Of all the mudslinging and smear campaigning across the country in this fraught election year, few races are as nasty as the one for governor of Ohio.

Dr. Amy Acton, a Democrat who was once the state’s chief public health officer, holds a narrow lead against Vivek Ramaswamy, a Republican who made a mint in pharmaceutical startups, according to a New York Times and Siena University poll released Sunday.

The two candidates differ significantly on policy matters, but their campaign advertisements, mailers and social media have not all been about substance.

Instead, voters might think one candidate is a con artist or the other is a drunk.

“It’s definitely ugly,” said Christopher Gagin, former chair of the Belmont County Republican Party. In past races, he and others said, even hard-hitting attack ads were mostly based on issues or a candidate’s past performance in office. “This,” Gagin said, “is all very, very personal.”

As is often the case, the campaign attacks in Ohio might be based on actual events, but the sound-bites are hardly the full stories. Voters might actually be tuning out all the toxicity.

Acton, who has faced an onslaught of attacks maligning her as a violent pill popper, is viewed more favorably than unfavorably by voters, according to the Times/Siena poll. Ramaswamy, who has been accused of making millions by swindling everyday Ohioans, is viewed more unfavorably than favorably, but by a narrow margin not much different from surveys taken months ago.

And there are few signs that the specific nature of the attacks is undermining traditional partisan loyalties.

Despite being painted as an out-of-touch billionaire, Ramaswamy has a healthy lead among Ohioans without college degrees, as would be expected for any Republican these days. Acton, painted as scandalously underqualified, has an even larger lead among Ohioans with college degrees, a reliable Democratic constituency.

Still, even if the voters are ignoring them, the ads are unquestionably nasty, especially the ones launched by groups backing Ramaswamy that aim at Acton.

“Ohio is not new to negative advertising, but typically that revolves around issues or maybe tying candidates to unpopular national figures,” said Robert Alexander, a professor at Bowling Green State University in northwest Ohio who directs a statewide poll. “But the personal nature, particularly of those anti-Acton ads, have been somewhat alarming.”

Ramaswamy backers are outspending the Acton camp on advertising by a more than 3-1 margin, and many of their ads have inflated the events of a single night in the Columbus suburbs in late August 2019.

A daughter of Acton’s called 911 to say that her stepfather and her mother were fighting and that her mother had been “drinking and throwing things.” In an incident report, a police officer who came to the house wrote that Acton and her husband had been arguing about her long work hours and that in the course of the argument she “grabbed hold of a mirror on the wall and pulled it down,” breaking the glass. The officer wrote that the two had been drinking and that she had taken medication.

The police left, and nothing came of it — until it was reported by NBC News this past April. Acton’s husband, Eric Acton, said in a statement that his wife had a single drink that night and that the argument, which he said he had started, was over before police showed up. The Acton campaign said the prescription medications were for migraines and high blood pressure. As for the mirror, she bumped into it, knocking it off the wall, the campaign said.

But the incident has become something of a foundational text for a vicious oeuvre of attacks. The state Republican Party has described Acton as “violent,” and “unstable,” posting computer-generated images of her jeep with a license plate that reads “Drunk Mom” or staring into a broken mirror on which is written, in bloodred lettering, “Mom has been drinking.”

“Amy Acton: Drinking. Drugs. Disaster. Disqualified,” said one ad among many, showing a spilled wineglass, an empty pill bottle and a woman passed out on a couch.

The Democrats’ counteroffensive has not been as intensely personal, directing its fire instead at Ramaswamy’s business history and ample wealth. But the hits have been nasty all the same.

Ads have called Ramaswamy a “con man” and a “swindler,” emphasizing the millions he made pitching his pharmaceutical startups and suggesting criminality that authorities have not alleged. One prominent ad features a man whose wife is suffering from Alzheimer’s disease, accusing Ramaswamy of making “hundreds of millions of dollars scamming people like me.”

(The ad is not dissimilar to an ad from the Ramaswamy campaign, in which a woman says she would never forgive Acton for the fact that her mother died alone during COVID-19 lockdowns. But an obituary surfaced by a progressive Ohio outlet showed that the woman’s mother died in Kentucky, six weeks after Acton had left state government in Ohio.)

While the anti-Ramaswamy ad does not make clear precisely how the man believes he was scammed, it is referring to Axovant, one of Ramaswamy’s pharmaceutical companies.

Axovant, which employed eight people, including Ramaswamy’s mother and brother, both physicians, was founded to bring to market an Alzheimer’s drug that pharmaceutical giant GlaxoSmithKline had given up on after four failed clinical trials.

Ramaswamy talked up the drug, intepirdine, wherever he could, portraying it as a potential breakthrough that “could help millions” of people. Then, six months after buying the drug, he took Axovant public in a debut that sent the company’s market value soaring to nearly $3 billion.

In late 2015, Ramaswamy sold off a portion of Axovant’s parent company, Roivant, claiming more than $37 million in capital gains on his tax return that year. In August 2017, he secured another big payday for Roivant when the Japanese conglomerate SoftBank led an investment of $1.1 billion in Roivant, which had a broad portfolio of pharmaceuticals. A few weeks later, intepirdine failed in a clinical trial and Axovant stock plunged.

The Acton camp has framed these events as a classic “pump and dump” that made Ramaswamy hugely rich while fleecing regular folks in the form of pension funds and retirement investments.

Ramaswamy has strongly denied such claims, saying if he had held onto the Roivant shares he sold, he would have made money. In an interview with the Times during his failed presidential campaign in 2023, he said criticism of his actions “grates on me a little bit.”

But in the ugly Ohio race, that criticism has taken center stage.

—

This article originally appeared in The New York Times.

By Campbell Robertson/Jessica Phelps
c. 2026 The New York Times Company