By Aara Ramesh
The Covid-19 pandemic may yet add another casualty to its list. The days of smoke-filled casino floors might just be a relic of the past. As cities like Las Vegas begin the long road to recovery, stakeholders in the brick-and-mortar gaming industry are grappling with an age-old issue — whether to ban smoking inside casinos entirely. Though the debate is not new, the pandemic certainly revived it. The underlying struggle is one of weighing fiscal realities against public health needs.
During the pandemic, it was simpler — pressing public health needs with long-term economic consequences outweighed the immediate financial implications. On one hand, casinos were forced to shut down to mitigate the risk of exposure, even as lockdowns prevented people from traveling. Unemployment rates soared and businesses of all sizes were severely impacted.
On the other hand, as more research was done into the virus, certain things became clear. With the virus being primarily a respiratory one, smokers with compromised lungs were more likely to be affected. Reminders not to touch your mouth or eyes became an echoing refrain.
In the post-Covid-19 era, these disparate needs have been thrown into sharp relief once more. Due to the nature of the virus and how it is transmitted, many casinos instituted temporary bans on indoor smoking last year. Now with business almost back to usual, many want those bans to become permanent.
But gaming properties struggled in 2020; they lost employees and revenue. They are just starting to bounce back. Casinos can generate up to $10 billion in tax revenue for state and local governments across the country. Permanent smoke-free policies can lead patrons away from a state, leading to a loss in that tax revenue.
But at the same time, the risks associated with smoking remain as front-of-mind as ever. Tobacco consumption is “the leading cause of preventable disease, disability, and death in the United States,” according to the CDC. Almost 500,000 people die every year as a result of smoking or being exposed to smoke, while 16 million more suffer serious smoking-related illnesses. Despite this, approximately 40 million American adults still smoke, meaning that a whopping 86.3% of the population doesn’t.
When it comes to casinos, however, the concern isn’t just for smokers on the floor. Passive smoking (through exposure to second-hand smoke) remains the biggest danger. The CDC estimates that approximately 58 million Americans who don’t smoke are still exposed to second-hand smoke. This increases the risk of heart attacks, heart disease, stroke and cancer by as much as 30% in non-smoking adults. Passive smoking is estimated to cause annually around 41,000 deaths related to lung cancer and heart disease in American adults, the CDC estimates. The CDC and the Surgeon General are quite clear on the scientific data linked to passive smoking — “There is no safe level of exposure to secondhand smoke. It causes stroke, lung cancer, and coronary heart disease in adults.”
Land-based gaming revenue is not limited strictly to gambling or the casino floor — these establishments have hotels, pools, resorts, restaurants, bars and event venues attached to them. Tourists do not flock to Las Vegas or Atlantic City only to gamble, though that might feature heavily in their plans. Casinos employ more than 361,000 people nationwide. Thus, smoking on the floor does not just impact gamblers, it can also impact adjacent industries and businesses.
The fact also remains, however, that although smoking is no longer popular with the vast majority of American adults, it is a habit disproportionately represented among regular patrons of gambling establishments, due to a historic “positive correlation between smoking and gambling.”
Casinos and gambling venues are among the few public places left where both employees and visitors are extremely likely to encounter second-hand smoke. The levels of exposure to smoke is particularly high for casinos, as compared to other enclosed public spaces that allow smoking, per the CDC.
For workers, sometimes they have no choice — the same place where they endure hours of exposure to tobacco smoke is the place they earn their livelihoods. Of the entire American workforce, casino workers and employees in bars and restaurants are more exposed to toxic second-hand smoke, per the CDC.
With this in mind, let’s look at the long and complicated history of the debate over tobacco use and what the proliferation of smoke-free policies might mean for the gaming industry as a whole.
The History of Tobacco In The US
Tobacco plants have been grown by Indigenous populations on the American continent since well before colonization. To date, it has important medicinal, traditional, sacred and ritual uses for many Indigenous Peoples. Until the advent of cigarettes in the 19th century, tobacco was mostly smoked in pipes and cigars and was chewed.
