Open Access Highly Accessed Research article

Tribal casinos in California: the last vestige of indoor smoking

David S Timberlake1*, Jun Wu1 and Wael K Al-Delaimy2

Author Affiliations

1 Program in Public Health, College of Health Sciences, University of California, Irvine, Anteater Instruction & Research Building, Irvine, CA, USA 92697-3957

2 Department of Family and Preventive Medicine, University of California, San Diego, La Jolla, CA, USA

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BMC Public Health 2012, 12:144  doi:10.1186/1471-2458-12-144

Published: 25 February 2012



High levels of airborne particles from secondhand smoke have been reported in California Indian casinos. Yet, little is known regarding the smoking status of casino patrons, their avoidance of secondhand smoke while visiting, and their views on a hypothetical smoking ban.


Predictors of visiting an Indian casino were assessed among participants of the 2008 California Tobacco Survey (n = 10, 397). Exposure to and avoidance of secondhand smoke were subsequently analyzed among a subset of participants who had visited a casino in the year prior to the survey (n = 3, 361).


Ethnic minorities, older individuals, current smokers and residents of sparsely populated regions of California were more likely than other demographic groups to visit a tribal casino. Avoidance of secondhand smoke was more frequent among the never smokers than former and current smokers, particularly those who last visited a casino lacking physical separation between non-smoking and smoking sections. The never smokers versus current smokers disproportionately expressed a willingness to extend their stay and visit again if smoking were prohibited.


If casinos became smoke free, then it is anticipated that they would be visited by a significantly larger number of Californians, including both patrons and those who otherwise would not have visited a casino.

Secondhand smoke; California tribal casinos; Smoking ban; Smoking prevalence