNG KUNING DI DESA WAKADIA KECAMATAN WATOPUTE KABUPATEN MUNA

The objective of this study is to ascertain the correlation between farmers' social capital and the sustainability of yellow corn farming in Wakadia Village, Watopute Subdistrict, Muna Regency. The study population consisted of all yellow corn farmers in Wakadia Village, Watopute Subdistrict, Muna Regency, comprising a total of 103 households. The number of samples was determined using the Slovin formula with a 10% error margin, resulting in a sample size of 51 respondents. The sampling technique employed was simple random sampling. The data collection techniques employed included surveys, interviews, and document analysis, with data collected using questionnaires. This study employs two variables: social capital, comprising trust, participation, networks, and social norms, and farm sustainability, encompassing economic, social, and environmental sustainability. The data were subjected to descriptive analysis using a class interval formula and a Rank Spearman correlation formula. The findings indicate that the social capital of farmers engaged in yellow corn farming in Wakadia Village, Watopute Subdistrict, Muna Regency is in an optimal category, suggesting that their social capital is capable of sustaining yellow corn farming over the long term. The sustainability of yellow corn farming in Wakadia Village is sufficient, indicating that farmers have implemented business sustainability indicators but still require improvement. There is a significant and positive relationship between farmers' social capital and yellow maize business sustainability in Wakadia Village.

Breaking barriers: The impact of girls’ education on poverty eradication in northern Nigeria – A Focus on Sokoto State

This research explores the critical role of girls' education in alleviating poverty in Sokoto State, Nigeria. It highlights the significant gender disparities in educational access, driven by cultural norms that prioritize boys' education, which impede both individual potential and broader economic growth. The research underscores that educated women contribute to workforce participation and family income, thereby fostering community development and reducing poverty. Despite some progress, challenges such as socio-cultural attitudes, inadequate infrastructure, and economic constraints persist, necessitating a multi-faceted approach involving policy reforms and community engagement. The study employs a mixed-methods methodology, revealing that while enrolment rates have improved, gender inequities remain pronounced. It advocates for targeted interventions and community involvement to shift perceptions and enhance girls' educational opportunities, ultimately aiming for sustainable development goals in Northern Nigeria.

Linguistic sensitivity in family therapy: A review of language adaptation strategies for enhancing therapeutic engagement

Language plays a pivotal role in family therapy, shaping the therapeutic process and influencing client engagement and outcomes. This review explores the significance of linguistic sensitivity in family therapy and examines various language adaptation strategies aimed at enhancing therapeutic engagement. Drawing upon existing literature, this paper synthesizes key findings and offers insights into effective approaches for addressing linguistic diversity within therapeutic contexts. Understanding the cultural and linguistic backgrounds of clients is essential for promoting inclusivity and facilitating effective communication in family therapy. Cultural competence encompasses not only an awareness of diverse cultural norms and values but also proficiency in navigating linguistic nuances. By recognizing the impact of language on therapeutic interactions, therapists can foster a more inclusive and empowering therapeutic environment. The review identifies several language adaptation strategies that therapists can employ to enhance therapeutic engagement with diverse client populations. These strategies include linguistic matching, which involves adjusting language patterns and communication styles to resonate with clients' linguistic preferences. Additionally, the use of culturally relevant metaphors, idioms, and storytelling techniques can facilitate deeper rapport and understanding between therapists and clients. Furthermore, the review discusses the importance of employing interpreters and bilingual therapists to bridge language barriers effectively. It emphasizes the need for clear communication protocols and the importance of training therapists in language adaptation techniques to ensure ethical and effective practice. Moreover, the review highlights the role of technology in language adaptation, such as the use of translation software and teletherapy platforms with multilingual capabilities. Leveraging technology can broaden access to therapy and support linguistic diversity in therapeutic settings. Linguistic sensitivity is fundamental to promoting inclusivity and effectiveness in family therapy. By adopting language adaptation strategies and embracing linguistic diversity, therapists can cultivate a more responsive and culturally competent approach to working with diverse families. This review underscores the importance of ongoing research and training initiatives to further enhance linguistic sensitivity within the field of family therapy.

The economics of gender norms

AbstractAn important dimension of social norms in any society are rules that describe and regulate the expected behavior, appearance, and demeanor of men and women. In this paper, I offer a short survey of how gender norms have been introduced and used in economics, what we know about how they are formed and transmitted and how they persist or change, and then consider how we might incorporate norms into economists’ perennial concerns about policy.

Rural-urban differentials in undernutrition among women in India: Evidence from a decomposition approach.

