Tobacco control efforts in the early 1990s, such as the ASSIST program, recognized the importance of mass media intervention in the environmental model, along with community organization and mobilization through coalition building and policy advocacy. Since 1998, the Higher Education Center has recommended that colleges and universities embrace an environmental prevention model, which provides a framework for campuses and surrounding communities to create effective and sustainable change regarding problems related to alcohol and other drug use and violence. Media-focused interventions can be regarded as structural-level approaches insofar as media affect the environment in which people live. Media activities to support policy initiatives use well-designed media campaigns, especially campaigns that generate news coverage (sometimes termed earned media coverage), although the paid media approach is sometimes preferred to ensure prime-time and adequate coverage. Engaging the media strategically to bring attention to an issue or to promote a policy is known as media advocacy. Evidence from a community trial on alcohol problem prevention suggests that training in media advocacy can increase electronic and print media coverage of news events generated by local individuals, resulting in greater public and leader attention paid to specific issues as well as to local policies aimed at reducing alcohol-involved injury. Results indicated that (1) framing in media advocacy can increase coverage of news events generated by local community members, including volunteers; (2) increased news coverage can be generated for both electronic (television) and print media; (3) increased news coverage did focus public attention on specific issues in support of prevention components; (4) while there are different audiences/readers for the print (newspaper) and electronic (TV) media, both audiences are affected; and (5) media advocacy can be more effective than a paid public information campaign in increasing public awareness of alcohol issues. This paper presents what research says about media-focused interventions.