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Tobacco use is the single most preventable cause of death and disease in the United States, causing more than 440,000 premature deaths annually. We can dramatically reduce the health and economic burden of tobacco use by employing proven tobacco control and prevention strategies. Policy interventions offer the greatest opportunity to influence decisions regarding tobacco use at the societal level. Tobacco control policy can drive social, environmental, and systems changes, and has a substantially greater impact than interventions that target individuals. A policy approach engages the larger community and empowers it to establish healthy social norms. Health departments, the primary governmental institutions charged with protecting the health of the public, play many different roles in advancing policy. The National Tobacco Control Program funds state health departments to educate the public and decision makers regarding evidence-based policy strategies. This article outlines those strategies, critical success factors, and challenges associated with policy-based interventions.