The social norms approach to health promotion has become remarkably popular in the last 20 years, particularly in the American college system. It is an alternative to traditional fear-based approaches of health education, which a growing body of research demonstrates is often ineffective in reducing alcohol and drug misuse. The social norms approach differs by recognizing that individuals, particularly young adults, tend to overestimate how heavily and frequently their peers consume alcohol, and that these perceptions lead them to drink more heavily themselves than they would otherwise do. Similar misperceptions have been found in a range of other health and non-health behaviours. The social norms approach aims to reduce these misperceptions, and thus personal consumption, through the use of media campaigns and personal feedback. Although the numbers of completed social norms projects outside the USA is small, the evidence from them is that the approach can be equally effective in both European and Australian contexts. It is also acknowledged that as an emergent field, there are limitations to the current social norms literature. There is a lack of randomized control trial studies, a lack of clarity of the role of referent groups and a need to better understand the processes through which misperceptions are transmitted. However, despite these issues, the social norms approach represents a new avenue for reducing alcohol and drug-related harm and is an area which merits further research.