The Role of Habit in Fast Food Consumption: Integrating Habit into the Theory of Planned Behaviour

The Role of Habit in Fast Food Consumption: Integrating Habit into the Theory of Planned Behaviour | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article The Role of Habit in Fast Food Consumption: Integrating Habit into the Theory of Planned Behaviour Elena Kokthi, Iliriana Miftari, Arbenita Hasani, Ira Tili, Alerta Basha This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6221337/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 21 Dec, 2025 Read the published version in Discover Sustainability → Version 1 posted 14 You are reading this latest preprint version Abstract This study examines the role of habitual behaviour in adolescent fast-food consumption and its implications for the Theory of Planned Behavior (TPB). While TPB traditionally explains behaviour through attitudes, subjective norms, and perceived behavioural control, our findings suggest that habitual automaticity, contextual triggers, and environmental cues are stronger predictors of fast-food consumption. The results show that higher maternal education reduces fast food as a meal replacement but does not significantly impact overall consumption frequency, indicating that external social and environmental factors outweigh parental influence. Additionally, fast food consumption persists even without advertising or promotions, reinforcing the habit-driven nature of this behaviour. These findings suggest that habit should be integrated into TPB as a direct predictor of behaviour, shifting intervention strategies from awareness-based approaches to habit-disruption models. Policies should focus on modifying food environments, leveraging social norms, and using behavioural nudges to encourage sustainable eating behaviours. adolescents fast food consumption theory of planned behaviour habit women sustainable consumption Figures Figure 1 Figure 2 1. Introduction Unhealthy diets, overweight, and obesity have become significant public health challenges, particularly among adolescents whose dietary patterns are shifting away from traditional Mediterranean diets toward increased fast-food consumption (FFC) (Cuenca-García et al., 2012; Gedamu, 2023; Jacka et al., 2011; Naja et al., 2015; Shayo, 2019; Vale et al., 2022, ). Industrialisation, urbanisation, and globalisation have drastically transformed food environments, making ultra-processed, energy-dense foods more accessible and affordable than fresh, nutritious alternatives (Gedamu, 2023; Kothe et al., 2015; Shayo, 2019; Vale et al., 2022; Vuolo et al., 2014). While obesity was once perceived as a problem in high-income countries, it is now rapidly rising in low and middle-income countries, especially in urban areas (Baker et al., 2020; Chong et al., 2023; Kalsum et al., 2018; Naja et al., 2015). A new form of food poverty has emerged not only in terms of food scarcity but also in nutritional quality, where unhealthy diets contribute significantly to non-communicable diseases (NCDs) (Adélia da Costa Pereira de Arruda Neta et al., 2021; Afshin et al., 2019; Ambikapathi et al., 2022; Gedamu, 2023; Vincze et al., 2023). In Albania, diet-related diseases—including diabetes, cardiovascular diseases, and hypertension—pose a growing health and economic burden. The cost of treating diabetes alone is estimated at €68.4 million per year, accounting for 0.44% of the country’s GDP, with additional costs stemming from lost productivity and premature mortality. Dietary risks contribute to 829.2 Disability-Adjusted Life Years (DALYs) per 100,000 people (Global Burden of Disease, 2023), highlighting the long-term impact of unhealthy eating habits. Given the significant social and economic implications, understanding the drivers of adolescent fast-food consumption is crucial for designing effective policy interventions. Fast-food establishments market their products as convenient, affordable, and socially appealing, making them particularly attractive to adolescents (Coffee et al., 2016a; Didarloo et al., 2022a; Dunn et al., 2011a). Research suggests that globalisation has contributed to obesity in low-income countries by flooding markets with inexpensive processed foods and expanding Western-style fast-food chains (Adair & Popkin, 2005; Baker et al., 2020; Dunn et al., 2011a). However, scholars argue that economic globalisation may also encourage investments in public health, as labour productivity and human capital become critical for economic competitiveness (Ambikapathi et al., 2022). In addition to global trends, local factors—such as urbanisation, household structures, and increased female labour force participation—have significantly reshaped food consumption patterns (Adair & Popkin, 2005; Kunto & Bras, 2018; Mama Chabi et al., 2022; Vliet et al., 2015). One key transformation is the rising participation of women in the workforce, which has led to greater reliance on fast food and pre-packaged meals due to time constraints (Kunto & Bras, 2018). Traditionally, women played a central role in food preparation, ensuring balanced home-cooked meals (A & Deepika, 2020). However, economic pressures and changing social norms have reduced the frequency of home-cooked meals, especially in urban settings where fast food is readily available (Ambikapathi et al., 2022; Caspi et al., 2012; Coffee et al., 2016b; Smith et al., 2013). This shift mainly affects adolescents, who, without structured meals, develop independent eating habits favouring convenience over nutrition (Kalsum et al., 2018; Kunto & Bras, 2018). These changes in the workforce indirectly contribute to rising fast food consumption, reinforcing the need for policies that promote healthier and more accessible food options without disproportionately burdening working women. This study applies the Theory of Planned Behavior (TPB) (Ajzen, 1991) to examine the determinants of adolescent fast-food consumption in Albania. TPB posits that behavioural intentions are shaped by attitudes, subjective norms, and perceived behavioural control, making it a helpful framework for understanding adolescent food choices (Ajzen, 1991; Didarloo et al., 2022a; Dunn et al., 2011a). This study explores how perceived benefits, and subjective norms influence attitudes toward fast food consumption and whether attitudes reinforce or discourage consumption frequency and weekly meal replacement with fast food. Moreover, the conceptual model explores whether perceived health risks determine weekly meal replacement with fast food and how demographic factors such as education impact fast food consumption among adolescents regarding consumption frequency and weekly meal replacement with fast food. The remainder of the paper is structured as follows: The second section reviews the literature on the influence of perceived benefits and risks, subjective norms, attitudes, and demographics on fast food consumption. The third section outlines the methodological framework. Section four discusses the results, and the final section presents conclusions and policy implications. 2. Literature review 2.1 Theoretical Framework and Hypotheses Behavioural models, such as the Theory of Planned Behavior (TPB), are widely applied to study the relationships between beliefs, attitudes, behavioural intentions, and actual behaviours in various human domains (Ajzen, 1991; Armitage & Conner, 1999; Barber, 2012; Chen & Tung, 2014, 2014; Didarloo et al., 2022b; Dunn et al., 2011b; Gakobo & Jere, 2016; McKee et al., 2019). Encouraging adherence to healthy dietary patterns is a significant public health challenge, and TPB allows researchers and policymakers to identify key determinants of nutritional choices and design effective interventions (Bassett-Gunter et al., 2015; McDermott et al., 2015). The TPB has been a reliable predictor of various health-related behaviours, explaining between 14% and 24% of the behavioural variance (McEachan et al., 2011)). Additionally, TPB has been successfully applied to predict dietary behaviours (McDermott et al., 2015), demonstrating that subjective norms, perceived behavioural control (PBC), and attitudes strongly influence food-related decision-making. Ajzen extended the TPB from the Theory of Reasoned Action (TRA) by incorporating perceived behavioural control, which refers to an individual's belief in their ability to perform a behaviour successfully (Ajzen, 1991, 2002; Ajzen et al., 2018). According to TPB, behavioural intentions—which are the strongest predictors of actual behaviour—are shaped by three main components: Subjective norms (social pressure and perceived approval from others) Perceived behavioural control (confidence in one's ability to act) Attitudes (positive or negative evaluations of the behaviours) (Ajzen, 1991). Additional variables have been integrated to enhance the model's predictive validity in explaining fast food consumption (FFC) patterns. Dunn et al. (2011) extended TPB by considering future consequences, fear of negative evaluation, and self-identification as a healthy eater to analyse FFC behaviours in Australia. Similarly, (Dunn et al., 2011a; Šapić et al., 2019; Sumardi et al., 2022) applied TPB and found that subjective norms were the most substantial predictors of fast-food consumption frequency (FFC). Sharifirad et al., (2013) further confirmed that social norms and past behaviour were significant predictors of FFC, while Mirkarimi et al. (2016) emphasised the influence of peer norms on adolescents' fast food consumption intentions. Also, TPB has been validated across various cultural and demographic contexts. Studies have shown that subjective norms significantly impact adolescents’ eating habits, with factors like fast food availability, taste, and parental influences as facilitators and barriers to healthy eating. Grier & Kumanyika, (2008) highlighted the role of marketing stimuli, showing how parental purchasing behaviours—often driven by limited nutritional knowledge—affect children's dietary choices. Furthermore, Seo et al. (2011) demonstrated the moderating role of peer influence in shaping adolescent fast food consumption. The review of TPB components relevant to FFC is detailed below, alongside the hypotheses that will be tested in this study. 2.2.1 Subjective Norms and Fast-Food Consumption (FFC) In TPB, subjective norms refer to an individual's perception of social pressure to perform or avoid a behaviour (Ajzen, 1991; Ajzen et al., 2018; Vallerand et al., 1992) (Ajzen & Fishbein, 1975). These norms include the influence of family, friends, teachers, and community expectations. Subjective norms are classified into two categories: Injunctive norms: Beliefs about what important social referents approve or disapprove of (Cialdini & Goldstein, 2004). Descriptive norms: Perceptions of what others do, shaping behavioural expectations (Cook et al., 1980). Subjective norms strongly influence FFC, particularly among adolescents, as they tend to be highly susceptible to peer and parental influences (Bagozzi, 2000; Cialdini & Goldstein, 2004). In various studies, subjective norms were the strongest predictors of FFC intentions in Iran (Sharifirad et al., 2013b), Turkey (Yarimoglu et al., 2019), Malaysia (Kamalul Ariffin et al., 2021), Australia (Dunn et al., 2011), and Romania (Bîlbîie et al., 2021). Additionally, studies indicate that subjective norms influence adolescents' eating behaviours more significantly than adults' (Dunn et al., 2011). The impact of injunctive norms (parental and teacher influence) versus descriptive norms (peer influence) remains debated, with some studies showing parental influence as dominant. In contrast, others indicate peer influence as more significant (Bîlbîie et al., 2021). Following this perspective, we suggest the following hypotheses: H1SN: Injunctive subjective norms from teachers and friends will substantially influence FFC frequency and WMR among adolescents in Albania. 2.2.2 Perceived Benefits and FFC Fast food consumption involves a trade-off between immediate rewards and long-term health risks (Dunn et al., 2011). Many individuals consume fast food for its convenience, affordability, and sensory appeal despite being aware of its potential adverse health impacts (Bawajeeh et al., 2020; Grier & Kumanyika, 2008; Imtiyaz et al., 2021; Kemp et al., 2013). Several studies highlight that taste, price fairness, and restaurant environment significantly affect customer satisfaction and FFC (Dave et al., 2009; Hanaysha, 2016). The perceived benefits of fast-food consumption include nutritional beliefs, such as consumers believing fast food provides essential nutrients (Bawajeeh et al., 2020; Grier & Kumanyika, 2008; Imtiyaz et al., 2021; Kemp et al., 2013). Economic factors are also important, as perceived affordability and value-for-money influence FFC decisions (Hanaysha, 2016). Finally, social factors, i.e. linked to Fast food outlets, are often perceived as fun and socially engaging spaces, particularly for adolescents (Caspi et al., 2012; Imtiyaz et al., 2021). Adolescents often view fast-food restaurants as social hubs, where a clean, aesthetically pleasing, and engaging environment fosters positive attitudes toward fast-food consumption despite potential nutritional drawbacks (Engler-Stringer et al., 2014; Shaw et al., 2023). Accordingly, in the present study, we will test the following hypothesis: H2PB4: Adolescents who perceive higher benefits related to fast food restaurants’ physical and social environment will show positive attitudes towards fast food consumption. 2.2.3 Attitudes and FFC Attitudes refer to favourable or unfavourable evaluations of behaviour (Ajzen & Fishbein, 1975). In the context of fast-food consumption, attitudes can be classified into affective attitudes (emotional preferences for taste and enjoyment FFC and cognitive attitudes (rational considerations of health and affordability) (Bîlbîie et al., 2021). Research suggests that positive attitudes toward fast food reinforce consumption behaviours, as individuals prioritise immediate gratification (Strathman et al., 1994)). Adolescents, in particular, exhibit temporal discounting, where short-term benefits such as taste, convenience, and social enjoyment outweigh long-term health concerns (Gardner, 2015; Gardner et al., 2014, 2023) Thus, we hypothesise: H3PATT: Adolescents with positive attitudes toward fast food will exhibit a higher frequency of fast food consumption - and weekly meal replacement with fast food , 2.2.4 Risk Perceptions of FFC Risk perception is crucial in shaping food choices, as individuals often weigh potential health risks against immediate benefits (I. U. Barlow et al., 2024; P. Barlow et al., 2016). However, in the case of fast-food consumption (FFC), adolescents may exhibit time discounting, prioritising short-term gratification (e.g., taste, convenience) while underestimating long-term health consequences (Kahneman, 2003; Kahneman et al., 1991). Studies indicate that as unhealthy food choices become more frequent, individuals become desensitised to risk perceptions (Kakoschke et al., 2015; Martinelli et al., 2023). This risk habituation may lead adolescents to ignore the health implications of fast-food consumption, reinforcing consumption patterns. Thus, we hypothesise: H4PR: Adolescents with higher perceived risks of fast-food consumption will exhibit lower weekly meal replacement with fast food. 2.2.5 Socioeconomic and Demographic Factors in Fast Food Consumption (FFC) One of the most notable recent trends in consumer food purchasing is the increased consumption of food outside the household, a pattern that has also emerged in Albania (Pow(Khurana, 2021; Kunto & Bras, 2018). Multiple socioeconomic factors drive this shift, including rising family incomes and increasing female labour participation. Studies indicate that fast-food consumption (FFC) frequency is significantly associated with household size, number of children, parents' education, household income, and the mother's employment status (Sharifirad et al., 2013). Additionally, several studies highlight that individual and social factors influence adolescent fast food consumption, particularly regarding parental perceptions of their child's diet quality(Allen et al., 2013; Crocetti et al., 2017). Given that family-based interventions are critical in shaping children's eating habits, addressing misconceptions and unhealthy parental beliefs may be essential for early intervention and obesity prevention (Allen et al., 2013; Crocetti et al., 2017; Davidson et al., 2011; Khurana, 2021). Based on this, we propose the following hypotheses: H5: Higher maternal education levels will be associated with a lower frequency of fast-food consumption and weekly meal replacement with fast food 3. Material and method 3.1 Data collection This study examines adolescents' fast-food consumption (FFC) patterns in Albania through a survey conducted from 2023 to 2024 in various locations within Tirana city. The target population includes private and public school adolescents, ensuring a representative sample of urban youth. The questionnaire was developed online. The survey collected demographic characteristics, including gender, age, parents’ education and employment status, education sector (public vs. private), and place of residence (urban/rural). Additionally, it explored the frequency of fast-food consumption, contextual factors influencing choices—such as place of consumption, reasons for eating fast food, and the extent to which home-cooked meals are replaced by fast food—attitudes toward health, and marketing influences, including advertising, pricing, and restaurant environments. This study incorporates indicators of food environment industrialisation to contextualise fast food consumption within Albania’s broader food system transformation. Between 2016 and 2021, packaged food sales increased by 44%, ultra-processed food (UPF) sales rose by 78%, and the supermarket sector expanded by 23.5% in 2017 and 7.4% in 2021, which persists. Additionally, 39% of meals are now consumed outside the home (INSTAT, 2023), while home-cooked meals are declining due to urbanisation, lifestyle changes, and increased access to fast food outlets (Food System Dashboard, 2023). These structural changes highlight the increasing reliance on processed and convenient foods, shaping adolescent consumption behaviour. A five-point Likert scale (1=strongly disagree… 5=strongly agree) measures participant preferences and attitudes toward fast food. Previous studies in Albania validated the scale, demonstrating its reliability and discriminative capacity in analysing food consumption behaviours (Hasani et al., 2022; Kokthi et al., 2022). By integrating fast food consumption trends with Albania’s evolving food retail landscape, this study comprehensively assesses the food system's industrialisation and its impact on adolescent dietary habits. Table 1: Participants characteristics (N=296) Variables Description frequency in % Gender 1. Males, 2. Females 46.3 53.7 Age Age categories: 12-13, 14-15, 16-17, 17-18, 17,8 35,6 13,6 33,0 Mother Education Low: 1-8 years. Medium: 8-12 years. High: more than 12 years 49,2 35,6 15,2 Father Education Low: 1-8 years. Medium: 8-12 years; High: more than 12 years 46,1 42,4 11,5 Mother employment status Employed Unemployed 79,6 20,4 Father employment status Employed Unemployed 88,5 11,5 Education sector Public Private 69,1 30,9 Residence Urban areas Rural areas 93,7 6,3 Source: Author's elaboration. 