PR, the Public, and Politicians: Using An Integrated Communications Strategy to Create Policy Change

Background:  In a 2006 Surgeon General’s report he concluded that there is “no risk-free level of exposure to secondhand smoke. Nonsmokers exposed to secondhand smoke at home or work increase their risk of developing heart disease by 25 to 30 percent and lung cancer by 20 to 30 percent. The finding is of major public health concern due to the fact that nearly half of all nonsmoking Americans are still regularly exposed to secondhand smoke.” In 2010 the State of North Carolina passed a Smoke-free Restaurants and Bars Law, which allows local governments to adopt and enforce smoke-free ordinances that are broader than State law in local government buildings, on local government grounds, in local vehicles, or in public places.

Program background:  Acting upon the authority granted under the smoke-free restaurants and bars law, the Orange County Board of Health decided to review existing smoke-free policies in the County and sponsor a more comprehensive smoking ban that would further minimize exposure to second hand smoke, including outdoors. In the four months leading up to the vote and subsequent County Commissioners vote, a major outreach and public relations campaign was implemented utilizing a combination of strategies including social media, traditional news media, public hearings, community leader meetings, and surveys. In all cases, both English and Spanish options were available.

Evaluation Methods and Results:  The project goal was to pass a comprehensive county-wide smoking ban that would include all public places, both in and out-of-doors to help reduce exposure to secondhand smoke and exposure to negative smoking behaviors in an effort to reduce children and teens from becoming smokers.  The success of the project was determined by the amount of pre-vote engagement and ultimately whether the rule passed. Methods:

• Surveys were sent out to three different target audiences: government officials; the general public; and community partners
• A series of meetings were also held with town and county officials to identify concerns
• The health department staff promoted the public Input opportunities via multiple channels and accepted input in a variety of ways including: online survey response, telephone hotline, US mail, e-mail, and at public hearings 
• Press releases, PSA’s, social media posts, letters to the editor, and other media outreach strategies were implemented to educate, promote, and persuade multiple audiences

The Board of Health received an unprecedented response from nearly 1,000 people, a more than 80% approval rating of the rule specifications, and more than 50 media hits resulting in passage of one of the most comprehensive public places smoking bans in the country.

Conclusions:  By utilizing a variety of communications strategies in policy development and the voting process of what could have been a potentially controversial policy, we were able to pass a public health law that will impact thousands of lives each year.

Implications for research and/or practice:  With so much emphasis being put on social media, integrating it as part of a larger communications with more traditional public relations strategies proved to be an effective method for creating public health policy.