Smoking in casinos is still allowed inside commercial gaming areas in 17 states. Numerous additional states with tribal casinos permit the indoor use of tobacco products. Over 50 years after the risks of secondhand smoke became understood, the American Lung Association is urging state legislators to ban smoking in casinos.
This week, the American Lung Association published its “State of Tobacco Control 2025.” The report assesses the measures taken by states and the federal government to eradicate the primary source of preventable mortality — tobacco consumption.
The national nonprofit health organization reports that 2024 was the 12th consecutive year in which no state enacted a comprehensive smoke-free law or addressed loopholes that permit gaming establishments to allow indoor smoking.
The evaluation assessed each state based on their performance in five essential domains: funding for tobacco prevention and cessation, smoke-free legislation, tobacco excise taxes, availability of programs aimed at assisting tobacco users in quitting, and the prohibition of flavored tobacco items, such as menthol.
“The U.S Surgeon General, in a seminal 2006 report on the health effects of secondhand smoke and reaffirmed in subsequent reports in 2010, 2014, and 2024, has concluded that secondhand smoke is a serious health hazard causing or making worse a wide range of diseases and conditions. It also concluded that there is no risk-free level of exposure to secondhand smoke and that the only way to fully eliminate exposure to secondhand smoke in indoor environments is to completely prohibit smoking,” the association wrote in its advocacy for smoke-free indoor workplaces and public places.
Where Is Smoking Permitted in Casinos?
In Arkansas, Indiana, Iowa, Kansas, Louisiana, Maine, Michigan, Mississippi, Missouri, Nevada, New Jersey, New Mexico, Oklahoma, Pennsylvania, Rhode Island, Virginia, and West Virginia, smoking is permitted in commercial casinos. Due to the indoor smoking permissions, none of those states received an “A” rating.
In New Jersey, the country's second-wealthiest gaming market after Nevada, recent legislative sessions have demonstrated sufficient backing to prohibit indoor smoking in Atlantic City and at parimutuel betting venues. However, no legislation has arrived at the governor's desk because of political stalemate and the casino industry's lobbying power, which argues that a tobacco ban would negatively impact revenue, cause job losses, and potentially result in the closure of one or two resorts.
"The plight of New Jersey’s casino workers has become a major statewide issue and has garnered national attention. Unfortunately, promises have been made and broken by the legislature when it comes to passing a smoke-free casinos bill,” the American Lung Association wrote in its New Jersey recap.
“New Jersey continues to see an unholy alliance of the casino industry working side by side with the tobacco industry,” the summary continued. “The organized interests in opposition to smoke-free casinos use the tobacco industry’s playbook minimizing the health effects of employees who continue to be exposed to deadly secondhand smoke, while the industry exaggerates their economic arguments.”
Lung Advocacy Pushes for Air Quality
The American Lung Association also targeted Nevada, which ranked among the lowest of all 50 states.
The American Lung Association has requested that the state where Las Vegas is located extend the Nevada Clean Indoor Air Act to cover casinos, boost funding for tobacco prevention and control efforts, and revise the tobacco retailer licensing program in the state.
In Pennsylvania, a state with a large gaming sector, the American Lung Association argues that the Clean Indoor Air Act needs to be revised to ban indoor smoking in casinos and bars where alcohol represents the majority of sales.
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