This document provides demographic information about Las Vegas, Nevada and discusses the impacts of secondhand smoke. It notes that Las Vegas has a population of over 2 million people and the major industries are gambling and tourism. Unemployment in Las Vegas is linked to unhealthy behaviors like increased smoking. The document then discusses the health effects of secondhand smoke, noting that it contains over 7,000 chemicals including 69 that cause cancer. Exposure to secondhand smoke is estimated to cause 41,000 deaths in the US each year and increases risks for heart disease, Alzheimer's, and other health issues.

1. Luis Rodriguez
HST 3700
Las Vegas, Nevada - Second Hand Smoke - Community Analysis
Community Diagnosis
Demographics
To many tourists, the strip is the first thing that comes to mind when Las Vegas is
mentioned (McCollister, 1992)Las Vegas is the city where high rollers can lose a fortune with a
simple toss of a dice, or a spin of the wheel (McCollister, 1992).Las Vegas’s is renowned for its
gambling, shopping, and fine dining (Forbes, 2014). Las Vegas is known by the many people
around the world as “The Entertainment Capital of the World” (Forbes, 2014).
In the city of Las Vegas, there are 425 smoke shops (Yellowpages, 2014d). There are 908
gas stations (Yellowpages, 2014c). Ninety-eight Walmarts would also be found in Las Vegas
(Yellowpages, 2014f). Eighty-four different Walgreens would be located in Clark County
(Yellowpages, 2014e) 198 different 7-Elevens can be located at your convenience in Las Vegas
(Yellowpages, 2014g). Seven Cigarette Expresses will help a smoker find their favorite
cigarettes in a swift manner (Yellowpages, 2014b). Eighty-seven wholesale and manufacture
smoke shops are also located in Las Vegas (Yellowpages, 2014a). These are all companies that
sell tobacco products at the convenience of the customers. Now that there a better understanding
of Las Vegas’ background, now it is appropriate to see how second hand smoke affects Las
Vegas.
Las Vegas is one city where people are fearless in making high risks decisions

2. (McCollister, 1992). Every year, tens of thousands of recent immigrants strive to live in Las
Vegas (Rusell, 2005). Las Vegas has an increasingly divided society (McKenzie, 2005). Las
Vegas, Nevada is the fastest growing city in the nation and is creating a global trend of reshaping
the spatial, social, and political order accordingly (McKenzie, 2005). One risk that is a health
hazard, and very important to be aware of, is smoking cigarettes that leads to second hand
smoke. Before the effects of second-hand smoke are analyzed, the demographics of Las Vegas,
Nevada will be discussed first; there is more to Las Vegas than just the strip.
The population of Las Vegas Nevada is 2,043,000 people (Forbes, 2014). The major
industries that are the backbone of Las Vegas’ income are gambling and tourism (Forbes, 2014).
The median household income is $50, 356 (Forbes, 2014). The median home price is $173,500
(Forbes, 2014). The unemployment rate is 8.2% (Forbes, 2014). As of 2013, the job growth is
2.9% (Forbes, 2014). The percentage of college students completing college is 22.1% (Forbes,
2014). For best places, business, and careers, Las Vegas is ranked 111 (Forbes, 2014). Las Vegas
is one of the most unionized cities in America, allowing low taxes to ease the stress and worry to
start a new business (Rusell, 2005). The job growth of Las Vegas is ranked 195 (Forbes, 2014).
The education in Las Vegas is ranked 163 (Forbes, 2014). The poverty rate in Las Vegas is 8
percent (Nevada, 2004). In some way, Nevada is still experiencing the effects of the Great
Recession because there are 100,000 people fewer with jobs than before the recession (Vogel,
2014).
Unemployment can greatly impact a person’s health for the worse (Pharr, Moonie,
Bungum, 2012). The unemployed have a higher risk of impaired mental health including
depression, anxiety, and stress (Pharr, Moonie, Bungum, 2012). People who have experienced
unemployment for more than thirty-seven months are two time more likely to be depressed, or

