Advertisement

Gambling with Our Health

Smoke-Free Policy Would Not Reduce Tribal Casino Patronage

      Background

      Tribal sovereignty exempts tribal casinos from statewide smoking bans.

      Purpose

      To conduct a tribally-led assessment to identify the characteristics of casino patrons at Lake of the Torches Resort Casino in Lac du Flambeau WI and their preferences for a smoke-free casino.

      Methods

      A survey was administered from April to August 2011 to a stratified random sample of 957 members of the casino players club to assess their preferences for a smoke-free casino. These members were categorized into three groups: those who reported being likely to (1) visit more; (2) visit less; or (3) visit the same if the casino prohibited smoking. They were characterized by age, education, sex, race/ethnicity, annual income, players club level, and reasons for visiting the casino. Statistical analyses were conducted on weighted data in October to December 2011. Weighted logistic regression was calculated to control for potential confounding of patron characteristics.

      Results

      Of the 957 surveyed patrons, 520 (54%) patrons were likely to visit more; 173 (18%) patrons to visit less; and 264 (28%) patrons were indifferent to the smoke-free status. Patrons more likely to prefer a smoke-free casino tended to be white, elderly, middle class and above, and visit the casino restaurants. Patrons within the lower tiers of the players club, almost half of the players club members, also showed a higher preference for a smoke-free casino.

      Conclusions

      This tribal casino would likely realize increased patronage associated with smoke-free status while also contributing to improved health for casino workers and patrons.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to American Journal of Preventive Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Costello E.J.
        • Compton S.N.
        • Keeler G.
        • Angold A.
        Relationships between poverty and psychopathology: a natural experiment.
        JAMA. 2003; 290: 2023-2029
        • U.S. Department of the Interior Indian Affairs
        2005 American Indian population and labor force report.
        U.S. Department of the Interior Indian Affairs, Washington DC2005
      1. White House. President Obama’s jobs and growth plan: the impact for Native Americans and the economy. Washington DC: White House, 2012. www.whitehouse.gov/sites/default/files/nativeamerican_factsheet_jobs.pdf

        • Williams D.R.
        • Costa M.V.
        • Odunlami A.O.
        • Mohammed S.A.
        Moving upstream: how interventions that address the social determinants of health can improve health and reduce disparities.
        J Public Health Manag Pract. 2008; 14: S8-S17
        • Anderson R.J.
        Tribal casino impacts on American Indians well-being: evidence from reservation-level census data.
        Contemp Econ Policy. 2013; 32: 291-300
        • Evans W.N.
        • Topoleski J.H.
        The social and economic impact of Native American casinos.
        Cambridge MA: National Bureau of Economic Research. 2002;
        • Wolfe B.
        • Jakubowski J.
        • Haveman R.
        • Courey M.
        The income and health effects of tribal casino gaming on American Indians.
        Demography. 2012; 49: 499-524
        • Jernigan V.B.B.
        • Duran B.
        • Ahn D.
        • Winkleby M.
        Changing patterns in health behaviors and risk factors related to cardiovascular disease among American Indians and Alaska Natives.
        Am J Public Health. 2010; 100: 677-683
        • Denny C.H.
        • Holtzman D.
        • Goins R.T.
        • Croft J.B.
        Disparities in chronic disease risk factors and health status between American Indian/Alaska Native and white elders: findings from a telephone survey, 2001 and 2002.
        Am J Public Health. 2005; 95: 825-827
        • CDC.
        Prevalence of cigarette use among 14 racial/ethnic populations—U.S., 1999–2001.
        MMWR Morb Mortal Wkly Rep. 2004; 53: 49-52
        • Welty T.K.
        • Rhoades D.A.
        • Yeh F.
        • et al.
        Changes in cardiovascular disease risk factors among American Indians: the Strong Heart Study.
        Ann Epidemiol. 2002; 12: 97-106
        • Galloway J.M.
        Cardiovascular health among American Indians and Alaska natives.
        Am J Prev Med. 2005; 29: 11-17
        • Indian Health Service.
        Trends in Indian health, 2000–2001.
        Indian Health Service, Rockville MD2004
        • Zhang Y.
        • Galloway J.M.
        • Welty T.K.
        • et al.
        Incidence and risk factors for stroke in American Indians.
        Circulation. 2008; 118: 1577-1584
        • Jemal A.
        • Siegel R.
        • Ward E.
        • et al.
        Cancer statistics, 2008, featuring cancer in American Indians and Alaska Natives.
        CA Cancer J Clin. 2008; 58: 71-96
        • Swan J.
        • Breen N.
        • Burhansstipanov L.
        • et al.
        Cancer screening and risk factor rates among American Indians.
        Am J Public Health. 2006; 96: 340-350
        • U.S.
        Census Bureau. Fact sheet: American Indians and Alaska Natives.
        Census Bureau, Washington DC: U.S.2011
        • Bullock A.
        • Bradley V.L.
        Family income supplements and development of psychiatric and substance use disorders among an American Indian population.
        JAMA. 2010; 304: 962-963
        • Costello E.J.
        • Erkanli A.
        • Copeland W.
        • Angold A.
        Association of family income supplements in adolescence with development of psychiatric and substance use disorders in adulthood among an American Indian population.
        JAMA. 2010; 303: 1954-1960
        • CDC.
        The health consequences of smoking: a report of the surgeon general.
        National Center for Chronic Disease Prevention and Health Promotion, Atlanta GA2004
        • CDC.
        Annual smoking-attributable mortality, years of potential life lost, and economic costs—U.S., 1995–1999.
        Morb Mortal Wkly Rep. 2002; 51: 300-303
        • CDC.
        Annual smoking-attributable mortality, years of potential life lost, and productivity losses—U.S., 2000–2004.
        Morb Mortal Wkly Rep. 2008; 57: 1226-1228
        • Repace J.L.
        Secondhand smoke in Pennsylvania casinos: a study of nonsmokers’ exposure, dose, and risk.
        Am J Public Health. 2009; 99: 1478-1485
        • Davis R.M.
        Exposure to environmental tobacco smoke: identifying and protecting those at risk.
        JAMA. 1998; 280: 1947-1949
        • Wipfli H.
        • Avila-Tang E.
        • Navas-Acien A.
        • et al.
        Secondhand smoke exposure among women and children: evidence from 31 countries.
        Am J Public Health. 2008; 98: 672-679
        • CDC.
        State smoke-free laws for worksites, restaurants, and bars—U.S., 2000–2010.
        Morb Mortal Wkly Rep. 2011; 60: 472-475
        • Mandel L.
        • Glantz S.
        Hedging their bets: tobacco and gambling industries work against smoke-free policies.
        Tob Control. 2004; 13: 268-276
      2. Association for Non-Smokers Rights. National Report on U.S. smokefree casinos and gambling facilities. Berkeley CA: 2013

