Social Influence
Thomas A. Wills, Michael G. Ainette, and Carmella Walker

Social Modeling Theory. The original version of social learning theory posited that behavior is influenced by modeling processes. In this theory a person observes the behavior of other persons and tends to model that behavior, particularly so if he/she feels a sense of attachment to the others (Bandura, 1977 xClose
Bandura, A. (1977). Social learning theory. Englewood Cliffs, NJ: Prentice-Hall.). For example, younger children could acquire healthy vs. unhealthy habits through observing the behavior of their parents (e.g., parental smoking or eating patterns). Evidence has shown correlations for example between parental substance use and children's smoking and alcohol use (Hawkins, Catalano, & Miller, 1992 xClose
Hawkins, J. D., Catalano, R. F., & Miller, J. Y. (1992). Risk and protective factors for alcohol and other drug problems in adolescence and early adulthood. Psychological Bulletin, 112, 64 105.), consistent with a modeling process (though there are other possible mechanisms). From the prevention perspective, this theory suggested that improvements in health-related behavior could be achieved by altering the modeling influence, for example through helping parents to quit smoking or adopt healthier diets (e.g., Loken, Swim, & Mittelmark, 1990 xClose
Loken, B., Swim, J., & Mittelmark, M. B. (1990). Heart Health Program: Applying social influence processes in a large-scale community health promotion program. In J. Edwards, R. S. Tindale, L. Heath, & E. J. Posavac (Eds.), Social influence processes and prevention (pp. 159-181). New York: Plenum.).

Social Pressure Theory. A development in social learning theory gave more emphasis to the role of peers, and posited that adoption of a health risk behavior (e.g., trying cigarettes) was influenced by explicit social pressure from peers in group contexts. Here it was suggested that peers might provide offers of cigarettes and then apply social pressure, through taunts or criticism, to teens who did not immediately go along with the offers (Evans, 1984 xClose
Evans, R. I. (1984). A social inoculation strategy to deter smoking in adolescents. In J. D. Matarazzo, S. M. Weiss, J. A. Herd, N. E. Miller, & S. M. Weiss (Eds.), Behavioral health: A handbook of health enhancement and disease prevention (pp. 765-774). New York: Wiley.; Evans & Raines, 1990 xClose
Evans, R. I., & Raines, B. E. (1990). Applying a social psychological model across health promotion interventions. In J. Edwards, R. S. Tindale, L. Heath, & E. J. Posavac (Eds.), Social influence processes and prevention (pp. 143-158). New York: Plenum.). This model of social factors became the basis for what was termed a social-inoculation approach to prevention, using filmed models to demonstrate assertive responses to social pressure situations, and thereby aiming to increase teens' resistance to peer pressures for unhealthy behaviors (Evans, Rozelle, Mittelmark, Hansen, Bane, & Havis, 1988 xClose
Evans, R., Rozelle, R., Mittelmark, M., Hansen, W. B., Bane, A. L., & Havis, J. (1988). Deterring the onset of smoking in children: Knowledge of immediate physiological effects and coping with peer pressure, media pressure and parent modeling. Journal of Applied Social Psychology, 8, 126-135., Evans, Rozelle, Maxwell, Raines, Dill, Guthrie, Henderson, & Hill, 1991 xClose
Evans, R., Rozelle, R., Maxwell, S., Raines, B., Dill, C., Guthrie, T., Henderson, A., & Hill, P. (1991). Social modeling films to deter smoking in adolescents: Results of a three-year field investigation. Journal of Applied Psychology, 66, 399-414.). Evidence has shown peers' substance use to be a direct influence on an adolescent's behavior (Ennett & Bauman, 1994 xClose
Ennett, S. T., & Bauman, K. E. (1994). The contribution of influence and selection to adolescent peer group homogeneity: The case of adolescent cigarette smoking. Journal of Personality and Social Psychology, 67, 653-663.; Wills & Cleary, 1999 xClose
Wills, T. A., & Cleary, S. D. (1999). Peer and adolescent substance use among 6th-9th graders: Latent growth analyses of influence versus selection mechanisms. Health Psychology, 18, 453-463.). The precise mechanism of peer influence remains under debate, because there is some discrepancy between adolescents' reports of peer behavior and the peers' own reports about their behavior (Bauman & Ennett, 1996 xClose
Bauman, K. A., & Ennett, S. T. (1996). On the importance of peer influence for adolescent drug use: Commonly neglected considerations. Addiction, 91, 185-198.), and there is little evidence that peer influence occurs through the exertion of explicit pressure on other teens (Kobus, 2003 xClose
Kobus, K. (2003). Peers and adolescent smoking. Addiction, 98(Suppl. 1), 37-55.).