3. anxious (Pharr, Moonie, Bungum, 2012). Unemployment is linked to unhealthy behaviors, such
as an increase in alcohol and tobacco consumption (Pharr, Moonie, Bungum, 2012). Being
employed satisfies a psychological need, which is healthy for the mind (Pharr, Moonie, Bungum,
2012). There is a relationship betweens one’s work status and mental health that means that
when one is employed, that person values their self-worth of employment (Pharr, Moonie,
Bungum, 2012).
There are seven common industries that the men of Las Vegas work in: Accommodation
and food and services (20%), construction (11%) administrative and support and waste
management services (9%), arts and entertainment (8%), professionals, scientific, and technical
services (6%), public administration (4%), and other transportation, support activities (4%) (Las
Vegas, 2014). There are seven common industries that the women in Las Vegas work in:
Accommodation and food services (21%), health care (13%), educational services (8%), arts,
entertainment, and recreation (7%), professional, scientific, and technical services (7%),
administrative and support and waste management services (5%), and public administration (5%)
(Las Vegas, 2014a).
There are seven common occupations for men and women in Las Vegas, Nevada, but
first the men will occupations will be mentioned (Las Vegas, 2014a). Five percent of men obtain
building cleaning and pest control occupations (Las Vegas, 2014a). Five percent have
management positions except in farms, ranch, and other agricultural managers (Las Vegas,
2014a). Five percent are responsible for food preparation, or work as cooks (Las Vegas, 2014a).
Four percent work as protective service workers (Las Vegas, 2014). Four percent have
maintenance, repairers, and installers (Las Vegas, 2014a). Three percent are material movers, or
laborers (Las Vegas, 2014a). The other 3% are driver/sales and truck drivers (Las Vegas, 2014a).

4. The women’s seven common occupations are similar to those of men, but not quite the
same. 8% of women have building cleaning and pest control occupations (Las Vegas, 2014a).
Three percent have management positions, except in the agriculture profession (Las Vegas,
2014a). Three percent are elementary and middle school teachers, personal care (except personal
appearance, but service workers), cooks, and registered nurses (Las Vegas, 2014a).
The population that makes up Las Vegas, 50% are males and 49.6% are females (Las
Vegas, 2014a). The median resident age is thirty-six years old and the Nevada median age is
thirty-six point five years old (Las Vegas, 2014a). In 2012, the median gross rent was $936 (Las
Vegas, 2014a From 2000 to 2012, there has been a $8,100 increase value of a home, or a condo
(Las Vegas, 2014a). Aside from the economic perspective, lets look more closely at the different
races that make up Las Vegas, Nevada.
Forty-seven point eight percent of the population in Las Vegas are white (Las Vegas,
2014a). Thirty-two point eight percent of the population make up the Hispanic community (Las
Vegas, 2014a). Ten percent of the population make up the Black community (Las Vegas, 2014a).
Five point nine percent of the population make up the Asian community (Las Vegas, 2014a).
Two point eight percent of the population make up the population that consists of two, or more
races in Las Vegas (Las Vegas, 2014a). Point three percent of the population in Las Vegas are
responsible for the Native Hawaiian and other Pacific Islander community (Las Vegas, 2014a).
Point two percent of the population is accountable for the American Indian community (Las
Vegas, 2014a). For every square mile, there are 5,264 people (Las Vegas, 2014a). Now lets
concentrate on the population of twenty five years and over in Las Vegas.
Eighty-three point three percent of the population in Las Vegas have earned a High
School diploma, or higher (Las Vegas, 2014a). Twenty one point eight percent have earned a

5. Bachelor’s degree (Las Vegas, 2014a). Seven point seven percent have earned a graduate, or
professional degree (Las Vegas, 2014a). Fourteen percent are unemployed (Las Vegas, 2014a).
The mean commuting time to work is twenty-four point six minutes (Las Vegas, 2014a). The
high school dropout rate is fourteen percent (Nevada, 2014). Twelve-point-nine percent have
some high school, but no diploma (Nevada, 2014). Now, the marriage related status of the
population for fifteen years and older in Las Vegas will be discussed.
Thirty-two point three percent of the population have never been married (Las Vegas,
2014a). Forty-four point three percent are now married (Las Vegas, 2014a). Two-point-eight
percent are separated (Las Vegas, 2014a). Five-point-six percent are widowed (Las Vegas,
2014a). Fifteen-point-one percent are divorced (Las Vegas, 2014a). Per 100,000 people, in 2012,
the crime rates in Las Vegas will be explored.
Risk Assessment
Per 100,000 people, there have been five-point-one murders (Las Vegas, 2014a). The rate
of rapes are forty-point-three rapes (Las Vegas, 2014a). The rate of robberies are 258.5 robberies
per 100,000 (Las Vegas, 2014a). The rate of assaults is 480.1 (Las Vegas, 2014a). The burglary
rate is 961.2 (Las Vegas, 2014a). The thefts rate is 1725.2 (Las Vegas, 2014a). The auto thefts
rate is 451.9 (Las Vegas, 2014a). Lastly, the arson rate is fourteen-point-six (Las Vegas, 2014a).
Lets take a step backwards and concentrate on what Las Vegas academically offers to its
students.
Las Vegas has sixty-eight elementary school in its city (Schools in Las Vegas, Nevada,
2014b). Also, Las Vegas has fourteen middle schools and eleven high schools in its city
(Schools in Las Vegas, Nevada, 2014b). Moreover, there are sixteen other alternative schools in
the city of Las Vegas (Schools in Las Vegas, Nevada, 2014b). Nevada high school students are

