Greece: Why don’t adolescents use motorcycle helmets?

Although helmets have been mandatory in Greece since 1977, compliance is low – around 20%. Motorized two-wheelers are pervasive - one in eleven Greeks owns one, and many of them are driven by youths between 15 and 24 years, whose compliance with the helmet law is extremely low. About 80% of youths who die in motorized two-wheeled vehicle are not wearing helmets.

To learn why helmets wearing rates are low in adolescents, researchers from Athens University Medical School examined more deeply the attitudes and beliefs of a group of secondary school students. To do this, they used qualitative methods, which included gathering information from 12 focus groups. Their methods were based on the “Health Belief Model” that says a person will engage in health action if he/she a) perceives himself susceptible to a disease and believes the consequences are serve, b) feels that the benefits of the recommended actions outweigh the barriers, and (c) receives positive cues to undertake the action.

The focus groups were segmented based on whether or not the adolescents in them used two-wheeled vehicles and helmets. Each of the groups were exposed to different topics about helmets, safety, risks, and motorcycle riding and they were shown two videos on motorcycle safety designed to elicit positive feelings and fear about riding.

The results showed that there were varying views of threat perception among users or non-users of motorcycles. Non-users felt there was a low-perceived risk of experiencing a road crash. This appeared to be due to a feeling of invulnerability and adolescent egocentrism. Students who reported high helmet use also reported high-perceived threat of a crash. For non-users of motorcycles, the most important benefit of wearing a helmet was to avoid getting a traffic ticket from the police.

According to non-users of helmets the main barriers to helmet use included low perceived risk of injury, low perceived efficacy of helmets, peer pressure, lack of appropriate information on helmet use, high helmet cost, lack of convenience, vision and hearing disturbances, and style reason.

Editor’s Note: This qualitative study provides an excellent in-depth view of some of the theoretical constructs that make up the “Health Belief Model.” It is a good model for “thinking through” elements that might be part of a campaign to increase helmet use.

Germeni E, Lionis C, Davou B, Petridou E. Understanding reasons for non-compliance in motorcycle helmet use among adolescents in Greece. Inj Prev 2009; 15:19-23.

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