Alicia Monahan blames secondhand smoke for two fainting episodes she experienced while working at Rivers Casino on Pittsburgh’s North Shore.

The table games dealer said she’s otherwise healthy but sometimes feels the effects of the smoke getting to her.

Since she started working at the casino in 2019, she collapsed on the job twice, once injuring her face so badly she needed stitches after the fall.

“It was very scary,” Monahan, 34, of Youngwood, said Thursday. “It was traumatic.”

Monahan said she’s considered quitting her job because she’s so uncomfortable around all of the cigarette and cigar smoke — but it’s the highest-paying job the mother of four has ever had. She said she makes more at the casino than she did in her prior position as a nursing aid, enticing her to stick with it despite her health concerns.

But she’s hopeful that smoking in casinos could soon be a thing of the past.

State Rep. Dan Frankel, D-Squirrel Hill, is spearheading an effort to ban smoking in casinos and other businesses that are exempt from Pennsylvania’s Clean Indoor Air Act, which prohibits smoking in most businesses.

“You shouldn’t have to choose between your job and your health,” Frankel told a small group of casino workers who gathered Thursday outside the casino along the Ohio River. The casino has 1,451 employees.

Currently, smoking is allowed in Pennsylvania casinos; full-service truck stops; tobacco shops; tobacco manufacturers, wholesalers and importers; private clubs; cigar bars; and bars and restaurants where food sales make up no more than 20% of revenue.

Frankel’s proposal would permit smoking only in cigar bars and private clubs where a majority of members support permitting it.

The measure also would ban vaping in all the businesses where smoking is barred.

Another provision would ban smoking in homes that are used for childcare businesses, Frankel said, because the secondhand smoke could linger even if people aren’t smoking directly in front of kids.

The goal, he said, is to close the loopholes that were left in 2008 when the legislature enacted the Clean Indoor Air Act.

Casino jobs, he said, pay well and come with good benefits. People shouldn’t be forced to endure secondhand smoke to hold those positions, he said.

Jennifer Rubolino leads Casino Employees Against Smoke Effects, or CEASE PA, to call for an end to smoking in casinos. She said she enjoys working as a table dealer at Rivers Casino but is concerned about breathing in smoke every shift.

“It’s just a healthy thing to do,” Rubolino said of banning smoking.

Rubolino said she’s considered leaving her role at the casino over the issue, but is hopeful the state legislature will pass the smoking ban, allowing her to keep her job without stressing over smoke.

Frankel said he expects bipartisan support for the measure once it’s on the floor for a vote.

“We heard from workers whose health had been impacted by the secondhand smoke in the casinos,” said Rep. Jessica Benham, D-South Side, a sponsor on the bill. “Even when they were placed in the ‘non-smoking’ sections, the smoke still traveled.”

Jonathan Cramer, 33, of Springdale, said that’s been his experience.

Cramer is assigned to a smoke-free section of the casino, but “it doesn’t make much of a difference.”

“The smoke comes right over,” he said. “People will be walking by with their cigars. It still affects us. There’s no way to stop the air from moving from one section to the other.”

Cramer said he preferred when people had to step outside of the casino to smoke, which was the norm for a period during the covid-19 pandemic. He said he wished that were still the case.

“I like this job,” he said. “It’s just I’d like to be able to breathe doing the job. There’s a lot of players that complain about the smoke, too.”

Benham said there wasn’t a major impact to the business when people took smoke breaks outside during the pandemic-era ban on smoking in casinos.

“Secondhand smoke has well-documented negative health impacts, and I believe that clean air is an important part of workplace safety,” Benham said. “I understand that some patrons enjoy the experience of smoking while gambling, but for me, that has to come second to the health of the workers.”

Secondhand smoke can cause a range of health issues, including lung cancer, respiratory infections, heart attacks and asthma, according to the American Lung Association. The association estimated that secondhand smoke causes more than 41,000 deaths per year.

Opinions from casino patrons Thursday were mixed.

“Smoking should be banned for sure,” Kevin David, 39, of Fox Chapel said. “I just don’t think it’s healthy for people that don’t smoke to be inhaling secondhand smoke.”

David said he often uses the smoke-free section of the casino, but “it doesn’t feel completely smoke-free.”

For smokers like Antoinette Greenwood, 29, of Clairton, smoking is part of the casino experience.

Greenwood, who puffed on a pink vape outside Rivers Casino Thursday, said she wouldn’t support a ban on smoking in casinos.

“We’re spending our money there,” she said. “We should be allowed to smoke in there.”

Bill Soost, 75, of Mars, said he doesn’t have a problem with people smoking in casinos — but he also isn’t convinced of the effects of secondhand smoke.

The former smoker said people can opt for the smoke-free sections, where they have less exposure.

“The place is large enough the smoke just dispersed everywhere,” he said.

Rivers Casino — which attracts about 3 million people per year — currently has designated smoking and nonsmoking areas throughout its gaming floor, spokesman Jack Horner said.

All the restaurants, BetRivers Sportsbook, the poker room, the event center, banquet rooms and the adjacent hotel are smoke-free areas.

Decisions about smoking in casinos, Horner said, are up to the state legislature.