Background: Global healthcare and nutrition policies have not eliminated the pressing public health issue of undernutrition, which remains a paramount public health concern in countries like India, coinciding with overweight and obesity, in the form of dual burden of malnutrition. Aim: This study delves into the rural-urban differential in undernutrition among reproductive-aged women in India for targeted policy interventions and to achieve universal health coverage. Methods: Data from the recent iteration of the National Family Health Survey (NFHS-5; 2019-21) were utilized to examine the factors influencing rural-urban differentials in women's undernutrition. A set of logistic regression and Fairlie's decomposition analysis are employed to identify the associated covariates and understand the factors driving these differentials. Results: The analysis reveals that rural women are significantly more vulnerable to undernutrition compared to urban counterparts, with factors such as education, wealth status, age, and dietary diversity playing key roles. The decomposition analysis of the rural-urban gap revealed that the variables considered in the study accounted for approximately 75% of the disparity. The difference in household wealth between rural and urban areas contributed about 63% of the explained gap, followed by educational status (16%), age group (11%), dietary diversity (8%), religion (5%), and media exposure (4%). Conclusion: The findings underscore the importance of targeted interventions addressing socio-economic inequalities to mitigate undernutrition among women in India. Enhancing access to education, improving economic opportunities, promoting dietary diversity, and challenging cultural norms are crucial steps towards achieving equitable nutritional outcomes and reducing the existing rural-urban disparity.

Biopsychosocial Health Considerations for Astronauts in Long-Duration Spaceflight: A Narrative Review.

Long-duration spaceflights beyond low-Earth orbit, including missions to the Moon and Mars, pose significant health risks. Although biomedical approaches commonly appear in the literature, considering psychological and social factors alongside physiologic health offers a more holistic approach to astronaut care. Integrating the biopsychosocial (BPS) framework into medical planning addresses complex spaceflight challenges and aids in developing mitigation strategies. This review examined health risks associated with long-duration spaceflight within a BPS framework. Sources included governmental space agencies, academic textbooks, and relevant publications from multiple databases. Considering the National Aeronautics and Space Administration's Human Research Program's 5 main hazards, a conceptual model was developed to highlight the multifactorial BPS effects of spaceflight. In space, astronauts face unique environments and biological adaptations, including fluid shift, plasma volume loss, bone density loss, and muscle atrophy. Noise and the absence of natural light disrupt circadian rhythms, causing sleep disturbances and fatigue, which affect physical and mental health. Studies on crews in isolated and confined extreme environments reveal psychosocial challenges, including impaired mood and cognition, interpersonal tension, and miscommunication. International collaboration in spaceflight introduces differences in communication, problem solving, and social customs due to diverse cultural backgrounds. Upcoming long-distance missions likely will amplify these challenges. This review emphasizes BPS health considerations in long-duration spaceflight. It highlights the interplay among psychological, social, and biological factors, advocating for multidisciplinary teams and a holistic approach to astronaut health and mission planning and the potential added value of BPS perspectives in considering countermeasures.

How Knowledge Spillover Entrepreneurship Influences the Adoption of Social Media and Customer Relationship Management

ABSTRACTBased on the knowledge‐based view, this paper investigates how the strategic integration of knowledge spillover through entrepreneurial orientation (EO), adoption of social media (SM) and customer relationship management (CRM), and environmental turbulence collectively manage to enhance firm performance in developing economies. To test these assertions, we surveyed managers from 519 randomly selected firms in China, and data were analyzed using SmartPLS 4.0. The results reflect that knowledge spillover through EO significantly enhances firm performance. In contrast, knowledge spillover through adopting SM mediates the relationship between EO and firm performance, whereas environmental turbulence and CRM moderate the relationship between adopting SM and firm performance. These findings enrich knowledge management literature from theoretical and managerial perspectives.

Validity of the Multigroup Ethnic Identity Measure for Māori, Pacific, Asian &amp; European adolescents

Abstract Background Ethnic identity is important for positive health and wellbeing outcomes, especially for Indigenous youth and adolescents from minoritised ethnic groups. The Multigroup Ethnic Identity Measure (MEIM) is widely used to examine ethnic identity as a general phenomenon across ethnic groups. However, evidence regarding its validity for adolescents from different ethnic backgrounds is mainly limited to the US context. This study investigated psychometric properties of the MEIM, for the first time, within a large ethnically diverse population-based sample in New Zealand. Methods We used data from the Growing Up in New Zealand study. Participants were 4500 12-year-olds and included 22.4% Māori (the Indigenous people of New Zealand), 16.7% Pacific, 14.8% Asian and 51.9% European young people. 45.7% were cisgender boy, 37.4% were cisgender girl, and 16.4% were non-binary, trans or unsure. We conducted factor analysis for the 12-item MEIM. Results Confirmatory factor analysis model fit tended to be best for a solution with two factors representing two ethnic identity subcomponents of Exploration and Affirmation/Belonging. A single ‘ethnic identity’ factor showed a slightly weaker model fit. Exploratory factor analysis revealed a 2-factor structure with a slightly different item composition as compared to the original MEIM subscales. The findings were largely comparable across ethnic groups. Conclusions The MEIM appears to be a valid measure for Māori, Pacific, Asian and European young people. However, nuances may exist due to unique contexts including structural factors, societal norms and challenges, opportunities and access to cultural engagement. Ethnic identity is strongly linked to health and wellbeing including quality of life, self-esteem and life satisfaction. Therefore, we recommend acknowledging nuances of ethnic identity during an important time of development within diverse cultural contexts, by applying subscales and subgroup analyses where possible. Key messages • The Multigroup Ethnic Identity Measure is valid and appropriate to use at age 12-years among diverse ethnic groups including Māori, Pacific, Asian and European. • Nuances of ethnic identity should be acknowledged as an important factor for health and wellbeing, especially during critical times of transition for adolescents within diverse cultural contexts.

