142nd APHA Annual Meeting and Exposition

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Evidence that a Smoke-free Policy at a Tribal Casino could Increase Patronage and Improve the Health of American Indians

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Monday, November 17, 2014 : 12:45 PM - 1:00 PM

Isaiah Brokenleg, MPH , Community Transformation Grant, Great Lakes Inter-Tribal Council, Lac du Flambeau, WI
Teresa K. Barber, MEd , Wisconsin Native American Tobacco Network, Great Lakes Inter-Tribal Council, Lac du Flambeau, WI
Nancy Bennett, BS , Northwest Portland Area Indian Health Board, Portland, OR
Simone Peart Boyce, PhD , ICF International, Atlanta, GA
Valarie Blue Bird Jernigan, DrPH, MPH , College of Public Health, University of Oklahoma Health Sciences Center, Tulsa, OK
Audio (mp3) recording Recorded Presentation (mp4)
Background: Several states have implemented smoking bans in casinos.  However tribal casinos are exempt from such bans due to tribal sovereignty.

Purpose: This tribally-led assessment, conducted from April to August, 2011, identified the characteristics of casino patrons at a tribal casino in northern WI and their preferences for a smoke-free casino.  Results were analyzed October to December, 2011. 

Methods: A stratified random sample of 957 members of the casino’s players club were surveyed 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, gender, race/ethnicity, annual income, player’s club level, and reasons for visiting the casino.  All statistical analyses were conducted on weighted data.  Weighted logistic regression was calculated to control for potential confounding of patron characteristics.

Results: Of the 957 surveyed patrons, 520 (54%) patrons were likely to visit more, 173 (18%) patrons to visit less, and 264 (28%) 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 player’s club, almost half of the player’s club members, also showed a higher preference for a smoke-free casino. 

Conclusions: This tribal casino would likely realize increased patronage with smoke-free status while also contributing to improved health for casino workers and patrons.

Learning Areas:

Assessment of individual and community needs for health education
Public health or related public policy
Public health or related research

Learning Objectives:
Discuss how this community-based participatory research collaboration between community, health, and economic leadership was successfully implemented within this community, allowing for this highly sensitive research to take place

Keyword(s): Community-Based Research (CBPR), Tobacco Control

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the principal or co-principal of multiple federally funded grants focusing on the epidemiology of tobacco prevention and control in Native American tribal communities. I am also the senior epidemiologist for the Great Lakes Intertribal Epidemiology Center
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 3235.0: Community Based Participatory Research and Policy Work to Address Obesity and Smoking in Native American Tribal Communities: Challenges and Opportunities