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Tobacco-Free Hiring Takes Hold; Both Smoking and Smokers Excluded

Posted Feb 15 2011 12:00am

Hiring practices in hospitals and medical businesses are now moving from "no smoking" to "no smokers." Details about this change were presented in a recent article (see: Tobacco-Free Hiring in Workplaces ). Below is an excerpt from it

More hospitals and other medical businesses in many states are adopting strict policies that make smoking a reason to turn away job applicants, saying they want to increase worker productivity, reduce health care costs and encourage healthier living. The policies reflect a frustration that softer efforts — like banning smoking on company grounds, offering cessation programs and increasing health care premiums for smokers — have not been powerful-enough incentives to quit. The new rules essentially treat cigarettes like an illegal narcotic. Applications now explicitly warn of “tobacco-free hiring,” job seekers must submit to urine tests for nicotine and new employees caught smoking face termination (see: Saliva and Urine Tests for Smoking ). This shift — from smoke-free to smoker-free workplaces — has prompted sharp debate, even among antitobacco groups, over whether the policies establish a troubling precedent of employers intruding into private lives to ban a habit that is legal....There is no reliable data on how many businesses have adopted such policies. But people tracking the issue say there are enough to examples to suggest the policies are becoming more mainstream. For example, hospitals in Florida, Georgia, Massachusetts, Missouri, Ohio, Pennsylvania, Tennessee and Texas, among others, stopped hiring smokers in the last year and more are openly considering the option....A number of these organizations have justified the new policies as advancing their institutional missions of promoting personal wellbeing and finding ways to reduce the growth in health care costs. About 1 in 5 Americans still smoke, which remains the leading cause of preventable deaths. And employees who smoke cost, on average, $3,391 more a year each in increased health care costs and lost productivity, according to federal estimates.

One of highest profile hospitals that stopped hiring smokers is the Cleveland Clinic. Its policy dates back to September, 2007. Here are some of the details about the operational aspects of the rule (see: Cleveland Clinic no-smoking policy has locals talking ):

The Cleveland Clinic policy...requires job candidates to be tested for cotinine, a nicotine metabolite. Those who test positive won't be hired but will be offered free smoking cessation and encouraged to reapply in 90 days if they quit. Current employees won't be affected.

It seems logical that a no-smokers rule is taking root in hospitals. First of all, there is pressure for such organizations, as part of the healthcare industry, to walk-the-walk. Secondly is the passive smoking rationale, which is to say that cigarette smoke is harmful to innocent patients and employees.Thirdly, I suspect that smokers may be less productive, in part because of being forced outside on breaks to grab a smoke. Fourthly, there is the healthcare cost reduction argument. Smokers are simply not as healthy as smokers and contribute to a disproportionate share of healthcare costs (see: State Medicaid Expenditures Attributable to Smoking ). Here is an interesting quote from this article:

In 2007 the total Medicaid expense for each of the 50 states was over $144 billion. A recent study by Dr Brian Armor and colleagues at the US Centers for Disease Control (CDC) calculated the proportion of Medicaid expenditure on smoking-caused disease. They reported that smoking prevalence in the adult Medicaid population is approximately 53% greater than that of the overall US adult population (34.5% vs 22.6% in 2006). Overall, about 11% ($22 billions) of Medicaid expenditure is on smoking-attributable costs (e.g. treating smoking-caused cancer, heart disease and respiratory diseases etc in Medicaid patients).

I will leave it to you to decide if a no-smokers-hired policy is unfair. What is inarguable is that smokers have become pariahs in our society. It's enough to drive one to drink.

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