3.2 Measurement As mentioned, this study focuses on adolescents and young adults in Albania, a demographic with a high interest in fast food consumption (FFC). This behaviour is primarily driven by convenience, affordability, and accessibility (Seo et al., 2011). Adolescents also experience lifestyle transitions that promote increased independence and greater exposure to fast food choices. Given the rapid transformation of the Albanian food system, TPB offers a structured approach to understanding adolescent dietary behaviours in an evolving urban environment. The following paragraphs present each TBP construct and items used in the present study. 3.2.1 Independent Variables This study assesses the key determinants of FFC using validated TPB-based constructs such as subjective norms, attitudes, perceived benefits and risks, and demographics toward FFC. 3.2.2 Subjective Norms Adolescents' food choices are shaped by reference groups, particularly parents, peers, and teachers (Cialdini & Goldstein, 2004). Six statements were developed to assess subjective norms and measured with a LIKERT scale of 1 – disagree entirely to 5 – completely agree. Reference group expectations ("I act as my parents, teachers, and friends would expect me to") and Perceived approval of behaviour: "I think that my parents, teachers, and friends like the fact that I consume fast food " see Table 2. Given the target group's developmental stage, social influences are expected to impact their intention and behaviour toward the FFC significantly. 3.2.3 Perceived Benefits of Fast Food While FFC is often linked to diet-related health risks, adolescents also perceive several benefits, including affordability—lower cost than restaurant meals—and convenience of purchase and consumption. Taste & Social Enjoyment – fast food is an appealing and accessible option. Five Likert-scale statements were used to measure perceived benefits ( i.e. The restaurants where fast food is served are very nice ones; 2) The restaurants where fast food is served are clean and safe;3) Fast food restaurants are a pleasant place to have birthday parties) see Table 2. 3.2.4 Attitudes Toward Fast Food Consumption Adolescents' attitudes toward fast food are often driven by habitual behaviours rather than rational decision-making (Gardner, 2015; Verplanken & Aarts, 1999; Verplanken & Sato, 2011). Despite awareness of health concerns, adolescents may continue consuming fast food (Frank, 2012). Attitudes were measured using nine Likert-scale items ( e.g., "I eat fast food even though I am aware it is not healthy, "Even if awareness is raised about the adverse effects of fast food on health, I believe I will continue eating it. see Table 2). 3.2.5 Risk Perception of Fast-Food Consumption Perceived risks are pre-existing beliefs about the adverse health effects of fast food, which often develop before individuals experience direct health consequences (Bîlbîie et al., 2021; Coffee et al., 2016b; Šapić et al., 2019; Sharifirad et al., 2013)Seven statements were developed to assess risk perception: "I think fast food products contain too much fat. Excessive consumption of fast food causes serious health problems." See Table 2 for statistics. Table 2: The TPB determinants analysis in FFC (N=296) TPB Determinants Mean Standard Deviation Subjective norms I act as my parents would expect me to (SN1) 2.9 1.15 I act as my teachers would like me to (SN2) 2.7 1.09 I act as my friends would like me to (SN3) 1.77 0.97 I think that my parent like the fact that I use FF to (SN4) 2.79 1.13 I think that my teachers would like my FF consumption (SN5) 2.33 1.14 I think that my friends like the fact that I use FF (SN6) 2.86 1.23 Perceived benefits I think that FF provides all the necessary nutritive elements I need (PB1) 2.05 0.97 I think that FF is offered in ample portions that satisfy hunger (PB2) 3.07 1.05 I think that FF is very tasty (PB3) 3.93 0.94 I think that FF costs much less than food in restaurants (PB4) 3.62 1.17 The restaurants where it is served FF are very nice ones (PB5) 3.13 0.97 The restaurants where it is served FF are clean and safe (PB6) 2.68 1.14 FF restaurant is a pleasant place to have birthday parties (PB7) 2.72 1.31 Attitudes I think it is not challenging to eat FF (ATT 1) 2.8 1.236 I eat FF also when I am dieting (ATT2) 2.2 1.186 I eat FF even though I am aware it is not healthy (ATT3) 3.5 1.11 I use FF, although I cook a meal so fast on my own (ATT4) 2.9 1.229 Even if awareness is raised of the adverse effects of FF on our health, I believe that I will continue eating FF (ATT5) 3.1 1.13 I use FF, although fast restaurants are far away (ATT6) 2.6 1.13 I use FF, although there is no advertising on TV, the internet (ATT7) 3.4 1.15 I use FF, although there is no promotional marketing offered (ATT8) 3.4 1.07 I use FF, although I must wait a long time to get it. (ATT9) 3 1.15 Perceived risks I think that FF is unhealthy (PR1) 3.8 1.16 I think that excessive consumption of FF causes serious health problems (PR2) 4.1 1.01 I think that FF products contain so much fat (PR3) 4 0.91 I think that FF has too much salt (PR4) 2.9 1.11 I think that FF products are very high in calories (PR5) 4 1.05 I think that FF products make you fat (PR6) 4.1 1.02 I think that FF products have been stored in freezing for a long time (PR7) 3.2 1.08 3.2.6. Dependent Variables Three dependent variables are analysed: attitudes, the Fast-Food Consumption Rate (FFCR), which measures the weekly frequency of fast-food consumption, and the Weekly Meal Replacement Frequency (WMRF), which measures how often adolescents replace home-cooked meals with fast food. Including WMRF alongside FFCR provides an additional perspective on adolescent fast-food consumption. While FFCR identifies consumption frequency, WMRF captures the extent to which home-cooked meals are displaced, offering additional insights into dietary patterns and long-term public health concerns. This distinction is critical for designing effective health policies and behavioural interventions that promote sustainable and balanced eating habits among adolescents. The FF types included in this study are identified through three focus groups developed with children of the group ages mentioned above in Albania. The main FF items consumed by the participants are hamburgers, donners, souvlaki, pizza, french fries, and sandwiches see Table 3. Other studies have also considered these items (Powell & Han, 2011), reflecting the impact of globalisation on children's consumption patterns (Adair & Popkin, 2005). The data results also justify exploring the consumption patterns toward different FF items in Table 3. Table 3: Fast Food Consumption Frequency and Weekly Meal Replacement. FF Type 1 Time per Week (%) 2 Times per Week (%) 3 or More Times per Week (%) Hamburger 39.8 51.8 8.4 Donner 91.1 3.1 5.8 Souvlaki 42.9 46.1 11 Pizza 45 40.8 14.1 French fries 36.1 45 18.8 Sandwiches 27.7 62.3 9.9 Weekly Meal Replacement Frequency (WMRF) 43.2 29.7 27 Source: Author's elaboration The conceptual model in Figure 1 is based on constructs that measure the impact of perceived benefits and subjective norms on consumer attitudes and fast-food consumption. The dependent variables were assessed using five-point Likert scales, as shown in Tables 2 and 3. The model was evaluated using Partial Least Squares Structural Equation Modeling (PLS-SEM) with the bootstrapping method, involving 5,000 resamples to estimate parameters and path coefficients. Cronbach’s alpha was used to ensure each construct's internal consistency and reliability. Confirmatory Factor Analysis (CFA) was conducted to test convergent and discriminant validity, with results exceeding established thresholds (CFA > 0.7; CR > 0.7; AVE > 0.5), demonstrating robust validity. Additionally, the model's explanatory power was assessed by calculating the total variance in fast food attitudes and consumption changes, influenced by factors related to subjective norms, perceived benefits, perceived risks, and education. Model fit was evaluated using the Standardized Root Mean Square Residual (SRMR), with values below 0.10 indicating satisfactory model validation. Descriptive analysis and analysis of variance are used for demographic effects analysis. 4. Discussion of results The demographic profile of the study sample provides insights into the respondents' characteristics and socio-economic background. The sample comprises 53.7% females and 46.3% males, indicating a slightly higher participation of female respondents. The age distribution is relatively balanced, with the most significant proportion of adolescents falling into the 14–15 age group (35.6%), followed by 17–18 years (33.0%), 12–13 years (17.8%), and 16–17 years (13.6%) see Table 1 . Regarding parental education, the majority of mothers have completed low (49.2%) or medium (35.6%) levels of education, while a smaller percentage (15.2%) have attained higher education. A similar trend is observed for fathers, where 46.1% have a low level of education, 42.4% have a medium level, and only 11.5% have pursued higher education. Regarding employment, 79.6% of mothers are employed, while 20.4% are unemployed, whereas fathers show a higher employment rate, with 88.5% employed and only 11.5% unemployed. The education sector attended by respondents indicates that 69.1% are enrolled in public schools, while 30.9% attend private institutions. Additionally, most participants reside in urban areas (93.7%), with only 6.3% coming from rural areas. This distribution reflects the increasing urbanisation trends in Albania, particularly the concentration of adolescents in cities, which may influence lifestyle patterns, including food consumption habits. The data highlights key socio-economic factors that may shape adolescents' behaviours and attitudes, particularly regarding fast-food consumption and lifestyle choices. Parental demographics, particularly mothers' education and employment status, will help us understand how socio-economic factors influence adolescents' food consumption patterns. Mothers' education levels play a crucial role in shaping household dietary habits, as higher education often correlates with greater nutritional awareness and a stronger preference for healthier food choices (Hinnig et al., 2018; Kalsum et al., 2018; Kunto & Bras, 2018; Mama Chabi et al., 2022). 4.1 Subjective Norms and FFC Results suggest that while social norms play a role in adolescent fast-food consumption, their influence appears to be weaker than expected, particularly in the case of peer influence. This might indicate that this age group actively seeks independence in decision-making, aligning with psychological theories on adolescent identity formation and conflict with authority figures (Becht et al., 2017; Crocetti et al., 2017). A key insight is that 77.4% of respondents report moderate to strong motivation to comply with social norms, but this compliance is selective. Parental influence remains the strongest, with 67.9% stating that they act as their parents would expect regarding food choices. However, this does not necessarily translate into healthy eating behaviours, as 42.2% believe their parents approve or are neutral toward fast food consumption. This suggests that parental approval or indifference may weaken the potential for healthier eating behaviours at home. Similarly, teachers' influence appears limited, with 63.2% stating that they act as their teachers would prefer, yet 56.4% believe teachers disapprove of fast-food consumption without significantly modifying their behaviour. This reinforces the idea that authoritative figures, such as teachers, may not influence adolescents’ personal food choices sufficiently. Peer influence is surprisingly low, with 81.4% stating that they do not feel influenced by their friends in consuming fast food. Only 32.1% believe their friends approve of fast-food consumption, indicating that adolescents view their dietary choices as personal decisions rather than socially driven behaviours. This result could also reflect a desire for autonomy and self-expression, where adolescents resist admitting external influence over their eating habits, even if such influence exists subconsciously (Crocetti et al., 2017; Luyckx et al., 2009). Adolescents may resist acknowledging the impact of social norms because a conflict between dependence and independence often marks this stage of development (Crocetti et al., 2017; Lawler & Thye, 1999; Vuolo et al., 2014). 4.2 Perceived Benefits of FFC Perceived benefits play a crucial role in shaping attitudes and consumption patterns. The findings indicate that adolescents strongly perceive fast food as tasty (M = 3.93, SD = 0.94), convenient (FF satisfies hunger: M = 3.07, SD = 1.058), and cost-effective (M = 3.62, SD = 1.177). However, nutritional value perception is relatively low (M = 2.05, SD = 0.979), suggesting that adolescents recognise fast food as a source of immediate gratification rather than balanced nutrition. Moreover, environmental factors such as restaurant atmosphere (M = 3.13, SD = 0.978) and safety and cleanliness (M = 2.68, SD = 1.148) have a moderate impact, while the perception of fast-food outlets as a place for social events like birthdays (M = 2.72, SD = 1.314) remains relatively low see Table 2 . This indicates that while adolescents value the accessibility and affordability of fast food, social factors related to restaurant environments play a secondary role in their food choices. 4.3 Attitudes Toward FFC Attitudes reflect the personal inclination toward consuming fast food, even when aware of its negative consequences. The findings show that adolescents continue to consume fast food despite being aware of its health risks (M = 3.5, SD = 1.11); see Table 2 . Additionally, they eat fast food even when alternative home-cooked meals are available (M = 2.9, SD = 1.229) or restaurants are not easily accessible (M = 2.6, SD = 1.13). A critical insight is that awareness alone does not significantly discourage FFC, as many adolescents are willing to continue consuming fast food even if more awareness campaigns were introduced (M = 3.1, SD = 1.136). This highlights the role of habit and automatic decision-making, suggesting that FFC is not just an intentional choice but a habitual behaviour driven by external cues. Additionally, responses indicate that FFC is not strongly influenced by advertising (M = 3.4, SD = 1.152) or promotional marketing (M = 3.4, SD = 1.073). Suggesting that marketing strategies may reinforce existing behaviours but are not adolescents' primary drivers of FFC. 4.5 Perceived Risks of FFC Despite recognising the negative health implications, adolescents continue to consume fast food. The results indicate that participants strongly agree that fast food is unhealthy (M = 3.8, SD = 1.163) and that excessive consumption causes serious health problems (M = 4.1, SD = 1.019). Additionally, there is high agreement that fast food is high in fat (M = 4, SD = 0.912) and calories (M = 4, SD = 1.054), leading to weight gain (M = 4.1, SD = 1.029). Interestingly, perceived risks do not significantly alter consumption behaviour. This confirms findings from previous research, where awareness of adverse health effects does not necessarily lead to behaviour change, particularly among adolescents who prioritise taste, convenience, and affordability over long-term health risks (Bargiota et al., 2013; Fitzgerald et al., 2010; Kalsum et al., 2018; Maulida et al., 2016). A notable insight is the lower agreement regarding food safety risks—adolescents are less concerned about storing fast food for extended periods (M = 3.2, SD = 1.086) or having excess salt (M = 2.9, SD = 1.112). This suggests that while they recognise the nutritional downsides of fast food, food safety concerns are not a significant deterrent in their decision-making. 4.6 Fast Food Consumption Patterns and Weekly Meal Replacement Frequency (WMRF) The results indicate varying consumption levels across different fast-food types, with some items significantly more frequently consumed than others. The most commonly consumed fast food item is donner, with 91.1% of adolescents consuming it at least once per week and only 5.8% consuming it three or more times per week. This high frequency suggests that donner may be perceived as a familiar, accessible, and preferred fast-food option, possibly due to its availability and affordability. Hamburgers, pizza, and souvlaki are also frequently consumed, with most adolescents eating them one to two times per week. Specifically, hamburgers are consumed at least once per week by 39.8%, with 51.8% eating them twice per week and 8.4% three or more times. Souvlaki follows a similar trend: 42.9% eat it once, 46.1% twice, and 11% three or more times per week. Pizza consumption is slightly higher in the three or more times per week category (14.1%), suggesting a strong preference for this food type among adolescents. Among side items, French fries are a staple, with 36.1% consuming them once weekly, 45% twice weekly, and 18.8% three or more times weekly. The relatively high frequency of French fries suggests that they are often paired with other fast-food items rather than consumed alone. Despite being a typical fast-food choice, sandwiches show a slightly different consumption pattern. 62.3% eat them twice weekly, 27.7% once weekly, and 9.9% three or more times per week. The frequency of twice-weekly consumption suggests that sandwiches might be considered a convenient meal replacement rather than an occasional indulgence. Weekly Meal Replacement Frequency (WMRF) The Weekly Meal Replacement Frequency (WMRF) data indicate that many adolescents use fast food as a substitute for home-cooked meals. About 57% of adolescents replace a home-cooked meal with fast food at least twice weekly, indicating a significant shift toward convenience-oriented eating habits. 