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A Foundation’s Win At Public Health Policy on Smoking



June 15th, 2010
by Billie Hall

Using Political Tactics and Strategies at the State Level to Achieve a Ban on Smoking in Indoor Public Places and Workspaces 

As a foundation committed to shaping health policy, we at the Sunflower Foundation made a decision to fund a public policy campaign as a special initiative, rather than a grant program, primarily because there was no nonprofit organization that had the capacity to direct an extensive political campaign in the window of time available. This experience has significantly informed our work in public policy, and we are sharing the strategies and lessons we learned with colleagues and other nonprofit organizations interested in public policy work.

The campaign was funded by Sunflower Foundation, with support from the Health Care Foundation of Greater Kansas City. Sunflower Foundation is classified as a public charity organization and reports its lobbying expenditures under section 501(h) of the Internal Revenue Code. Please note that only foundations classified as public charities can engage in lobbying. Private foundations may support public charities that lobby, but there are specific rules they must follow. Click here for more information on the legal aspects related to foundation lobbying.

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After a decade of observing proposed legislation on public smoking bans die for lack of support in the Kansas Legislature, the Sunflower Foundation decided to develop and support a grassroots campaign for the sole objective of getting a statewide law passed that prohibits smoking in public settings. After two years of planning, the campaign was launched in January 2009. Fifteen months later (March 2010), Kansas Gov. Mark Parkinson (D), whose personal commitment to the issue was significant, signed into law the Kansas Clean Indoor Air Act. The ban on smoking in indoor public places and workspaces, including bars and restaurants, is effective 1 July 2010. (Certain venues are exempt.)

What we knew…

Going into the campaign for clean indoor air, we knew that we had public opinion and evidence-based science on our side. According to a public opinion poll commissioned in 2008 by the Sunflower Foundation, 71 percent of Kansas voters were in favor of a state law. The opposition to such a ban on smoking was well organized, and those helping the opposition were politically influential, however. The case that they made against the law focused on civil liberties and local control. Those who opposed the legislation organized Kansas business owners around business rights and fear of economic losses, even though data from states with smoking bans did not justify this fear.

What we did…

To break the cycle, we hired a national firm that works at the grassroots level to teach us how to mount an effective grassroots campaign. The firm told us what we already had come to know: People matter, and their voices need to be heard. To complement the grassroots advocacy, we hired an experienced Kansas lobbying firm to work with our legislators. We also began an aggressive online advocacy campaign, beginning with a traditional Web-based messaging and media approach and adding social media, including Facebook and Twitter, to our strategies. Finally, we brought the public health partners together to work out in advance their responses to any issues that might divide them (for example, smoking ban exemptions). This “lines in the sand” exercise was done to help the partners withstand the opposition’s “death by a thousand cuts” attempt to weaken the legislation to the point of complete ineffectiveness.

What happened…

Our work began tentatively in 2009 and in earnest in 2010. In 2009, the Kansas Senate passed a smoking ban bill that was sent to the House. Knowing that there were not enough votes in favor in the Kansas House in 2009, our lobbying team worked with legislative leadership so that the bill would move to conference committee and carry over to the 2010 session. Once we knew where the twenty “maybe” votes were, the campaign ramped up its grassroots advocacy efforts and targeted the home districts of those representatives.

Using data from the state voter files, we contracted with a phone messaging firm to call thousands of registered voters in the targeted districts and asked each of them about their position on clean indoor air. Four groups of constituents were identified: those potentially interested individuals who might sign the Clean Air Kansas pledge and provide names of other potential contacts; supporters or individuals who signed the Clean Air Kansas pledge and provided their names and contact information; members of Clean Air Kansas who undertook one action for the cause, such as calling their legislator or attending a meeting; and individuals who participated in two or more actions on behalf of the campaign—the aptly named “Super Advocates”—who were then recruited for campaign work or to testify before the legislature.

The campaign also used the concept of “pings,” or personal contacts between a legislator and a supporter (such as face-to face meetings, phone calls, or a handwritten letter). The goal of pings is to create an environment around the targeted lawmakers in which it seems everyone is talking about the issue—thus moving the conversation beyond the statehouse to the policy makers’ communities.

The Voices Project—A Breakthrough

As the grassroots activity increased, Kansans began sharing their personal stories and why they wanted a state indoor smoking ban. Working with the phone messaging firm, the campaign designed an innovative system that gave those people we called the option to record a personal message. The results were amazing.

Within one month, over 10,000 supportive Kansas voters had been identified, and more than 4,000 compelling “audio postcards” were collected from the targeted districts. The stories ran the gamut from hope to heartbreak, and the storytellers ranged from employee to business owner, and from health professional to smoker–each with a different personal reason for supporting the campaign. To manage the volume of stories, the team created custom CDs. These CDs were given to the lawmakers in the targeted districts weekly, as they left the legislative session for their long drive from Topeka back to their home districts.

Many lawmakers recognized the voices of their friends and neighbors, although they had never discussed this issue with most of them before. The recordings were also catalogued and featured on the campaign’s Web site, which enabled the media to connect real people and real stories across Kansas to the issue. Read a news article by the Kansas Health Institute’s News Service here.

The Clean Air Kansas campaign and its consultants won a 2010 Pollie Award for their innovative use of technology for the Voices Project.

Lessons Learned

First, it’s crucial to know where the public is on an issue as you develop a public policy strategy. Polling is an excellent way to make that determination, and it’s a good idea to oversample the areas that fit the political landscape in which you’re working. (In Kansas, for example, that meant Republican primary voters.)

Second, we learned that, as advocates, we tended to focus too much on legislative processes. We need to be sure that policy makers are hearing the same advocacy messages in their everyday lives as they do in their legislative lives.

Third, we need to incorporate political thinking and strategies in all of our public health policy work. The most effective campaigns include direct lobbying, grassroots advocacy, and media—especially social media. All of these components were crucial for this legislative victory.

It’s time to employ the power of the grassroots, new media, and lobbying so that we can achieve our health goals and help those we serve live healthier, safer lives.

The Sunflower Foundation was established in 2000 as the result of a $75 million settlement from litigation involving the Kansas attorney general, the Kansas insurance commissioner, and Blue Cross Blue Shield of Kansas. The settlement agreement charged the foundation with serving the health needs of Kansans.

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1 Trackback for “A Foundation’s Win At Public Health Policy on Smoking”

  1. Clean Air Kansas featured in Health Affairs blog | Kansas Grassroots
    August 17th, 2011 at 11:39 pm

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