Normative identity work: exploring Erich Fromm’s perspective on self and society

This article explores the potential of normative identity work to foster humanistic transformation, drawing from Erich Fromm’s social theory. By engaging with Fromm’s insights into the interplay between individuals and societal structures, the analysis demonstrates how identity work – understood as an ongoing process of self-construction within social contexts – can confront what Fromm terms the ‘pathology of normalcy’. Central to the discussion are Fromm’s reflections on identity and its relationship to the human needs for rootedness, relatedness and the construction of a frame of orientation. The article integrates Fromm’s views on identity with contemporary identity research, illustrating the tensions between conforming to societal expectations and the pursuit of self-realisation. It introduces the ‘normative ABC of identity work’, a model structured around three key dimensions: agency, belonging and coherence. This model offers a lens to examine the various ways societal forces shape identity work, influencing individuals in directions that may either align with societal norms or open pathways towards humanistic growth and transformation. In the conclusion, the article emphasises the relationship between identity work and Fromm’s concept of social character, highlighting how social character can reflect and reinforce societal patterns while also pointing to the transformative potential embedded in humanistic values. This synthesis provides a critical framework for understanding how identity work can both sustain and challenge existing social norms and power structures.

‘We do not include tests and treatment for those [STI] conditions’: the trouble in navigating access and care for STIs among gay, bisexual men and transgender and other MSM in Kenya and Rwanda

Abstract Background Lesbian, gay, bisexual men, and transgender persons (LGBT) in Kenya and Rwanda have a hard time accessing healthcare, in particular sexual health screening. We used a social norms and values framework to examine determinants of access to healthcare, with specific attention to sexual healthcare. Methods We draw on cross-sectional mixed methods research in Kenya and Rwanda that examined the lived experiences of sexual and gender minorities in access to health services. A cross-sectional quantitative survey in Rwanda (n = 499) and Kenya (n = 1,550) was conducted with LGBT people. We conducted key informant interviews (n = 81), in-depth interviews (n = 48), digital storytelling (n = 3), and focus group discussions (n = 30). We used a mixed-methods thematic and content analysis to integrate quantitative and qualitative findings. Findings Accessibility and quality of care were the main barriers to healthcare services. The results indicate widespread discrimination and stigma toward LGBT people in service provision. Approximately half of the survey participants, 47%, reported challenges accessing health services, and 25% indicated they experienced discrimination in healthcare. Qualitative results link low quality of care to stigma and discrimination. “Mostly at the hospitals, there are times people take too much time discussing who we are instead of giving us the treatment we seek, and send us to mental health to first deal with our sexuality issues since they think it is a ‘sickness.’” (Focus group, Muhanga, Rwanda). Our study highlights challenges in navigating sexual healthcare in government, faith-based, and donor-funded health facilities. Conclusions Access to healthcare services, particularly sexual health screening and prevention, is a growing issue for LGBT people in Kenya and Rwanda. Stigma acts as a significant barrier to high-quality healthcare. Sensitivity training and educational opportunities for healthcare professionals are urgently needed to address stigma.

Social norms and social opportunities: a qualitative study of influences on tobacco use among urban adolescent girls in Ghana

