Adolescent smoking is a significant public health concern in the UK and across  Europe. 
This study examines smoking behaviours, methods of accessing cigarettes  and use of non-commercial (fake, foreign and single) cigarettes across a sample  of schoolchildren. Relationships with alcohol consumption, deprivation, personal  income and extra-curricular activities are also explored. 
A cross-sectional survey of 9833 15- and 16-year-old  schoolchildren in the North West of England.  
Cigarettes were most commonly accessed from off-licences and newsagents, but  pupils also reported non-commercial access through friends, family and street  sellers/neighbours. A high percentage of smokers had bought foreign (57%), fake  (28%) and single (54%) cigarettes. Frequent binge drinking, not participating in  extra-curricular activities, receiving greater personal income, and having  parents that smoked were significantly associated with being a regular and  heavier smoker. Frequent binge drinking was also significantly associated with  buying foreign/fake or single cigarettes. A higher percentage of those living in  deprived areas were current smokers, although deprivation was not an independent  predictor of cigarette use.  
Strategies that  restrict commercial access to cigarettes among adolescents may increase their  reliance on social methods of access, and use of fake, foreign and single  cigarettes. Interventions to reduce adolescent smoking must recognize the  critical role of parents and communities in discouraging smoking and preventing  social access to cigarettes in children. 
A joint approach to prevention is  required that targets children at risk of smoking, heavy alcohol use and  associated health-damaging behaviours. 
Request Reprint E-Mail:  s.k.hughes@ljmu.ac.uk

 
