Tribal public health practitioners from the Great Lakes Intertribal Council partnered with Dr. Valarie Blue Bird Jernigan, associate professor of health promotion sciences at the University of Oklahoma College of Public Health, and citizen of the Choctaw Nation of Oklahoma, to identify the characteristics of casino patrons at the Lake of the Torches Resort and Casino in Lac du Flambeau, WI and their preferences for a smoke-free casino.  The study, funded by Centers for Disease Control and Prevention and conducted from April to August 2011, surveyed a stratified random sample of 957 members of the casino players club to assess their preferences for a smoke-free casino. These members were categorized into three groups: those who reported being likely to (1) visit more; (2) visit less; or (3) visit the same if the casino prohibited smoking. They were characterized by age, education, sex, race/ethnicity, annual income, players club level, and reasons for visiting the casino. Statistical analyses were conducted on weighted data in October to December 2011. Weighted logistic regression was calculated to control for potential confounding of patron characteristics. Of the 957 surveyed patrons, 520 (54 percent) patrons were likely to visit more; 173 (18 percent) patrons to visit less; and 264 (28 percent) patrons were indifferent to the smoke-free status. Patrons more likely to prefer a smoke-free casino tended to be white, elderly, middle class and above, and visit the casino restaurants. Patrons within the lower tiers of the players club, almost half of the players club members, also showed a higher preference for a smoke-free casino. The study concludes that this tribal casino would likely realize increased patronage associated with smoke-free status while also contributing to improved health for casino workers and patrons. This study adds to a growing body of literature that demonstrates the casinos will not lose patrons by banning smoking.

[Photo: Dr. Valarie Blue Bird Jernigan]

Additionally, the study is unique in that it was led by a group of tribal practitioners and researchers who used a participatory research orientation aimed to build the capacity of tribal government, health, and economic leadership to design a study of importance to the community and utilize study findings to engage in community-based participatory policy work, now underway in this tribal nation. This tribal nation, whose members indirectly benefit from casino revenue, was responsive to community concerns about secondhand smoke exposure and their desire to implement this assessment. Other tribal communities may replicate these efforts and tribes may be uniquely suited, particularly given their sovereign political and economic status, to play a leadership role in a smoke-free casino movement. The study will appear in the American Journal of Preventive Medicine September issue, and appears online here: http://www.ajpmonline.org/article/S0749-3797%2814%2900171-8/abstract