Background Looked after children have worse social and health outcomes compared to their peers. There is a higher level of substance misuse, including smoking among looked After Children.

Aims To assess the profile of smoking in looked after children in the region.

Methods We undertook a survey on smoking between April and June 2011 among the looked after children. A total of 29 children completed the survey.

Results 53% of the smokers between the ages of 11 and 18 years were girls and 47% were boys. 18% of the children were between the ages of 11 and 13 years, 27% were between 14 and 16 years and 55% were between 17 and 18 years.

Majority of the children had their first experience of smoking between 10 and 14 years. 54% of the children who smoke lived in residential care compared to 46% in foster care. There are 3 times the number of adult workers who smoke and twice the number of children who co smoke in the residential care of smokers compared to non-smokers. Majority of the children (66%) obtained cigarettes from the local shops fairly easily.

Majority of the children (78%) had a good understanding of the adverse consequences of smoking. Only 20% reported adverse personal consequences. 55% reported strong motivation to quit smoking.

Most of them reported receiving useful information regarding smoking from the LAC team and social workers. 70% of the children did not receive any useful information from their schools. Only 40% felt that there are strong support systems in place currently. 45 % preferred group sessions, 27% preferred one to one counselling sessions, 18% preferred support from the social workers and foster carers

Conclusions Smoking continues to remain a significant health problem in looked after children. The study highlights the need for further strengthening our existing support systems including provision of early health promotion in schools and LAC clinics, smoking support for adult workers in residential care, reminders to the local shops regarding the minimum legal age for selling tobacco and provision of group and individual counselling sessions.