27% of those who replace three or more meals per week with fast food indicate a concern about reliance on fast food, which could have long-term health and nutritional implications. The high frequency of meal replacement with fast food suggests that adolescents prioritise convenience over nutritional value, reinforcing the role of habit and accessibility in shaping eating behaviours. Given the findings on perceived risks and attitudes toward fast food, adolescents recognise the unhealthiness of fast food but continue consuming it, possibly due to the ease of access, taste preference, and social norms. The preference for donner, souvlaki, and pizza may reflect local food traditions and urban food culture, where these items are commonly available and considered socially acceptable choices among peers. Nearly 30% replace meals with fast food multiple times per week, suggesting a need for policy interventions to promote healthier meal options in schools and urban areas. These findings highlight adolescents' reliance on fast food as a convenient meal option, with certain food items (donners, hamburgers, pizza, and fries) dominating consumption patterns. The high weekly meal replacement rates reinforce the need for targeted interventions to encourage healthier eating habits, mainly focusing on reducing dependency on fast food as a primary meal source and promoting balanced alternatives. Addressing the habitual nature of fast-food consumption and its social reinforcement could play a crucial role in shaping healthier dietary behaviours in the long term. 4.7 Partial Least Squares Structural Equation Modeling (PLS-SEM) results Cronbach’s Alpha values the construct's subjective norms, perceived benefits and risks of fast-food consumption, and positive attitudes towards fast-food consumption exceeded the minimum threshold of 0.7, indicating reliable internal consistency (Nunnally, 1978). Furthermore, confirmatory factor analysis demonstrated strong reliability, as all indicator loadings for these constructs exceeded the recommended threshold of 0.7 (Hair et al., 2013). Composite reliability values for constructs of perceived benefits and risks of fast food consumption, subjective norms, and positive attitudes towards fast food consumption were higher than 0.7, as suggested by (Hair et al., 2017) Table 5 and AVE value above 0.5 as recommended by (Fornell & Larcker, 1981) Table 6 . Table 4 Comprehensive breakdown of items forming the constructs in the estimated model (Fig. 1 ) Construct Items SN – Subjective norms SN1 – I act as my teacher would like me to SN2 – I act as my friends would like me to PB – Perceived benefits toward fast food PB1 - The restaurants where fast food is served are very nice ones; PB2 - The restaurants where fast food is served are clean and safe; PB3- A fast food restaurant is a pleasant place to have birthday parties. PATT – Positive attitudes toward fast food PATT1 - I eat FF also when I am dieting PATT2 - I use fast food although I have to wait a long time to get it PR – Perceived risk toward fast food PR1 – I think fast food is unhealthy PR2 – I think that fast food products make you fat Table 5 Composite reliability analysis Original sample (O) Standard deviation (STDEV) T statistics (|O/STDEV|) P values PATT 0.804 0.020 39.724 0.000 PB 0.868 0.014 61.926 0.000 PR 0.835 0.020 41.951 0.000 SN 0.738 0.031 23.505 0.000 Notes. PATT = positive attitudes, PB = Perceived benefits, PR = Perceived risks, SN = subjective norms Table 6 Average Variance Extracted (AVE) Original sample (O) Standard deviation (STDEV) T statistics (|O/STDEV|) P values PATT 0.673 0.028 24.079 0.000 PB 0.687 0.026 26.637 0.000 PR 0.717 0.029 25.142 0.000 SN 0.586 0.034 17.404 0.000 Notes. PATT = positive attitudes, PB = Perceived benefits, PR = Perceived risks, SN = subjective norms The discriminant validity of the model was assessed using the Heterotrait-Monotrait Ratio (HTMT). The analysis confirmed the model's validity, as all values in the HTMT matrix were below the recommended threshold of 0.90 Table 7 . Table 7 Heterotrait-Monotrait (HTMT) matrix of the estimated model Original sample (O) 2.5% 97.5% ME FFFC 0.049 0.003 0.154 PATT FFFC 0.664 0.508 0.822 PATT ME 0.008 0.014 0.181 PB FFFC 0.395 0.258 0.508 PB ME 0.017 0.016 0.146 PB PATT 0.821 0.693 0.960 PR FFFC 0.096 0.045 0.235 PR ME 0.059 0.017 0.192 PR PATT 0.134 0.065 0.397 PR PB 0.108 0.073 0.305 SN FFFC 0.387 0.180 0.919 SN ME 0.229 0.099 0.613 SN PATT 0.807 0.480 1.593 SN PB 0.611 0.404 1.201 SN PR 0.591 0.323 1.208 WMR FFFC 0.188 0.083 0.287 WMR ME 0.124 0.015 0.235 WMR PATT 0.456 0.306 0.622 WMR PB 0.167 0.052 0.289 WMR PR 0.383 0.239 0.531 WMR SN 0.231 0.061 0.573 Notes. PATT = positive attitudes, PB = Perceived benefits, PR = Perceived risks, SN = subjective norms, WMR = Weekly meal replacement, ME = mother education Source: Authors' elaboration The SRMR fit index for the saturated and estimated models is 0.09, within the acceptable threshold of ≤ 0.1, indicating a good model fit (Bentler & Bonett, 1980). These findings provide insights into the factors shaping consumer attitudes and behaviour towards fast food, confirming some of the hypothesised relationships while challenging others. Subjective norms show a positive and statistically significant association with positive attitudes toward fast food consumption among adolescents (βSN → PATT = 0.177; t = 10.204; p = 0.001). Hypothesis H1SN was accepted . However, the coefficient is relatively low, suggesting that while social influence is important, its impact on attitude formation is moderate. The lower coefficient can be explained by two key factors: conflicting social influences. In line with other studies, adolescents navigate multiple and often contradictory social influences regarding food choices (Crocetti et al., 2017; Cruwys et al., 2015; Story et al., 2002). Thus, Peers may encourage fast food consumption as a social activity, while teachers and parents may advocate for healthier dietary choices. This conflict results in a weaker overall effect of subjective norms, as adolescents may feel pressure from both directions, leading to ambivalence rather than strong alignment with either group. Similarly, adolescents are in a transitional phase of identity formation, meaning they experiment with independence while still being influenced by external expectations (Becht et al., 2017; Vuolo et al., 2014). During this stage, they may not have fully stable food preferences and may fluctuate between seeking peer approval and responding to authoritative health messages (Crocetti et al., 2017; Maulida et al., 2016; Shaw et al., 2023).This developmental inconsistency dilutes subjective norms' impact on attitudes, contributing to a lower coefficient in the model. Similarly, as shown in Fig. 2 , Adolescents' perceived benefits of fast-food consumption are positively and statistically significantly associated with positive attitudes toward fast food (β PB → PATT = 0.480; t = 10.204; p = 0.000) hypothesis H2PB accepted . Adolescents who perceive fast food restaurants as pleasant, clean, and safe environments (PB3, PB4, PB6) are more likely to develop positive attitudes toward fast food consumption. This highlights the importance of fast-food restaurants' physical and social environment in shaping adolescent consumer behaviour. The high factor loadings of PB3 (0.854), PB4 (0.786), and PB6 (0.845) confirm that cleanliness, safety, and social appeal (e.g., birthday parties) are critical perceived benefits. The findings that positive attitudes significantly influence both fast food consumption frequency (β = 0.484, p = 0.000) and weekly meal replacement with fast food (β = 0.305, p = 0.000, hypothesis H3PATT accepted ) reinforce the idea that attitude formation plays a central role in adolescent eating behaviours. However, a closer examination of the items used to measure attitudes—such as AT2 (" I eat fast food even when I am dieting") and AT5 ("I use fast food although I know...") —suggests that these behaviours are not necessarily reflective of a rational, planned decision-making process but instead of habitual consumption patterns. This distinction is critical because it challenges the traditional Theory of Planned Behavior (TPB) assumption that adolescent fast-food consumption is primarily deliberate, intention-driven behaviour. Instead, the findings suggest that habit formation and automaticity play a dominant role, meaning that once an adolescent has developed positive attitudes toward fast food, consumption may become a routine rather than a consciously planned action. Perceived risks (PR) of fast-food consumption negatively and statistically significantly impact weekly meal replacement with fast food (βPR→WMR = -0.271; t = 5.465; p = 0.360; hypothesis H4PR rejected ). This suggests that although adolescents recognise the risks of fast-food consumption (PR1: "Fast food is unhealthy," PR7: "Fast food makes you fat"), this awareness frequently influences their decision to replace meals with fast food. This could be due to optimism bias, believing the risks will not affect them personally(Ait-hadad et al., 2020; Kelloniemi et al., 2005; Pereira das Neves et al., 2024), or present bias favouring immediate gratification over long-term health consequences (Kakoschke et al., 2015; Katz et al., 1973). Additionally, the mother’s education is negatively associated with the consumption frequency of fast food and weekly meal replacement with fast food (β ME→FFFC = -0.046; t = 0.978; p = 0.328; β ME→WMR = -0.111; t = 1.976; p = 0.048; hypothesis H5WMR accepted . However, the mother’s education does not significantly affect fast food consumption frequency (β = -0.046, p = 0.328), leading to the rejection of H5FFC. Suggesting that while higher maternal education is associated with lower reliance on fast food as a meal replacement, it does not significantly reduce overall fast-food consumption frequency. Educated mothers may provide healthier meal options at home, but adolescents may still consume fast food for social or convenience reasons. Studies suggest that mothers with higher education levels are more likely to promote healthier eating habits at home, including increased consumption of fruits, vegetables, and home-cooked meals (Pearson et al., 2009). This aligns with the notion that parental education plays a crucial role in shaping children's food preferences and nutritional awareness (Scaglioni et al., 2018). However, similar to the findings in this study, research also indicates that parental influence weakens during adolescence, as external factors such as peer influence, convenience, and exposure to fast food marketing become stronger determinants of food choices ((Bassett et al., 2008; Bassett-Gunter et al., 2015)). Furthermore, the globalised, industrialised food system has made fast food more accessible and embedded in social interactions, leading adolescents to consume fast food outside the home despite having healthier options (Ambikapathi et al., 2022; Engler-Stringer et al., 2014; Shaw et al., 2023). Additionally, time constraints and urban lifestyles make adolescents more likely to eat outside the home, diminishing the impact of home-based dietary education (Beydoun et al., 2011); this is evidenced in Albania, where 39% of the increase in consumption is outside the home. Overall, these findings reinforce the argument that while maternal education can positively influence home eating environments, it is insufficient to restrain adolescent fast-food consumption alone. Interventions should extend beyond household-level education and focus on peer-led nutrition initiatives, structural food policy changes, and strategies to modify the social and environmental cues that drive fast food consumption (Verstraeten et al., 2016). 5. Conclusions The findings of this study emphasise that adolescent fast-food consumption is habitual mainly rather than planned behaviour, challenging traditional models like the Theory of Planned Behavior (TPB). Despite the awareness of the health risks associated with fast food, adolescents continue to consume it due to behavioural automaticity, contextual triggers, and resistance to external influences. The high mean scores for automatic responses to environmental cues suggest that consumption is not solely driven by marketing but is embedded in routine behaviours and situational contexts. Additionally, subjective norms have a relatively weak influence, likely due to conflicting pressures from different social groups (e.g., parents, teachers, and peers), which dilutes their impact on food choices. Moreover, the study highlights the role of maternal education in shaping adolescent food consumption patterns. While higher maternal education is associated with lower reliance on fast food as a meal replacement, it does not significantly reduce overall fast-food consumption frequency. This suggests that while mothers may provide healthier meal alternatives at home, adolescents still consume fast food due to external factors such as social interactions and convenience. These findings point to the need for interventions that go beyond household education and address the broader food environment, including peer influences, accessibility, and behavioural aspects. Given these insights, practical strategies to promote sustainable food choices and reduce adolescent fast food consumption should focus on habit disruption rather than just awareness campaigns. This includes increasing friction in accessing fast food and promoting alternative habitual behaviours such as mindful eating and healthier social dining spaces. Additionally, the role of women, particularly mothers, in fostering sustainable food choices must be further strengthened through policy interventions that empower them as key actors in food education, school meal planning, and community-based nutrition programs. Addressing individual and systemic factors influencing adolescent food choices will be crucial in fostering long-term dietary sustainability and public health improvements. Practical implications The findings emphasise the need for habit-focused interventions over traditional awareness campaigns to reduce adolescent fast food consumption. Given the influence of behavioural automaticity and contextual triggers, policymakers should implement choice architecture strategies, making healthier options more accessible in schools and public spaces. Peer-driven initiatives like school challenges and social media campaigns can help reshape food norms. Behavioural nudges and digital tools like pre-ordering healthy meals and gamified tracking apps can also disrupt automatic consumption. A multi-level approach integrating parental education, policy restrictions, and social norm shifts is essential for fostering long-term sustainable eating behaviours. Theoretical implications The findings challenge traditional consumer behaviour models by highlighting habitual automaticity, contextual triggers, and environmental cues as primary drivers of adolescent fast-food consumption in a globalised, industrialised food system. Unlike the Theory of Planned Behavior (TPB), which assumes rational decision-making, this study suggests that fast food consumption is mainly habitual and reinforced by structural food system influences. A habit-centred consumer behaviour model is needed, integrating automatic responses, environmental reinforcement, and food system accessibility to explain why individuals persist in consuming fast food and ultra-processed foods despite health and sustainability concerns, offering a more accurate framework for behavioural interventions and policy development. Declarations Author Contributions: Conceptualization EK, AB, IM and AB; methodology EK and AB; software IM and AB; validation IT, formal analysis EK and IM, and AH.; investigation EK and IT ; writing EK, AB, AH, IM and IT—All authors have read and agreed to the published version of the manuscript. Ethical statement This research was conducted following the ethical regulations of the Ethics Committee of the Agriculture University of Tirana. The Ethics Committee reviewed and approved the study protocol. All participants provided informed consent before they participated in the study. The study complies with all institutional and national regulations governing human subject’s research. Competing interests The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. Informed Consent Statement Informed consent was obtained from all participants before their involvement in the study. Participants were informed that their participation was voluntary and that they could withdraw at any time without consequence. The study involved completing a questionnaire, and participants were assured that their data would be kept confidential and used solely for research purposes. Anonymity was guaranteed, and no identifying information was collected or disclosed. Data privacy protocols were followed under the ethical guidelines of the Agriculture University of Tirana Ethics Committee. Consent to Publish declaration: Not applicable. This study does not include any person’s data (including individual details, images, or videos). Data Availability Statement The data supporting this study's findings are available from the corresponding author upon reasonable request. Sources of Funding This study was conducted within the project of the National Agency of Scientific Research and Innovation (NASRI) and Agricultural University of Tirana. We would like to thank the National Agency of Scientific Research and Innovation for financing and contributions to this research. Conflict of Interest The authors have no conflicts of interest to declare. Clinical trial number: Not applicable. References A, E. R., & Deepika, P. (2020). 