Tobacco has been recognized as a serious public health issue that threatens
people’s health in Palau, Micronesia, especially as young people consume tobacco in
multiple ways. The research of this thesis begins with a description of the complex mix
of habits, social norms, history, and cultural practice that make up tobacco use in Palau.
Then an intervention project using “journaling behavior change paradigm” among
young adults based on their own reflections on tobacco use by writing journals, is
described. A high prevalence of tobacco use in all forms was revealed in this study,
among which chew betel nuts with tobacco is the most popular method. Friend and
family members’ attitude play important roles in affecting people’s tobacco use. Also,
the evaluation of journaling paradigm reveals potential in lowering tobacco
consumption in Palau and other countries by raising awareness of the problem through
the writing of journals and diaries