Media advocacy, or advocacy seeking media attention, can shape the policy environment, but the relationship between the nature of news media coverage of public health topics and policy outcomes has received insufficient research attention. We present the first large-scale study of news coverage of tobacco to focus on the potential impact for policy outcomes. Through our analysis of 9859 tobacco-focused news articles from ioo leading US daily newspapers between 2001 and 2003 we examined whether tobacco issues are newsworthy, and if so, whether coverage is favorable to policy progress. We found strong evidence for news-worthiness, and a tendency for coverage to highlight policy approaches to tackling tobacco. Coverage emphasized successes rather than setbacks, and newspaper editors lent support to tobacco control positions. There were, however, areas that did not garner sufficient attention to sustain a meaningful policy message. Our analysis of coverage of controversial issues also revealed areas where tobacco control efforts seem to pushing against ideological boundaries.