Vietnam is currently considering a Tobacco Harm Prevention Law and the Ministry of Health has been asked to provide supporting evidence. This analysis explores factors influencing uptake of evidence in that legislation process. The political environment reflects the government's ambivalence over how to balance health and socioeconomic issues of tobacco control in a state-owned industry. Although the growing presence of transnational tobacco companies is alarming, the role of Framework Convention on Tobacco Control in prompting government compliance with set milestones is encouraging. Evidence of effectiveness of interventions for health needs now to be complemented with socioeconomic evaluation, and strengthening of the ties between advocates and decision makers.