Problem/Objective: Secondhand smoke (SHS) is a cause of cancer, heart disease, and respiratory disease. Casino workers have the highest exposures to SHS of virtually any occupational group. Riverboat casinos appear to have especially high SHS levels. Casinos have resisted smoke-free workplace laws, pleading economic losses, but offering no hard data. As a result, many casino workers suffer severe injuries from on-the-job SHS exposure, often losing their health, their livelihood, and sometimes their lives.

Methods: Some workers have sought redress in the courts, suing their employers or the tobacco industry. Specific cases will be discussed involving casino workers in Nevada, New Jersey, Indiana, and Louisiana, win, lose, and draw. Measurements of casino exposure and dose will be reviewed. Defendants claim SHS exposures are “low” and other sources caused the workers' illnesses. Plaintiffs claim “high” exposures to SHS caused their disease.

Results: In the world of toxic torts litigation involving allegations of injury from secondhand smoke, how does the expert witness use multidisciplinary science in the establishment of evidence in a court of law? How have these plaintiffs fared in high stakes litigation, and what does it take to win?

Conclusions: Smoke-free workplace laws will prevent these injuries, and also protect casino patrons from hazardous levels of secondhand smoke.