This tip of the week from Apple demonstrates how to use OS X's built in save for PDF feature, but while reducing the resolution and thus file size of images.
Basically here's what to do:
1) Choose "File" -> "Print" from the menu like normal
2) in the print dialogue box, choose "ColorSync" from the options pop up menu
3) From the "Quartz Filter" menu, choose "Reduce file size"
4) Use the "Save as PDF" menu like normal
(Found via Daring Fireball)
Apagoinc also make a commercial utility called PDF Shrink that shrinks existing PDF files, and gives lots of options.