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.
Qualitative study using 14 focus groups.
Schools and community projects in disadvantaged areas of Birmingham, UK.
Eighty-five smokers and non-smokers aged 12-15 years.
Focus group topic guides.
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.
The ban in selling cigarettes to those under 18 in the United Kingdom appears to be easily circumvented, and one important route appears to be 'proxy sales' in which young people approach strangers outside retailers and ask them to purchase cigarettes on their behalf.