6. judged in reading, writing, and math (USNews, 2014). Multiple Nevada high school participate
in the GEAR UP programs, which offers grants for students to attend Nevada System of Higher
Education colleges and universities (USNews, 2014). To receive a grant, students must
participate in tutoring, attend a participating school, and have a GPA of at least 2.0 (USNews,
2014). One of the highly ranked Nevada school is in Las Vegas - Advanced Technologies
Academy (USNews, 2014). There are 134,449 students enrolled in a school and 5,734 full-time
teachers (USNews, 2014).
Nevada children are not impressive in the overall well-being category (Millard, 2014).
Looking at the quality of children’s health, education, economic security, and state families, the
only two states behind Nevada are New Mexico and Mississippi (Millard, 2014). In 2012, close
to forty percent of the Nevada’s high school seniors did not graduate in time (Millard, 2014).
Nevada still ranks in 47th place in children’s health considering Nevada has the highest rate of
uninsured children in the U.S - 17% compared to the national average of 7% (Millard, 2014). In
the state of Nevada, one in four children live in poverty (Millard, 2014) This rate has increased
to eighty-five percent since 1990 (Millard, 2014).
The health and fitness is not so impressive compared to other cities (MensFitness, 2014).
Las Vegas residents are three percent more likely than average to use their health-club
membership (MensFitness, 2014). Thirty-eight-point-seven percent of adults are heavy enough to
most likely experience weight-related health problems; compared to the national average of 36 %
(MensFitness, 2014). Las Vegas residents scored poorly in the fruits and vegetables consumption
(MensFitness, 2014). Only twenty-one percent of the Las Vegas residents eat the recommended
of five, or more servings per day. Las Vegas has sixty-nine municipal parks, which is a small
amount compared to other cities (MensFitness, 2014). There has been a connection of obesity

7. rates and the lack of access to parks and green space (MensFitness, 2014). Las Vegas residents
participate in sports fifteen percent less than average while there is sixty-eight percent more fast-
food joints than the average (MensFitness, 2014). Moreover, Las Vegas has 106 percent more
pizza places per capita than the average (MensFitness, 2014). For every 10,748 residents, there is
one basketball court (MensFitness, 2014). Ice Cream shops are 151 percent more popular in Las
Vegas than average (MensFitness, 2014). Other students participate in a CDC-sponsored
program to reduce obesity and other chronic diseases, but Nevada does not (MensFitness, 2014).
On the contrary, there has been an increase in adolescents walking and using their bicycle to
transport them to school (Bungum, Lounsbery, Moonie, & Gast, 2009). Smokers will discourage
people to ride their bicycles, or walk.
At Risk Group
It is important to begin by understanding of who smokes. Although there are no specific
statistics for Las Vegas, there are statistical highlights of Nevada. Nevada ranks 43rd among the
rest of the states that smoke (CDC, 2014). Twenty-two percent of the adult population (18+
years) are current cigarette smokers (CDC, 2014). The national median is 18.4% (CDC, 2014).
Males tend to smoke more than females (CDC, 2014). Students with only a high school diploma
smoke more cigarettes than students with an education less and more than a high school diploma
(CDC, 2014). Las Vegas is ranked 10th place that have smoking problems (TheDailyBeast,
2011). Las Vegas smokers smoke an average of 14.2 cigarettes and sixty-six percent have tried
to quit with the help of a patch, gum, or support program (TheDailyBeast, 2011). Let’s focus on
what exactly second hand smoke is.
Secondhand smoke, also known as environmental smoke, involuntary smoke, and passive
smoke, is the combination of smoke given off by a burning tobacco product and smoke exhaled

