What happens in Vegas, stays in your lungs: An assessment of fine particulate matter in casinos that prohibit and allow smoking in Las Vegas, NV

Abstract

Introduction Despite progress in adoption of smoke-free policies, casinos are exempted in some smoke-free laws, including in Nevada. In 2020 for the first time, a resort-style casino in Las Vegas, Nevada prohibited smoking indoors. This study will be the first to assess air quality in this smoke-free casino and compare results with other Las Vegas casinos that continue to allow smoking. Methods A real-time personal aerosol monitor was used to evaluate particulate matter with a diameter <2.5 μm (PM2.5), a surrogate for secondhand smoke (SHS). PM2.5 was measured at 8 Las Vegas casinos, including the smoke-free casino. Each casino was visited twice, and PM2.5 was assessed in smoking-permitted gaming areas and casino areas where smoking is otherwise prohibited. A t-test assessed the differences in average PM2.5 levels for each casino type. Results Average PM2.5 in gaming areas was 164.9 µg/m3 in casinos that allow smoking, compared to 30.5 µg/m3 in the smoke-free casino. For areas of casinos where smoking is otherwise prohibited, average PM2.5 was 83.2 µg/m3 in casinos which allowed smoking in gaming areas, compared to 48.1 µg/m3 in the smoke-free casino. Average PM2.5 levels were significantly higher in casinos that allow smoking, for both casino gaming areas and areas where smoking is otherwise prohibited (p=<0.05). Conclusion Despite robust evidence about the harms of SHS, tens of thousands of casino employees and tens of millions of tourists are exposed to high levels of SHS in Las Vegas casinos annually. PM2.5 levels in gaming areas of Las Vegas casinos that allow smoking are 5.4 times higher than the smoke-free casino. The only way to protect people from exposure to SHS is to prohibit smoking in all indoor areas.