Home Institution

Tulane University

Publication Date

Fall 2010

Program Name

Chile: Public Health, Traditional Medicine, and Community Empowerment


Background: According to a study in 2008 by the National Agency for the Control of Narcotics, 26.1% of Chilean adolescents between the ages of 12-18 had used tobacco at least once during the month of the study and 13% used tobacco daily. Even though smoking has negative health effects, many adolescents in Chile still smoke. Since the 1970s, low self-esteem has been proposed as a risk factor for the development of poor health behaviors. Recent investigations have shown that, when measured in the social, school, family, self-body image, sports and physical activity, and global realms of the life of an adolescent, low self-esteem might serve as a protective factor against the development of smoking in adolescence. Moreover, if used in conjunction with the Transtheoretical Model, interventions directed at increasing the protective associations of self-esteem with smoking in adolescence could have significant effects.

The purpose of this study is to determine the correlation between the readiness to change according to the Transtheoretical Model and self-esteem, following six different domains of the life of an adolescent, Chilean smoker.

Methodology: This study was conducted with a self-response, three part survey in a high school in the city of Arica, Chile. The survey was applied to 160 students in the first, second, and third years of study. Of these 160 students, 53 were used to form the sample. A smoker was defined as a person who had smoked one cigarette or cigar in the last six months. These 53 students answered general questions about themselves, their friends, their families in regards to smoking, their self-esteem, and their readiness to change.

Results: 52% were grouped into the Action stage of the Transtheoretical model, 31% into the Contemplation stage, and 17% into the Precontemplation stage. The majority of scores for the social, family, self-body image and global self-esteems were in the upper half of the range of their respective scales while the majority of scores for school self-esteem were in the lower half. The scores for the sports/physical activity self-esteem were found to be the most balanced. Consistent patterns were not found between the readiness to change and the six different types of self-esteems.

Conclusions: No correlation was found between the readiness to change and the six different types of self-esteem. However, patterns were found between the level of the readiness to change and the current smoking status of the parents of the smoker. Differences in the results of the six self-esteem scores between this study and those of previous research highlight the need for cultural awareness in practice and research. They support the premise that self-esteem can serve as a protective and risk factor for smoking in adolescence. Results also indicate that interventions based on the Transtheoretical Model and those that seek to change health behaviors by focusing on self-esteem should focus on the influential environments of adolescents and not just the attitudes, practices, or beliefs of the adolescents themselves.


Community Health | Community Health and Preventive Medicine | Family, Life Course, and Society | Inequality and Stratification | Other Chemicals and Drugs | Public Health Education and Promotion | Substance Abuse and Addiction


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