Health groups have blasted a bid by James Packer's Crown Limited to allow smoking across the entire gaming floor of its proposed Sydney casino, an area that could be as large as the MCG playing surface.
Quit Victoria executive director Fiona Sharkie accused Crown of "putting profit before the health of their staff and consumers".
NSW Cancer Council manager of tobacco control Scott Walsberger said it was disappointed in the NSW government's conditional approval of the proposal and said potential employees would have to choose "between a job at the casino and their health".
Crown's proposal, conditionally accepted by NSW Premier Barry O'Farrell last week, describes allowing smoking in the gaming area as "absolutely critical".
The company has proposed a 24-hour-a-day gaming area of up to 20,000 square metres.
"It's such a backward step considering that we've had smoke-free workplaces in this country across different states for probably two decades," Ms Sharkie said.
"We don't think there should be exemptions for high-roller rooms - they're still exposing workers to enormous harms."
Crown's Sydney rival, The Star, has an exemption from NSW anti-smoking laws in its high-roller areas, as does Crown's Melbourne high-roller area, the Mahogany Room.
Mr Packer said Crown had struck a deal with union United Voice and would install "state-of-the-art air quality technology".
But Ms Sharkie said there was "no safe level of exposure to second-hand smoke".
"The research shows you need a tornado-like suction to be of any benefit, so the risk of harm is very high," she said.
A Crown spokesman said the company "takes the issue of staff occupational health and safety extremely seriously".
The entire Sydney gaming floor at Crown's proposed Sydney casino is to be a "VIP gaming area", with entry restricted to members and a minimum bet per hand of $20.