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6221337","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":448282522,"identity":"bf89ba9c-619d-4fc4-b841-d7c990526201","order_by":0,"name":"Elena Kokthi","email":"","orcid":"","institution":"Agriculture University of Tirana","correspondingAuthor":false,"prefix":"","firstName":"Elena","middleName":"","lastName":"Kokthi","suffix":""},{"id":448282523,"identity":"f1990967-49e9-4f57-b8b5-1e77f669ce50","order_by":1,"name":"Iliriana Miftari","email":"","orcid":"","institution":"Unversity of Prishtina, Kosovo","correspondingAuthor":false,"prefix":"","firstName":"Iliriana","middleName":"","lastName":"Miftari","suffix":""},{"id":448282524,"identity":"dbb77155-7e73-494f-b9e2-366187425baf","order_by":2,"name":"Arbenita Hasani","email":"data:image/png;base64,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","orcid":"","institution":"Unversity of Prishtina, Kosovo","correspondingAuthor":true,"prefix":"","firstName":"Arbenita","middleName":"","lastName":"Hasani","suffix":""},{"id":448282526,"identity":"5ac04026-bb33-4347-af79-8585cea320f0","order_by":3,"name":"Ira Tili","email":"","orcid":"","institution":"University of Medicine Tirana","correspondingAuthor":false,"prefix":"","firstName":"Ira","middleName":"","lastName":"Tili","suffix":""},{"id":448282528,"identity":"6b06b2ed-4931-4cdf-a066-57f8e5be5f58","order_by":4,"name":"Alerta Basha","email":"","orcid":"","institution":"Agriculture University of Tirana","correspondingAuthor":false,"prefix":"","firstName":"Alerta","middleName":"","lastName":"Basha","suffix":""}],"badges":[],"createdAt":"2025-03-13 15:23:16","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6221337/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6221337/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1007/s43621-025-02466-1","type":"published","date":"2025-12-21T15:58:36+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":81543703,"identity":"5f0415ea-ce61-4aac-9578-d8ad1a19c6c1","added_by":"auto","created_at":"2025-04-28 11:25:18","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":29094,"visible":true,"origin":"","legend":"\u003cp\u003eExploratory model of factors influencing the frequency of FFC and WMR with fast food\u003c/p\u003e","description":"","filename":"floatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-6221337/v1/26bf867b4c203c27a93efd24.png"},{"id":81543702,"identity":"574be42c-4cb1-4e3f-b6eb-3789c972d46a","added_by":"auto","created_at":"2025-04-28 11:25:18","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":54328,"visible":true,"origin":"","legend":"\u003cp\u003eStructural equation model illustrating the relationships between subjective norms, perceived benefits, perceived risks, attitudes, and fast food consumption frequency among adolescents\u003c/p\u003e","description":"","filename":"floatimage2.png","url":"https://assets-eu.researchsquare.com/files/rs-6221337/v1/a45650cdf6eaff7e7288aa2c.png"},{"id":98814031,"identity":"3e24e8fe-f0e8-4682-b936-555c91f4929a","added_by":"auto","created_at":"2025-12-22 16:09:44","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1322230,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6221337/v1/0b3dfa92-9e1d-4d98-995f-d8bd452788fa.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"The Role of Habit in Fast Food Consumption: Integrating Habit into the Theory of Planned Behaviour","fulltext":[{"header":"1. Introduction","content":"\u003cp\u003eUnhealthy diets, overweight, and obesity have become significant public health challenges, particularly among adolescents whose dietary patterns are shifting away from traditional Mediterranean diets toward increased fast-food consumption (FFC) (Cuenca-Garc\u0026iacute;a et al., 2012; Gedamu, 2023; Jacka et al., 2011; Naja et al., 2015; Shayo, 2019; Vale et al., 2022, ). Industrialisation, urbanisation, and globalisation have drastically transformed food environments, making ultra-processed, energy-dense foods more accessible and affordable than fresh, nutritious alternatives (Gedamu, 2023; Kothe et al., 2015; Shayo, 2019; Vale et al., 2022; Vuolo et al., 2014). While obesity was once perceived as a problem in high-income countries, it is now rapidly rising in low and middle-income countries, especially in urban areas (Baker et al., 2020; Chong et al., 2023; Kalsum et al., 2018; Naja et al., 2015). A new form of food poverty has emerged not only in terms of food scarcity but also in nutritional quality, where unhealthy diets contribute significantly to non-communicable diseases (NCDs) (Ad\u0026eacute;lia da Costa Pereira de Arruda Neta et al., 2021; Afshin et al., 2019; Ambikapathi et al., 2022; Gedamu, 2023; Vincze et al., 2023).\u003c/p\u003e \u003cp\u003eIn Albania, diet-related diseases\u0026mdash;including diabetes, cardiovascular diseases, and hypertension\u0026mdash;pose a growing health and economic burden. The cost of treating diabetes alone is estimated at \u0026euro;68.4\u0026nbsp;million per year, accounting for 0.44% of the country\u0026rsquo;s GDP, with additional costs stemming from lost productivity and premature mortality. Dietary risks contribute to 829.2 Disability-Adjusted Life Years (DALYs) per 100,000 people (Global Burden of Disease, 2023), highlighting the long-term impact of unhealthy eating habits. Given the significant social and economic implications, understanding the drivers of adolescent fast-food consumption is crucial for designing effective policy interventions.\u003c/p\u003e \u003cp\u003eFast-food establishments market their products as convenient, affordable, and socially appealing, making them particularly attractive to adolescents (Coffee et al., 2016a; Didarloo et al., 2022a; Dunn et al., 2011a). Research suggests that globalisation has contributed to obesity in low-income countries by flooding markets with inexpensive processed foods and expanding Western-style fast-food chains (Adair \u0026amp; Popkin, 2005; Baker et al., 2020; Dunn et al., 2011a). However, scholars argue that economic globalisation may also encourage investments in public health, as labour productivity and human capital become critical for economic competitiveness (Ambikapathi et al., 2022). In addition to global trends, local factors\u0026mdash;such as urbanisation, household structures, and increased female labour force participation\u0026mdash;have significantly reshaped food consumption patterns (Adair \u0026amp; Popkin, 2005; Kunto \u0026amp; Bras, 2018; Mama Chabi et al., 2022; Vliet et al., 2015). One key transformation is the rising participation of women in the workforce, which has led to greater reliance on fast food and pre-packaged meals due to time constraints (Kunto \u0026amp; Bras, 2018). Traditionally, women played a central role in food preparation, ensuring balanced home-cooked meals (A \u0026amp; Deepika, 2020). However, economic pressures and changing social norms have reduced the frequency of home-cooked meals, especially in urban settings where fast food is readily available (Ambikapathi et al., 2022; Caspi et al., 2012; Coffee et al., 2016b; Smith et al., 2013). This shift mainly affects adolescents, who, without structured meals, develop independent eating habits favouring convenience over nutrition (Kalsum et al., 2018; Kunto \u0026amp; Bras, 2018). These changes in the workforce indirectly contribute to rising fast food consumption, reinforcing the need for policies that promote healthier and more accessible food options without disproportionately burdening working women.\u003c/p\u003e \u003cp\u003eThis study applies the Theory of Planned Behavior (TPB) (Ajzen, 1991) to examine the determinants of adolescent fast-food consumption in Albania. TPB posits that behavioural intentions are shaped by attitudes, subjective norms, and perceived behavioural control, making it a helpful framework for understanding adolescent food choices (Ajzen, 1991; Didarloo et al., 2022a; Dunn et al., 2011a). This study explores how perceived benefits, and subjective norms influence attitudes toward fast food consumption and whether attitudes reinforce or discourage consumption frequency and weekly meal replacement with fast food. Moreover, the conceptual model explores whether perceived health risks determine weekly meal replacement with fast food and how demographic factors such as education impact fast food consumption among adolescents regarding consumption frequency and weekly meal replacement with fast food.\u003c/p\u003e \u003cp\u003eThe remainder of the paper is structured as follows: The second section reviews the literature on the influence of perceived benefits and risks, subjective norms, attitudes, and demographics on fast food consumption. The third section outlines the methodological framework. Section four discusses the results, and the final section presents conclusions and policy implications.\u003c/p\u003e"},{"header":"2. Literature review","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003e2.1 Theoretical Framework and Hypotheses\u003c/h2\u003e \u003cp\u003eBehavioural models, such as the Theory of Planned Behavior (TPB), are widely applied to study the relationships between beliefs, attitudes, behavioural intentions, and actual behaviours in various human domains (Ajzen, 1991; Armitage \u0026amp; Conner, 1999; Barber, 2012; Chen \u0026amp; Tung, 2014, 2014; Didarloo et al., 2022b; Dunn et al., 2011b; Gakobo \u0026amp; Jere, 2016; McKee et al., 2019). Encouraging adherence to healthy dietary patterns is a significant public health challenge, and TPB allows researchers and policymakers to identify key determinants of nutritional choices and design effective interventions (Bassett-Gunter et al., 2015; McDermott et al., 2015). The TPB has been a reliable predictor of various health-related behaviours, explaining between 14% and 24% of the behavioural variance (McEachan et al., 2011)). Additionally, TPB has been successfully applied to predict dietary behaviours (McDermott et al., 2015), demonstrating that subjective norms, perceived behavioural control (PBC), and attitudes strongly influence food-related decision-making.\u003c/p\u003e \u003cp\u003eAjzen extended the TPB from the Theory of Reasoned Action (TRA) by incorporating perceived behavioural control, which refers to an individual's belief in their ability to perform a behaviour successfully (Ajzen, 1991, 2002; Ajzen et al., 2018). According to TPB, behavioural intentions\u0026mdash;which are the strongest predictors of actual behaviour\u0026mdash;are shaped by three main components:\u003c/p\u003e \u003cp\u003e \u003col\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eSubjective norms (social pressure and perceived approval from others)\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003ePerceived behavioural control (confidence in one's ability to act)\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eAttitudes (positive or negative evaluations of the behaviours) (Ajzen, 1991).\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003c/ol\u003e \u003c/p\u003e \u003cp\u003eAdditional variables have been integrated to enhance the model's predictive validity in explaining fast food consumption (FFC) patterns. Dunn et al. (2011) extended TPB by considering future consequences, fear of negative evaluation, and self-identification as a healthy eater to analyse FFC behaviours in Australia. Similarly, (Dunn et al., 2011a; Šapić et al., 2019; Sumardi et al., 2022) applied TPB and found that subjective norms were the most substantial predictors of fast-food consumption frequency (FFC). Sharifirad et al., (2013) further confirmed that social norms and past behaviour were significant predictors of FFC, while Mirkarimi et al. (2016) emphasised the influence of peer norms on adolescents' fast food consumption intentions.\u003c/p\u003e \u003cp\u003eAlso, TPB has been validated across various cultural and demographic contexts. Studies have shown that subjective norms significantly impact adolescents\u0026rsquo; eating habits, with factors like fast food availability, taste, and parental influences as facilitators and barriers to healthy eating. Grier \u0026amp; Kumanyika, (2008) highlighted the role of marketing stimuli, showing how parental purchasing behaviours\u0026mdash;often driven by limited nutritional knowledge\u0026mdash;affect children's dietary choices. Furthermore, Seo et al. (2011) demonstrated the moderating role of peer influence in shaping adolescent fast food consumption. The review of TPB components relevant to FFC is detailed below, alongside the hypotheses that will be tested in this study.\u003c/p\u003e \u003cdiv id=\"Sec4\" class=\"Section3\"\u003e \u003ch2\u003e2.2.1 Subjective Norms and Fast-Food Consumption (FFC)\u003c/h2\u003e \u003cp\u003eIn TPB, subjective norms refer to an individual's perception of social pressure to perform or avoid a behaviour (Ajzen, 1991; Ajzen et al., 2018; Vallerand et al., 1992) (Ajzen \u0026amp; Fishbein, 1975). These norms include the influence of family, friends, teachers, and community expectations. Subjective norms are classified into two categories:\u003c/p\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003eInjunctive norms: Beliefs about what important social referents approve or disapprove of (Cialdini \u0026amp; Goldstein, 2004).\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eDescriptive norms: Perceptions of what others do, shaping behavioural expectations (Cook et al., 1980).\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003cp\u003eSubjective norms strongly influence FFC, particularly among adolescents, as they tend to be highly susceptible to peer and parental influences (Bagozzi, 2000; Cialdini \u0026amp; Goldstein, 2004). In various studies, subjective norms were the strongest predictors of FFC intentions in Iran (Sharifirad et al., 2013b), Turkey (Yarimoglu et al., 2019), Malaysia (Kamalul Ariffin et al., 2021), Australia (Dunn et al., 2011), and Romania (B\u0026icirc;lb\u0026icirc;ie et al., 2021).\u003c/p\u003e \u003cp\u003eAdditionally, studies indicate that subjective norms influence adolescents' eating behaviours more significantly than adults' (Dunn et al., 2011). The impact of injunctive norms (parental and teacher influence) versus descriptive norms (peer influence) remains debated, with some studies showing parental influence as dominant. In contrast, others indicate peer influence as more significant (B\u0026icirc;lb\u0026icirc;ie et al., 2021). Following this perspective, we suggest the following hypotheses:\u003c/p\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003e \u003cem\u003eH1SN: Injunctive subjective norms from teachers and friends will substantially influence FFC frequency and WMR among adolescents in Albania.\u003c/em\u003e \u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section3\"\u003e \u003ch2\u003e2.2.2 Perceived Benefits and FFC\u003c/h2\u003e \u003cp\u003eFast food consumption involves a trade-off between immediate rewards and long-term health risks (Dunn et al., 2011). Many individuals consume fast food for its convenience, affordability, and sensory appeal despite being aware of its potential adverse health impacts (Bawajeeh et al., 2020; Grier \u0026amp; Kumanyika, 2008; Imtiyaz et al., 2021; Kemp et al., 2013). Several studies highlight that taste, price fairness, and restaurant environment significantly affect customer satisfaction and FFC (Dave et al., 2009; Hanaysha, 2016). The perceived benefits of fast-food consumption include nutritional beliefs, such as consumers believing fast food provides essential nutrients (Bawajeeh et al., 2020; Grier \u0026amp; Kumanyika, 2008; Imtiyaz et al., 2021; Kemp et al., 2013). Economic factors are also important, as perceived affordability and value-for-money influence FFC decisions (Hanaysha, 2016). Finally, social factors, i.e. linked to Fast food outlets, are often perceived as fun and socially engaging spaces, particularly for adolescents (Caspi et al., 2012; Imtiyaz et al., 2021). Adolescents often view fast-food restaurants as social hubs, where a clean, aesthetically pleasing, and engaging environment fosters positive attitudes toward fast-food consumption despite potential nutritional drawbacks (Engler-Stringer et al., 2014; Shaw et al., 2023). Accordingly, in the present study, we will test the following hypothesis:\u003c/p\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003e \u003cem\u003eH2PB4: Adolescents who perceive higher benefits related to fast food restaurants\u0026rsquo; physical and social environment will show positive attitudes towards fast food consumption.\u003c/em\u003e \u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section3\"\u003e \u003ch2\u003e2.2.3 Attitudes and FFC\u003c/h2\u003e \u003cp\u003eAttitudes refer to favourable or unfavourable evaluations of behaviour (Ajzen \u0026amp; Fishbein, 1975). In the context of fast-food consumption, attitudes can be classified into affective attitudes (emotional preferences for taste and enjoyment FFC and cognitive attitudes (rational considerations of health and affordability) (B\u0026icirc;lb\u0026icirc;ie et al., 2021).\u003c/p\u003e \u003cp\u003eResearch suggests that positive attitudes toward fast food reinforce consumption behaviours, as individuals prioritise immediate gratification (Strathman et al., 1994)). Adolescents, in particular, exhibit temporal discounting, where short-term benefits such as taste, convenience, and social enjoyment outweigh long-term health concerns (Gardner, 2015; Gardner et al., 2014, 2023)\u003c/p\u003e \u003cp\u003eThus, we hypothesise:\u003c/p\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003e \u003cem\u003eH3PATT: Adolescents with positive attitudes toward fast food will exhibit a higher frequency of fast food consumption - and weekly meal replacement with fast food\u003c/em\u003e,\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section3\"\u003e \u003ch2\u003e2.2.4 Risk Perceptions of FFC\u003c/h2\u003e \u003cp\u003eRisk perception is crucial in shaping food choices, as individuals often weigh potential health risks against immediate benefits (I. U. Barlow et al., 2024; P. Barlow et al., 2016). However, in the case of fast-food consumption (FFC), adolescents may exhibit time discounting, prioritising short-term gratification (e.g., taste, convenience) while underestimating long-term health consequences (Kahneman, 2003; Kahneman et al., 1991).\u003c/p\u003e \u003cp\u003eStudies indicate that as unhealthy food choices become more frequent, individuals become desensitised to risk perceptions (Kakoschke et al., 2015; Martinelli et al., 2023). This risk habituation may lead adolescents to ignore the health implications of fast-food consumption, reinforcing consumption patterns.\u003c/p\u003e \u003cp\u003eThus, we hypothesise:\u003c/p\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003eH4PR: \u003cem\u003eAdolescents with higher perceived risks of fast-food consumption will exhibit lower weekly meal replacement with fast food.\u003c/em\u003e\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section3\"\u003e \u003ch2\u003e2.2.5 Socioeconomic and Demographic Factors in Fast Food Consumption (FFC)\u003c/h2\u003e \u003cp\u003eOne of the most notable recent trends in consumer food purchasing is the increased consumption of food outside the household, a pattern that has also emerged in Albania (Pow(Khurana, 2021; Kunto \u0026amp; Bras, 2018). Multiple socioeconomic factors drive this shift, including rising family incomes and increasing female labour participation. Studies indicate that fast-food consumption (FFC) frequency is significantly associated with household size, number of children, parents' education, household income, and the mother's employment status (Sharifirad et al., 2013).