American tobacco farmers and the communities in which they live face an increasingly uncertain and tenuous future. In many rural American communities, churches function as the moral and social compass that guides community life. In North Carolina's rural communities, churches and tobacco are inseparable. Indeed, churches in tobacco-dependent communities are often referred to as tobacco churches. These churches experience tensions and contradictions that exist within the multiple cultures of which they are a part: denominations, banks, locally owned businesses, schools, and community centers. Ethical dilemmas abound as the moral dimensions of public health and livelihood are weighed against the backdrop of the common good. This article will give an overview of the conflict, then delve more deeply into the historical and societal components that have shaped the tobacco culture and the roles, past, present, and future, that churches have or could play. Current pressures related to public health and rural economic viability will be examined. Cases illustrating the possible central role of the church at both the local and regional level will be presented to build an argument for the constructive role of the church for communities undergoing radical social, economic, and cultural change. © 2000 John Wiley & Sons, Inc.