Gender differences in prescription misuse intention among university students: Insights from the theory of planned behaviour

Objective

This study aimed to explore the predictors of prescription misuse intentions among university students using the theory of planned behaviour (TPB), with a particular focus on gender differences in the influence of normative pressure, attitudes, and refusal self-efficacy.

Methods

A cross-sectional survey design was employed, a total of 597 (males) and 924 (females) aged (15 to 28), university students from three universities of Kashmir Valley (India) participated in the study using purposive sampling. Structural Equation Modelling (SEM) and multi-group analysis were applied to examine the predictors of prescription misuse intentions and Gender-specific differences in these relationships.

Results

The findings revealed that normative pressure (β = 0.419, p < 0.001) and attitudes towards prescription misuse (β = 0.159, p < 0.001) were positively associated with students' prescription misuse intentions. In contrast, refusal self-efficacy was negatively related to misuse intentions (β = −0.204, p < 0.001). Multi-group analysis showed significant gender differences, particularly in the effect of refusal self-efficacy, with females demonstrating stronger protective effects against misuse (difference = 0.222, p = 0.000). No significant gender differences were found for normative pressure and attitudes.

Conclusion

The study highlights the importance of addressing both normative pressures and attitudes in reducing prescription misuse intentions, with gender-specific interventions focusing on enhancing refusal self-efficacy, particularly for females. These findings have important implications for developing targeted interventions for university students, including nursing students, where the potential for prescription misuse may be elevated due to academic and social pressures.