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Like flashing lights, dings and coins splashing into a slot machine tray, an equally familiar — even stereotypical — casino experience involves plumes of smoke wafting skyward from patrons puffing on ash-tipped cigarettes.

Casinos, and the states that host them, have permitted smoking for decades, with the industry bypassing a sweeping ban that in the 2000s outlawed the practice on airplanes, in restaurants and in other indoor places.

The rationale behind that exemption is seemingly shifting, as the ongoing covid-19 pandemic shines a light on the health and safety of casino workers and patrons.

Across the country, 20 states have banned smoking in casinos, including neighboring states Delaware, Maryland, New York and Ohio, according to the nonprofit American Nonsmokers’ Rights Foundation.

Two facilities in Pennsylvania — Parx Casino in Bucks County and Mount Airy Casino Resort in Monroe County — have remained smoke-free after the state lifted a temporary smoking ban implemented during the pandemic. The state’s other 14 licensed casinos again dished out ashtrays and cordoned off tobacco-friendly spaces once the smoking ban was lifted in June.

“There is clearly, undeniably, a relationship between smokers and gambling,” said Alan Feldman of the International Gaming Institute at the University of Nevada, Las Vegas. “However, there are so many places in different states, different countries where smoking is not permitted in casinos. The challenge is one of competitive advantage.”

Despite a shift in conversations, not everyone is on board with banning smoking in casinos. Arguments from opponents often bring up issues such as losing customers, resulting in lower revenues. Others suggest installing air filtration systems will help limit any lingering smoke.

“I’ve never seen a smoke-free casino work as long as I’ve been in the industry,” said Sean Sullivan, general manager of Live! Casino Pittsburgh in Hempfield’s Westmoreland Mall. “I’m not aware of one that has worked. They’ve tried … but most shut down because you’re just alienating a fairly large” group of people.

Listening to smokers

Locally, casinos seem hard-pressed to make changes to smoking regulations, with most following guidelines distributed by state officials.

In Pennsylvania, the Clean Indoor Air Act permits casinos to allow smoking on up to 50% of the casino floor, said Doug Harbach, spokesman for the Pennsylvania Gaming Control Board. Smoking is not permitted in areas such as restaurants, clubs, entertainment venues, lobbies and meeting areas.

“As members of the hospitality industry, we seek to accommodate the needs of both our smoking and nonsmoking customers,” officials with Hollywood Casino at the Meadows, owned by Penn National, said in a statement.

The Washington County casino uses ventilation systems and high ceilings, while separating smoking and nonsmoking areas.

“The real power at the end of the day on this issue rests with our customers who can vote with their pocketbooks if they feel like we’re not doing a good enough job catering to their needs,” read the statement from Hollywood Casinos, a brand of Berks County-based Penn National Gaming, which owns about 40 casinos nationwide. “It’s a balance, and one that we feel the marketplace should determine, particularly in such a competitive environment with other gaming facilities nearby and in neighboring states.”

Smoking is permitted on about half of the floor at Rivers Casino Pittsburgh on the North Shore.

“We will continue to defer to state and local officials with regard to smoking policy,” spokesman Jack Horner said.

Live! Casino Pittsburgh opens a quarter of its casino floor to smokers.

Sullivan said that during the pandemic, an outside patio was constructed to allow patrons to smoke. He noted that several people complained about not being able to smoke indoors.

“I would say that we listen to our guests, so if my guests tell me in some formal fashion … I listen,” he said. “And clearly, there’s an audience that likes smoking in casinos.”

Pushing back

The push to ban smoking at U.S. casinos largely began in 2008 with the creation of the organization Breathe Easy with Smokefree Casinos by the American Nonsmokers’ Rights Foundation, said President and CEO Cynthia Hallett.

The goal, Hallett said, is to make all casinos smoke-free to limit the exposure of secondhand smoke to casino workers and patrons.

“This is not to say that this issue is trying to pit smokers against nonsmokers, but it’s for people who smoke to smoke in a way that doesn’t harm others,” Hallett said.

According to the Centers for Disease Control and Prevention, secondhand smoke can cause heart disease, lung cancer and respiratory disease. Each year, about 41,000 deaths in the United States are related to secondhand smoke exposure, the CDC reported.

