Secondhand Smoke and Gaming Facilities

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The 2006 U.S. Surgeon General's Report, "The Health Consequences of Involuntary Exposure to Secondhand Smoke," concluded that 100% smokefree workplace policies are the only effective way to eliminate secondhand smoke exposure in the workplace. Even sophisticated ventilation systems do not eliminate the health hazards of secondhand smoke.1 Casino, bar, and restaurant workers remain significantly more exposed to toxic secondhand smoke in their jobsite compared to other segments of the U.S. workforce.

The National Institute for Occupational Safety and Health (NIOSH) recommends making all casinos 100% smokefree to ensure indoor air within casinos is safe for workers to breathe.



Ventilation and air filtration systems do not protect workers or patrons from exposure to secondhand smoke. These systems can reduce odor, but not the health hazards. The U.S. Surgeon General determined that there is no "risk-free level of exposure to secondhand smoke." Separating smokers from nonsmokers, installing smoking rooms, or even sophisticated air cleaning technologies cannot eliminate the health hazards of secondhand smoke exposure nor remove all the poisons, toxins, gases, and particles found in secondhand smoke. Additionally, heating, ventilation, and air conditioning systems can distribute secondhand smoke throughout a building.11











  1. U.S. Department of Health and Human Services. The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2006.
  2. National Institute for Occupational Health and Safety. Environmental and Biological Assessment of Environmental Tobacco Smoke Among Casino Dealers, May 2009. Download at
  3. Curran, J., "For casino workers, smoke study underscores hazard," Newsday/AP, October 17, 2004.
  4. Repace, J., "Secondhand Smoke in Pennsylvania Casinos: A Study of Nonsmokers' Exposure, Dose, and Risk," American Journal of Public Health published online ahead of print June 18, 2009.
  5. Trout D.; Decker J.; Mueller C.; Bernert J.T.; Pirkle J., "Exposure of casino employees to environmental tobacco smoke," JOEM. 1998 March;40(3): 270-6. Accessed on May 20, 2004. Download at
  6. Anderson, K.; Kliris, J.; Murphy, L.; Carmella, S.; Han, S.; Link, C.; Bliss, R.; Puumala, S.; Hecht, S., "Metabolites of Tobacco-Specific Lung Carcinogen in Nonsmoking Casino Patrons," Cancer Epidemiology, Biomarkers & Prevention, 12:1544-1546, December 2003.
  7. Repace, J., "Respirable Particles and Carcinogens in the Air of Delaware Hospitality Venues Before and After a Smoking Ban." JOEM, September 10, 2004.
  8. Collier, A.C., Dandge, S.D., Woodrow, J.E., Pritsos, C.A.; "Differences in DNA-damage in non-smoking men and women exposed to environmental tobacco smoke (ETS)" Toxicology Letters 158(1): 10-19, July 28, 2005.
  9. Pilkington, et. al., "Health impacts of exposure to second hand smoke (SHS) amongst a highly exposed workforce: survey of London casino workers," BMC Public Health 2007, 7:257. Download at:
  10. Geoffrey T. Fong, et. al., "The Impact of the Smoke-Free Ontario Act on Air Quality and Biomarkers of Exposure in Casinos: A Quasi-Experimental Study," Ontario Tobacco Control Conference, Niagara Falls, Ontario, December 2, 2006.
  11. U.S. Department of Health and Human Services. The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2006.
  12. Samet, J.; Bohanon, Jr., H.R.; Coultas, D.B.; Houston, T.P.; Persily, A.K.; Schoen, L.J.; Spengler, J.; Callaway, C.A., "ASHRAE position document on environmental tobacco smoke," American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE), [2005?].
  13. [n.a.], "Casino Queen Before and After Smokefree Law PPT slide," Roswell Park Cancer Institute, [n.d.].
  14. [n.a.], "Colorado Casinos Safer After Smoke-Free Law: Research Shows Air Quality Improvement in Casinos' First Smoke-Free Month," California Department of Public Health, February 26, 2008.
  15. Repace, J., "Respirable particles and carcinogens in the air of Delaware hospitality venues before and after a smoking ban," Journal of Occupational & Environmental Medicine 46(9): 887-905, September 2004.
  16. New Jersey GASP, "[press release re: Indoor air quality testing in Rhode Island and New Jersey casinos.]," New Jersey GASP, February 5, 2007. Download at:
  17. Travers, M., "[Presentation at Fallen Leaf Lake 2007.]," Roswell Park Cancer Institute, June 2, 2007.
  18. Adopted by the NCLGS Executive Committee on January 10, 2009. Accessed on June 23, 2009 at
  19. Mandel, L.L.; Alamar, B.C.; Glantz, S.A., "Smoke-free law did not affect revenue from gaming in Delaware," Tobacco Control; 14: 10-12, 2005.
  20. Gowrylow, M. "Press release: Businesses bounce back from smoking ban," Washington Department of Revenue, June 10, 2008.
  21. Connolly, G.N.; Carpenter, C.; Alpert, H.R.; Skeer, M.; Travers, M., "Evaluation of the Massachusetts Smoke-Free Workplace Law: a preliminary report," Division of Public Health Practice, Harvard School of Public Health, Tobacco Research Program, April 4, 2005. Download at
  22. Glantz, S.A.; Wilson-Loots, R., "No association of smoke-free ordinances with profits from bingo and charitable games in Massachusetts," Tobacco Control;12: 411-413, 2003.
  23. [n.a.], "Smoke-Free Bar Fact Sheet," BREATH, [n.d.].
  24. California State Board of Equalization: California Department of Health Services, Tobacco Control Section, November 2002; State of California, Employment Development Department, Labor Force Statistics, November 2003.
  25. Pritsos, C.A., "The percentage of gamblers who smoke: a study of Nevada casinos and other gaming venues," Reno, NV: University of Nevada, Department of Nutrition, 2006.
  26. [n.a.], "[press release re: 'New poll finds nearly 7 in ten New Jersey Voters Support Smoke-Free Casinos,'" NJ Breathes, October 31, 2007.
  27. J.D. Power and Associates Reports: A Vast Majority of Southern California Indian Gaming Casino Customers Express Desire for a Smoke-Free Environment, July 1, 2008.
  28. Field Research Corporation, "2004 Field Research Poll Results," California Department of Health Services, September 2004.
  29. Dalla, N., "Poll Results: To Smoke or Not to Smoke - That is the Question," Card Player, December 17, 2003. Downloaded at
  30. [n.a.], "Commercial tobacco-free Illinois Frequency Questionnaire," Greenberg Quinlan Rosner Research, June 1, 2008.
  31. [n.a.], "New Mexicans Concerned About Tobacco (NMCAT) Tobacco Policy Survey December 2007, " Research & Polling Inc., December 2007.
  32. [n.a.], "Delaware Statewide Survey," IMPACT, American Lung Association, American Heart Association, American Cancer Society, [n.d.].
  33. [n.a.], "A Snapshot of Perspectives on Second-Hand Smoke in the Workplace," Critical Insights, September 2004.
  34. [n.a.], "[Press release re: "Helena Voters Overwhelmingly Support the City's Smoking Ordinance, and Believe it Should Be Fully Enforced Without Delay."]," Harstad Strategic Research, Inc., June 27, 2004.