Small proportions of actively-smoking patrons and high PM2.5 levels in southern California tribal casinos: support for smoking bans or designated smoking areas

Abstract

BackgroundNearly all California casinos currently allow smoking, which leads to potentially high patron exposure to secondhand tobacco smoke pollutants. Some argue that smoking restrictions or bans would result in a business drop, assuming > 50% of patrons smoke. Evidence in Nevada and responses from the 2008 California tobacco survey refute this assertion. The present study investigates the proportion of active smokers in southern California tribal casinos, as well as occupancy and PM2.5 levels in smoking and nonsmoking sections.MethodsWe measured active-smoker and total-patron counts during Friday or Saturday night visits (two per casino) to smoking and nonsmoking gaming areas inside 11 southern California casinos. We counted slot machines and table games in each section, deriving theoretical maximum capacities and occupancy rates. We also measured PM2.5 concentrations (or used published levels) in both nonsmoking and smoking areas.ResultsExcluding one casino visit with extremely high occupancy, we counted 24,970 patrons during 21 casino visits of whom 1,737 were actively smoking, for an overall active- smoker proportion of 7.0% and a small range of ~5% across casino visits (minimum of 5% and maximum of 10%). The differences in mean inter-casino active-smoker proportions were not statistically significant. Derived occupancy rates were 24% to 215% in the main (low-stakes) smoking-allowed slot or table areas. No relationship was found between observed active-smoker proportions and occupancy rate. The derived maximum capacities of nonsmoking areas were 1% to 29% of the overall casino capacity (most under 10%) and their observed occupancies were 0.1 to over 3 times that of the main smoking-allowed casino areas. Seven of twelve visits to nonsmoking areas with no separation had occupancy rates greater than main smoking areas. Unenclosed nonsmoking areas don’t substantially protect occupants from PM2.5 exposure. Nonsmoking areas encapsulated inside smoking areas or in a separate, but unenclosed, area had PM2.5 levels that were 10 to 60 μg/m3 and 6 to 23 μg/m3 higher than outdoor levels, respectively, indicating contamination from smoking.ConclusionsAlthough fewer than roughly 10% of casino patrons are actively smoking on average, these individuals substantially increase PM2.5 exposure for all patrons in smoking and unenclosed nonsmoking areas. Nonsmoking areas may be too inconvenient, small, or undesirable to serve a substantial number of nonsmoking patrons. Imposing indoor smoking bans, or contained smoking areas with a maximum capacity of up to 10% of the total patronage, would offer protection from PM2.5 exposures for nonsmoking patrons and reduce employee exposures.

Gambling with Our Health

“…33 Similarly, the large majority of surveyed casino patrons in this study did not smoke, were bothered by the casino smoke, and believed secondhand smoke is harmful. These findings are consistent with other studies that have shown that only 20% of casino patrons smoke, 27,37 smoking bans are not cited as reasons people visit casinos less, 28,33,38–40 and smoking bans do not result in revenue loss for casinos. 41–44 …”

Continuous weeklong measurements of indoor particle levels in a Minnesota Tribal Casino Resort

“…Klepeis et al [10] found a somewhat lower active smoker proportion of 7 % (range, 5–10 %) in 11 southern California casinos. The observed percent of active smokers is also similar to the smoking prevalence of Minnesota adults (14.4 %, Minnesota Adult Tobacco Survey) [14].…”

Advancing smoke-free policy adoption on the Navajo Nation

“…[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.…”