In 2018, the American Cancer Society conducted a study that compared secondhand smoke particulate levels in U.S. casinos. The study included 66 casinos that permitted smoking and three that did not.

Researchers found that smoke-free casinos had 94% lower levels of secondhand smoke particulate. In about half of the smoking casinos, the particulate exceeded a level known to increase cardiovascular risk to nonsmokers after less than two hours of exposure, the study said.

“… We’ve got the science that says there’s no risk-free level of exposure to secondhand smoke,” Hallett said. “We also have the economic impact reports that say for restaurants, bars and even looking at the casino industry, that business remains the same or increases. We know there is both a health and an economic benefit to going smoke-free.”

Efforts are being made across the country to limit exposure to secondhand smoke in casinos.

In Pennsylvania, lawmakers this year introduced two bills to limit smoking to no more than 25% of space in casinos, Harbach said.

The first, House Bill 211, was introduced by state Rep. Tony DeLuca, D-Penn Hills. The second, Senate Bill 124, was introduced by state Sen. Wayne Fontana, D-Brookline. Both bills were referred to various committees. Harbach said he was unsure of any other discussions regarding smoking in casinos.

It was not immediately clear if Mount Airy will remain smoke-free. A spokesman said the casino’s decision to go smoke-free has been met with positive feedback from smokers and nonsmokers. He noted there are designated smoking areas throughout the property.

Efforts elsewhere

Efforts also are underway to ban smoking in New Jersey casinos.

Atlantic City casino workers this month protested the New Jersey Legislature after officials passed a bill giving tax breaks to casinos rather than acting on a measure that would permanently prohibit smoking in the facilities, the Associated Press reported. If passed, the bill would end a narrow exemption that prohibits indoor smoking except in casinos.

Other facilities across the country that have banned the use of cigarettes have taken measures to ensure smokers are not excluded.

In Ohio, which passed a smoking ban in 2006, several casinos have built elaborate smoking patios. Hollywood Gaming at Dayton Raceway last year built a second, 4,700-square-foot patio that includes heat lamps and exhaust fans.

According to the Springfield Sun-News, the patios are bracketed by two walls of the main building and a ceiling. Open areas are covered by screens that can be raised or lowered.

Other smoke-free casinos are popping up in states that still permit smoking within the facilities.

In Las Vegas, Park MGM is now smoke-free in the casino, convention center, restaurants, bars and hotel. Designated smoking areas are located throughout the facility. Similarly, Palace Casino Resort in Biloxi, Miss., is smoke-free. The facility features a smoking lounge with its own heating and air conditioning units.

In addition, the Navajo Nation last month banned the use of cigarettes within casinos and other public spaces.

“It’s just a question of, ‘why not?’,” Hallett said. “Why wouldn’t you go smoke-free? People don’t often talk about the costs of keeping smoking in casinos, and I think that is a big factor because you have costs related to health care for those employees, days lost from work, if they quit having to retrain somebody and also the loss of individuals who won’t go to a smoke-filled casino.”

Looking forward

As back-and-forth conversations continue between opponents and those who want to ban smoking, it was not clear whether a shift could be imminent for the casino industry.

Feldman of UNLV suggested it is a move the industry could take in the coming years.

“Over time, I think it’s a shift the industry is likely to take. … The nonsmoking areas are growing and growing and growing, pretty much isolating the casino,” Feldman said.

He added, “I think you have to look at some of the states that don’t allow smoking — and, quite frankly, the performance of those states seems to suggest that casinos will thrive just fine without smoking.

“That doesn’t mean that everyone is willing to make it, and it does not mean there will not be an initial decline in revenues.”

Sullivan, of Live! Casino, said talks will continue but predicted change is unlikely.

“Even states that said ‘no smoking’ have found a way to allow smoking,” Sullivan said.

The American Gaming Association does not have an official position on smoking, said President and CEO Bill Miller. Potential smoking bans will be up to states, municipalities and casino properties, he said.

“That is going to be an issue that continues to work itself out,” Miller told Play NJ, an independent website covering legal and regulated gambling in the state. “But we’ve already seen some properties make decisions around smoking, post-covid, that they were forced to make during covid, and without detrimental effects.”