8. by a smoker (National Cancer Institute [NCI], 2004). Exposure to secondhand smoke (SHS)
from cigarettes is estimated to cause 41,000 deaths among non-smoking U.S adults each year and
a staggering $5.6 billion annually in lost in productivity (King, Patel, & Babb, 2014).
There are sixty-nine chemicals in secondhand smoke that are known to cause cancer
(NCI, 2004). Secondhand smoke is also known to cause heart disease in adults, sudden infant
death syndrome, ear infections, and asthma attacks in children (NCI, 2004). To be clear, there is
no safe level of exposure to secondhand smoke (NCI, 2004).
There are more than 7,000 chemicals that have been identified in secondhand smoke, and
of those 7,000 chemicals, 250 of them are known to be harmful (NCI, 2004). At least sixty-nine
toxic chemicals in secondhand smoke causes cancer (NCI, 2004). Smoke is also linked to the
increased risk for Alzheimer’s disease and other forms of dementia (Fisher Center For
Alzheimer’s Research Foundation, 2012). There are international studies that have found that
you only need to inhale smoke-filled air to increase the chances of suffering deleterious effects
of cigarette smoke (Fisher Center For Alzheimer’s Research Foundation, 2012). More
specifically, secondhand smoke is linked to thinking and memory problems (Fisher Center For
Alzheimer’s Research Foundation, 2012). A current study found that people who are exposed to
secondhand smoke have a 29 percent greater chance of developing severe dementia in old age
(Fisher Center For Alzheimer’s Research Foundation, 2012). Secondhand smoke also causes
other severe health hazards and diseases.
Secondhand smoke exposure is linked to cardiovascular disease (World Health
Federation [WHF], 2014). Smoking causes about ten percent of cardiovascular disease (CVD)
and is the second leading cause of CVD, after high blood pressure (WHF, 2014). Globally,
tobacco causes 6 million deaths a year (WHF, 2014). Constant exposure to secondhand smoke,

9. either at home or at work, has been found to double the risk of having a heart attack (WHF,
2014). Children area at a higher risk as well.
Nicotine is a ganglion stimulator and a depressor (Al-Sayed & Ibrahim, 2014). Cotinine
is a major metabolite of nicotine and is helps measure passive exposure to tobacco smoke (Al-
Sayed & Ibrahim, 2014). It is estimated from cotinine measurements that the total nicotine dose
received by children whose parents are smokers is equivalent to children who actively smoke 60
to 150 cigarettes per year and children with nonsmoking parents have the lowest exhaled CO
concentrations (Al-Sayed & Ibrahim, 2014). Children’s immune system are not fully developed,
so it is important to have a smoke-free home because children spend more time at home,
therefore, are likely to experience more intense and prolonged smoke exposure from parental
smoking (Al-Sayed & Ibrahim, 2014).
Passive smoking affects the immune system and makes children more vulnerable of
getting sick (Al-Sayed & Ibrahim, 2014). Smoking both affects the cell-mediated and humoral
immune responses (Al-Sayed & Ibrahim, 2014). Nicotine blocks lymphocyte proliferation and
differentiation including suppression of antibody-forming cells (Al-Sayed & Ibrahim, 2014).
Being exposed to smoke leads to alterations in the epithelial function, such as a decrease in
mucociliary activity, which causes a reduces clearance of inhaled substances (Al-Sayed &
Ibrahim, 2014). The risk is doubled if both parents smoke (Al-Sayed & Ibrahim, 2014). In the
state of Nevada, from 2010-2011, 55 percent of all the homes have at least one smoker in each
home (King, Patel, & Babb, 2014).
Home is most likely the best place to keep children away from a smoking environment
(Webmd, 2014). Exposure to secondhand smoke can cause asthma in children who have not
previously showed symptoms and make asthma symptoms more clear (Environmental Protection

10. Agency [EPA], 2011). For infants who are exposed to secondhand smoke on a regular basis, they
are at a very high risk of low respiratory track infections, such as pneumonia and bronchitis
(EPA, 2011). Environmental tobacco smoke (ETS) is a human carcinogen, which is responsible
for about 3,000 lung cancer deaths per year in the U.S (EPA, 2011). The people of Las Vegas
smoke for many reasons: social, stress, a way to relax, etc. We will take a look at the associations
between psychological demands, decisions, and job strain with smoking in female (majority of
the employees) hotel room cleaners in Las Vegas to have a better understanding of what keeps
the habit of cigarette smoking alive (Rugulies, Sherzer, Krause, 2008).
Over the last two decades, in Las Vegas, there has been strong evidence that has evolved
explaining the link between exposure to adverse psychological characteristics that leads to
increased job strain that causes smoking (Bongers, de Winter, Kompier, & Hildebrandt, 1993;
Davis & Heany, 2000; Grenier & Krause, 2000). The disadvantage psychological work
characteristics increase the likelihood to poor health behaviors, especially smoking, perhaps as a
way to tolerate stressful condition and negative emotions (Rugulies, Sherzer, Krause, 2008).
Although there isn’t a concrete evidence proving this hypothesis, in some studies, participants
exposed to adverse psychological work characteristics showed a higher prevalence of intense
smoking (Rugulies, Sherzer, Krause, 2008).
It is well documented that women with low income are more likely to smoke than women
with high income (Rugulies, Sherzer, Krause, 2008). Smokers with job strain smoke, on average,
twelve cigarettes per day, whereas smokers without job strain smoke seven cigarettes (Rugulies,
Sherzer, Krause, 2008). The educated, the highly skilled upper end of the economy do well -
everyone from attorneys, doctors, consultants, to health professionals - find opportunities that
reward their choice of career (Rothman, 2000). These professionals sell their knowledge

