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Procedia - Social and Behavioral Sciences 78 (2013) 230 234

PSIWORLD 2012

The Impact of Gender Norms on Alcohol and Tobacco Use at

Romanians
Andreea C. Brabetea*, Mara del Pilar Snchez-Lpeza, Isabel Cullar-Floresa, Raquel
Rivas-Dieza
Universidad Complutense de Madrid, Facultad de Psicologa, Campus de Somosaguas 28223, Pozuelo de Alarcn, Madrid. Spain

Abstract
The objective of this study is to determine whether adaptation to gender norms is related to tobacco and alcohol use in a
sample of Romanian people. The results showed that the degree of conformity to gender norms was associated to some of
these types of behavior. These conclusions have important implications for action on health, since they show how important
masculine/feminine gender identity is, in regard to health behaviors.

2012The
The
Authors.
Published
by Elsevier
B.V.
2013
Authors.
Published
by Elsevier
B.V.
Selection and/or
peer-review
under responsibility
of PSIWORLD
2012
Selection
and/or
peer-review
under responsibility
of PSIWORLD
2012
Keywords: Tobacco use; Alcohol use; Conformity to Masculine Inventory Norms; Conformity to Feminine Inventory Norms; Romanian
people

1. Introduction
The pattern of health/illness, different in men and women, is such not only due to their biological differences,
but the lifestyle and risk factors derived from gender issues (Evans & Steptoe, 2002; Snchez-Lpez, 2003).
Men die younger than women in most countries around the world (Mathers, Sadana, Salomon, Murray, &
Lopez, 2001; White & Cash, 2003; World Health Organization, 2000). In 2008, in Romania life expectancy for
men was 69.71 years and 76.86 for women (the mean age of life expectancy of the 27 countries of European
Union in 2007 was 76.06 years for men and 82.21 years for women) (Institutul National de Sanatate Publica,
2010). This is due, partly, to health behaviors such as tobacco and alcohol use, diet, exercise, use of social
support, safety practices, and efforts to prevent disease (e.g., annual medical check-ups). Recent studies estimate

* Corresponding author. Tel.: +34-62-9325501; fax: +34-91-3943189.

E-mail address: ac.brabete@psi.ucm.es

1877-0428 2013 The Authors. Published by Elsevier B.V.

Selection and/or peer-review under responsibility of PSIWORLD 2012
doi:10.1016/j.sbspro.2013.04.285

Andreea C. Brabete et al. / Procedia - Social and Behavioral Sciences 78 (2013) 230 234

that 50% of morbidity and mortality is due to this type of modifiable health behaviors adopted by men and
women (Mokdad, Marks, Stroup & Gerberding, 2004).
In 2004, the alcohol use was considered the third global risk factor for disease and disability meanwhile the
tobacco use was considered the sixth (WHO, 2011). In 2004, almost 4% of all death causes worldwide have been
attributed to alcohol (6.2% for men and 1.1% for women) (WHO, 2011). Tobacco kills nearly six million people
every year, more than 5 million are users and ex users and more than 600.000 are nonsmokers exposed to passive
smoking (WHO, 2012).
In 2005, in Romania, 22.1% of men and 51.6% of women declared they were abstainers. Of those who have
consumed alcohol during 2003-2005, the average use rate was 24.48 liters of pure alcohol per person aged 15
years or older. While women consumed 15.02 liters, men doubled the quantity and consumed 31.75 (WHO,
2011). According to the European Commission (2009), the prevalence of tobacco consumption in Romania is
28.1% (the EU average is 26.4%). Men smoke more than women, but it has been observed that at younger ages,
men and women present equal prevalences (Negoescu, 2001).
Results from a cross-national study on assessing male college students in both Kenya and the United States
indicated that masculinity related to fewer health promoting behaviors and more health risk behaviors for men
from both countries (Mahalik, Lagan & Morrison, 2006). This conclusion supported previous research, which
stated that traditional masculinity is associated to higher rates of alcohol and substance abuse (Blazina &
Watkins, 1996). For example, Cullar-Flores and Snchez-Lpez (2011) reported that high scores on the
Dominant and Playboy scales were related to alcohol use. Liu and Iwamoto (2007) found that Emotional Control
and Risk-Taking significantly predicted alcohol use. There are fewer studies on the connection between gender
norms and tobacco consumption. However, it was found that masculinity is related to smoking behavior (Brabete
& Snchez-Lpez, 2012; Emslie, Hunt & Macintyre, 2002).
There is little research on the role of gender norms and substance use at women. High scores on the
Investment in Appearance scale is related to alcohol and tobacco use, whereas low scores on the Involvement
with Children scale and the Sexual Fidelity is related to alcohol use (Brabete & Snchez-Lpez, 2012). There
have also been found negative relationships between the alcohol use and tobacco use and the Romantic
Relationship and Domestic scales (Snchez-Lpez, Cullar-Flores & Dresch, 2012).
The objective of this study is to determine whether adaptation to gender norms is anyway related to tobacco
and alcohol use.
2. Method
2.1. Participants and procedure
The sample of this research consists of 750 Romanian people (489 women and 261 men) aged between 16 and
72 years, mean age 28.93 (SD = 10.7). In Table 1 are described the characteristics of the sample.
We used the snowball method (taking into account the limitations involved in this procedure). In all cases,
the instrument was individually self-administered; an initial sheet of instructions was also handed out. After the
purpose of the investigation had been explained, and the participants had been offered the possibility of
participating -guaranteeing their anonymity and their freedom to leave the study at any time with no
consequences- all the participants gave their consent. A total of 947 questionnaires were handed out, of which
approximately 125 were lost and the rest (72) were discarded because the instruments were not fully completed.
2.2. Instruments
There were applied two questions for ascertaining tobacco and alcohol consumption.

