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 < 0.001) and getting drunk (β = 1.80; p < 0.001). We found interaction between SAQ-score and perceived drinking norms (β=-0.10; p < 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.