BackgroundTobacco use is a global public health threat and a leading preventable cause of death in the world. While cigarette use among youth has been decreasing in high-income countries, low- and middle-income countries have contrastingly high rates of adolescent smoking. In Ghana, smoking prevalence is lower than in other parts of the African continent and more common among men than women; however the gender gap in tobacco use among adolescents has narrowed, with shisha use among girls recently surpassing boys. These trends toward increased relative use among adolescent girls are a cause for concern and highlight the need for interventions to prevent and/or reduce tobacco use in this population.MethodsWe conducted in-depth interviews with girls aged 13–20 (n = 148) and their parents (n = 7) in Ghana’s largest two cities – Accra and Kumasi, to explore the physical, social, and psychological context underlying smoking perceptions and behavior.ResultsWe identified 11 key insights into influences on smoking behavior, organized into the broader themes of perceptions of smoking, environmental factors, and internal factors. Findings underscore that perceptions around smoking are very much driven by girls’ social world, which is generally small and parent-centric for non-smokers at younger ages but can start to expand as girls get farther along in school or leave school entirely. After what may have been a sheltered adolescence, many older girls in Ghana look for ways to express their independence in decision-making and a few may use their developing agency to rationalize limited or infrequent tobacco use if they perceive the benefits to them outweigh the potential consequences.ConclusionsOur findings highlight strong social influences on girls’ perceptions, exposure to opportunities, and decision-making in ways that can often be protective against smoking, particularly at younger ages, but may also leave girls unprepared to manage challenging situations later in life. Understanding this context in Ghana will be important for any future programming aiming to prevent smoking initiation among adolescents.

Leveraging Behavioural Insights to Create Healthier Online Environment for Children

Abstract Issue/Problem The proliferation of digital marketing poses a significant threat to children’s health and well-being, necessitating innovative solutions grounded in cross-disciplinary systems approach. Description of the problem Children’s exposure to harmful digital marketing is pervasive, influencing their preferences, behaviours, and health outcomes. Traditional regulatory approaches often fall short in addressing the dynamic nature of online advertising, exacerbating the challenge. Without effective interventions, children remain vulnerable to the detrimental effects of marketing for unhealthy products and services, undermining public health efforts. Results Integrating behavioural sciences with public health suggests promising avenues for addressing the complexities of harmful digital marketing to children. The WHO KidAd app is a ground-breaking tool designed for objective monitoring of digital marketing. Coupled with evidence-based behavioural strategies such as nudges, choice architecture, and social norms, policymakers can influence decision-making in favour of healthier choices, thereby reducing the impact of harmful marketing. By understanding the decision-making processes and behavioural patterns involved, policymakers can design targeted interventions to mitigate exposure and protect children. Lessons Learned The application of behavioural sciences in public health policy-making yields valuable lessons. Firstly, personalized and contextually relevant interventions resonate more effectively with target audiences, enhancing their efficacy. Secondly, leveraging behavioural insights allows for the design of interventions that complement existing regulatory frameworks, filling gaps in enforcement and compliance. Thirdly, interdisciplinary collaboration between public health experts, policymakers, and behavioural scientists is essential for developing evidence-based strategies tailored to the digital landscape’s evolving challenges. [Grant: APVV-22-0587] Speakers/Panelists Amandine Garde Law &amp; Non-Communicable Diseases Unit, Liverpool, UK

Is harmonizing to social drinking norms associated with alcohol use in Danish high school students?

Abstract Background Alcohol use is positively linked with perceived drinking norms within the peer group and the social plasticity hypothesis proposes that youth are very good at harmonizing to social norms (social attunement). Youth with high social attunement may adjust their drinking habits to the perceived drinking norms of the peer group to a higher extent potentially leading to a larger impact on personal alcohol use. This study examined if frequency of personal alcohol use was associated with perceived peer approval of drinking and the role of social attunement in Danish high school students aged 15-19 years. Methods An online survey was administered to 2977 first-year students from 16 public high schools in Denmark. Students reported past month alcohol use (drinking days, using TLFB) and perceived approval of alcohol use among peers of their grade. Social attunement was calculated as a sum score of the 11-item Dutch Social Attunement Questionnaire (SAQ) (range: 11-77; α = 0.81). Number of drinking days was analysed as dependent variable, with age, gender, perceived peer approval and SAQ-score as independent variables. Results Older students were more likely to perceive peers to approve drinking (β = 0.25; p = 0.004) and getting drunk (β = 0.22; p = 0.003). More females (83.2%) than males (81.8%; p = 0.003) perceived peers to approve youth getting drunk. Multilevel regressions showed increased drinking days for students perceiving peers to approve of drinking (β = 1.68; p &amp;lt; 0.001) and getting drunk (β = 1.80; p &amp;lt; 0.001). We found interaction between SAQ-score and perceived drinking norms (β=-0.10; p &amp;lt; 0.001) indicating that perceived peer approval had less effect on drinking days for students with high SAQ-score. Conclusions Social attunement explained additional variance in the association between personal alcohol use and perceived drinking norms. Our findings stress the importance of addressing the influence of behavioural adaptation in e.g. school-based health promotion programs. Key messages • Students perceiving peers to approve of youth alcohol use drink more frequent, but the link is weakened when the need to harmonize to perceived drinking norms are high. • Social attunement needs to be considered when examining the link between individual alcohol consumption and perceived drinking norms and should be addressed in e.g. school health programs.