Due to the effects of their illness and disease management, adolescents undergoing treatment for cancer are particularly vulnerable to the harmful effects of tobacco use and exposurebto second-hand smoke. In addition, these patients experience risk exposure levels equal to or greater than control subjects, according to findings of a North American study. Two thirds reported being exposed to second-hand smoke in the home, and more than one quarter had a history of tobacco smoking. The researchers collected self-report data from families attending large outpatient oncology clinics, where the adolescent patient had at least one adult family member who was a confirmed smoker. The average age of the adolescent was 13.9 years and 62% were male. Most were receiving treatment for haematological malignancy (78%), solid tumours (15%) and central nervous system disease (7%). Adolescent patients living with cancer were found to be no more likely to try tobacco products than their peers living without cancer. However, they were found to be living in households that increased the risk of smoking exposure and were less likely to have household bans on smoking and tobacco use. The authors recommend surveillance and health promotion interventions that decrease possibly injurious household behaviours.