This paper examines the historicalexperience of tobacco control in the last five decades andshares important lessons of public health interventions toinform current and future tobacco control programs in othercountries. The paper is divided into four parts. The firstpart gives an overview of the political economy, principalinfluences and interventions in tobacco control in theUnited States. It stresses the importance of informationshocks and the role played by grassroots organizations. Thecurrent situation of tobacco control in the United States isfurther discussed in the second part, with emphasis on theeconomic case that led to litigation, as well as theresponse of the industry and the States. The third partfocuses on the present efforts of multilaterals like theWorld Bank, technical United Nation (UN) agencies such asthe World Health Organization, in the context of the newglobal governance structure: the Framework Convention onTobacco Control (FCTC). The last section discusses lessonslearned and provides recommendations for comprehensivetobacco control programs.