50 Years in the Fight for Clean Air: Why the Future of Responsible Gaming is Smokefree
While all casino executives support responsible gaming, there are a few that also support smoking in their properties, even though it endangers the health of all its customers and employees. Cynthia Hallett, the president and CEO of Americans for Nonsmokers' Rights (ANR) and the ANR Foundation, explains why those two conflicting stances need to be rectified.
Every September, the casino industry observes Responsible Gaming Education Month (RGEM) to promote safe, intentional play. Gaming operators urge patrons to set budget limits, monitor their playing time, and take regular breaks. But truly embracing responsibility in the gaming industry needs to be more than just marketing campaigns—it requires providing patrons with casino environments in which they can make safe, healthy decisions. As the gaming industry reflects on what it means to operate responsibly, their definition must evolve to match the public health standards that have been established across nearly every other sector over the past 50 years. If casinos were serious about responsible gaming, they would eliminate indoor smoking.
The industry’s core messaging during RGEM focuses on encouraging casino patrons to take breaks and stay intentional about their gaming—but gaming floors that allow smoking are engineered to encourage the exact opposite.
While the vast majority of casino patrons today are nonsmokers, the overlap between tobacco use and severe gambling issues is undeniable: research from the Rutgers Center for Gambling Studies reveals that 77.6% of high-risk problem gamblers use tobacco. Casino operators recognize this direct link between indoor smoking and prolonged play, according to an independent study by C3 Gaming, and the National Council on Problem Gambling has explicitly stated that implementing smokefree casino policies is likely to reduce problem gambling while improving overall public health.
At Risk Patrons & Employees
Allowing those patrons at risk for problem gambling behaviors to smoke at slot machines and table games removes the natural pause that comes from having to physically walk outside to take a smoke break. That brief trip to an outdoor designated smoking area provides a critical moment of clarity and a chance to reevaluate budget and time limits. Indoor smoking on gaming floors fuels irresponsible, uninterrupted gambling when tobacco use is already linked to problem gaming. And yet, despite almost three decades of RGEM, smoking is the norm in casinos’ biggest markets.
Smokefree policies have become the norm across industries, but the gaming sector has fallen significantly behind. This year, Americans for Nonsmokers’ Rights (ANR) marks its 50th anniversary. Since our founding in 1976, public health standards in the United States have undergone a monumental shift. Decades ago, smoking was accepted on airplanes, in hotel rooms, and inside workplaces across the country. Through persistent advocacy, evidence-based policy, and public education, ANR helped lead the transformation that made clean indoor air the national standard.
The transition to smokefree environments has been a resounding success, contrary to arguments that smokefree policies are bad for business. It has been 36 years since domestic flights went smokefree, and more people are flying than ever before. This year is also the 20th anniversary of Westin, Marriott, and Starwood eliminating indoor smoking across their U.S. properties to meet overwhelming consumer demand for clean air. Over the past two decades, this progress extended into the gaming sector as well, with dozens of Tribal gaming operators and commercial jurisdictions successfully transitioning to 100 percent smokefree indoor policies. But despite five decades of proven progress, casino markets across the country—including Atlantic City, Las Vegas, Pennsylvania—remain stark exceptions, continuing to rely on outdated, irresponsible indoor smoking loopholes that endanger workers and patrons alike.
Non-Smokers Unite
Across the country, adult smoking rates have dropped to historic lows, and modern consumers across all demographics overwhelmingly prioritize health, wellness, and clean environments. The majority of casino-goers do not smoke and actively prefer smokefree spaces—a trend that is demonstrated by the success of smokefree casinos across the country.
No Smoke More Profit
This year, New Orleans is celebrating the 11th anniversary of its comprehensive indoor smokefree law. When the city extended smokefree protections to casinos over the strong objections of industry operators, opponents predicted economic ruin. Instead, the transition delivered undeniable public health and financial benefits. Recent research from Louisiana State University documented measurable declines in health issues—including cancer rates—following the implementation of the clean indoor air ordinance, all while local gaming properties flourished. In the past decade, Caesars Entertainment completed a $435 million transformation of its New Orleans property, secured the naming rights for the Superdome, and opened a major new entertainment venue, proving that public health and casino business thrive in smokefree environments.
Just as businesses have a responsibility to provide a safe, healthy, and smokefree environment to protect their patrons, they also have a responsibility to do the same for their workers. The burden of indoor smoking falls disproportionately on moderate-to-low income casino workers who do not have the luxury of simply leaving their position if they are affected by toxic secondhand smoke on the job. Exposure to such toxic air is life-threatening for these workers, who face increased respiratory and cardiovascular health risks.
New Jersey Leaders
Over the past five years, ANR has worked alongside Casino Employees Against Smoking Effects (CEASE), a movement ignited by New Jersey casino workers advocating for clean air in their workplaces that has expanded to include workers from across the country. They know that smokefree casinos can thrive. Atlantic City’s neighboring Parx Casino in Pennsylvania operated successfully after voluntarily remaining smokefree following temporary COVID-19 health mandates. The casino even saw the strongest post-COVID recovery in table games revenue among Philadelphia-area casinos, and since then, it has remained one of the state’s highest performing brick and mortar casinos.
As we observe Responsible Gaming Education Month in 2026, casino leaders must reconcile their public commitments to player well-being with the reality of their indoor air policies. An industry cannot claim to champion responsible behavior while maintaining air quality standards from 1976—especially when it is economically feasible to transition to smokefree policies. Casinos must align their properties with the past 50 years of public health progress. Closing indoor smoking loopholes protects employee health, supports player self-regulation, and meets the expectations of the modern consumer. It is time for the gaming industry to end the hypocrisy, eliminate indoor smoking on all gaming floors nationwide, and step into a modern, healthy, and genuinely responsible era.
Cynthia Hallett, MPH, is the president and CEO of Americans for Nonsmokers’ Rights (ANR) and the ANR Foundation, where she’s worked since 1997. Cynthia’s career in tobacco control began in 1989 at the Los Angeles County Department of Health Services Tobacco Control Program. Over the last 28 years, she has spearheaded successful smokefree air campaigns, tracked and exposed tobacco industry interference, served as a media spokesperson and keynote lecturer, as well as provided technical assistance, training, and strategic guidance on smokefree workplaces including restaurants, bars, and casinos, tobacco-free college campuses, and electronic cigarette restrictions across the U.S. and internationally.