Unsurprisingly, the anti-smoking movement has been in existence for as long as tobacco use has. In the initial years of smoking’s popularity (1880–1920) the quest to prohibit it was largely led by the temperance movement, with objections being mostly on moral and hygienic grounds.
Smoking, particularly cigarettes, gained popularity during the two World Wars, primarily among soldiers but also among the wider population. This was the “Golden Age” of the cigarette, with estimates suggesting that a full half of the industrialized world’s population were smokers by 1950.
It wasn’t until the 1940s and 1950s that researchers began to link smoking and serious diseases including cancer. In 1972, a series of studies began to indicate that environmental tobacco smoke (ETS) — that is, second-hand smoke — poses a risk to non-smokers as well. The following year, Arizona was the first state to classify ETS exposure as a public hazard, citing that in its restriction of smoking in certain public spaces. In 1992, the Environmental Protection Agency (EPA) labeled ETS as one of the most dangerous carcinogens known.
As our collective understanding of tobacco has grown, laws and policies have evolved regulating its use have also changed. Whereas before it might have sufficed to separate sections of smokers and non-smokers indoors, today, the Surgeon General is clear that this is not enough. Nor is ventilation a sufficient means by which to protect people from the risks of second-hand smoke.
As of last year, 27 states, the District of Columbia and the territories of American Samoa, the Marshall Islands, Puerto Rico and the U.S. Virgin Islands had laws making both public and private bars, restaurants and worksites 100% smoke-free indoors.
Before Covid-19 restrictions forced casinos to shut down, there were almost 800 smoke-free, non-tribal gaming establishments across 20 states. CDC officials said that there are currently over 200 tribal and non-tribal casinos that have reopened as smoke-free after the pandemic. In some cases, the move has been permanent. In others, it’s temporary.
The Case Of The Economy Vs. Public Health
The aim of smoke-free policies is not to stigmatize tobacco use or control the behavior of those who choose to smoke. Rather, it is to mitigate health risks to others in the vicinity. Smoke-free laws do not aim to ostracize smokers completely. Most establish designated smoking areas, usually outside, where the risk of second-hand smoke being transmitted to non-smokers would be minimal.
The CDC says that banning smoking indoors altogether is the only fool-proof mechanism to protect non-smokers from being exposed to second-hand smoke and minimize the associated health risks. It is also extremely effective in helping smokers quit and discouraging people from taking up smoking. According to some of the Center’s estimates, “Communities that enact comprehensive smoke-free laws see up to a 17% reduction in hospital heart attack admissions.”
Measures to ban smoking indoors are popular with the public, to the degree that they do not negatively affect the hospitality industry in terms of sales or employment. Roughly one in four regular patrons of casinos support smoke-free policies and an estimated 45.4% of smokers favor smoke-free casinos, according to some advocates.
Most casino executives and experts in Nevada say that a blanket smoking ban in the state’s casinos would have a negative impact on revenue. One study from the 1990s, commissioned by the Las Vegas and Reno-Sparks chambers of commerce, highlighted a possible loss of $1.9 billion over five years, and a sales-tax revenue drop off of $50 million and around 20,000–30,0000 jobs lost in the first year.
Since this study was conducted, however, several states and tribe-owned casinos have implemented smoke-free policies and have seen few — if any — long-term financial impacts, beyond the initial adjustment period. Some studies have shown a short-term financial impact of banning smoking, with a slight fall in revenue. But it has also been found that casinos are able to recover from this slump and even outperform their pre-ban business. Smokers seem to be quicker to adjust to a smoke-free environment, while many non-smokers actively avoid smoky venues.
Anecdotal evidence from restaurant operators in Las Vegas seems to indicate that banning smoking does not impact business. In fact, it can actually be a draw for customers. Popular tourist cities like New Orleans prohibit indoor smoking but have not reported any significant adverse reaction.
Numerous researchers have investigated the direct and indirect fiscal benefits of companies choosing to go smoke-free. Casinos can save on cleaning and maintenance. Workers use fewer sick days and, thus, might be more productive. The CDC estimates that nearly $170 billion is spent annually in the U.S. on medical care for smoking-related illnesses in adults alone. Research supported by the American Cancer Society indicates that companies will have to pay less in health insurance premiums. Smoke-free policies can also potentially reduce fire and liability insurance payments.
