This article reports on findings from a one-year national evaluation of the Primary School/Primary Care Health Links (PS/PC HL) initiative, commissioned in 2003 by the National Drug Prevention Development Team, on behalf of the Department of Health (DH). The primary aim of the PS/PC HL initiative was to develop links between primary and community health care professionals and primary school children in order to increase the children’s knowledge and understanding of a range of health issues. This involved developing innovative ways in which parents could engage in the health education of their children at primary school level. As part of the evaluation, a questionnaire was sent to parents (n = 69) and children (n = 464) to discover to what extent discussions about health issues, in particular substance misuse, were held at home and what messages children were receiving. In this context, substance misuse includes drugs, alcohol and tobacco. This article also examines children’s attitudes towards smoking and alcohol, and considers how parental influence affects children’s ideas about the acceptability of these substances. The findings indicated that whilst over 65% of parents thought that their children knew a lot about exercise and healthy eating, only 20% thought that their children were well informed about alcohol and drug misuse. Despite 80% of children in our survey reporting that they would prefer to discuss health problems with their parents, substance misuse appeared to be a topic rarely discussed at home. The findings confirm, (i) the need for family and community cohesiveness and (ii) reinforces the need for an increase in parents’ knowledge and motivation in order to (iii) raise their confidence in their conversations with their children about substance misuse. Partnership working between teachers, health professionals and parents would appear to be the ideal in effectively reinforcing health messages to children; however, the authors suggest that the culture of accountability both in the teaching and health professions often hinders this process.