\u003c/p\u003e \u003cp\u003eAdditionally, several studies highlight that individual and social factors influence adolescent fast food consumption, particularly regarding parental perceptions of their child's diet quality(Allen et al., 2013; Crocetti et al., 2017). Given that family-based interventions are critical in shaping children's eating habits, addressing misconceptions and unhealthy parental beliefs may be essential for early intervention and obesity prevention (Allen et al., 2013; Crocetti et al., 2017; Davidson et al., 2011; Khurana, 2021).\u003c/p\u003e \u003cp\u003eBased on this, we propose the following hypotheses:\u003c/p\u003e \u003cp\u003e \u003cem\u003eH5: Higher maternal education levels will be associated with a lower frequency of fast-food consumption and weekly meal replacement with fast food\u003c/em\u003e \u003c/p\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"3. Material and method","content":"\u003cp\u003e\u003cstrong\u003e\u003cem\u003e3.1 Data collection\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study examines adolescents\u0026apos; fast-food consumption (FFC) patterns in Albania through a survey conducted from 2023 to 2024 in various locations within Tirana city. The target population includes private and public school adolescents, ensuring a representative sample of urban youth. The questionnaire was developed online. The survey collected demographic characteristics, including gender, age, parents\u0026rsquo; education and employment status, education sector (public vs. private), and place of residence (urban/rural). Additionally, it explored the frequency of fast-food consumption, contextual factors influencing choices\u0026mdash;such as place of consumption, reasons for eating fast food, and the extent to which home-cooked meals are replaced by fast food\u0026mdash;attitudes toward health, and marketing influences, including advertising, pricing, and restaurant environments. This study incorporates indicators of food environment industrialisation to contextualise fast food consumption within Albania\u0026rsquo;s broader food system transformation. Between 2016 and 2021, packaged food sales increased by 44%, ultra-processed food (UPF) sales rose by 78%, and the supermarket sector expanded by 23.5% in 2017 and 7.4% in 2021, which persists. Additionally, 39% of meals are now consumed outside the home (INSTAT, 2023), while home-cooked meals are declining due to urbanisation, lifestyle changes, and increased access to fast food outlets (Food System Dashboard, 2023). These structural changes highlight the increasing reliance on processed and convenient foods, shaping adolescent consumption behaviour.\u003c/p\u003e\n\u003cp\u003eA five-point Likert scale (1=strongly disagree\u0026hellip; 5=strongly agree) measures participant preferences and attitudes toward fast food. Previous studies in Albania validated the scale, demonstrating its reliability and discriminative capacity in analysing food consumption behaviours (Hasani et al., 2022; Kokthi et al., 2022). By integrating fast food consumption trends with Albania\u0026rsquo;s evolving food retail landscape, this study comprehensively assesses the food system\u0026apos;s industrialisation and its impact on adolescent dietary habits.\u003c/p\u003e\n\u003cp\u003eTable 1: Participants characteristics (N=296)\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 33px;\"\u003e\n \u003cp\u003eVariables\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 43px;\"\u003e\n \u003cp\u003eDescription\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22px;\"\u003e\n \u003cp\u003efrequency in %\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 33px;\"\u003e\n \u003cp\u003eGender\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 43px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; 1. Males,\u003c/p\u003e\n \u003cp\u003e2. Females\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22px;\"\u003e\n \u003cp\u003e46.3\u003c/p\u003e\n \u003cp\u003e53.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 33px;\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 43px;\"\u003e\n \u003cp\u003eAge categories:\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e12-13,\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e14-15,\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e16-17,\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e17-18,\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e17,8\u003c/p\u003e\n \u003cp\u003e35,6\u003c/p\u003e\n \u003cp\u003e13,6\u003c/p\u003e\n \u003cp\u003e33,0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 33px;\"\u003e\n \u003cp\u003eMother Education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 43px;\"\u003e\n \u003cp\u003eLow: 1-8 years.\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eMedium: 8-12 years.\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eHigh: more than 12 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22px;\"\u003e\n \u003cp\u003e49,2\u003c/p\u003e\n \u003cp\u003e35,6\u003c/p\u003e\n \u003cp\u003e15,2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 33px;\"\u003e\n \u003cp\u003eFather Education\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 43px;\"\u003e\n \u003cp\u003eLow: 1-8 years.\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eMedium: 8-12 years;\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eHigh: more than 12 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22px;\"\u003e\n \u003cp\u003e46,1\u003c/p\u003e\n \u003cp\u003e42,4\u003c/p\u003e\n \u003cp\u003e11,5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 33px;\"\u003e\n \u003cp\u003eMother employment status\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 43px;\"\u003e\n \u003cp\u003eEmployed\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eUnemployed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22px;\"\u003e\n \u003cp\u003e79,6\u003c/p\u003e\n \u003cp\u003e20,4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 33px;\"\u003e\n \u003cp\u003eFather employment status\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 43px;\"\u003e\n \u003cp\u003eEmployed\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eUnemployed\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22px;\"\u003e\n \u003cp\u003e88,5\u003c/p\u003e\n \u003cp\u003e11,5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 33px;\"\u003e\n \u003cp\u003eEducation sector\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 43px;\"\u003e\n \u003cp\u003ePublic\u0026nbsp;\u003c/p\u003e\n \u003cp\u003ePrivate\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22px;\"\u003e\n \u003cp\u003e69,1\u003c/p\u003e\n \u003cp\u003e30,9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 33px;\"\u003e\n \u003cp\u003eResidence\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 43px;\"\u003e\n \u003cp\u003eUrban areas\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eRural areas\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22px;\"\u003e\n \u003cp\u003e93,7\u003c/p\u003e\n \u003cp\u003e6,3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eSource: Author\u0026apos;s elaboration.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u003cstrong\u003e3.2 Measurement\u0026nbsp;\u003c/strong\u003e\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eAs mentioned, this study focuses on adolescents and young adults in Albania, a demographic with a high interest in fast food consumption (FFC). This behaviour is primarily driven by convenience, affordability, and accessibility (Seo et al., 2011). Adolescents also experience lifestyle transitions that promote increased independence and greater exposure to fast food choices. Given the rapid transformation of the Albanian food system, TPB offers a structured approach to understanding adolescent dietary behaviours in an evolving urban environment. The following paragraphs present each TBP construct and items used in the present study.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e3.2.1 Independent Variables\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThis study assesses the key determinants of FFC using validated TPB-based constructs such as\u0026nbsp;subjective\u0026nbsp;norms, attitudes, perceived benefits and risks, and demographics toward FFC.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e3.2.2 Subjective Norms\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eAdolescents\u0026apos; food choices are shaped by reference groups, particularly parents, peers, and teachers (Cialdini \u0026amp; Goldstein, 2004). Six statements were developed to assess subjective norms and measured with a LIKERT scale of 1 \u0026ndash; disagree entirely to 5 \u0026ndash; completely agree. Reference group expectations \u003cem\u003e(\u0026quot;I act as my parents, teachers, and friends would expect me to\u0026quot;)\u003c/em\u003e and Perceived approval of behaviour: \u003cem\u003e\u0026quot;I think that my parents, teachers, and friends like the fact that I consume fast food\u003c/em\u003e\u0026quot; see Table 2. Given the target group\u0026apos;s developmental stage, social influences are expected to impact their intention and behaviour toward the FFC significantly.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e3.2.3 Perceived Benefits of Fast Food\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eWhile FFC is often linked to diet-related health risks, adolescents also perceive several benefits, including affordability\u0026mdash;lower cost than restaurant meals\u0026mdash;and convenience of purchase and consumption. Taste \u0026amp; Social Enjoyment \u0026ndash; fast food is an appealing and accessible option. Five Likert-scale statements were used to measure perceived\u0026nbsp;benefits (\u003cem\u003ei.e.\u0026nbsp;\u003c/em\u003e\u003cem\u003e\u0026nbsp;The restaurants where fast food is served are very nice ones; 2) The restaurants where fast food is served are clean and safe;3) Fast food restaurants are a pleasant place to have birthday parties)\u003c/em\u003e see Table 2.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e3.2.4 Attitudes Toward Fast Food Consumption\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eAdolescents\u0026apos; attitudes toward fast food are often driven by habitual behaviours rather than rational decision-making\u0026nbsp;(Gardner, 2015; Verplanken \u0026amp; Aarts, 1999; Verplanken \u0026amp; Sato, 2011). Despite awareness of health concerns, adolescents may continue consuming fast food (Frank, 2012). Attitudes were measured using nine Likert-scale items (\u003cem\u003ee.g., \u0026quot;I eat fast food even though I am aware it is not healthy, \u0026quot;Even if awareness is raised about the adverse effects of fast food on health, I believe I will continue eating it.\u003c/em\u003e see Table 2).\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e3.2.5 Risk Perception of Fast-Food Consumption\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003ePerceived risks are pre-existing beliefs about the adverse health effects of fast food, which often develop before individuals experience direct health consequences (B\u0026icirc;lb\u0026icirc;ie et al., 2021; Coffee et al., 2016b; \u0026Scaron;apić et al., 2019; Sharifirad et al., 2013)Seven statements were developed to assess risk perception: \u0026quot;I think fast food products contain too much fat. Excessive consumption of fast food causes serious health problems.\u0026quot; See Table 2 for statistics.\u003c/p\u003e\n\u003cp\u003eTable 2: The TPB determinants analysis in FFC (N=296)\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"642\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 520px;\"\u003e\n \u003cp\u003eTPB Determinants\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 52px;\"\u003e\n \u003cp\u003eMean\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 70px;\"\u003e\n \u003cp\u003eStandard Deviation\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 520px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSubjective norms\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 52px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 520px;\"\u003e\n \u003col start=\"1\" type=\"1\"\u003e\n \u003cli\u003eI act as my parents would expect me to \u0026nbsp;(SN1)\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 52px;\"\u003e\n \u003cp\u003e2.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 70px;\"\u003e\n \u003cp\u003e1.15\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 520px;\"\u003e\n \u003col start=\"2\" type=\"1\"\u003e\n \u003cli\u003eI act as my teachers would like me to \u0026nbsp;(SN2)\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 52px;\"\u003e\n \u003cp\u003e2.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 70px;\"\u003e\n \u003cp\u003e1.09\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 520px;\"\u003e\n \u003col start=\"3\" type=\"1\"\u003e\n \u003cli\u003eI act as my friends would like me to \u0026nbsp; (SN3)\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 52px;\"\u003e\n \u003cp\u003e1.77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 70px;\"\u003e\n \u003cp\u003e0.97\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 520px;\"\u003e\n \u003col start=\"4\" type=\"1\"\u003e\n \u003cli\u003eI think that my parent like the fact that I use FF \u0026nbsp;to \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;(SN4)\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 52px;\"\u003e\n \u003cp\u003e2.79\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 70px;\"\u003e\n \u003cp\u003e1.13\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 520px;\"\u003e\n \u003col start=\"5\" type=\"1\"\u003e\n \u003cli\u003eI think that my teachers would like my FF consumption \u0026nbsp; (SN5)\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 52px;\"\u003e\n \u003cp\u003e2.33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 70px;\"\u003e\n \u003cp\u003e1.14\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 520px;\"\u003e\n \u003col start=\"6\" type=\"1\"\u003e\n \u003cli\u003eI think that my friends like the fact that I use FF \u0026nbsp;(SN6)\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 52px;\"\u003e\n \u003cp\u003e2.86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 70px;\"\u003e\n \u003cp\u003e1.23\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 520px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePerceived benefits\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 52px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 520px;\"\u003e\n \u003col start=\"1\" type=\"1\"\u003e\n \u003cli\u003eI think that FF provides all the necessary nutritive elements I need (PB1)\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 52px;\"\u003e\n \u003cp\u003e2.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 70px;\"\u003e\n \u003cp\u003e0.97\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 520px;\"\u003e\n \u003col start=\"2\" type=\"1\"\u003e\n \u003cli\u003eI think that FF is offered in ample portions that satisfy hunger (PB2)\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 52px;\"\u003e\n \u003cp\u003e3.07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 70px;\"\u003e\n \u003cp\u003e1.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 520px;\"\u003e\n \u003col start=\"3\" type=\"1\"\u003e\n \u003cli\u003eI think that FF is very tasty (PB3)\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 52px;\"\u003e\n \u003cp\u003e3.93\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 70px;\"\u003e\n \u003cp\u003e0.94\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 520px;\"\u003e\n \u003col start=\"4\" type=\"1\"\u003e\n \u003cli\u003eI think that FF costs much less than food in restaurants (PB4)\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 52px;\"\u003e\n \u003cp\u003e3.62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 70px;\"\u003e\n \u003cp\u003e1.17\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 520px;\"\u003e\n \u003col start=\"5\" type=\"1\"\u003e\n \u003cli\u003eThe restaurants where it is served FF are very nice ones (PB5)\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 52px;\"\u003e\n \u003cp\u003e3.13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 70px;\"\u003e\n \u003cp\u003e0.97\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 520px;\"\u003e\n \u003col start=\"6\" type=\"1\"\u003e\n \u003cli\u003eThe restaurants where it is served FF are clean and safe (PB6)\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 52px;\"\u003e\n \u003cp\u003e2.68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 70px;\"\u003e\n \u003cp\u003e1.14\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 520px;\"\u003e\n \u003col start=\"7\" type=\"1\"\u003e\n \u003cli\u003eFF restaurant is a pleasant place to have birthday parties (PB7)\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 52px;\"\u003e\n \u003cp\u003e2.72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 70px;\"\u003e\n \u003cp\u003e1.31\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 520px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAttitudes\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 52px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 520px;\"\u003e\n \u003col start=\"1\" type=\"1\"\u003e\n \u003cli\u003eI think it is not challenging to eat FF (ATT 1)\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 52px;\"\u003e\n \u003cp\u003e2.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 70px;\"\u003e\n \u003cp\u003e1.236\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 520px;\"\u003e\n \u003col start=\"2\" type=\"1\"\u003e\n \u003cli\u003eI eat FF also when I am dieting (ATT2)\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 52px;\"\u003e\n \u003cp\u003e2.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 70px;\"\u003e\n \u003cp\u003e1.186\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 520px;\"\u003e\n \u003col start=\"3\" type=\"1\"\u003e\n \u003cli\u003eI eat FF even though I am aware it is not healthy (ATT3)\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 52px;\"\u003e\n \u003cp\u003e3.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 70px;\"\u003e\n \u003cp\u003e1.11\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 520px;\"\u003e\n \u003col start=\"4\" type=\"1\"\u003e\n \u003cli\u003eI use FF, although I cook a meal so fast on my own (ATT4)\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 52px;\"\u003e\n \u003cp\u003e2.