title: A systematic review of the salient role of feminine norms on substance use among women.
abstract: Substance use among women is a growing and significant public health concern. Given women's vulnerability to substance-use related consequences, it is essential to understand the factors that explain within-group variability in substance use and related problems. Feminine norms, or the beliefs and expectations of what it means to be a woman, appear to be a promising and theoretically-important social determinant of substance use. The present systematic review identifies the current trends and limitations of research examining feminine norms and substance use outcomes among women.
  
  
  
  A systematic review was conducted for peer-reviewed, full-text journal articles written in English published between 2000-2015. Articles that fit the following inclusion criteria: a) use of a feminine norms/ideology or feminine role conflict measure, b) sampling women with a mean age of 15 or higher, and c) quantitative, were included.
  
  
  
  Twenty-three eligible studies were identified. Many women engaged in heavy episodic drinking or were classified as high-risk drinkers. Seventy-four percent of the studies detected a significant relationship between feminine norms and substance use, of which 52% of the studies reviewed reported the harmful role of feminine norms as conferring risk for alcohol use. In addition to substance use risk, women who more strongly endorsed traditional feminine norms were more likely to report concomitant chronic diseases and eating disorder behavior.
  
  
  
  The systematic review highlights that femininity appears to play a distinct and significant role in explaining within-group differences and patterns of substance use among women.
authors.affiliation: Department of Psychology, University of Maryland, College Park, MD 20742, USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Brady
authors.affiliation: Department of Psychology, University of Maryland, College Park, MD 20742, USA. Electronic address: diwamoto@umd.edu.
authors.forename: Derek K
authors.initials: DK
authors.lastname: Iwamoto
authors.affiliation: Department of Counseling and Clinical Psychology, Teachers College, Columbia University, New York, NY 10027, USA.
authors.forename: Margaux
authors.initials: M
authors.lastname: Grivel
authors.affiliation: Department of Psychology, University of Maryland, College Park, MD 20742, USA.
authors.forename: Aylin
authors.initials: A
authors.lastname: Kaya
authors.affiliation: Department of Counseling and Clinical Psychology, Teachers College, Columbia University, New York, NY 10027, USA.
authors.forename: Lauren
authors.initials: L
authors.lastname: Clinton
mesh_terms: D000328:Adult; D005260:Female; D057227:Femininity; D006801:Humans; D012307:Risk Factors; D066262:Social Norms; D019966:Substance-Related Disorders / Q000523:psychology*; D016387:Women's Health
keywords: Alcohol use; Feminine norms; Tobacco use; Women