This chapter assesses the principal components of an effective tobacco control programme in relation to efficacy, reach (i.e. numbers of smokers influenced) and cost-effectiveness. National targets for the reduction of prevalence are most likely to be achieved through the use of high reach interventions such as fiscal policy and mass communications. Restrictions on smoking at work may contribute to declines in consumption, but advice from health professionals, though effective, has limited impact owing to low reach. Measures aimed primarily at youth can delay, but not prevent, recruitment to smoking. Media publicity not only reduces smoking, but also creates a climate of opinion in favour of effective measures such as fiscal policy. In the long run, health professionals can achieve more for their patients through the media than through personal advice.