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 70px;\"\u003e\n \u003cp\u003e1.229\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 520px;\"\u003e\n \u003col start=\"5\" type=\"1\"\u003e\n \u003cli\u003eEven if awareness is raised of the adverse effects of FF on our health, I believe that I will continue eating FF (ATT5)\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 52px;\"\u003e\n \u003cp\u003e3.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 70px;\"\u003e\n \u003cp\u003e1.13\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 520px;\"\u003e\n \u003col start=\"6\" type=\"1\"\u003e\n \u003cli\u003eI use FF, although fast restaurants are far away (ATT6)\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 52px;\"\u003e\n \u003cp\u003e2.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 70px;\"\u003e\n \u003cp\u003e1.13\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 520px;\"\u003e\n \u003col start=\"7\" type=\"1\"\u003e\n \u003cli\u003eI use FF, although there is no advertising on TV, the internet (ATT7)\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 52px;\"\u003e\n \u003cp\u003e3.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 70px;\"\u003e\n \u003cp\u003e1.15\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 520px;\"\u003e\n \u003col start=\"8\" type=\"1\"\u003e\n \u003cli\u003eI use FF, although there is no promotional marketing offered (ATT8)\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 52px;\"\u003e\n \u003cp\u003e3.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 70px;\"\u003e\n \u003cp\u003e1.07\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 520px;\"\u003e\n \u003col start=\"9\" type=\"1\"\u003e\n \u003cli\u003eI use FF, although I must wait a long time to get it. (ATT9)\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 52px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 70px;\"\u003e\n \u003cp\u003e1.15\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 520px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePerceived risks\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 52px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 520px;\"\u003e\n \u003col start=\"1\" type=\"1\"\u003e\n \u003cli\u003eI think that FF is unhealthy (PR1)\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 52px;\"\u003e\n \u003cp\u003e3.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 70px;\"\u003e\n \u003cp\u003e1.16\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 520px;\"\u003e\n \u003col start=\"2\" type=\"1\"\u003e\n \u003cli\u003eI think that excessive consumption of FF causes serious health problems (PR2)\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 52px;\"\u003e\n \u003cp\u003e4.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 70px;\"\u003e\n \u003cp\u003e1.01\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 520px;\"\u003e\n \u003col start=\"3\" type=\"1\"\u003e\n \u003cli\u003eI think that FF products contain so much fat (PR3)\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 52px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 70px;\"\u003e\n \u003cp\u003e0.91\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 520px;\"\u003e\n \u003col start=\"4\" type=\"1\"\u003e\n \u003cli\u003eI think that FF has too much salt (PR4)\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 52px;\"\u003e\n \u003cp\u003e2.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 70px;\"\u003e\n \u003cp\u003e1.11\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 520px;\"\u003e\n \u003col start=\"5\" type=\"1\"\u003e\n \u003cli\u003eI think that FF products are very high in calories (PR5)\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 52px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 70px;\"\u003e\n \u003cp\u003e1.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 520px;\"\u003e\n \u003col start=\"6\" type=\"1\"\u003e\n \u003cli\u003eI think that FF products make you fat (PR6)\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 52px;\"\u003e\n \u003cp\u003e4.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 70px;\"\u003e\n \u003cp\u003e1.02\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 520px;\"\u003e\n \u003col start=\"7\" type=\"1\"\u003e\n \u003cli\u003eI think that FF products have been stored in freezing for a long time (PR7)\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 52px;\"\u003e\n \u003cp\u003e3.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 70px;\"\u003e\n \u003cp\u003e1.08\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u003cstrong\u003e3.2.6. Dependent Variables\u003c/strong\u003e\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThree dependent variables are analysed: attitudes, the Fast-Food Consumption Rate (FFCR), which measures the weekly frequency of fast-food consumption, and the Weekly Meal Replacement Frequency (WMRF), which measures how often adolescents replace home-cooked meals with fast food. Including WMRF alongside FFCR provides an additional perspective on adolescent fast-food consumption. While FFCR identifies consumption frequency, WMRF captures the extent to which home-cooked meals are displaced, offering additional insights into dietary patterns and long-term public health concerns. This distinction is critical for designing effective health policies and behavioural interventions that promote sustainable and balanced eating habits among adolescents. The FF types included in this study are identified through three focus groups developed with children of the group ages mentioned above in Albania. The main FF items consumed by the participants are hamburgers, donners, souvlaki, pizza, french fries, and sandwiches see Table 3. Other studies have also considered these items (Powell \u0026amp; Han, 2011), reflecting the impact of globalisation on children\u0026apos;s consumption patterns (Adair \u0026amp; Popkin, 2005). The data results also justify exploring the consumption patterns toward different FF items in Table 3.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable 3: Fast Food Consumption Frequency and Weekly Meal Replacement.\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 53px;\"\u003e\n \u003cp\u003eFF Type\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 15px;\"\u003e\n \u003cp\u003e1 Time per Week (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 15px;\"\u003e\n \u003cp\u003e2 Times per Week (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 15px;\"\u003e\n \u003cp\u003e3 or More Times per Week (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 53px;\"\u003e\n \u003cp\u003eHamburger\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 15px;\"\u003e\n \u003cp\u003e39.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 15px;\"\u003e\n \u003cp\u003e51.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 15px;\"\u003e\n \u003cp\u003e8.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 53px;\"\u003e\n \u003cp\u003eDonner\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 15px;\"\u003e\n \u003cp\u003e91.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 15px;\"\u003e\n \u003cp\u003e3.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 15px;\"\u003e\n \u003cp\u003e5.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 53px;\"\u003e\n \u003cp\u003eSouvlaki\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 15px;\"\u003e\n \u003cp\u003e42.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 15px;\"\u003e\n \u003cp\u003e46.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 15px;\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 53px;\"\u003e\n \u003cp\u003ePizza\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 15px;\"\u003e\n \u003cp\u003e45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 15px;\"\u003e\n \u003cp\u003e40.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 15px;\"\u003e\n \u003cp\u003e14.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 53px;\"\u003e\n \u003cp\u003eFrench fries\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 15px;\"\u003e\n \u003cp\u003e36.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 15px;\"\u003e\n \u003cp\u003e45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 15px;\"\u003e\n \u003cp\u003e18.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 53px;\"\u003e\n \u003cp\u003eSandwiches\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 15px;\"\u003e\n \u003cp\u003e27.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 15px;\"\u003e\n \u003cp\u003e62.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 15px;\"\u003e\n \u003cp\u003e9.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 53px;\"\u003e\n \u003cp\u003eWeekly Meal Replacement Frequency (WMRF)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 15px;\"\u003e\n \u003cp\u003e43.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 15px;\"\u003e\n \u003cp\u003e29.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 15px;\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eSource: Author\u0026apos;s elaboration\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe conceptual model in Figure 1 is based on constructs that measure the impact of perceived benefits and subjective norms on consumer attitudes and fast-food consumption. The dependent variables were assessed using five-point Likert scales, as shown in Tables 2 and 3. The model was evaluated using Partial Least Squares Structural Equation Modeling (PLS-SEM) with the bootstrapping method, involving 5,000 resamples to estimate parameters and path coefficients. Cronbach\u0026rsquo;s alpha was used to ensure each construct\u0026apos;s internal consistency and reliability. Confirmatory Factor Analysis (CFA) was conducted to test convergent and discriminant validity, with results exceeding established thresholds (CFA \u0026gt; 0.7; CR \u0026gt; 0.7; AVE \u0026gt; 0.5), demonstrating robust validity. Additionally, the model\u0026apos;s explanatory power was assessed by calculating the total variance in fast food attitudes and consumption changes, influenced by factors related to subjective norms, perceived benefits, perceived risks, and education. Model fit was evaluated using the Standardized Root Mean Square Residual (SRMR), with values below 0.10 indicating satisfactory model validation. Descriptive analysis and analysis of variance are used for demographic effects analysis.\u003c/p\u003e"},{"header":"4. Discussion of results","content":"\u003cp\u003eThe demographic profile of the study sample provides insights into the respondents' characteristics and socio-economic background. The sample comprises 53.7% females and 46.3% males, indicating a slightly higher participation of female respondents. The age distribution is relatively balanced, with the most significant proportion of adolescents falling into the 14\u0026ndash;15 age group (35.6%), followed by 17\u0026ndash;18 years (33.0%), 12\u0026ndash;13 years (17.8%), and 16\u0026ndash;17 years (13.6%) see Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e. Regarding parental education, the majority of mothers have completed low (49.2%) or medium (35.6%) levels of education, while a smaller percentage (15.2%) have attained higher education. A similar trend is observed for fathers, where 46.1% have a low level of education, 42.4% have a medium level, and only 11.5% have pursued higher education. Regarding employment, 79.6% of mothers are employed, while 20.4% are unemployed, whereas fathers show a higher employment rate, with 88.5% employed and only 11.5% unemployed.\u003c/p\u003e \u003cp\u003eThe education sector attended by respondents indicates that 69.1% are enrolled in public schools, while 30.9% attend private institutions. Additionally, most participants reside in urban areas (93.7%), with only 6.3% coming from rural areas. This distribution reflects the increasing urbanisation trends in Albania, particularly the concentration of adolescents in cities, which may influence lifestyle patterns, including food consumption habits. The data highlights key socio-economic factors that may shape adolescents' behaviours and attitudes, particularly regarding fast-food consumption and lifestyle choices. Parental demographics, particularly mothers' education and employment status, will help us understand how socio-economic factors influence adolescents' food consumption patterns. Mothers' education levels play a crucial role in shaping household dietary habits, as higher education often correlates with greater nutritional awareness and a stronger preference for healthier food choices (Hinnig et al., 2018; Kalsum et al., 2018; Kunto \u0026amp; Bras, 2018; Mama Chabi et al., 2022).\u003c/p\u003e \u003cdiv id=\"Sec19\" class=\"Section2\"\u003e \u003ch2\u003e4.1 Subjective Norms and FFC\u003c/h2\u003e \u003cp\u003eResults suggest that while social norms play a role in adolescent fast-food consumption, their influence appears to be weaker than expected, particularly in the case of peer influence. This might indicate that this age group actively seeks independence in decision-making, aligning with psychological theories on adolescent identity formation and conflict with authority figures (Becht et al., 2017; Crocetti et al., 2017). A key insight is that 77.4% of respondents report moderate to strong motivation to comply with social norms, but this compliance is selective. Parental influence remains the strongest, with 67.9% stating that they act as their parents would expect regarding food choices. However, this does not necessarily translate into healthy eating behaviours, as 42.2% believe their parents approve or are neutral toward fast food consumption. This suggests that parental approval or indifference may weaken the potential for healthier eating behaviours at home. Similarly, teachers' influence appears limited, with 63.2% stating that they act as their teachers would prefer, yet 56.4% believe teachers disapprove of fast-food consumption without significantly modifying their behaviour. This reinforces the idea that authoritative figures, such as teachers, may not influence adolescents\u0026rsquo; personal food choices sufficiently. Peer influence is surprisingly low, with 81.4% stating that they do not feel influenced by their friends in consuming fast food. Only 32.1% believe their friends approve of fast-food consumption, indicating that adolescents view their dietary choices as personal decisions rather than socially driven behaviours. This result could also reflect a desire for autonomy and self-expression, where adolescents resist admitting external influence over their eating habits, even if such influence exists subconsciously (Crocetti et al., 2017; Luyckx et al., 2009). Adolescents may resist acknowledging the impact of social norms because a conflict between dependence and independence often marks this stage of development (Crocetti et al., 2017; Lawler \u0026amp; Thye, 1999; Vuolo et al., 2014).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec20\" class=\"Section2\"\u003e \u003ch2\u003e4.2 Perceived Benefits of FFC\u003c/h2\u003e \u003cp\u003ePerceived benefits play a crucial role in shaping attitudes and consumption patterns. The findings indicate that adolescents strongly perceive fast food as tasty (M\u0026thinsp;=\u0026thinsp;3.93, SD\u0026thinsp;=\u0026thinsp;0.94), convenient (FF satisfies hunger: M\u0026thinsp;=\u0026thinsp;3.07, SD\u0026thinsp;=\u0026thinsp;1.058), and cost-effective (M\u0026thinsp;=\u0026thinsp;3.62, SD\u0026thinsp;=\u0026thinsp;1.177). However, nutritional value perception is relatively low (M\u0026thinsp;=\u0026thinsp;2.05, SD\u0026thinsp;=\u0026thinsp;0.979), suggesting that adolescents recognise fast food as a source of immediate gratification rather than balanced nutrition. Moreover, environmental factors such as restaurant atmosphere (M\u0026thinsp;=\u0026thinsp;3.13, SD\u0026thinsp;=\u0026thinsp;0.978) and safety and cleanliness (M\u0026thinsp;=\u0026thinsp;2.68, SD\u0026thinsp;=\u0026thinsp;1.148) have a moderate impact, while the perception of fast-food outlets as a place for social events like birthdays (M\u0026thinsp;=\u0026thinsp;2.72, SD\u0026thinsp;=\u0026thinsp;1.314) remains relatively low see Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e. This indicates that while adolescents value the accessibility and affordability of fast food, social factors related to restaurant environments play a secondary role in their food choices.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec21\" class=\"Section2\"\u003e \u003ch2\u003e4.3 Attitudes Toward FFC\u003c/h2\u003e \u003cp\u003eAttitudes reflect the personal inclination toward consuming fast food, even when aware of its negative consequences. The findings show that adolescents continue to consume fast food despite being aware of its health risks (M\u0026thinsp;=\u0026thinsp;3.5, SD\u0026thinsp;=\u0026thinsp;1.11); see Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e. Additionally, they eat fast food even when alternative home-cooked meals are available (M\u0026thinsp;=\u0026thinsp;2.9, SD\u0026thinsp;=\u0026thinsp;1.229) or restaurants are not easily accessible (M\u0026thinsp;=\u0026thinsp;2.6, SD\u0026thinsp;=\u0026thinsp;1.13). A critical insight is that awareness alone does not significantly discourage FFC, as many adolescents are willing to continue consuming fast food even if more awareness campaigns were introduced (M\u0026thinsp;=\u0026thinsp;3.1, SD\u0026thinsp;=\u0026thinsp;1.136). This highlights the role of habit and automatic decision-making, suggesting that FFC is not just an intentional choice but a habitual behaviour driven by external cues. Additionally, responses indicate that FFC is not strongly influenced by advertising (M\u0026thinsp;=\u0026thinsp;3.4, SD\u0026thinsp;=\u0026thinsp;1.152) or promotional marketing (M\u0026thinsp;=\u0026thinsp;3.4, SD\u0026thinsp;=\u0026thinsp;1.073). Suggesting that marketing strategies may reinforce existing behaviours but are not adolescents' primary drivers of FFC.