Social Norms vs. fear Appeals: Mixing Alcohol with Prescription Drugs - a Message Testing Study

Subst Use Misuse. 2021;56(9):1397-1402. doi: 10.1080/10826084.2021.1928212. Epub 2021 Jun 6.


The purpose of this study was to compare the perceived effectiveness of a social norms message to a fear appeal message regarding prescription drug use and alcohol interactions among college students. Participants: Participants (n = 378) were college students enrolled at a large public Midwest university. Methods: Researchers used a cross-sectional research design to collect data from undergraduate college students. Messages were randomly assigned to one of two residence halls and were assessed using an electronic survey. Participants anonymously evaluated the messages based on their understanding, interest, creativity, believability, relevance, and usefulness using an online questionnaire. Results: Results from the General Linear Model analysis indicated a significant effect for the gender x message interaction, with females rating the fear appeal message higher than males. Significant effects were also found for the main effects of gender, message type, and Greek status. Conclusion: Overall, students preferred the fear appeal to the social norms message. Participants found the social norms message less believable than the fear appeal and indicated they understood the fear appeal better than the social norms message. However, social norm messages appeared to resonate better with abstainers than with regular alcohol users.

Keywords: Health communication; alcohol and drug interactions; college students; fear appeals; social norms.

MeSH terms

  • Cross-Sectional Studies
  • Fear
  • Female
  • Greece
  • Humans
  • Male
  • Prescription Drugs*
  • Social Norms
  • Universities


  • Prescription Drugs