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Cross-national comparative analysis of tobacco control strategies can alert health advocates to how opportunities for public health action, types of action, and probabilities for success are shaped by political systems and cultures. This article is based on case studies of tobacco control in the United States, Canada, Britain, and France. Two questions are addressed: (a) To whom were the dangers of smoking attributed? and (b) What was the role of collective action--grassroots level organization--in combating these dangers? Activists in Canada, Britain, and France moved earlier than the United States did to target the tobacco industry and the state. Locally based advocacy centered on passive smoking has been far more important in the United States. The author concludes that U.S.-style advocacy has played a major role in this country's smoking decline but is insufficient in and of itself to change the corporate practices of a wealthy and politically powerful industry.
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