Teresa Price was 22 when she became a table-games dealer in 1978 on the Las Vegas Strip. At that time, cigarette and cigar smoking was allowed nearly everywhere — offices, restaurants, grocery stores, airplanes, even hospitals. Casinos were no exception.
Today, nearly all workplaces in Nevada have gone smoke-free, but casino employees such as Price still work in smoky environments.
In 2017, after 35 years of full- and part-time work, Price took a medical leave after being diagnosed with non-Hodgkin’s lymphoma and heart disease.
Never a smoker herself and otherwise healthy and fit, Price blames second-hand smoke at work for her ailments.
“I love the job and meeting new people every day,” Price, 63, told the Las Vegas Sun. “But the environment is unhealthy.”
Second-hand smoke has been shown to increase the risk of lung cancer and heart disease, and some research shows a link between second-hand smoke and non-Hodgkin’s lymphoma. No level of exposure is considered safe, according to the U.S. Surgeon General.
Kanie Kastroll, a Las Vegas casino employee for 30 years and a volunteer organizer with the dealers’ union, UAW Local 3555, said she has seen colleagues like Price become sick with cancer or other conditions.
“It’s one of the biggest complaints other than abusive guests that (the union) has,” Kastroll said. “When you’re sick, you get sicker, or you’re sicker longer.”
Many casinos in Las Vegas have systems to remove smoke and circulate fresh air, said Dawn Christensen, a vice president at the Nevada Resort Association. Individual casino companies declined to comment for this story.
“From specialized ventilation and filtration systems to air-handling units located at table games and the bases of gaming devices, the industry continues to utilize the latest innovations to provide improved air quality for our employees and guests,” Christensen wrote in a statement.
But the Centers for Disease Control, the American Society of Heating, Refrigerating and Air-Conditioning Engineers and researchers warn that no air cleaning system can eliminate health risks associated with second-hand smoke.
“The particle size of the constituents of smoke are so small that these air filters don’t do a thing,” said Chris Pritsos, director of the Nevada Agricultural Experiment Station at the University of Nevada, Reno and author of several studies on second-hand smoke in casinos. “They might knock it down 10% or so, but that does not stop the harmful effects.”
The only way to reduce health risks associated with second-hand smoke is to ban smoking or install completely separate filtration systems in entirely nonsmoking areas, said Maria Azzarelli, chronic disease prevention manager at the Southern Nevada Health District.
Much of Nevada went smoke-free in 2006 when voters approved what became known as the Nevada Clean Indoor Air Act.
For the first time, Nevadans and tourists could no longer smoke wherever there were slot machines, such as in grocery stores. But there were exceptions: bars; age-restricted taverns and saloons that don’t serve food; strip clubs and brothels; and casino floors.
The Nevada Legislature revised the law to also allow smoking in tobacco-related private conventions and in bars and taverns that don’t allow minors. No revisions have been made since 2011.
Because there is no law banning smoking in casinos, the only smoke-free casinos in state history became that way by choice.
The American Nonsmokers’ Rights Foundation lists one as the Fernley Nugget, about 40 miles (64 kilometers) east of Reno.
When it opened in 2011, the goal was to create a smokeless gambling environment, said Scott Tate, casino general manager. Since then, the Fernley Nugget has developed a devoted following of patrons and employees.
“I’m not going to sit here and say I’m pro-smoke-free facilities,” Tate said. “I will say I think there’s a niche for it.”
The economic impacts of restricting or banning smoking in Nevada casinos could be far-reaching, said David Schwartz, a gambling historian at the University of Nevada, Las Vegas.
People “seem to enjoy smoking and gambling at the same time,” Schwartz said, and gambling revenue declined by about 15% in other jurisdictions after the enactment of a smoking ban.
But Pritsos conducted a 2011 study that found those who gamble in Nevada’s major destinations — Reno, Lake Tahoe and Las Vegas — do not smoke at a higher rate than the general population.
Over 40% of American adults smoked in 1964, compared with 14% in 2017, according to the CDC. Today, 15.7% of adult Nevadans smoke cigarettes, half the rate from 1999.
Former cocktail waitress Lysa Buonanno, who worked in bars on the Las Vegas Strip and elsewhere from 1992 to 2009, has been in treatment for stage 4 lung cancer for eight years.
Buonanno, who never smoked and described herself as a lifelong runner and “health nut,” believes exposure to smoke on the job contributed to the cancer.
“I was in that environment full-time for 17 years,” she said. “Especially in the bar atmosphere, where it was much smaller and ceilings were lower, it was extremely smoky. You felt it and you saw it as soon as you walked in the door.”
Paula Larson-Schusster, a casino dealer downtown and on the Strip since 1990, said one or two smokers at a table at a time can make her eyes itch and her clothes reek by the end of an eight-hour shift.
Never a smoker, Larson-Schusster, 60, said she has a “smoker’s cough” after 29 years of working in casinos. She also gets frequent sinus infections, bronchitis and chest congestion — all of which are associated with second-hand smoke exposure, studies show.
While Buonanno, Kastroll and Price want the state to ban smoking in casinos, Larson-Schusster doesn’t want to affect companies’ profits or workers’ jobs.
“The bottom line is: If we don’t have customers, I don’t have a job,” she said.
In a state where casino companies dominate the economic and political scene, Nevada lawmakers don’t seem keen to ban smoking.
“It’s just part of the Las Vegas culture,” said former Nevada assemblyman and senator and current Clark County Commissioner Tick Segerblom. “We do things other states don’t do, and that’s why people come here.”