The film follows Nick Naylor (Aaron Eckhart), the charming, fast-talking chief spokesman for the "Academy of Tobacco Studies" — a front organization for the big tobacco industry. Nick’s job is to defend smoking on television talk shows, fight lawsuits from cancer victims (known as "the dying"), and lobby against anti-smoking legislation, all while using slick logical fallacies and moral relativism.

His philosophy: "The one thing you cannot lie about is the truth." He argues that he’s simply giving adults the freedom to choose, and that risk is part of American freedom.

The plot kicks into gear when a jealous rival journalist, with the help of a health-obsessed Vermont senator (William H. Macy), tries to destroy Nick’s reputation. Meanwhile, Nick juggles being a role model to his young son, Joey (Cameron Bright), while negotiating the cutthroat world of "M.O.D. (Merchants of Death)" — a group of lobbyists representing firearms, alcohol, and tobacco who meet for "kill-the-pig" dinners.