have been discussing these decisions with each other. Since smoking is harmful to the lungs and compromises the immune system, current and former smokers may have more severe complications from COVID-19 than nonsmokers. Tribal leaders recognized there was a unique opportunity to go smoke-free, and this bold move guarantees casinos are doing everything possible to protect employees and patrons from unclean air. (Commercial tobacco use like cigarette smoking is differentiated from tobacco used for traditional purposes, as seen locally in the “Keep Tobacco Sacred” advertising campaign.) Health disparities related to commercial tobacco use are also disproportionately high.

In Wisconsin, 37% of American Indian adults smoke, and in Minnesota the rate nears 60% - much higher than both states’ general smoking rates of 16% and 14%, respectively. Casinos have long been havens for smokers, and American Indians smoke at much higher rates than the general population. These decisions are creating ripples of necessary change across communities in Indian Country. As of this writing, one quarter of all tribal casinos in the country have reopened fully smoke-free, and many more have adopted partial smoke-free policies. But in an astonishing move, many tribal leaders also are incorporating smoke-free indoor air policies as the industry reopens. These health measures reflect recommendations from the Centers for Disease Control and Prevention and gaming industry trends, such as limiting capacity and monitoring temperatures. After implementing new health measures to help contain a virus that has ravaged parts of Indian Country, many tribal casinos are now reopening. closed their doors, unplugging a vital lifeline to their communities’ economies. In response to COVID-19, tribal casinos across the U.S.

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