Purpose: The purpose of this paper is to examine trends in smoking prevalence among adolescents and young adults in the UK and to identify any developments in health education theory and practice relating to adolescent tobacco use since 2000. The implications of such research are discussed. Design/methodology/approach: A literature search was conducted focusing on UK studies covering the period 2000-2007. Findings: Since the start of the new millennium a slight downward shift in smoking prevalence has been recorded among 11-15 year olds after at least two decades of little change. International studies suggest that smoking rates among British adolescents are below the average of other European nations. Greater declines in smoking have been evident in young adult smokers. Smoking uptake occurs in response to a range of factors. Recent research has provided further insight into the psychology of young people although young people's attitudes towards smoking do not necessarily predict smoking uptake. Although there is a correlation between smoking uptake and other substance use, the evidence to support the gateway theory is inconclusive. Youth smoking prevention programmes devised by the tobacco industry may do more harm than good and the motives for providing such schemes are questionable. Despite extensive research, there is little evidence that school-based smoking education programmes have a lasting impact on youth smoking prevalence. By contrast, population-wide measures are more likely to result in the de-normalisation of smoking and have a stronger influence on youth smoking. Health educators should support government and other agency initiatives to reduce smoking across the population as a whole rather than focusing on purely youth-oriented campaigns. Originality/value: This paper examines trends in youth smoking in the UK since the millennium. In addition it provides a comparison with international trends and points to the value of population-wide tobacco control measures. It will be of interest to those involved with health and education. (Contains 1 figure and 1 note.)