Social Norm Theory. While the previous models focused on more direct forms of influence, several models have focused more on individuals' perceptions of social norms about a health behavior. These perceptions, whether accurate or not, can serve as a form of social influence if individuals adopt health-related behaviors that they perceive to be approved by their social reference group. This conception of social influence derives in part from the Theory of Planned Behavior which postulates that perceptions of social norms about a behavior are an important influence on action (Ajzen, 1985 xClose
Ajzen, I. (1985). From intentions to actions: A theory of planned behavior. In J. Kuhl & J. Beckmann (Eds.), Action control: From cognition to behavior (pp. 11-39). Heidelberg, Germany: Springer., 1991 xClose
Ajzen, I. (1991). The theory of planned behavior. Organizational Behavior and Human Decision Processes, 50, 179-211.). It is also represented in theories about the impact of social consensus, which suggest that individuals make inferences about the acceptability of a behavior through consulting their perceptions of how prevalent the behavior is in the population (Marks & Miller, 1987 xClose
Marks, G., & Miller, N. (1987). Research on the false consensus effect: An empirical and theoretical review. Psychological Bulletin, 102, 72 90.). This perception is particularly important for behaviors such as adolescent smoking, because studies show that young persons tend to overestimate the frequency of smoking among teens (Sherman, Presson, Chassin, Corty, & Olshavsky, 1983 xClose
Sherman, S. J., Presson, C. C., Chassin, L., Corty, E., & Olshavsky, R. (1983). The false consensus effect in estimates of smoking prevalence. Personality and Social Psychology Bulletin, 9, 197-207.) and smokers tend to overestimate this even more (Gibbons, Gerrard, & Helwig-Larsen, 1995 xClose
Gibbons, F. X., Gerrard, M., & Helweg-Larsen, M. (1995). Prevalence estimates and adolescent risk behavior: Cross cultural differences in social influence. Journal of Applied Psychology, 80, 107-121.; Sussman, Dent, Mestel-Rauch, Johnson, Hansen, & Flay, 1988 xClose
Sussman, S., Dent, C. W., Mestel-Rauch, J., Johnson, C. A., Hansen, W. B., & Flay, B. R. (1988). Adolescent nonsmokers, triers, and regular smokers' estimates of cigarette smoking prevalence: When do overestimations occur and by whom? Journal of Applied Social Psychology, 18, 537-551.). This conception of social influence has been embedded in prevention programs that aim to reduce smoking initiation through correcting erroneous perceptions of social norms through showing participants real data indicating that relatively few adolescents smoke and the majority of teens have relatively negative norms about smoking and other drug use (Hansen & Graham, 1991 xClose
Hansen, W. B., & Graham, J. W. (1991). Preventing alcohol, marijuana, and cigarette use among adolescents: Peer pressure resistance training versus establishing conservative norms. Preventive Medicine, 20, 414-430.). This approach can have advantages because social-inoculation programs tend to have reverse effects with teens who are already smoking (Donaldson, Graham, Piccinin, & Hansen, 1995 xClose
Donaldson, S. I., Graham, J. W., Piccinin, A. M., & Hansen, W. B. (1995). Resistance skills training and onset of alcohol use: Evidence for beneficial and potentially harmful effects in public and private schools. Health Psychology, 14, 291-300.).

