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Aims To assess the feasibility and effectiveness of a new service using referral liaison advisers to increase the number of referrals of parents/carers at selected Children's Centres to National Health Service (NHS) Stop Smoking Services (SSS) and/or smoke-free families schemes (SFS). Design This mixed-methods pilot study collected numerical data on indicators of smoking behaviours and carried out face-to-face and telephone interviews. Settings Thirteen Children's Centres in Liverpool and Nottingham using local providers of smoking cessation services, from September 2010 to April 2011. Participants Parents and carers registered with, and staff working for, Children's Centres. Measures Number of smokers referred to smoking cessation services and/or smoke-free family schemes and the views of service providers and users on the new service. Findings In Liverpool, 181 referrals to NHS SSS were made from 331 identified smokers (54.7%); extrapolated to 12 months, this represents a 182% increase in referrals from baseline and a similar extrapolation indicates a 643% increase from baseline of referrals to smoke-free families schemes. There were no reliable baseline data for Nottingham; 31 referrals were made (30.7% of smokers) to SSS and 44 referrals to SFS from 52 contacts (84.6%). The interviews highlighted the need for sustained personal contact with parents/carers to discuss smoking behaviours and concerns and their willingness to be referred to SFS as part of caring for their child. Conclusions Routine recording of smoking status and appropriate follow-up by trained staff in Children's Centres can lead to significant numbers of clients attending stop-smoking services, although relatively few stop smoking.

Aims To explore how young people continue to access cigarettes following an increase of the age of sale to 18 years and the implications for future smoking prevention policy and practice. Design Qualitative study using 14 focus groups. Setting Schools and community projects in disadvantaged areas of Birmingham, UK. Participants Eightyfive smokers and non-smokers aged 12‐15 years. Measurements Focus group topic guides. Findings While young people did use social sources to access cigarettes, most obtained cigarettes from small local shops. Smoking and non-smoking participants knew which shops sold to underage children and what strategies to employ, suggesting a widespread acceptance of underage sales in some communities. Some young people bought directly from retailers, reporting that the retailers did not ask for identification. Some young people reported that retailers were complicit, knowingly selling to underage smokers.Young people waited outside shops and asked strangers to buy them cigarettes (proxy sales). Young people expressed cynicism about some shopkeepers’ motives, who they believed knew that they were selling to under-18s, but did not care as long as they made a profit. Conclusions The ban in selling cigarettes to thoseunder18intheUnitedKingdomappearstobeeasilycircumvented,andoneimportantrouteappearstobe‘proxy sales’ in which young people approach strangers outside retailers and ask them to purchase cigarettes on their behalf.