"Only Sixteen" was inspired by the sixteenth birthday of Lou Rawls' stepsister, Eunice. The song was originally intended for actor Steve Rowland, who often hung around the Keen studio. Rowland asked Cooke to write a song for him, and Cooke borrowed the bridge from an earlier song of his, "Little Things You Do". Rowland's manager disliked the song, and Cooke re-recorded it for himself.
Dr. Hook released a version of "Only Sixteen" in the winter of 1976. Their version was the most successful chart release of the song. It reached number six on the U.S. Billboard Hot 100 and number five on the Cash Box Top 100. Dr. Hook's version spent 22 weeks on the charts and became a Gold record. The song was banned by the BBC.