Social Perception Theory. Social-perception models take a somewhat different approach through positing that an individual's perceptions of persons who engage in healthy or unhealthy behaviors can have a motivating effect for their own behavior. For example with adolescent smoking, the basic concept is that if an individual perceives teens who smoke in relatively favorable terms (i.e., popular, attractive) then he/she will be more likely to take up cigarette smoking. One conception of this type of influence posits that smoking initiation occurs through wanting to adopt the social image of the prototype user and hence become more popular/attractive (Gibbons & Gerrard, 1995 xClose
Gibbons, F. X., & Gerrard, M. (1995). Predicting young adults' health risk behavior. Journal of Personality and Social Psychology, 69, 505-517.; Gibbons, Gerrard, & Lane, 2003 xClose
Gibbons, F. X., Gerrard, M., & Lane, D. J. (2003). A social reaction model of adolescent health risk. In J. M. Suls & K. A. Wallston (Eds.), Social psychological foundations of health and illness (pp. 107-136). Oxford, UK: Blackwell.). Another conception of this type of influence is a desire to identify with a particular subgroup of adolescents ("crowds") who are viewed as socially attractive or influential in the school setting (Mosbach & Leventhal, 1988 xClose
Mosbach, P., & Leventhal, H. (1988). Peer group identification and smoking. Journal of Abnormal Psychology, 97, 238-245.; Sussman, Dent, McAdams, Stacy, Burton, & Flay, 1994 xClose
Sussman, S., Dent, C. W., McAdams, L. A., Stacy, A. W., Burton, D., & Flay, B. R. (1994). Group self-identification and adolescent cigarette smoking: A 1-year prospective study. Journal of Abnormal Psychology, 103, 576-580.). Even though teens tend to have fairly negative perceptions of users in general, studies show that those who relatively more favorable perceptions of users are more likely to adopt smoking or alcohol use (Blanton, Gibbons, Gerrard, Conger, & Smith, 1997 xClose
Blanton, H., Gibbons, F. X., Gerrard, M., Conger, K. J., & Smith, G. E. (1997). The role of family and peers in the development of prototypes associated with health risks. Journal of Family Psychology, 11, 1-18.; Chassin, Tetzloff, & Hershey, 1985 xClose
Chassin, L. A., Tetzloff, C., & Hershey, M. (1985). Self image and social image factors in adolescent alcohol use. Journal of Studies on Alcohol, 46, 39-47.), and this concept has been extended to behaviors such as contraception and condom use (Blanton, VandenEijnden, Buunk, Gibbons, Gerrard, & Bakker, 2001 xClose
Blanton, H., VandenEijnden, R. J. J. M., Buunk, B. P., Gibbons, F. X., Gerrard, M., & Bakker, A. (2001). Social images in the prediction and promotion of condom use. Journal of Applied Social Psychology, 31, 274-295.; Gibbons, Gerrard, & Boney McCoy, 1995 xClose
Gibbons, F. X., Gerrard, M., & Boney McCoy, S. (1995). Prototype perceptions predict (lack of) pregnancy prevention. Personality and Social Psychology Bulletin, 21, 85-93.). In contrast, relatively favorable perceptions of abstainers have been shown to have a protective effect with regard to substance use and sexual risk behavior (Gerrard, Gibbons, Reis-Bergan, Trudeau, Vande Lune, & Buunk, 2002 xClose
Gerrard, M., Gibbons, F. X., Reis-Bergan, M., Trudeau, L., Vande Lune, L., & Buunk, B. P. (2002). Inhibitory effects of drinker and nondrinker prototypes on adolescent alcohol consumption. Health Psychology, 21, 601-609.; Wills, Gibbons, Gerrard, Murry, & Brody, 2003 xClose
Wills, T. A., Gibbons, F. X., Gerrard, M., Murry, V., & Brody, G. (2003). Family communication and religiosity related to substance use and sexual behavior in early adolescence. Psychology of Addictive Behaviors, 17, 312-323.). Because social perceptions are malleable, intervention programs have used the approach of modifying social images in a healthier direction in order to deter early onset of smoking and alcohol use (Brody, Murry, Gerrard, Gibbons, Molgaard, McNair, Brown, Wills, Spoth, Luo, Chen, & Neubaum-Carlan, 2004 xClose
Brody, G. H., Murry, V. M., Gerrard, M., Gibbons, F. X., Molgaard, V., McNair, L. A., Brown, A. C., Wills, T. A., Spoth, R. L., Luo, Z., Chen, Y-F., & Neubaum-Carlan, E. (2004). The Strong African-American Families program: Translating research into prevention programming. Child Development, 75, 900-917.; Gerrard, Gibbons, & Gano, 2003 xClose
Gerrard, M., Gibbons, F. X., & Gano, M. (2003). Adolescents' risk perceptions and behavioral willingness: Implications for intervention. In D. Romer (Ed.), Reducing adolescent risk: Toward an integrated approach (pp. 75-81). Newbury Park, CA: Sage.; Gerrard, Gibbons, Brody, Murry, Cleveland, & Wills, 2006 xClose
Gerrard, M., Gibbons, F.X., Brody, G.H., Murry, V.M., Cleveland, M.J., & Wills, T.A. (2006). A theory-based dual focus alcohol intervention for pre-adolescents: The Strong African American Families Program. Psychology of Addictive Behavior. 20, 185-195.).