There are those who contend that smoke-free policies should be determined by individual companies in the private sector. Though this idea is sound in theory, market dynamics mean that single casinos or operators are unlikely to risk losing to competition by being the first or one of the few to ban smoking indoors. Thus, both the government and tribal authorities need to act in concert to impose a uniform rule on smoking indoors. Further, though casinos are not owned by the state, it is important to consider the public health costs — often borne by the government — associated with second-hand smoking.
Given the intricate links between Indigenous Americans and tobacco use for sacred purposes, casinos and revenue streams, experts say that it is crucial to involve community leaders in any decision-making around smoke-free policies. Each tribe is different, and may have their own cultural sensitivities and traditions, so the policy must be unique and tailored to the local context. Advocates for smoke-free casinos do not target overall tobacco consumption. Rather, their focus is on tobacco in terms of commercial uses.
Where To Now?
The debate rages on. Casinos in Atlantic City and Pennsylvania were among those who imposed temporary bans on smoking indoors in 2020, as the pandemic continued to rage. Pennsylvania and New Jersey are, respectively, the second and third largest states in terms of gross gambling revenue raked in, so all eyeballs are on them.
As of June 2021, the public health emergency declared in New Jersey over Covid-19 has expired, meaning that smoking can now resume inside casinos once more. There is pressure on lawmakers and casino owners from both sides of the debate as the state tries to balance fears of patrons fleeing to neighboring Pennsylvania to gamble and a rising consciousness of public health threats post-Covid. Though there are vehement opponents to making the ban permanent, some believe that it is only a matter of time before it does.
The case of Nevada is much more complicated, as a result of it being the largest state for gambling revenue. The 2006 Nevada Clean Indoor Air Act regulates indoor smoking in some areas but explicitly excludes casinos from the list of prohibited spaces. Individual casinos, however, can make the choice themselves about smoke-free policies. This year, Park MGM became the Las Vegas Strip’s first-ever entirely smoke-free hotel-casino.
Vegas has long been considered a bastion of freedom, the ideal place for those looking to relax and escape restrictive rules — including those for cigarette smoking. That attitude seems to have changed over recent years, however, and particularly after the pandemic. Some travelers have indicated that whether a casino permits smoking indoors or not can be a “make-or-break” factor in their choice of destination.
Meanwhile, some Indigenous tribes have also made their casinos smoke-free. In May, a group of Eastern Band of Cherokee Indians (EBCI) proposed an ordinance to amend the Cherokee Code to completely prohibit smoking indoors at their casinos. This impacted Harrah’s Cherokee Casino Resort and Harrah’s Valley River Casino in North Carolina. One member of the board said that going smoke-free would make it easier for the tribe’s casinos to attract employees.
Also, Shreveport, a city in northwest Louisiana, will have its smoking ban become permanent on August 1. Originally passed in June 2020 as a temporary stop-gap, The Smoke Free Air Act was set to come into effect last August. However, due to economic concerns related to the pandemic, its implementation was pushed to August 1, 2021. With this move, Shreveport will join other cities in the state, including Baton Rouge and New Orleans.
Experts seem to agree that there is no easy, perfect solution here. Casino operators do not want their employees to become sick or suffer; at the same time, they do not want to have to downsize their labor force because of a loss in revenue. Workers in cities like Las Vegas depend on the gaming industry for their livelihoods. They also deserve to have a healthy, clean work environment.
One particularly poignant anecdote on the CDC website highlights the true nature of this debate and its manifold complexities. Nathan, a member of the Oglala Sioux tribe, worked for 11 years at a casino where he was regularly exposed to cigarette smoke. Despite never being a smoker himself, he developed asthma and permanent lung damage, leading to his premature death at the age of 54 in October 2013.
Stories like this are on the forefront of decision-makers’ minds as they continue to decide on the best course of action in the post-pandemic era.
In the post-pandemic era it seems like the pendulum is swinging in the direction of those who advocate for smoke-free casinos, but it still might be a while until we get there.
To see a full list of smoke-free gaming properties in the U.S., please click here.