11. (Rothman, 2000). On the other hand, wage workers, the semi-skilled and unskilled people in the
economic, simply have lost value (Rothman, 2000). Wage workers do not have job security,
wages, or exceptional benefits (Rothman, 2000). Inevitably, smoking decreases in men and
women of high socioeconomic position and becomes predominantly a habit in people of low
socioeconomic positions (Rugulies, Sherzer, Krause, 2008). The amount of cigarettes smoked
varies depending what ethnicity is being evaluated.
Participants of African American and Caucasian ethnicity were more likely to be smokers
compared to participants of Hispanic ethnicity (Rugulies, Sherzer, Krause, 2008). Also,
participants who were born in the United States were more likely to smoke (Rugulies, Sherzer,
Krause, 2008). In a specific occupation - hotel room cleaner - participants of Hispanic ethnicity
born in the USA were 2.4 times more likely to be smokers than Hispanic room cleaners born
outside of the USA (Rugulies, Sherzer, Krause, 2008). Smokers of African American and
Caucasian ethnicity and smokers born in the USA also smoked more cigarettes (Rugulies,
Sherzer, Krause, 2008). Moreover, people who are sensitive to stressors are more likely to be
smokers as well (Rugulies, Sherzer, Krause, 2008). The social scene is Las Vegas has plenty of
smokers as well.
In the absence of a smoke free law that covers bars and nightclubs, the people in these
venues are exposed to a high level of secondhand smoke (Fallin, Neilands, Jordan, & Ling
2014). Bars and nightclubs have been an important social scenes that have welcomed lesbian,
gay, bisexual, and transgender (LGBT) rights movement (Fallin, Neilands, Jordan, & Ling
2014). However, compared with non-LGBT venues, LGBT bars and nightclubs have higher
smoking rates due to a friendly, welcoming environment, compared to heterosexual venues
(Fallin, Neilands, Jordan, & Ling 2014). Overall, exposure to SHS in bars and nightclubs was

12. frequent: eighty-five-point-six percent of patrons (people who give financial support, or other
type of support to another person) of LGBT bars and nightclubs and 78.5% of patrons of non-
LGBT venues reported that they have been exposed to SHS in a bar, or nightclub in the past
seven days (Fallin, Neilands, Jordan, & Ling 2014). Nevada has historically lagged behind the
nation in progressing in taking action towards smoke-free policies (Fallin, Neilands, Jordan, &
Ling 2014). Adolescents are also being exposed to secondhand smoke in Las Vegas casinos.
Smoke-free laws, which restrict smoking in certain areas, are vital in reducing, or
eliminating secondhand smoke exposure (Fallin, Neilands, Jordan, & Ling 2014). The Nevada
Clean Indoor Air Act (NCIAA), a non-comprehensive smoke-free law, permits smoking in
designated areas of casinos, bars, and taverns (Cochran, Henriques, York, & Kiyoung, 2012).
The law banned smoking in childcare facilities, movie theaters, arcades, public places, retail
establishments, indoor areas of restaurants, and school property (Nevada Revised Statutes,
2006). The set rules of many casinos consist of a combination of gaming, dining, and
entertainment venues, that the NCIAA has made a mixture of smoking and nonsmoking zones
within Nevada casinos (Cochran, Henriques, York, & Kiyoung, 2012).
This study turned its focus towards a specific demographic: children (Cochran,
Henriques, York, & Kiyoung, 2012). Despite the adult nature of casinos, multiple on and off
strip casinos in Las Vegas have made attempts to cater to younger audiences (Cochran,
Henriques, York, & Kiyoung, 2012). Given well-documented research of the effects of smoke
drift on nearby non smoking zones and the ineffectiveness of partial smoke-free laws, the scope
of this study is to focus its attention on the potential, excessive SHS exposure to children (York
& Lee, 2010). Blood and urine cotinine concentrations, a metabolic byproduct of nicotine
produced by the body, produces twice as high in children as those found in nonsmoking adults