Social Communication Theory. Communication models consider how discussions between parents and children are focused to directly communicate parental norms and values about health-related behavior. It is known that parental norms about substance use by teens (which tend to be fairly negative) are related to adolescents' behavior, and communication models have generated evidence showing that frequency of parent-child communication about the behaviors is related to rates of adolescent substance use and sexual risk taking (Brody, Flor, Hollett-Wright, & McCoy, 1998 xClose
Brody, G. H., Flor, D. L., Hollett-Wright, N., & McCoy, J. K. (1998). Children's development of alcohol use norms: Contributions of parent and sibling norms, children's temperaments, and parent-child discussions. Journal of Family Psychology, 12, 209-219.; Whitaker & Miller, 2000 xClose
Whitaker, D. J., & Miller, K. S. (2000). Parent adolescent discussions about sex: Impact on peer influences of sexual behavior. Journal of Adolescent Research, 15, 251-274.; Wills et al., 2003 xClose
Wills, T. A., Gibbons, F. X., Gerrard, M., Murry, V., & Brody, G. (2003). Family communication and religiosity related to substance use and sexual behavior in early adolescence. Psychology of Addictive Behaviors, 17, 312-323.). Intervention models have used this conception of social influence to design educational components to stimulate parent-child discussion about health behaviors and provide guidelines to parents on how to communicate their norms and values about these topics (Brody, Murry, Gerrard, Gibbons, McNair, Brown, Wills, Molgaard, Spoth, Luo, & Chen, 2006 xClose
Brody, G. H., Murry, V. M., Gerrard, M., Gibbons, F. X., McNair, L., Brown, A. C., Wills, T. A., Molgaard, V., Spoth, R. L., Luo, Z., & Chen, Y-F. (2006). The Strong African-American Families Program: Prevention of youths' high-risk behavior and a test of a model of change. Journal of Family Psychology, 20, 1-11.; Spoth, Redmond, & Shin, 1999 xClose
Spoth, R., Redmond, C., & Shin, C. (1999). Direct and indirect parenting outcomes of family-focused preventive interventions. Journal of Consulting and Clinical Psychology, 66, 385-399.).

Media Exposure Theory. A recent development in social influence theory is studies that consider how exposure to cues in mass media (television, movies, or print advertising) affects viewers' attitudes and intentions about health behaviors. With a focus on adolescents, there is accumulated evidence that tobacco advertising and marketing strategies could influence teens' behavior through portraying smoking as attractive, and possibly weight-reducing (Pierce, Lee, & Gilpin, 1994 xClose
Pierce, J. P., Lee, L., & Gilpin, E. A. (1994). Smoking initiation by adolescent girls, 1944 through 1988: An association with targeted advertising. Journal of the American Medical Association, 271, 608-611.). This research was based on a variant of modeling theory, positing that frequent exposure to cues showing smoking in exciting and pleasurable situations, and associated with attractive or unconventional characters, would lead to more favorable attitudes toward smoking (DiFranza, Richards, Paulman, Wolf-Gillespie, Fletcher, Jaffe, & Murray, 1991 xClose
DiFranza, J. R., Richards, J. W., Jr., Paulman, P. M., Wolf-Gillespie, N., Fletcher, C., Jaffe, R. D., & Murray, D. (1991). RJR Nabisco's cartoon camel promotes Camel cigarettes to children. Journal of the American Medical Association, 266, 3149-3153.; Evans, Farkas, Gilpin, Berry, & Pierce, 1995 xClose
Evans, N., Farkas, A., Gilpin, E., Berry, C., & Pierce, J. P. (1995). Influence of tobacco marketing and exposure to smokers on adolescent susceptibility to smoking. Journal of the National Cancer Institute, 87, 1538-1545.). Recent studies have found that movie exposure to smoking by actors is related to smoking initiation among adolescents, so there is evidence of an influence on smoking behavior (Distefan, Pierce, & Gilpin, 2004 xClose
Distefan, J. M., Pierce, J. P., & Gilpin, E. A. (2004). Do favorite movie stars influence adolescent smoking initiation? American Journal of Public Health, 94, 1239-1244.; Sargent, Beach, Dalton, Mott, Tickle, Ahrens, & Heatherton, 2001 xClose
Sargent, J. D., Beach, M. L., et al. (2001). Effect of seeing tobacco use in films on trying smoking among adolescents: cross sectional study. British Medical Journal, 323, 1394-1397.). The exact mechanism through which this effect occurs has not been established at present; it may involve some combination of cognitive/attitudinal changes or effects on affiliation with substance-using peers (Sargent, Wills, Stoolmiller, Gibson, & Gibbons, 2006 xClose
