According to official estimates cigarette smoking in Britain is responsible for 50,000 premature deaths annually, about seven times the number of people killed in road accidents. Every year some 15,000 still births result from smoking by pregnant women. The annual cost of treating smoking-related diseases was estimated to be £85 million in 1977. Furthermore, the number of working days lost yearly through illnesses associated with smoking has been put at roughly four times that lost through strikes. Even ignoring avoidable human suffering, therefore, there are strong arguments in favour of curbing smoking, though these have to be weighed against the revenue and employment provided by the tobacco industry. For over 20 years successive British Governments have undertaken to discourage smoking but their record has been compared unfavourably with that of Governments elsewhere. Slow progress is due, in part, to the tobacco lobby’s role in the policy making process. Policy making is a complex, continuous activity, difficult to observe and varying according to the subject. There are, however, common elements which enable generalisations to be made. First, an issue has to compete against numerous others for a place on the policy agenda.