Background. Performers in the adult film industry are routinely exposed to bloodborne pathogens. In 2012, public health advocates in Los Angeles County convinced voters to pass a ballot initiative—Measure B—to mandate condom use on adult film sets. This article presents a case study of the advocacy coalition’s strategies used to achieve greater workplace safety using the advocacy coalition framework. Method. The authors were given access to all memoranda, market research, and campaign tools used to promote Measure B. To reconstruct adult film industry counterefforts, the authors reviewed trade publications, social media, and blog posts. Results. When legislative efforts failed, advocates engaged in a step-by-step strategy built around voters to achieve passage of a ballot initiative mandating condom use for all adult films produced in Los Angeles County. Although the industry immediately filed a lawsuit after passage of Measure B, its constitutionality has been upheld. Conclusions. Measure B passed because public health advocates were able to assemble scientific evidence, build public support, counter false claims, and maintain consistent messages throughout the campaign. The adult film industry lacked social capital, cohesion, and nimbleness. To bolster regulatory efforts, appealing to voters to favor safe workplaces may be an effective advocacy strategy for other industries.