Smoking is barred inside Maryland's five casinos. But slots player Gregory Wilson believes Horseshoe Casino Baltimore hit the jackpot with its eight outdoor "smoking terraces," which allow him to light up while indulging his passion for the machines.
"It's my way of relaxing," said the 56-year-old registered nurse, a cigarette tucked between his fingers as he played penny slots on a second-floor deck the size of a large apartment balcony.
Gambling and smoking have long been linked in the public consciousness, and there is debate in the industry about whether no-smoking policies undermine casino profits.
Smoking is permitted in casinos in Las Vegas, Atlantic City, N.J., and in neighboring Pennsylvania and West Virginia. Horseshoe says its terraces meet consumer demand, but the smoking decks have attracted the scrutiny of health advocates.
While some clean-air groups say the decks are preferable to indoor smoking, others call them workplace hazards nonetheless.
"Even though they call it a patio, somebody has got to work there," said Stephanie Steinberg, chairwoman of the advocacy group Smoke-Free Gaming of America. "They say it's outdoors, but do you breathe when you're outdoors?"
Horseshoe is the only casino in Maryland that offers outdoor slots and smoking — for now.
Rocky Gap Casino Resort, which overlooks a lake and state park near Cumberland, won approval last month to convert a smoking deck into a gambling area with 30 slot machines. Smoking still will be permitted on the deck, which is being upgraded with a new heating, ventilation and air conditioning system.
The casino acted in response to patrons' requests, general manager Scott Just said, and because it wants to be sure it can compete with casinos in West Virginia and Pennsylvania.
Neither neighboring state prohibits smoking inside casinos (some West Virginia counties have enacted bans independently).
"We try to accommodate and be all things to all people," Just said. "If there is something the guests request and we can accommodate them, it's a great thing."
The outdoor gaming area, to be completed around Aug. 1, will be enclosed on three sides and have a roof with a 3-foot overhang on the fourth. The side "facing the lake is actually open, so there is a beautiful view," Just said. "We worked with the county and the state just to make sure our design did not come under the [state's] clean air act. As long as we kept one side open, it would not be considered an enclosed space."
Casinos in Nevada and Atlantic City maintain smoke-free areas, but patrons can find a place to smoke and play if they wish.
MGM Resorts International, which owns and operates casinos around the country, said technology permits it to offer smoking without endangering other guests.
"With the benefit of modern HVAC and ventilation, we are able to provide our customers with an all but smoke-free environment because the ventilation systems clean the air so quickly and so thoroughly," said MGM spokesman Gordon Absher.
Nonetheless, the casino resort MGM is building at National Harbor in Prince George's County will fall under the state ban, and Absher said no outdoor gaming areas are planned.
The American Cancer Society's Cancer Action Network says secondhand smoke remains a hazard even in casinos with modern ventilation systems.
Cathy Callaway, the network's associate director of state and local campaigns, said she was wary of casinos setting a bad example.
"We're seeing a lot of casinos expand to more family-friendly environments," she said. "A lot of casinos have facilities for concerts or other events. Seeing [smoking] as an acceptable behavior could have a detrimental effect on young people."
Research shows a behavioral link between smoking and gambling. Smoking is more than twice as common among problem gamblers as among the general population, one study found. Another study found that smokers contribute a disproportionate share of slot machine revenue compared to nonsmokers.
"Smoking is a powerful reinforcement for the trance-inducing rituals associated with gambling," the study concluded.
All of the state's casinos have outdoor smoking areas, but Horseshoe — and soon Rocky Gap — will be the only ones offering the combination of smoking and slots.
Robert J. Norton, president of Maryland Live, the state's largest casino, said many of its customers say they find the indoor smoking ban appealing. He said the casino at Arundel Mills is considering outdoor gaming and smoking patios.
"If it makes sense," he said, "we'll do it."
Hollywood Casino Perryville is exploring the possibility too, general manager Matthew Heiskell said.
Maryland's fifth casino, Ocean Downs, "has thought about it," general manager Joe Cavilla said. But because the Eastern Shore casino also has a harness racing track, it already has "a lot of outdoor areas that allow smoking," Cavilla said.
Since many jurisdictions around the country prohibit smoking in public places and workplaces, casinos that allow it can seem an anachronism.
"Most casino companies have chosen to not go smoke-free on their own," said Bronson Frick, associate director of Americans for Nonsmokers' Rights, a California-based group. Where there are bans, he said, "it's the result of statewide or local laws.
"In the case of Maryland, it had its statewide smoke-free law before casinos were added, so operators knew that when they were bidding."
Frick said he has visited the smoking decks at Horseshoe Baltimore. While he is broadly concerned about workers' exposure to secondhand smoke, Frick said Horseshoe's decks don't require casino staff to be present all the time "so they don't have to stand there in the smoke."
On a second-floor deck overlooking a side street and a Public Storage warehouse one recent weekday afternoon, a waitress appeared occasionally to take drink orders from slots players. Wilson, playing a game called Lobstermania 2, said his only regret was the muggy weather.
"I would prefer to smoke on the inside because it's a little warm," the Washington man said. "If it's inclement weather, you can't play. If it's raining or snowing, normally all the machines are covered up."
Another Horseshoe smoker, Jesse Davis, 60, of Baltimore, said he plays slots of various denominations and knew of no other place where his cigarette "breaks" could also be gambling sessions.
Davis said he will often start playing inside, then move out to one of the decks "when I want to take a puff."
The decks provide patrons "more choices to explore how they like their entertainment," said Noah Hirsch, Horseshoe's vice president of marketing. "Definitely when the weather is nice out, we see better demand."
Horseshoe has eight smoking decks offering slots, and one without any machines.
Horseshoe and Rocky Gap permit electronic cigarette "vaping" indoors.
"Currently there is not a regulation covering e-cigarettes, so they are allowed," Rocky Gap's Just said.
Horseshoe was not subject to a city measure enacted last year banning the use of e-cigarettes from nearly everywhere that traditional cigarette smoking is prohibited. Bars and restaurants also can opt out of the ban if they post prominent signs on their entrances and menus informing potential customers.
Maryland Live, Hollywood Perryville and Ocean Downs all say they prohibit e-cigarette use inside.
"We kind of just enforce it [the no-smoking rule] as one policy," said Cavila, of Ocean Downs. "It's just easier that way."
Horseshoe's smoking decks are modeled on those of Ohio's ThistleDown Racino, which opened a smoking patio in 2013. Horseshoe and ThistleDown are both managed by Caesars entities.
ThistleDown's outdoor gaming area was "really where we started to see the true demand for smoking and gaming areas outside of casinos," Horsehoe general manager Chad Barnhill said. "We saw a huge demand, we saw significant play on those games. We wanted to be able to put it into play here."