Objective The Smoke-free Illinois Act was implemented in January 2008, one month after the beginning of a national recession. In December 2010, the Illinois legislature proposed new legislation that would provide an exemption for casinos from the act until neighbouring states also implement smoke-free casino policies. Lobbyists and gaming commission representatives argued that Illinois casinos were losing patrons to casinos in neighbouring states that allow smoking. This study examined the influence of the act on casino admissions in Illinois and neighbouring states in light of the economy.

Methods A multilevel model was developed to examine monthly casino admissions from January 2007 to December 2008.

Results There was no difference in changes in admissions across the four states over time after accounting for the economic downturn.

Conclusions The Smoke-Free Illinois Act did not have a detectable effect on Illinois casino admissions.