Understanding reasons for non-compliance in motorcycle helmet use among adolescents in Greece

Inj Prev. 2009 Feb;15(1):19-23. doi: 10.1136/ip.2008.019356.


Objective: To explore attitudes towards two-wheel motorized vehicle (TWMV) helmet use among adolescents in a country with poor legal compliance.

Design: Self-administered questionnaires were completed by 523 high school students to define the sample of a qualitative study; thereafter, the Health Belief Model (HBM) was applied in 12 focus groups comprising 70 students.

Setting: Three randomly selected public secondary schools in middle-income areas of Athens, Greece.

Results: Students reporting frequent helmet use were characterized by a high perceived threat of a TWMV-related injury, which seemed to be associated with both prior experience of an injury and receiving information on helmet wearing from "significant others." Students reporting helmet non-use were characterized by a low threat perception, possibly attributable to adolescent egocentrism and accompanying feelings of invulnerability or to lack of knowledge and experience in risk identification. A sharp contrast was noted regarding the most important perceived benefit of helmet use, expressed among users as "protection in the case of a road crash" and among non-users as "avoiding tickets from traffic police". Main barriers to helmet use, as identified by non-users, included: low perceived efficacy of helmets; peer pressure; lack of appropriate information on helmet use; high helmet cost; lack of convenience; vision and hearing disturbance; and style reasons.

Conclusions: When social norms of low compliance to safety laws prevail, qualitative research can assist in developing tailored educational interventions targeting behavior modification among adolescents.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Accidents, Traffic / psychology*
  • Adolescent
  • Attitude to Health*
  • Female
  • Greece
  • Head Protective Devices / statistics & numerical data*
  • Health Behavior
  • Health Education
  • Humans
  • Male
  • Motorcycles*
  • Perception