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec22\" class=\"Section2\"\u003e \u003ch2\u003e4.5 Perceived Risks of FFC\u003c/h2\u003e \u003cp\u003eDespite recognising the negative health implications, adolescents continue to consume fast food. The results indicate that participants strongly agree that fast food is unhealthy (M\u0026thinsp;=\u0026thinsp;3.8, SD\u0026thinsp;=\u0026thinsp;1.163) and that excessive consumption causes serious health problems (M\u0026thinsp;=\u0026thinsp;4.1, SD\u0026thinsp;=\u0026thinsp;1.019). Additionally, there is high agreement that fast food is high in fat (M\u0026thinsp;=\u0026thinsp;4, SD\u0026thinsp;=\u0026thinsp;0.912) and calories (M\u0026thinsp;=\u0026thinsp;4, SD\u0026thinsp;=\u0026thinsp;1.054), leading to weight gain (M\u0026thinsp;=\u0026thinsp;4.1, SD\u0026thinsp;=\u0026thinsp;1.029). Interestingly, perceived risks do not significantly alter consumption behaviour. This confirms findings from previous research, where awareness of adverse health effects does not necessarily lead to behaviour change, particularly among adolescents who prioritise taste, convenience, and affordability over long-term health risks (Bargiota et al., 2013; Fitzgerald et al., 2010; Kalsum et al., 2018; Maulida et al., 2016). A notable insight is the lower agreement regarding food safety risks\u0026mdash;adolescents are less concerned about storing fast food for extended periods (M\u0026thinsp;=\u0026thinsp;3.2, SD\u0026thinsp;=\u0026thinsp;1.086) or having excess salt (M\u0026thinsp;=\u0026thinsp;2.9, SD\u0026thinsp;=\u0026thinsp;1.112). This suggests that while they recognise the nutritional downsides of fast food, food safety concerns are not a significant deterrent in their decision-making.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec23\" class=\"Section2\"\u003e \u003ch2\u003e4.6 Fast Food Consumption Patterns and Weekly Meal Replacement Frequency (WMRF)\u003c/h2\u003e \u003cp\u003eThe results indicate varying consumption levels across different fast-food types, with some items significantly more frequently consumed than others. The most commonly consumed fast food item is donner, with 91.1% of adolescents consuming it at least once per week and only 5.8% consuming it three or more times per week. This high frequency suggests that donner may be perceived as a familiar, accessible, and preferred fast-food option, possibly due to its availability and affordability. Hamburgers, pizza, and souvlaki are also frequently consumed, with most adolescents eating them one to two times per week. Specifically, hamburgers are consumed at least once per week by 39.8%, with 51.8% eating them twice per week and 8.4% three or more times. Souvlaki follows a similar trend: 42.9% eat it once, 46.1% twice, and 11% three or more times per week. Pizza consumption is slightly higher in the three or more times per week category (14.1%), suggesting a strong preference for this food type among adolescents. Among side items, French fries are a staple, with 36.1% consuming them once weekly, 45% twice weekly, and 18.8% three or more times weekly. The relatively high frequency of French fries suggests that they are often paired with other fast-food items rather than consumed alone.\u003c/p\u003e \u003cp\u003eDespite being a typical fast-food choice, sandwiches show a slightly different consumption pattern. 62.3% eat them twice weekly, 27.7% once weekly, and 9.9% three or more times per week. The frequency of twice-weekly consumption suggests that sandwiches might be considered a convenient meal replacement rather than an occasional indulgence.\u003c/p\u003e \u003cp\u003e \u003cem\u003eWeekly Meal Replacement Frequency (WMRF)\u003c/em\u003e \u003c/p\u003e \u003cp\u003eThe Weekly Meal Replacement Frequency (WMRF) data indicate that many adolescents use fast food as a substitute for home-cooked meals. About 57% of adolescents replace a home-cooked meal with fast food at least twice weekly, indicating a significant shift toward convenience-oriented eating habits. 27% of those who replace three or more meals per week with fast food indicate a concern about reliance on fast food, which could have long-term health and nutritional implications. The high frequency of meal replacement with fast food suggests that adolescents prioritise convenience over nutritional value, reinforcing the role of habit and accessibility in shaping eating behaviours. Given the findings on perceived risks and attitudes toward fast food, adolescents recognise the unhealthiness of fast food but continue consuming it, possibly due to the ease of access, taste preference, and social norms. The preference for donner, souvlaki, and pizza may reflect local food traditions and urban food culture, where these items are commonly available and considered socially acceptable choices among peers. Nearly 30% replace meals with fast food multiple times per week, suggesting a need for policy interventions to promote healthier meal options in schools and urban areas.\u003c/p\u003e \u003cp\u003eThese findings highlight adolescents' reliance on fast food as a convenient meal option, with certain food items (donners, hamburgers, pizza, and fries) dominating consumption patterns. The high weekly meal replacement rates reinforce the need for targeted interventions to encourage healthier eating habits, mainly focusing on reducing dependency on fast food as a primary meal source and promoting balanced alternatives. Addressing the habitual nature of fast-food consumption and its social reinforcement could play a crucial role in shaping healthier dietary behaviours in the long term.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec24\" class=\"Section2\"\u003e \u003ch2\u003e4.7 Partial Least Squares Structural Equation Modeling (PLS-SEM) results\u003c/h2\u003e \u003cp\u003eCronbach\u0026rsquo;s Alpha values the construct's subjective norms, perceived benefits and risks of fast-food consumption, and positive attitudes towards fast-food consumption exceeded the minimum threshold of 0.7, indicating reliable internal consistency (Nunnally, 1978). Furthermore, confirmatory factor analysis demonstrated strong reliability, as all indicator loadings for these constructs exceeded the recommended threshold of 0.7 (Hair et al., 2013). Composite reliability values for constructs of perceived benefits and risks of fast food consumption, subjective norms, and positive attitudes towards fast food consumption were higher than 0.7, as suggested by (Hair et al., 2017) Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e and AVE value above 0.5 as recommended by (Fornell \u0026amp; Larcker, 1981) Table\u0026nbsp;\u003cspan refid=\"Tab6\" class=\"InternalRef\"\u003e6\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComprehensive breakdown of items forming the constructs in the estimated model (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"2\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eConstruct\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eItems\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSN \u0026ndash; Subjective norms\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSN1 \u0026ndash; I act as my teacher would like me to\u003c/p\u003e \u003cp\u003eSN2 \u0026ndash; I act as my friends would like me to\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePB \u0026ndash; Perceived benefits toward fast food\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePB1 - The restaurants where fast food is served are very nice ones;\u003c/p\u003e \u003cp\u003ePB2 - The restaurants where fast food is served are clean and safe;\u003c/p\u003e \u003cp\u003ePB3- A fast food restaurant is a pleasant place to have birthday parties.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePATT \u0026ndash; Positive attitudes toward fast food\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePATT1 - I eat FF also when I am dieting\u003c/p\u003e \u003cp\u003ePATT2 - I use fast food although I have to wait a long time to get it\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePR \u0026ndash; Perceived risk toward fast food\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePR1 \u0026ndash; I think fast food is unhealthy\u003c/p\u003e \u003cp\u003ePR2 \u0026ndash; I think that fast food products make you fat\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003e\u003cem\u003eComposite reliability analysis\u003c/em\u003e\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOriginal sample (O)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eStandard deviation (STDEV)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eT statistics (|O/STDEV|)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eP values\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePATT\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.804\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.020\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e39.724\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePB\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.868\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.014\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e61.926\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.835\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.020\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e41.951\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.738\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.031\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e23.505\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003eNotes. PATT\u0026thinsp;=\u0026thinsp;positive attitudes, PB\u0026thinsp;=\u0026thinsp;Perceived benefits, PR\u0026thinsp;=\u0026thinsp;Perceived risks, SN\u0026thinsp;=\u0026thinsp;subjective norms\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab6\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 6\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eAverage Variance Extracted (AVE)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOriginal sample (O)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eStandard deviation (STDEV)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eT statistics (|O/STDEV|)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eP values\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePATT\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.673\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.028\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e24.079\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePB\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.687\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.026\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e26.637\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.717\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.029\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e25.142\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.586\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.034\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e17.404\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003eNotes. PATT\u0026thinsp;=\u0026thinsp;positive attitudes, PB\u0026thinsp;=\u0026thinsp;Perceived benefits, PR\u0026thinsp;=\u0026thinsp;Perceived risks, SN\u0026thinsp;=\u0026thinsp;subjective norms\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe discriminant validity of the model was assessed using the Heterotrait-Monotrait Ratio (HTMT). The analysis confirmed the model's validity, as all values in the HTMT matrix were below the recommended threshold of 0.90 Table\u0026nbsp;\u003cspan refid=\"Tab7\" class=\"InternalRef\"\u003e7\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab7\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 7\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eHeterotrait-Monotrait (HTMT) matrix of the estimated model\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOriginal sample (O)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.5%\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e97.5%\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eME \u0026lt;-\u0026gt; FFFC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.049\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.003\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.154\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePATT \u0026lt;-\u0026gt; FFFC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.664\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.508\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.822\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePATT \u0026lt;-\u0026gt; ME\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.008\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.014\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.181\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePB \u0026lt;-\u0026gt; FFFC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.395\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.258\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.508\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePB \u0026lt;-\u0026gt; ME\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.017\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.016\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.146\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePB \u0026lt;-\u0026gt; PATT\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.821\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.693\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.960\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePR \u0026lt;-\u0026gt; FFFC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.096\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.045\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.235\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePR \u0026lt;-\u0026gt; ME\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.059\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.017\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.192\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePR \u0026lt;-\u0026gt; PATT\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.134\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.065\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.397\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePR \u0026lt;-\u0026gt; PB\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.108\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.073\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.305\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSN \u0026lt;-\u0026gt; FFFC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.387\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.180\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.919\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSN \u0026lt;-\u0026gt; ME\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.229\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.099\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.613\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSN \u0026lt;-\u0026gt; PATT\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.807\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.480\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.593\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSN \u0026lt;-\u0026gt; PB\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.611\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.404\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.201\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSN \u0026lt;-\u0026gt; PR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.591\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.323\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.208\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWMR \u0026lt;-\u0026gt; FFFC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.188\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.083\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.287\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWMR \u0026lt;-\u0026gt; ME\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.124\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.015\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.235\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWMR \u0026lt;-\u0026gt; PATT\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.456\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.306\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.622\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWMR \u0026lt;-\u0026gt; PB\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.167\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.052\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.289\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWMR \u0026lt;-\u0026gt; PR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.383\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.239\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.531\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWMR \u0026lt;-\u0026gt; SN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.231\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.061\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.573\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003eNotes. PATT\u0026thinsp;=\u0026thinsp;positive attitudes, PB\u0026thinsp;=\u0026thinsp;Perceived benefits, PR\u0026thinsp;=\u0026thinsp;Perceived risks, SN\u0026thinsp;=\u0026thinsp;subjective norms, WMR\u0026thinsp;=\u0026thinsp;Weekly meal replacement, ME\u0026thinsp;=\u0026thinsp;mother education\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eSource: Authors' elaboration\u003c/p\u003e \u003cp\u003eThe SRMR fit index for the saturated and estimated models is 0.09, within the acceptable threshold of \u0026le;\u0026thinsp;0.1, indicating a good model fit (Bentler \u0026amp; Bonett, 1980). These findings provide insights into the factors shaping consumer attitudes and behaviour towards fast food, confirming some of the hypothesised relationships while challenging others.\u003c/p\u003e \u003cp\u003eSubjective norms show a positive and statistically significant association with positive attitudes toward fast food consumption among adolescents (βSN \u0026rarr; PATT\u0026thinsp;=\u0026thinsp;0.177; t\u0026thinsp;=\u0026thinsp;10.204; p\u0026thinsp;=\u0026thinsp;0.001). Hypothesis \u003cb\u003eH1SN was accepted\u003c/b\u003e. However, the coefficient is relatively low, suggesting that while social influence is important, its impact on attitude formation is moderate. The lower coefficient can be explained by two key factors: conflicting social influences. In line with other studies, adolescents navigate multiple and often contradictory social influences regarding food choices (Crocetti et al., 2017; Cruwys et al., 2015; Story et al., 2002). Thus, Peers may encourage fast food consumption as a social activity, while teachers and parents may advocate for healthier dietary choices. This conflict results in a weaker overall effect of subjective norms, as adolescents may feel pressure from both directions, leading to ambivalence rather than strong alignment with either group. Similarly, adolescents are in a transitional phase of identity formation, meaning they experiment with independence while still being influenced by external expectations (Becht et al., 2017; Vuolo et al., 2014). During this stage, they may not have fully stable food preferences and may fluctuate between seeking peer approval and responding to authoritative health messages (Crocetti et al., 2017; Maulida et al., 2016; Shaw et al., 2023).This developmental inconsistency dilutes subjective norms' impact on attitudes, contributing to a lower coefficient in the model.