Moderators of peer influence effects for adolescents’ smoking and vaping norms and outcomes in high and middle-income settings
Abstract
Background Peer influence is central to adolescent smoking initiation, yet its impact varies depending on individual and contextual factors. Understanding which moderators (personality, contextual, cultural, and environmental traits) shape these processes can inform more effective prevention strategies. We investigated hypothesized moderators of peer influence for adolescent smoking/vaping norms and other smoking-related outcomes in high and low-middle-income countries (LMICs): Northern Ireland and Bogotá. Methods Across 12 schools ( n = 1,344, age 12–13 years), participants completed novel behavioral economics experiments measuring social norms, and self-report surveys, before and after school-based prevention interventions (ASSIST and Dead Cool). We examined how peer influence effects were moderated by setting, intervention type, gender, school socio-economic status (SES), personality traits, social network positions, and self-efficacy. Moderation was examined using regressions with interactions between peer-group means (friends, school classes, school year groups) of the outcome variables and moderators ( p ≤ 0.01). Results Peer influence was moderated by study setting, intervention, gender, school SES, personality characteristics (pro-sociality, fear of negative evaluation, extraversion), and social network structure. Effects were stronger among girls and in schools with lower SES. ASSIST schools showed greater peer influence effects than Dead Cool, reflecting the…
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