Background: For young people who smoke, access to smokefree support is challenged by low readiness and an expectation that a cessation service will “make me quit”. During pregnancy, the need to protect from smoking effects becomes urgent due to the risks to the developing fetus. Services need to assess and address “low readiness” and have a “take the service to the people” approach in order to improve access to smokefree support for young people, especially if pregnant.

Strategy: We will describe the ripple effect of influence in one family that resulted from a home visiting intervention, Smokechange, offered to a 16 year old pregnant woman referred by her midwife. The young woman accepted support as did her mother, 15 year old partner and two teenaged siblings. The intervention strategy was to increase readiness. All five people participated together in six home visit sessions, some had further support by telephone and all made smokefree attempts during their time with the programme. As well, discussions and activities created opportunities for them to consider as a family the impact of becoming smokefree for themselves and the new baby. As well as the five family members, another five ‘close' others were involved in discussions because sessions happened in the home setting.

Conclusion: Young people who smoke that would ordinarily not have accessed cessation support were drawn into smokefree discussions and support because the service was responsive to their “low ready” status and was offered in their home.