Almost one million Americans put their lives at risk working in bars, betting establishments, billiard halls, bowling alleys or bingo halls where they spend years breathing in second hand tobacco smoke. A recent analysis of published data from these five workplaces (called the „5 B’s”) suggests that over a lifetime, between 1 and 4 out of every 1000 workers will die from lung cancer caused directly by second hand tobacco smoke at work. Mortality rates from heart diseases could be an order of magnitude higher, say the authors.

In a review of 17 studies, ambient nicotine concentrations in the five workplaces ranged from 9.8 µg/m³ in betting establishments to 76 µg/m³ in bingo halls. These concentrations are 2.4 to 18.5 times higher than nicotine concentrations in offices and 1.5 to 11.7 times higher than concentrations in restaurants. Unlike offices and restaurants, however, workplaces such as casinos and billiard halls are largely excluded from regulations governing passive smoking. The authors say it’s time to end this disparity, which has continued partly because the tobacco industry funds their opposition to passive smoking regulations. They conclude that bringing the 5 B’s in line with other workplaces would reduce workers’ exposure to passive smoking (a US government target) and help reduce social inequalities in health; workers in bars, casinos, and bowling alleys are among the lowest paid workers in the US.