13. (Cochran, Henriques, York, & Kiyoung, 2012). Each year, SHS exposure is responsible for
7,500 to 15,000 hospitalizations of children aged 18 months, or younger (U.S Department of
Health and Human Services, 2006).
Clean indoor air acts have served as a national patchwork for regulating smoking
behavior (Cochran, Henriques, York, & Kiyoung, 2012). In the past twenty years, state, and
county have had smoke-free regulations and laws that have been enacted across the United States
(Cochran, Henriques, York, & Kiyoung, 2012). Of the twenty-four states with casino-type
gambling allowed, only eight of those states have laws requiring 100% smoke-free environment
(ANR, 2011). It is estimated about 70% of the US population is protected by smoke-free laws,
but the majority of casinos workers and patrons in the US are at risk of SHS exposure
(Americans for Nonsmokers’ Rights [ANR], 2011).
In the study, an observer found smoking in all gaming areas with no smoking noted in
any of the children-friendly areas (Lee, Hahn, Robertson, Lee, Vogel, & Travers, 2009). Despite
the alarming information, there are no federal regulations for indoor air quality (Cochran,
Henriques, York, & Kiyoung, 2012). The Environmental Protection Agency (EPA) is required
by the Clean Air Act to set National Ambient Air Quality Standards (Cochran, Henriques, York,
& Kiyoung, 2012). According to these standards, exposure to Particle Matter 2.5 microns
(PM2.5), which is primarily made up of SHS from cigarettes, pipes, and cigars, should not exceed
annual and 24 hour concentrations of 15 and 35 µg/m3 respectively (Fong, Sendzik, Kennedy,
Elton, Jahn, Travers, 2006). This study found that the mean PM2.5 levels in 16 Nevada casinos
exceeded the 24-hour exposure limit in both gaming and non-smoking restaurant areas
(Cochran, Henriques, York, & Kiyoung, 2012). With mean exceeding PM2.5 concentrations in
child-friendly zones exceeding the annual exposure levels set forth by the EPA, the ambient air

14. quality in attached nonsmoking areas is not adequately preserved (Cochran, Henriques, York, &
Kiyoung, 2012). In the absence of federal indoor air regulations, there is a clear lack of energy
and focus for business to ensure clean air in the microenvironment that casinos create (Cochran,
Henriques, York, & Kiyoung, 2012). The current policy in Nevada has failed to maintain safe
indoor air quality for children in casinos (Cochran, Henriques, York, & Kiyoung, 2012).
NCIAA does not adequately preserve air quality in protected nonsmoking areas according to
EPA pollution guidelines (Cochran, Henriques, York, & Kiyoung, 2012). There should be more
focus, effort, and energy to not overlook an aspect in casino smoking policies: children
(Cochran, Henriques, York, & Kiyoung, 2012). Consequently, the shortcomings of smoke-free
legislation to protect certain groups in society (i.e. casino workers, bartenders, restaurant
workers, etc) have been carefully observed (Pilkington, 2007; Pristos, 2006; Pearson, Angulo,
Bourcier, Freeman, & Valdez, 2007).
Even though the majority of officials recognized smoking as a health hazard and nicotine
as addictive, there was not enough support to strengthen the NCIAA, raising cigarette excise
taxes (York, Pristos, Gutierrez, 2012). No other state relies on gaming revenues as much as
Nevada (York, Pristos, Gutierrez, 2012). Elected officials who have never smoked are more
supportive of comprehensive smoke-free (SF) laws than those who currently smoke, have a
history of smoking, or have a family member who has smoked (Anderson, Buller, Voeks,
Borland, Helme, Bettinghaus, 2006; Cohen, deGuia, Ashley, Ferrence, Northrup, Studlar, 2002;
deGuia, Cohen, Ashley, Pederson, Ferrence, Bull, et al., 2003).
State officials who report tobacco use and SHS exposure is a community problem also
show greater support for indoor SHS laws (Anderson, Buller, Voeks, Borland, Helme,
Bettinghaus, 2006). In 2006, Nevada citizens voted for the Nevada Clean Indoor Air Act, but the

