Commercial casinos throughout the country are often exempt from smoke-free workplace laws. Now a new study led by UC San Francisco has found that when smoking is banned in casinos, it results in considerably fewer emergency calls for ambulances.

The study is the first to examine the health impact of smoking bans in casinos.

Stanton A. Glantz, PhD

The authors conclude that if smoke-free laws were to apply to casinos as well as other businesses, it would prevent many medical emergencies and reduce public health costs.

“Our study suggests that exempting casinos from smoke-free laws means that more people will suffer medical emergencies as a result,” said lead author Stanton A. Glantz, PhD, UCSF professor of medicine and director of the Center for Tobacco Control Research and Education at UCSF.

“The research shows strong evidence of a significant drop in ambulance calls due to less secondhand smoke exposure,” Glantz said. “Inhaling secondhand smoke increases the likelihood of dangers with blood clots and makes it more difficult for arteries to expand properly – changes that can trigger heart attacks. Legislative and tribal exemptions for casinos, which are all too common, are potentially putting employees and customers at risk of secondhand smoke exposure.”

For decades, Glantz and his colleagues at UCSF have been pioneers in tobacco research, disclosing how the tobacco industry manipulated its products and led the public into cigarette addiction.

The latest research was published on Aug. 5 in the American Heart Association journal Circulation.

Colorado Case Study

Currently, the majority of states allow smoking in state-regulated gambling. Most tribal casinos also allow smoking.

The new research centered on Gilpin County, a rural community in the high country of Colorado that is about an hour outside Denver. A major tourist destination, the county has more than two dozen casinos in its gaming district, which occupies about 3 square miles of the county. Approximately, 6,000 people live in the county, but the researchers said that more than 40,000 people at a time are working or visiting the area.

The study tracked more than 16,600 ambulance calls from January 2000 through December 2012.

Colorado put a law into effect in 2006 requiring workplaces, restaurants, bars and other public spaces – but not casinos – to be smoke-free. Ambulance calls dropped nearly 23 percent in these places. During that timeframe, there was no significant change in calls from casinos that continued to allow smoking.

Two years later, when the smoking ban was expanded to include casinos, ambulance calls from casinos dropped nearly 20 percent while there was no further change at other locations.

The researchers say the results have important implications for clinicians and policy makers “since they show big, fast effects of eliminating secondhand smoke.”

“The message to policymakers is clear: stop granting casinos exemptions,” Glantz said.

The study was co-authored by Erin Gibbs, deputy director of the Gilpin Ambulance Authority in Colorado.

The study was supported by the National Cancer Institute (Grant CA-61021).

UCSF is a leading university dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care.

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