Sargent, J. D., Wills, T. A., Stoolmiller, M., Gibson, J., & Gibbons, F. X. (2006). Alcohol use in motion pictures and its relation with early-onset teen drinking. Journal of Studies on Alcohol, 67, 54-65.). The implications of these findings for preventive intervention have been explored in several projects with mass media programs designed to deter teen smoking or alcohol use (Donohew, Lorch, & Palmgreen, 1991 xClose
Donahew, L., Lorch, E., & Palmgreen, P. (1991). Sensation seeking and targeting of televised anti-drug public service announcements. In L. Donohew, H. E. Sypher, & W. J. Bukoski (Eds.), Persuasive communications and drug abuse prevention (pp. 209-228). Hillsdale, NJ: Erlbaum.; Sargent, Dalton, Heatherton, & Beach, 2003 xClose
Sargent, J. D., Dalton, M. A., et al. (2003). Modifying exposure to movie smoking: a novel approach to preventing adolescent smoking. Archives of Pediatrics and Adolescent Medicine, 157, 643-648.; Wakefield, Flay, Nichter, & Giovino, 2003 xClose
Wakefield, M., Flay, B. R., Nichter, M., & Giovino, G. (2003). Role of the media in influencing trajectories of adolescent smoking. Addiction, 98(Supplement 1), 79-103.).

Neighborhood Context Theory. Environmental theories have added another dimension to health behavior theory through considering the influence of larger social contexts. In this conception, the attributes of larger social units such as neighborhoods may have an influence on behavior, above and beyond the impact of factors impinging on a person from his/her immediate social context of family and friends (Leventhal & Brooks-Gunn, 2000 xClose
Leventhal, T., & Brooks-Gunn, J. (2000). The neighborhoods they live in: The effects of neighborhood residence on child and adolescent outcomes. Psychological Bulletin, 126, 309-337.). It has been hypothesized that adoption of unhealthy behavior may be influenced by neighborhood variables including the overall level of poverty and residential instability, and the prevalence of crime and aggressive behavior (Hawkins et al., 1992 xClose
Hawkins, J. D., Catalano, R. F., & Miller, J. Y. (1992). Risk and protective factors for alcohol and other drug problems in adolescence and early adulthood. Psychological Bulletin, 112, 64-105.; Petraitis, Flay, & Miller, 1995 xClose
Petraitis, J., Flay, B. R., & Miller, T. Q. (1995). Theories of adolescent substance use: Organizing pieces in the puzzle. Psychological Bulletin, 117, 67-86.; Wills, Pierce, & Evans, 1996 xClose
Wills, T. A., Pierce, J. P., & Evans, R. I. (1996). Large-scale environmental risk factors for substance use. American Behavioral Scientist, 39, 808-822.). Conversely, factors that help to bind a community together, such as social trust and civic engagement, can serve as protective factors (Kawachi, Kennedy, Lochner, & Prothrow-Stith, 1997 xClose
Kawachi, I., Kennedy, B. P., Lochner, K., & Prothrow-Stith, D. (1997). Social capital, income inequality, and mortality. American Journal of Public Health, 87, 1491-1498.). Research on neighborhood factors and health behavior are still emerging but recent studies have shown that environmental factors are related to smoking behavior (Diez-Roux, Merkin, Hannan, Jacobs, & Kiefe, 2003 xClose
Diez-Roux, A. V., Merkin, S., Hannan, P., Jacobs, D. R., & Kiefe, C. I. (2003). Area characteristics, individual-level socioeconomic factors, and smoking in young adults. American Journal of Epidemiology, 157, 315-326.; Novak & Clayton, 2001 xClose
Novak, S. P., & Clayton, R. R. (2001). The influence of school environment and self-regulation on transitions between stages of cigarette smoking. Health Psychology, 20, 196-207.) and that family and peer risk factors have more effect on adolescent substance in adverse environments (Gibbons, Gerrard, Cleveland, Wills, & Brody, 2004 xClose
Gibbons, F. X., Gerrard, M., Cleveland, M. J., Wills, T. A., & Brody, G. H. (2004). Perceived discrimination and substance use in African-American parents and their children: A panel study. Journal of Personality and Social Psychology, 86, 517-529.). The implications of this theoretical approach are beginning to be explored but suggest that approaches such as neighborhood policing, economic development, and modifications to the built environment may have an impact on health status.