15. NCIAA allow for indoor smoking in casino gaming areas, stand-alone bars, and taverns, strip
clubs and brothels, and retail tobacco stores (York, Pristos, Gutierrez, 2012). Twenty-three of 63
Nevada legislators responded to a survey about their opinion of second hand smoking (York,
Pristos, Gutierrez, 2012). Eighty-seven percent of respondents agreed that smoking is a serious
health hazard while 52% believed that being exposed to SHS was a serious health hazard (York,
Pristos, Gutierrez, 2012). Also, 79% of respondents believed that nicotine is not addicting while
13% were unsure as to whether people smoke cigarettes because they were addicted to nicotine
(York, Pristos, Gutierrez, 2012). Interestingly, only 50% of officials surveyed believed SHS
exposure was a serious health hazard (York, Pristos, Gutierrez, 2012). This makes health
professionals feel uneasy considering the high number of NV citizens working in, and visitors
going to bars, taverns, casinos, strip clubs, and brothels (York, Pristos, Gutierrez, 2012). Even
more concerning, the majority of the legislators believed that a $1 increase in the cigarette tax
would hurt gaming and tax revenues, while being aware that a high number of people are
exposed to SHS (York, Pristos, Gutierrez, 2012). A 2010 Nevada poll found that 86% of the
states citizens believe it is important to work in a smoke-free environment (York, Pristos,
Gutierrez, 2012).
Intervention Priorities and Goals
Desired Change
The desired change is to change the level of knowledge, causes, and effects about
secondhand smoke towards children and adults. Moreover, policy advocates should strengthen
the current NICCIA and tobacco control laws. If people are not aware of how secondhand smoke
and tobacco smoking, affects the human body, then the people are going to smoke with less
worry. Millions of people know that smoking is bad for you, but I strongly believe that people do

16. not understand why and how tobacco smoking is bad for you; there is a difference.
Understanding how and why tobacco smoking is a serious health hazard could change the
perspective of smoking that, I believe, could create an undesirable motive to smoke that results
in a positive, healthier change. I strongly believe the legislators should be educated and the
federal government.
Target Audience
The best, realistic, method to reduce the incidence, prevalence, and impact of secondhand
smoke exposure in the community is to educate the politicians and legislators to help them
understand the negative effects of secondhand smoke. If these powerful people really understand
the negative effects of secondhand smoke that affects, not only for someone’s health, but the
economy (health care costs and lost of productivity), I believe more healthy people would feel
physically better that would benefit the their own health, other’s health, and the economy. As
said before, a majority of smokers preferred a smoke-free environment. For people who
absolutely do not smoke, these customers are not going to the tavern, bars, clubs, etc. Their voice
should reach out to the legislators.
Legislators, lawmakers, politicians, could ask for a variety of ways to advertise a much
better understanding of the health hazards of secondhand smoke that can be widely
commercialised that reaches all age groups so the education, and understanding of secondhand
smoke could improve to and spread to the adult and children audience to create a positive,
healthy change.The amount of money that is lost due to lost of productivity, and the cost of
health care towards people with tobacco smoking related health problems, all that money could
be spent on many other things including all sorts of adult entertainment that the state of Nevada
is afraid of losing if they strengthen the smoke-free laws.

17. The money could be spent of innovative ideas for bars, clubs, taverns, more parks,
recreational fields, etc, to attract more tourists and the local citizens. The people who visit
casinos, taverns, clubs, strip clubs, etc in Las Vegas, these people are initially interested in
participating in all sorts of adult entertainment. Therefore, cigarette smoking will not turn away
curious people, who are already interested people, or people who are willing to take risks.
Perhaps it is reasonable to say that cigarette smoking is a myth in the eyes of legislators of Las
Vegas, or the state of Nevada, that believe that the absence of smoking could deplete the state’s
revenue due to negative beliefs about the absence of cigarettes.
Barriers to Desired Change
The barriers to the desired change is that many legislators who are older adults have fixed
beliefs of secondhand smoke and cigarette smoking that would be difficult to educate and
change. Many Nevada and Las Vegas legislators are afraid to lose state, city annual revenue.
Certain type of people deny facts because certain facts will not be convenient to believe, or deny
certain facts for other, personal reasons. Having Nevada legislators be open minded and be
willing to be educated about the serious health hazards of secondhand smoke may be very
difficult. One can hear people educate them, but few listen, understand, process certain topics
and information. These barriers have a high risk of smoke-free laws to remain weak in Las
Vegas and throughout the state of Nevada.
Theories that will work best in this scenario
The best theories that would work best in this scenario is the Transtheoretical Model and
the Health Belief Model. The transtheoretical model consists of stages of change. The history
context of this model took bits and pieces from other theories, or models and put them together.

