The Roy Castle Lung Cancer Foundation’s report ‘New issues and age-old challenges: a review of young people’s relationship with tobacco’ highlights a roadmap for action: A return to national leadership and spreading and sustaining local excellence. Smoking is a habit developed in early age with two-thirds of smokers starting before the age of 18 and 40% per cent of smokers become regular smokers before the age of 16. The report highlights the new realities for tobacco and young people which includes: smoking, a habit forged early in life; tobacco-reduction, a (potentially) slippery slope; depictions of smoking in modern media; combating complacency in a fairer society. The report also includes shifting issues in youth smoking from illicit tobacco, shisha, cannabis and electronic cigarettes. The findings illustrate that tobacco use among young people is evolving and the consequences of this continue to be felt amongst society’s worst-off citizens. The report makes a call for an overarching vision that is comprehensive and ambitious for tobacco prevention and control in the UK. The survey findings for the report were collected by MHP Communications.