As part of a comprehensive tobacco education campaign, local health departments throughout California have been engaged in the process of enacting local clean indoor air ordinances to protect the public from the effects of secondhand smoke. This paper describes how a Northern California Bay Area health department worked with city and county governments to pass ordinances in the face of persistent tobacco industry opposition. The key strategies used by the health department included organizing broad-based coalitions, achieving effective use of the media, and educating the business community. Tobacco industry tactics included establishing local front groups that launched a massive misinformation campaign to frighten local businesses into believing that passage of an ordinance would adversely affect their business. Finally, the authors discuss how the tobacco industry has created a climate through state and national legislative activity to undermine the ability of local health departments to pursue effective tobacco control policies, most notably through preemptive legislation.