\u003c/p\u003e \u003cp\u003eSimilarly, as shown in Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e, Adolescents' perceived benefits of fast-food consumption are positively and statistically significantly associated with positive attitudes toward fast food (β\u003csub\u003ePB\u003c/sub\u003e \u0026rarr; \u003csub\u003ePATT\u003c/sub\u003e = 0.480; t\u0026thinsp;=\u0026thinsp;10.204; p\u0026thinsp;=\u0026thinsp;0.000) hypothesis \u003cb\u003eH2PB accepted\u003c/b\u003e. Adolescents who perceive fast food restaurants as pleasant, clean, and safe environments (PB3, PB4, PB6) are more likely to develop positive attitudes toward fast food consumption. This highlights the importance of fast-food restaurants' physical and social environment in shaping adolescent consumer behaviour. The high factor loadings of PB3 (0.854), PB4 (0.786), and PB6 (0.845) confirm that cleanliness, safety, and social appeal (e.g., birthday parties) are critical perceived benefits.\u003c/p\u003e \u003cp\u003eThe findings that positive attitudes significantly influence both fast food consumption frequency (β\u0026thinsp;=\u0026thinsp;0.484, p\u0026thinsp;=\u0026thinsp;0.000) and weekly meal replacement with fast food (β\u0026thinsp;=\u0026thinsp;0.305, p\u0026thinsp;=\u0026thinsp;0.000, hypothesis \u003cb\u003eH3PATT accepted\u003c/b\u003e) reinforce the idea that attitude formation plays a central role in adolescent eating behaviours. However, a closer examination of the items used to measure attitudes\u0026mdash;such as AT2 (\"\u003cem\u003eI eat fast food even when I am dieting\") and AT5 (\"I use fast food although I know...\")\u003c/em\u003e\u0026mdash;suggests that these behaviours are not necessarily reflective of a rational, planned decision-making process but instead of habitual consumption patterns. This distinction is critical because it challenges the traditional Theory of Planned Behavior (TPB) assumption that adolescent fast-food consumption is primarily deliberate, intention-driven behaviour. Instead, the findings suggest that habit formation and automaticity play a dominant role, meaning that once an adolescent has developed positive attitudes toward fast food, consumption may become a routine rather than a consciously planned action.\u003c/p\u003e \u003cp\u003ePerceived risks (PR) of fast-food consumption negatively and statistically significantly impact weekly meal replacement with fast food (βPR\u0026rarr;WMR = -0.271; t\u0026thinsp;=\u0026thinsp;5.465; p\u0026thinsp;=\u0026thinsp;0.360; \u003cb\u003ehypothesis H4PR rejected\u003c/b\u003e). This suggests that although adolescents recognise the risks of fast-food consumption (PR1: \"Fast food is unhealthy,\" PR7: \"Fast food makes you fat\"), this awareness frequently influences their decision to replace meals with fast food. This could be due to optimism bias, believing the risks will not affect them personally(Ait-hadad et al., 2020; Kelloniemi et al., 2005; Pereira das Neves et al., 2024), or present bias favouring immediate gratification over long-term health consequences (Kakoschke et al., 2015; Katz et al., 1973). Additionally, the mother\u0026rsquo;s education is negatively associated with the consumption frequency of fast food and weekly meal replacement with fast food (β\u003csub\u003eME\u0026rarr;FFFC\u003c/sub\u003e = -0.046; t\u0026thinsp;=\u0026thinsp;0.978; p\u0026thinsp;=\u0026thinsp;0.328; β\u003csub\u003eME\u0026rarr;WMR\u003c/sub\u003e = -0.111; t\u0026thinsp;=\u0026thinsp;1.976; p\u0026thinsp;=\u0026thinsp;0.048; hypothesis \u003cb\u003eH5WMR accepted\u003c/b\u003e. However, the mother\u0026rsquo;s education does not significantly affect fast food consumption frequency (β = -0.046, p\u0026thinsp;=\u0026thinsp;0.328), leading to the rejection of H5FFC. Suggesting that while higher maternal education is associated with lower reliance on fast food as a meal replacement, it does not significantly reduce overall fast-food consumption frequency. Educated mothers may provide healthier meal options at home, but adolescents may still consume fast food for social or convenience reasons. Studies suggest that mothers with higher education levels are more likely to promote healthier eating habits at home, including increased consumption of fruits, vegetables, and home-cooked meals (Pearson et al., 2009). This aligns with the notion that parental education plays a crucial role in shaping children's food preferences and nutritional awareness (Scaglioni et al., 2018). However, similar to the findings in this study, research also indicates that parental influence weakens during adolescence, as external factors such as peer influence, convenience, and exposure to fast food marketing become stronger determinants of food choices ((Bassett et al., 2008; Bassett-Gunter et al., 2015)). Furthermore, the globalised, industrialised food system has made fast food more accessible and embedded in social interactions, leading adolescents to consume fast food outside the home despite having healthier options (Ambikapathi et al., 2022; Engler-Stringer et al., 2014; Shaw et al., 2023).\u003c/p\u003e \u003cp\u003eAdditionally, time constraints and urban lifestyles make adolescents more likely to eat outside the home, diminishing the impact of home-based dietary education (Beydoun et al., 2011); this is evidenced in Albania, where 39% of the increase in consumption is outside the home.\u003c/p\u003e \u003cp\u003eOverall, these findings reinforce the argument that while maternal education can positively influence home eating environments, it is insufficient to restrain adolescent fast-food consumption alone. Interventions should extend beyond household-level education and focus on peer-led nutrition initiatives, structural food policy changes, and strategies to modify the social and environmental cues that drive fast food consumption (Verstraeten et al., 2016).\u003c/p\u003e \u003c/div\u003e"},{"header":"5. Conclusions","content":"\u003cp\u003eThe findings of this study emphasise that adolescent fast-food consumption is habitual mainly rather than planned behaviour, challenging traditional models like the Theory of Planned Behavior (TPB). Despite the awareness of the health risks associated with fast food, adolescents continue to consume it due to behavioural automaticity, contextual triggers, and resistance to external influences. The high mean scores for automatic responses to environmental cues suggest that consumption is not solely driven by marketing but is embedded in routine behaviours and situational contexts. Additionally, subjective norms have a relatively weak influence, likely due to conflicting pressures from different social groups (e.g., parents, teachers, and peers), which dilutes their impact on food choices.\u003c/p\u003e \u003cp\u003eMoreover, the study highlights the role of maternal education in shaping adolescent food consumption patterns. While higher maternal education is associated with lower reliance on fast food as a meal replacement, it does not significantly reduce overall fast-food consumption frequency. This suggests that while mothers may provide healthier meal alternatives at home, adolescents still consume fast food due to external factors such as social interactions and convenience. These findings point to the need for interventions that go beyond household education and address the broader food environment, including peer influences, accessibility, and behavioural aspects.\u003c/p\u003e \u003cp\u003eGiven these insights, practical strategies to promote sustainable food choices and reduce adolescent fast food consumption should focus on habit disruption rather than just awareness campaigns. This includes increasing friction in accessing fast food and promoting alternative habitual behaviours such as mindful eating and healthier social dining spaces. Additionally, the role of women, particularly mothers, in fostering sustainable food choices must be further strengthened through policy interventions that empower them as key actors in food education, school meal planning, and community-based nutrition programs. Addressing individual and systemic factors influencing adolescent food choices will be crucial in fostering long-term dietary sustainability and public health improvements.\u003c/p\u003e \u003cp\u003e \u003cb\u003ePractical implications\u003c/b\u003e \u003c/p\u003e \u003cp\u003eThe findings emphasise the need for habit-focused interventions over traditional awareness campaigns to reduce adolescent fast food consumption. Given the influence of behavioural automaticity and contextual triggers, policymakers should implement choice architecture strategies, making healthier options more accessible in schools and public spaces. Peer-driven initiatives like school challenges and social media campaigns can help reshape food norms. Behavioural nudges and digital tools like pre-ordering healthy meals and gamified tracking apps can also disrupt automatic consumption. A multi-level approach integrating parental education, policy restrictions, and social norm shifts is essential for fostering long-term sustainable eating behaviours.\u003c/p\u003e \u003cp\u003e \u003cb\u003eTheoretical implications\u003c/b\u003e \u003c/p\u003e \u003cp\u003eThe findings challenge traditional consumer behaviour models by highlighting habitual automaticity, contextual triggers, and environmental cues as primary drivers of adolescent fast-food consumption in a globalised, industrialised food system. Unlike the Theory of Planned Behavior (TPB), which assumes rational decision-making, this study suggests that fast food consumption is mainly habitual and reinforced by structural food system influences. A habit-centred consumer behaviour model is needed, integrating automatic responses, environmental reinforcement, and food system accessibility to explain why individuals persist in consuming fast food and ultra-processed foods despite health and sustainability concerns, offering a more accurate framework for behavioural interventions and policy development.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAuthor Contributions:\u0026nbsp;\u003c/strong\u003eConceptualization EK, AB, IM and AB; methodology EK and AB; software IM and AB; validation IT, formal analysis EK and IM, \u0026nbsp;and AH.; investigation EK and IT ; writing EK, AB, AH, IM and IT\u0026mdash;All authors have read and agreed to the published version of the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical statement\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research was conducted following the ethical regulations of the Ethics Committee of the Agriculture University of Tirana. The Ethics Committee reviewed and approved the study protocol. All participants provided informed consent before they participated in the study. The study complies with all institutional and national regulations governing human subject\u0026rsquo;s research.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInformed Consent Statement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eInformed consent was obtained from all participants before their involvement in the study. Participants were informed that their participation was voluntary and that they could withdraw at any time without consequence. The study involved completing a questionnaire, and participants were assured that their data would be kept confidential and used solely for research purposes. Anonymity was guaranteed, and no identifying information was collected or disclosed. Data privacy protocols were followed under the ethical guidelines of the Agriculture University of Tirana Ethics Committee.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent to Publish declaration:\u003c/strong\u003e Not applicable. This study does not include any person\u0026rsquo;s data (including individual details, images, or videos).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Availability Statement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data supporting this study\u0026apos;s findings are available from the corresponding author upon reasonable request.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSources of Funding\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was conducted within the project of the National Agency of Scientific Research and\u003c/p\u003e\n\u003cp\u003eInnovation (NASRI) and Agricultural University of Tirana. We would like to thank the National\u003c/p\u003e\n\u003cp\u003eAgency of Scientific Research and Innovation for financing and contributions to this research.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflict of Interest\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors have no conflicts of interest to declare.\u003c/p\u003e\n\u003cp\u003eClinical trial number: Not applicable.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eA, E. R., \u0026amp; Deepika, P. (2020). Role of Women and Youth in Food Security and Rural Livelihood. \u003cem\u003eInternational Journal of Agriculture Extension and Social Development\u003c/em\u003e, \u003cem\u003e3\u003c/em\u003e(2), 68\u0026ndash;70. https://doi.org/10.33545/26180723.2020.v3.i2b.57\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAdair, L. S., \u0026amp; Popkin, B. M. (2005). 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From Fish and Bushmeat to Chicken Nuggets: The Nutrition Transition in a Continuum From Rural to Urban Settings in the Tri Frontier Amazon Region. \u003cem\u003eEthnobiology and Conservation\u003c/em\u003e. https://doi.org/10.15451/ec2015-7-4.6-1-12\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eVuolo, M., Mortimer, J. T., \u0026amp; Staff, J. (2014). Adolescent Precursors of Pathways From School to Work. \u003cem\u003eJournal of Research on Adolescence\u003c/em\u003e, \u003cem\u003e24\u003c/em\u003e(1), 145\u0026ndash;162. https://doi.org/10.1111/jora.12038\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"discover-sustainability","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"disu","sideBox":"Learn more about [Discover Sustainability](https://www.springer.com/43621)","snPcode":"","submissionUrl":"","title":"Discover Sustainability","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Discover Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"adolescents, fast food consumption, theory of planned behaviour, habit, women, sustainable consumption","lastPublishedDoi":"10.21203/rs.3.rs-6221337/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6221337/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eThis study examines the role of habitual behaviour in adolescent fast-food consumption and its implications for the Theory of Planned Behavior (TPB). While TPB traditionally explains behaviour through attitudes, subjective norms, and perceived behavioural control, our findings suggest that habitual automaticity, contextual triggers, and environmental cues are stronger predictors of fast-food consumption. The results show that higher maternal education reduces fast food as a meal replacement but does not significantly impact overall consumption frequency, indicating that external social and environmental factors outweigh parental influence. Additionally, fast food consumption persists even without advertising or promotions, reinforcing the habit-driven nature of this behaviour. These findings suggest that habit should be integrated into TPB as a direct predictor of behaviour, shifting intervention strategies from awareness-based approaches to habit-disruption models. Policies should focus on modifying food environments, leveraging social norms, and using behavioural nudges to encourage sustainable eating behaviours.\u003c/p\u003e","manuscriptTitle":"The Role of Habit in Fast Food Consumption: Integrating Habit into the Theory of Planned Behaviour","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-04-28 11:25:14","doi":"10.21203/rs.3.rs-6221337/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-05-27T11:43:49+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-05-22T19:58:29+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"264507474264142226958064616279376809378","date":"2025-05-15T12:36:06+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-05-15T10:55:16+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-05-14T15:34:01+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"202782827702701511088231694250375973188","date":"2025-05-07T15:21:49+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"67007649512175301662927929424461624368","date":"2025-05-07T12:57:55+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"71787762825842761755939726422164198426","date":"2025-05-07T06:12:54+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-04-26T06:29:41+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"39029082617491336963655646733507126449","date":"2025-04-26T03:47:25+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-04-24T12:23:59+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-04-09T11:54:19+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-04-09T11:52:56+00:00","index":"","fulltext":""},{"type":"submitted","content":"Discover Sustainability","date":"2025-03-13T15:16:35+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"discover-sustainability","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"disu","sideBox":"Learn more about [Discover Sustainability](https://www.springer.com/43621)","snPcode":"","submissionUrl":"","title":"Discover Sustainability","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Discover Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"f33793ec-18ae-4755-8e54-6ac8e98bc18b","owner":[],"postedDate":"April 28th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-12-22T16:03:28+00:00","versionOfRecord":{"articleIdentity":"rs-6221337","link":"https://doi.org/10.1007/s43621-025-02466-1","journal":{"identity":"discover-sustainability","isVorOnly":false,"title":"Discover Sustainability"},"publishedOn":"2025-12-21 15:58:36","publishedOnDateReadable":"December 21st, 2025"},"versionCreatedAt":"2025-04-28 11:25:14","video":"","vorDoi":"10.1007/s43621-025-02466-1","vorDoiUrl":"https://doi.org/10.1007/s43621-025-02466-1","workflowStages":[]},"version":"v1","identity":"rs-6221337","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6221337","identity":"rs-6221337","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}