Key Points: Obstacles to smokefree ordinances typically include perceptions of economic harm, preserving business rights, and state preemption laws. Nonetheless, statewide tobacco control and grassroots organizations that join forces with academia can promote policy change, as exemplified in Charleston, SC. Key elements of a broad based campaign included public opinion surveys, health-related research, and prominent citizen involvement. Grassroots support for smoke-free legislation was reflected in surveys indicating over two-thirds of both residents and tourists favored smokefree legislation. Air quality testing revealed a four-fold increase in air pollution within smoking establishments relative to EPA standards, and an 18-fold increase relative to smokefree venues. A coordinated media release of these reports served to educate the public, broadening citizen support. Engaging the support of influential citizens, including a prominent organizer within the African American community, significantly contributed to collective efforts, and identifying a champion within City Council gave the issue a vocal and important political voice. The 2006 Surgeon General's Report on the health effects of secondhand smoke supplemented these efforts. The success of this collaborative campaign was evidenced by passage of a comprehensive smokefree ordinance in January 2007.

Learning Objectives: To identify critical elements of an effective multi-method campaign, relying on partnerships between grassroots organizations and academia, in which smokefree policies can be enacted even within preemption states with strong historical and economic tobacco ties.

Benefits: Smokefree ordinances can be enacted with perseverance and through critical elements of a broad based campaign, offering direct relevance and guidance for policy change within other, similar municipalities.