Preventing the uptake of smoking in young people.

s The number of children and young people starting to smoke is increasing. As 82% of smokers take up the habit during teenage years the increasing rates of young smokers will eventually feed through into adult smoking rates. s The uptake of smoking is a complex process and is rarely a single distinct event. A factor strongly associated with decisions to start smoking is the influence of family members and peers. s There is no simple way to prevent children and young people from taking up smoking. School-based programmes have achieved limited success, although social reinforcement/social norms type programmes seem to be more effective than traditional knowledge-based interventions. s Mass media campaigns can influence smoking behaviour. Both the intensity and duration over which the messages are delivered appear to be important factors. s Enforcement of the law relating to cigarette sales to underage youth can have an effect on retailer behaviour, but the impact on smoking behaviour is likely to be small. s Community approaches involving different intervention components can influence smoking behaviour, particularly when multiple sites within a community are targeted. s Most programmes have targeted 11–17 year olds. However, attitudes towards smoking and experimentation with cigarettes may already be established by this time. Programme implementation before regular patterns of smoking behaviour are formed should be considered. This may involve targeting children as young as 4–8 years of age. This bulletin reviews the evidence for the effectiveness of interventions aimed at preventing the uptake of smoking in young people.