The Duluth clean indoor air ordinance: Problems and success in fighting the tobacco industry at the local level in the 21st century

Case study methodology was used to investigate the tobacco industry's strategies to fight local tobacco control efforts in Duluth, Minn. The industry opposed the clean indoor air ordinance indirectly through allies and front groups and directly in a referendum. Health groups failed to win a strong ordinance because they framed it as a youth issue rather than a workplace issue and failed to engage the industry's economic claims. Opponents' overexploitation of weaknesses in the ordinance allowed health advocates to construct a stronger version. Health advocates should assume that the tobacco industry will oppose all local tobacco control measures indirectly, directly, or both. Clean indoor air ordinances should be framed as workplace safety issues.