        • National International Gaming Commission.
        Economic report.
        National Indian Gaming Commission, Washington DC2009
        • Berg C.
        Smoke-free policies in the workplace and in the home among American Indians.
        J Health Dispar Res Pract. 2012; 5: 81-91
        • Stamatakis K.A.
        • Brownson R.C.
        • Luke D.A.
        Risk factors for exposure to environmental tobacco smoke among ethnically diverse women in the U.S. J Womens.
        Health Gend Based Med. 2002; 11: 45-51
        • Kooreman H.
        • Judson-Patrick A.M.
        • Wright E.
        The economic impact of smoke-free policies on business and health.
        Center for Health Policy, Indianapolis IN2009
        • Timberlake D.S.
        • Wu J.
        • Al-Delaimy W.K.
        Tribal casinos in California: the last vestige of indoor smoking.
        BMC Public Health. 2012; 12: 144
        • Brokenleg I.
        • Tornes E.
        Walking toward the sacred: our great lakes tobacco story.
        Great Lakes Inter-Tribal Epidemiology Center, Eagle River WI2013
        • Forster J.L.
        • Brokenleg I.
        • Rhodes K.L.
        • Lamont G.R.
        • Poupart J.
        Cigarette smoking among American Indian youth in Minneapolis‚ St. Paul.
        Am J Prev Med. 2008; 35: S449-S456
        • Hand R.
        What every player should know about theoretical win.
        Casino Review Journal. 2011;
        • Klepeis N.E.
        • Omoto J.
        • Ong S.L.
        • Omoto H.S.
        • Dhaliwal N.
        Small proportions of actively-smoking patrons and high PM2. 5 levels in southern California tribal casinos: support for smoking bans or designated smoking areas.
        BMC Public Health. 2012; 12: 819
        • Harris J.K.
        • Carothers B.J.
        • Luke D.A.
        • Silmere H.
        • McBride T.D.
        • Pion M.
        Exempting casinos from the Smoke-Free Illinois Act will not bring patrons back: they never left.
        Tob Control. 2012; 21: 373-376
        • Mandel L.L.
        • Glantz S.A.
        Hedging their bets: tobacco and gambling industries work against smoke-free policies.
        Tob Control. 2004; 13: 268-276
        • Zelnick J.
        • Campbell R.
        • Levenstein C.
        • Balbach E.
        Clearing the air: the evolution of organized labor’s role in tobacco control in the United States.
        Int J Health Serv. 2008; 38: 313-331
        • Mandel L.
        • Alamar B.
        • Glantz S.
        Smoke-free law did not affect revenue from gaming in Delaware.
        Tob Control. 2005; 14: 10-12
        • Glantz S.
        • Wilson-Loots R.
        No association of smoke-free ordinances with profits from bingo and charitable games in Massachusetts.
        Tob Control. 2003; 12: 411-413
        • Alpert H.R.
        • Carpenter C.M.
        • Travers M.J.
        • Connolly G.N.
        Environmental and economic evaluation of the Massachusetts smoke-free workplace law.
        J Community Health. 2007; 32: 269-281
      3. California State Board of Equalization: California Department of Health Services–Tobacco Control Section. Employment Development Department, Labor Force Statistics Report, 2003.

        • Satter D.E.
        • Roby D.H.
        • Smith L.M.
        • Avendano K.K.
        • Kaslow J.
        • Wallace S.P.
        Costs of smoking and policy strategies for California American Indian communities.
        J Cancer Educ. 2012; 27: S91-S105
        • Jiang R.O.T.
        • Cheng K.I.C.
        • Acevedo-Bolton V.
        • et al.
        Measurement of fine particles and smoking activity in a statewide survey of 36 California Indian casinos.
        J Expos Sci Environ Epidemiol. 2011; 21: 31-41
        • Repace J.L.
        • Jiang R.-T.
        • Acevedo-Bolton V.
        • et al.
        Fine particle air pollution and secondhand smoke exposures and risks inside 66 U.S. casinos.
        Environ Res. 2011; 111: 473-484
        • Fichtenberg C.M.
        • Glantz S.A.
        Effect of smoke-free workplaces on smoking behaviour: systematic review.
        BMJ. 2002; 325: 188
        • Bauer J.E.
        • Hyland A.
        • Li Q.
        • Steger C.
        • Cummings K.M.
        A longitudinal assessment of the impact of smoke-free worksite policies on tobacco use.
        Am J Public Health. 2005; 95: 1024-1029