{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T13:39:15Z","timestamp":1774877955737,"version":"3.50.1"},"reference-count":27,"publisher":"BMJ","issue":"4","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Tob Control"],"accepted":{"date-parts":[[2023,2,3]]},"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:sec>\n<jats:title>Introduction<\/jats:title>\n<jats:p>Despite progress in adoption of smoke-free policies, smoking in casinos is allowed in some US states, including Nevada. In 2020, for the first time, a resort-style casino in Las Vegas prohibited smoking voluntarily. This study is the first to assess air quality in this casino and compare results with similar casinos that allow smoking.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>A real-time personal aerosol monitor evaluated particulate matter with a diameter &lt;2.5\u2009\u00b5m (PM2.5), a surrogate for secondhand smoke (SHS). PM2.5 was measured at eight Las Vegas casinos, including the smoke-free casino. Each casino was visited twice, and PM2.5 was assessed in smoking-permitted gaming areas and areas where smoking is otherwise prohibited.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>\nAverage PM2.5 levels were significantly higher in casinos that allow smoking, for both casino gaming areas and areas where smoking is otherwise prohibited (p&lt;0.05). Mean PM2.5 in gaming areas was 164.9 \u00b5g\/m\n<jats:sup>3<\/jats:sup>\nin casinos that allow smoking and 30.5 \u00b5g\/m\n<jats:sup>3<\/jats:sup>\nin the smoke-free casino. Mean PM2.5 in areas where smoking is otherwise prohibited was 83.2 \u00b5g\/m\n<jats:sup>3<\/jats:sup>\nin casinos which allowed smoking in gaming areas, and 48.1 \u00b5g\/m\n<jats:sup>3<\/jats:sup>\nin the smoke-free casino.\n<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Conclusion<\/jats:title>\n<jats:p>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, with PM2.5 levels 5.4 times higher in gaming areas when compared with a smoke-free casino. The only way to protect people from SHS exposure is to prohibit smoking in all indoor areas.<\/jats:p>\n<\/jats:sec>","DOI":"10.1136\/tc-2022-057861","type":"journal-article","created":{"date-parts":[[2023,2,23]],"date-time":"2023-02-23T18:05:17Z","timestamp":1677175517000},"page":"545-548","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["What happens in Vegas, stays in your lungs: an assessment of fine particulate matter in casinos that prohibit and allow smoking in Las Vegas, Nevada, USA"],"prefix":"10.1136","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5612-4019","authenticated-orcid":false,"given":"Michael A","family":"Tynan","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin A","family":"Cohen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey R","family":"Harris","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2023,2,23]]},"reference":[{"key":"2024072401151130000_33.4.545.1","unstructured":"U.S. Department of Health and . The health consequences of involuntary exposure to tobacco smoke: A report of the surgeon general. Atlanta (GA), 2006."},{"key":"2024072401151130000_33.4.545.2","unstructured":"U.S. Department of Health and . The health consequences of smoking-50 years of progress: A report of the surgeon general. Atlanta (GA), 2014."},{"key":"2024072401151130000_33.4.545.3","unstructured":"\u00d6berga M , Woodward A , Jaakkolac MS , et al . Global estimate of the burden of disease from second-hand smoke. 2010."},{"key":"2024072401151130000_33.4.545.4","unstructured":"Institute of Medicine . Secondhand smoke exposure and cardiovascular effects: making sense of the evidence. Washington (DC), 2010."},{"key":"2024072401151130000_33.4.545.5","unstructured":"American Nonsmokers Rights Foundation. Percent of U.S . State populations covered by 100% smokefree air laws 2022. Available: https:\/\/no-smoke.org\/wp-content\/uploads\/pdf\/percentstatepops.pdf [Accessed 5 Apr 2022]."