5,6,7 According to the US Surgeon General, no amount of exposure to secondhand smoke is safe and the only way to fully protect nonsmokers from secondhand smoke is through 100% smokefree indoor air environments. 4 Secondhand smoke increases the risk of heart attacks, heart disease, stroke, lung cancer, and other cancers by up to 30% among nonsmoking adults. In the United States, approximately 58 million nonsmokers are still exposed to secondhand smoke. 2 The levels of fine particle air pollution found inside a casino were four to six times that of outside air, even in a well-ventilated casino. 2 For example, one study revealed that 50% of the casinos sampled had air pollution levels known to cause cardiovascular disease after only 2 hours of exposure. 1 The level of smoking in a casino can be especially high compared with other enclosed public places where smoking is permitted.
In 2017, commercial casinos employed more than 361,000 people. 1 As the industry grows, allowing smoking in casinos presents a challenge for tobacco prevention and control efforts because of increased secondhand smoke exposure for both patrons and casino workers. 1 In 2020, casinos earned $30 billion in gross revenue. During the past 25 years, the commercial casino industry has grown from casinos in two places-Atlantic City, New Jersey, and the state of Nevada-to 465 casinos in 30 states.
