Measuring Indoor Air Quality and Engaging California Indian Stakeholders at the Win-River Resort and Casino: Collaborative Smoke-Free Policy Development

Abstract

Most casinos owned by sovereign American Indian nations allow smoking, even in U.S. states such as California where state laws restrict workplace smoking. Collaborations between casinos and public health workers are needed to promote smoke-free policies that protect workers and patrons from secondhand tobacco smoke (SHS) exposure and risks. Over seven years, a coalition of public health professionals provided technical assistance to the Redding Rancheria tribe in Redding, California in establishing a smoke-free policy at the Win-River Resort and Casino. The coalition provided information to the casino general manager that included site-specific measurement of employee and visitor PM2.5 personal exposure, area concentrations of airborne nicotine and PM2.5, visitor urinary cotinine, and patron and staff opinions (surveys, focus groups, and a Town Hall meeting). The manager communicated results to tribal membership, including evidence of high SHS exposures and support for a smoke-free policy. Subsequently, in concert with hotel expansion, the Redding Rancheria Tribal Council voted to accept a 100% restriction of smoking inside the casino, whereupon PM2.5 exposure in main smoking areas dropped by 98%. A 70% partial-smoke-free policy was instituted ~1 year later in the face of revenue loss. The success of the collaboration in promoting a smoke-free policy, and the key element of air quality feedback, which appeared to be a central driver, may provide a model for similar efforts.

Advancing smoke-free policy adoption on the Navajo Nation

“…This data-driven approach resulted in adoption of a smoke-free casino policy in January 2014. 23 However, similar to the Navajo Nation experience, Redding Rancheria tribal council concerns with revenue resulted in a rollback of the 100% smoke-free policy to a 70% smoke-free policy. 23 While these two experiences illustrate that financial concerns are a barrier to casino secondhand smoke policy adoption, Leischow et al 10 identified 12 of 394 smoke-free tribal casinos, suggesting that a business case can be made for smoke-free tribal casinos.…”

“…23 However, similar to the Navajo Nation experience, Redding Rancheria tribal council concerns with revenue resulted in a rollback of the 100% smoke-free policy to a 70% smoke-free policy. 23 While these two experiences illustrate that financial concerns are a barrier to casino secondhand smoke policy adoption, Leischow et al 10 identified 12 of 394 smoke-free tribal casinos, suggesting that a business case can be made for smoke-free tribal casinos. Babb et al 17 recommended assessing the economic impact of smokefree casino policies in the context of potential savings from reduced healthcare, cleaning and other costs.…”

“…Similarly, the Redding Rancheria policy campaign developed an important ally in casino manager Gary Hayward. 23 Health messaging provided to them by advocates motivated both of these decision makers. Providing such evidence to internal champions is crucial to policy success.…”

“…[16][17][18] Casino workers and patrons are exposed to high levels of secondhand smoke, including carcinogens and fine particulate matter associated with cardiovascular disease (PM 2.5 ). [18][19][20][21][22][23] Air quality studies demonstrate that non-smoking areas within casinos, without physical barriers, provide no protection from secondhand smoke exposure; non-smoking areas, partially separated from smoking areas, provide minimal protection and smoke-free areas, completely separated from smoking areas by physical barriers, provide good protection. 18 21 22 Studies show that a small portion of actively smoking casino patrons (7-12%) are responsible for the high levels of secondhand smoke found in casinos and ventilation systems are not effective at removing secondhand smoke.…”

A Casino goes smoke free: a longitudinal study of secondhand and thirdhand smoke pollution and exposure

“…This is the first study to examine THS pollution and exposure in a casino after 21 years of daily smoking 9. Before, during and after a comprehensive smoking ban, we monitored changes in tobacco smoke pollutants in the air, on surfaces and in dust and examined exposure of non-smokers associated with a 4-hour visit in the casino.…”