18. Behavior change concerning this model is all, or nothing. There are no impulse actions, or
decisions and the desired behavior change will change over time. The transtheoretical model
mentions that the at risk populations are not prepared to take action, or not ready to make the
change. Specific processes and principles of change should be applied at specific stages of
progress. Within this model, there are multiple stages: precontemplation, contemplation,
preparation, action, maintenance, termination, and decisional balance. Furthermore, the theory
that would as well is the health belief model.
The health belief model talks about perceived susceptibility, perceived severity,
perceived benefits, and perceived barriers. Perceived susceptibility talks about how likely do you
think you have a health issue; in this case, secondhand smoke related illnesses. Some people are
aware that secondhand smoke exposure is a health hazard just like smoking. Perceived severity
mentions how serious does someone have, in this case it is secondhand smoke related health
issues. People are aware that smoking is harmful for the body, so inhaling the toxic chemicals
after someone just exhaled a cloud of tobacco smoke would make people move away from the
smoker in some settings (this excludes clubs, taverns, clubs, etc.). Most people know that if they
are not around someone who smokes, then they are not harming their health. The negative
aspects of staying away from smokers is that smokers could be friends and family. Mostly
everyone enjoys spending time with their family and people who do not smoke can not regulate
how often and when a smoker wants to smoke.
Application of Theory
Las Vegas fits the theory now because there are many people in in different stages within
the transtheoretical theory that are probably working on to quit smoking. It is hard to say what
specific stage Las Vegas is in, but I believe it is reasonable to say that different groups of people

19. are in different stages of this model due to their socioeconomic status, level of education, and
obstacles that cause distractions from focusing on eliminating the harmful effects of secondhand
smoke, or smoking.
I believe this is the ideal model to apply to this situation because the problem is
secondhand smoke and smoking. Having someone to quit, or quitting smoking require steps
because rarely anyone quits smoking taking the cold turkey method (quit smoking immediately).
Quitting smoking requires support, steps, encouragement, education, and rewards. This relates to
the decisional balance stage. People weigh the pros/cons and there must be an increase amount of
pros to the standard deviation to increase the chances of progress towards quitting smoking. I
focus in quitting smoking, and not so much secondhand smoke because people who smoke cause
secondhand smoke. Without the smoker, there would not be secondhand smoke. If smokers
understand and appreciate the reality that if they quit smoking, they can live longer, live
healthier, save money, see their children/grandchildren grow, feel better, decrease stress, and be
overall happier. These pros outweigh the only con - feed the addiction of nicotine to feel
temporarily at ease right after smoking.
Even though there are smoke-free laws that take place in Las Vegas, these smoke-free
laws are weakly enforced. The reason these smoke-free laws remain weak, is because it seems
the number one factor that Las Vegas, or Nevada legislators only worry about is revenue. There
is progress, but not as progressive as other states. Nevada is one of the last states to enforce
smoke-free laws because legislators are afraid to risk the declination of annual revenue.
The health belief model is what legislators and the citizens of Las Vegas believe they
have the issue to some extent. Many are experiencing the health consequences from secondhand
smoke, or smoking and are taking steps to change their quality of health. They know that the

20. habit is a hazardous, and finally, after experiencing the life threatening consequences, they are
aware that they have barriers in front of them to make that positive change of quitting smoking.
For perceived barriers, quitting smoking results in headaches, irritation, and withdrawals of the
absence of nicotine. Many people are committed in quitting smoking because after some amount
of time, they finally have come to an understanding that smoking cuts multiple years from their
life. The perceived benefits are great because quitting smoking helps one to feel better, save
money, and enjoy life with family and friends for a longer time, which makes people happy. One
of the most beautiful things in life is seeing your family grow, and many smokers would rather
have smoke-free laws greatly enforced because it will help them quit because they are doing it
together. More importantly, people would do it for the kids.
Rejected Theories
Social cognitive theory is a theory that will not apply in Las Vegas concerning
secondhand smoke, or smoking. The purpose of this theory is to understand and predict
individual and group behavior. The theory explains that if you do something, it will change the
environment. A lot of people smoke because they enjoy, are addicted, or need something in their
hand. People do not choose to smoke because they want legislators to change public
environmental laws (i.e smoke-free laws). Also, the theory mentions that response consequences
will influence behavior. Well, people who are aware that smoking is bad for them in some way
shape, or form, but it is not enough for them to give up smoking that causes secondhand smoke,
or choosing to stay from from secondhand smoke if they have a choice.