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Researchers examined the relationship between self-esteem and smoking behavior among Japanese elementary and junior high school students. Students (2,090) in fourth to ninth grade from three elementary schools and two junior high schools in the Hyogo and Niigata prefectures completed an anonymous questionnaire. Self-esteem was measured using the Harter Perceived Competence Scale, the Pope Self-Esteem Scale, and the Rosenberg Self-Esteem Scale. Results indicated that never smokers had higher cognitive, family, and global self-esteem, but lower physical self-esteem than ever smokers. Grade and gender were significantly associated with self-esteem, showing a decrease of self-esteem with increases in grade and a higher level of self-esteem among boys than girls. The results suggest that effective smoking prevention programs for Japanese early adolescents should be integrated into more comprehensive health education or health promotion programs including self-esteem enhancement training.

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