},{"key":"2024072401151130000_33.4.545.6","doi-asserted-by":"crossref","first-page":"623","DOI":"10.15585\/mmwr.mm6524a4","article-title":"State and local comprehensive smoke-free laws for worksites, restaurants, and bars-United States, 2015","volume":"65","author":"Tynan","year":"2016","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2024072401151130000_33.4.545.7","doi-asserted-by":"publisher","DOI":"10.1136\/tobaccocontrol-2013-051368"},{"key":"2024072401151130000_33.4.545.8","doi-asserted-by":"publisher","DOI":"10.1097\/01.jom.0000141644.69355.52"},{"key":"2024072401151130000_33.4.545.9","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2008.146241"},{"key":"2024072401151130000_33.4.545.10","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-1446.2010.00843.x"},{"key":"2024072401151130000_33.4.545.11","doi-asserted-by":"publisher","DOI":"10.1097\/JOM.0b013e318212235f"},{"key":"2024072401151130000_33.4.545.12","doi-asserted-by":"publisher","DOI":"10.1038\/jes.2009.75"},{"key":"2024072401151130000_33.4.545.13","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1016\/j.envres.2011.02.007","article-title":"Fine particle air pollution and secondhand smoke exposures and risks inside 66 us casinos","volume":"111","author":"Repace","year":"2011","journal-title":"Environ Res"},{"key":"2024072401151130000_33.4.545.14","unstructured":"Jones J . Los angeles times. In: Park MGM is first resort in Las Vegas to ban smoking 16. September 2020."},{"key":"2024072401151130000_33.4.545.15","unstructured":"MGM Park . Nomad las vegas reopen as the strip\u2019s first smoke-free casino resort press release. 2020. Available: https:\/\/investors.mgmresorts.com\/investors\/news-releases\/press-release-details\/2020\/PARK-MGM--NOMAD-LAS-VEGAS-REOPEN-AS-THE-STRIPS-FIRST-SMOKE-FREE-CASINO-RESORT\/default.aspx"},{"key":"2024072401151130000_33.4.545.16","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2010.08.013"},{"key":"2024072401151130000_33.4.545.17","doi-asserted-by":"publisher","DOI":"10.1136\/tc.2007.020479"},{"key":"2024072401151130000_33.4.545.18","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2014-007530","article-title":"Assessing the effect of Michigan\u2019s smoke-free law on air quality inside restaurants and casinos: a before-and-after observational study","volume":"5","author":"Shamo","year":"2015","journal-title":"BMJ Open"},{"key":"2024072401151130000_33.4.545.19","doi-asserted-by":"publisher","DOI":"10.1136\/tobaccocontrol-2017-054052"},{"key":"2024072401151130000_33.4.545.20","unstructured":"Las vegas convention and visitors authority . Las vegas historic tourism statistics. 1970-2021. Available: http:\/\/res.cloudinary.com\/simpleview\/image\/upload\/v1646339932\/clients\/lasvegas\/Las_Vegas_Historical_1970_to_2021_ed406c05-0e5d-4800-a39b-ddb7c9f6f6c0.pdf"},{"key":"2024072401151130000_33.4.545.21","unstructured":"University of Nevada Las Vegas . Las vegas strip casino employment university of nevada las vegas. Center for Gaming Research, 2022."},{"key":"2024072401151130000_33.4.545.22","unstructured":"Centers for Disease Control and Prevention . STATE tobacco activities tracking and evaluation (STATE) system. n.d. Available: http:\/\/www.cdc.gov\/tobacco\/statesystem"},{"key":"2024072401151130000_33.4.545.23","unstructured":"American Nonsmokers Rights . Reopening casinos smokefree: the new normal 2022. Available: https:\/\/smokefreecasinos.org\/reopening-casinos-smokefree-the-new-normal\/ [Accessed 9 May 2022]."},{"key":"2024072401151130000_33.4.545.24","unstructured":"Kurtzleben D . Navajo nation bans indoor smoking in public places, including casinos. National Public Radio November 14, 2021. Available: https:\/\/www.npr.org\/2021\/11\/14\/1055640666\/navajo-nation-bans-indoor-smoking-in-public-places-including-casinos"},{"key":"2024072401151130000_33.4.545.25","doi-asserted-by":"publisher","DOI":"10.1136\/tc.2007.021196"},{"key":"2024072401151130000_33.4.545.26","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1177\/0033354919834581","article-title":"Attitudes toward smoke-free casino policies among US adults, 2017","volume":"134","author":"Tynan","year":"2019","journal-title":"Public Health Rep"},{"key":"2024072401151130000_33.4.545.27","doi-asserted-by":"publisher","DOI":"10.1136\/tobaccocontrol-2011-050301"}],"container-title":["Tobacco Control"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/tc-2022-057861","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,24]],"date-time":"2024-07-24T17:39:49Z","timestamp":1721842789000},"score":1,"resource":{"primary":{"URL":"https:\/\/tobaccocontrol.bmj.com\/lookup\/doi\/10.1136\/tc-2022-057861"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,23]]},"references-count":27,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2024,6,20]]},"published-print":{"date-parts":[[2024,7]]}},"alternative-id":["10.1136\/tc-2022-057861"],"URL":"https:\/\/doi.org\/10.1136\/tc-2022-057861","relation":{},"ISSN":["0964-4563","1468-3318"],"issn-type":[{"value":"0964-4563","type":"print"},{"value":"1468-3318","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,2,23]]}}}