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Andreea C. Brabete et al. / Procedia - Social and Behavioral Sciences 78 (2013) 230 234

To assess participant womens conformity to feminine norms, the Conformity to Femininity Norms
Inventory (Mahalik et al., 2005) was administered. The inventory consists of 84 items answered on a 4-point
scale ranging from strongly disagree to strongly agree. The statements were designed to measure various
attitudes, beliefs, and behaviors associated with feminine gender roles, both traditional and untraditional. They
are grouped in eight feminine norms: Nice in Relationships, Thinness, Modesty, Domestic, Care for Children,
Romantic Relationships, Sexual Fidelity, Investment in Appearance.
Table 1. Sociodemographic characteristics of participants

Marital status

Education level

Employment status

Socioeconomic level

Age (Range 16 to 72 years)

Singles
Married
Living in couple
Separated or divorced
Widow
Primary
Secondary
High School
University
Master and/or PhD
Fixed work
Housewife
Student
Retired
Unemployed
Low
Medium-Low
Medium-High
High

Total sample
N
465
222
36
21
5
4
12
209
405
119
409
20
285
20
9
52
310
372
16
MEAN
28.93

(N=750)
%
62.1
29.6
4.8
2.8
0.7
0.5
1.6
27.9
54
15.9
54.6
2.7
38
2.7
1.2
6.9
41.3
49.6
2.1
SD
10.7

The Conformity to Masculinity Norms Inventory (Mahalik et al., 2003) contains 94 items answered on a 4point Likert scale (0 = completely disagree, 1 = disagreement, 2 = agreement, 3 = total agree). The statements
have been devised to measure attitudes, beliefs and behaviour reflecting conformity or non-conformity with
eleven messages associated with masculine gender roles: Winning, Emotional Control, Risk-taking, Violence,
Power over Women, Dominant, Playboy, Self Reliance, Primacy of Work, Disdain for Homosexuals and Pursuit
of Status.
3. Results and conclusions
The results of the present study partly support our hypothesis based on the influence of specific
feminine/masculine gender norms on tobacco and alcohol use at women and men (see Table 2 and Table 3). Risk
taking, Violence and Playboy scales are related to the alcohol use. It has been observed that there are different
gender norms that are positively correlated to the tobacco use: Risk taking, Violence, Power over women and
Self-Reliance. These results confirm previous research, for example, Liu and Iwamoto (2007) and Cullar-Flores
and Snchez-Lpez (2011) reported that high scores on the Playboy scale were related to alcohol use and
drinking problems.. This data suggests that some male gender norms could be more important than others in
understanding the relationship between male health behavior and gender norms, and can further support our
understanding of why men engage in riskier health behaviors as part of developing a masculine identity

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Andreea C. Brabete et al. / Procedia - Social and Behavioral Sciences 78 (2013) 230 234

(Courtnenay, 2001; Harrison, Chin & Ficarrotto, 1992). Men who adopt traditional gender norms place their
health at risk (Mahalik, Burns & Syzdek, 2007).
Table 2. Point-biserial correlations between CFNI scores and tobacco use and alcohol-taking
CFNI scales

Tobacco Use

-.02

-.08*

.04

-.18**

-.09*

-.04

-.06

.08*

CFNI
total
-.10*

-.02

-.19**

.03

-.22**

-.10*

-.11**

-.20**

-.01

-.20**

Yes/No
Alcohol Use
Yes/No

Note. 1 = Nice Relationships, 2 = Involvment with Children, 3 = Thinness, 4 = Sexual Fidelity, 5= Modesty, 6= Romantic
Relationship, 7 = Domestic, 8 = Investment in Appearance; * p < .05** p < .01
Table 2. Point-biserial correlations between CMNI scores and tobacco use and alcohol-taking
CMNI scales

10

11

Tobacco Use

.04

-.03

.12*

.10*

.11*

-.04

.10

.13*

.06

-.08

-.08

CMNI
total
.08

.00

-.08

.10*

.11*

.07

-.01

.11*

-.04

-.20

-.04

-.04

.03

Yes/No
Alcohol Use
Yes/No
Note. 1= Winning, 2 = Emotional Control, 3= Risk Taking, 4 = Violence 5 = Power over women, 6 = Dominant, 7 = Playboy,
8= Self-Reliance, 9 = Primacy of work, 10 = Disdain for homosexuality, 11 = Pursuit of Status; * p < .05** p < .01

As for women, our results show that the degree of conformity with feminine gender norms in our study
maintains a significant linear relationship confirming our hypothesis. In the case of both alcohol and tobacco use,
Involvement with children, Sexual Fidelity and Modesty are related inversely to these behaviors. Only high
scores on the Investment in Appearance are related to tobacco use. These results suggest that women are less
likely to consume tobacco and alcohol because such behavior is not consistent with traditional female gender
norms.
To sum up, with regard to tobacco and alcohol use, these findings show that gender socialization of
masculinity and femininity is related to these behaviors. Therefore, it is important to assess the conformity to
masculine and feminine norms is important in psychological research and practice, because it intends to
understand mens and womens health in order to suggest potential preventive and remedial interventions for
improving both health behaviors.
In practice, it has been noted that the cognitive restructuring worked in the case of the gender patterns (e.g.
Barrowclough et al; Hensley et al., 2004). The aim of these techniques is to change the gender patterns for men
and women (Mahalik, 1999) that interfere with health behaviours. This will work on the question of prevention in
order to reduce risk behaviours and increase health-promoting behaviors.
Acknowledgements
This research was supported by a grant from the Complutense University of Madrid, Spain. Financing
Programme for Research.

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Andreea C. Brabete et al. / Procedia - Social and Behavioral Sciences 78 (2013) 230 234

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