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You’re a Smoker? Sorry, We Can’t Hire You

You’re a Smoker? Sorry, We Can’t Hire You

You don’t need me to tell you that smoking is bad for you; that it lowers your life expectancy and increases your risk for cancer, lung disease, heart disease and too many other illnesses to name. Some 19 percent of Americans 18 and over smoke and tobacco is responsible for one out of five deaths — 440,000 a year. People still smoke despite all this, so shouldn’t some more drastic steps be taken — like banning them from jobs?

Or is such a ban a completely wrong-headed approach? Isn’t smoking a choice? If people decide to do it (and I know plenty who do, including quite a few of my 20-something college students), they are doing so in full knowledge of the dangers and consequences.Two groups of academics at the University of Pennsylvania debated these issues in separate articles in the leading medical journal The New England Journal of Medicine.

Not Hiring Smokers Is Job Discrimination

A no-smoker hiring policy is “discriminatory and unethical,” says the first article, which is by Harald Schmidt of the University of Pennsylvania’s institute of health economics, Kristin Voigt of McGill University and Ezekiel Emanuel, an administrator and professor of medical ethics and health policy at Penn.

29 states have indeed passed laws “prohibiting employers from refusing to hire job candidates because they smoke.” But we need to keep in mind the tobacco industry’s role in funding efforts to influence state legislatures. Not surprisingly, more contributions from the tobacco industry mean that a state has a lower “tobacco policy score,” Schmidt, Voigt and Emanuel write in their article, The Ethics of Not Hiring Smokers.

They also point out that it is hardly the case that people can just quit as smoking is addictive. Plus, rates of tobacco use vary among socioeconomic groups, with these being higher among those who are poorer and have less education. Rather than penalizing people for circumstances they are not entirely in control of, we need to increase “support for healthy behaviors.”

Not Hiring Smokers Can Motivate Them to Quit

The CEO of the University of Pennsylvania Health System, Ralph Muller, is one of the authors of the second article, Conflicts and Compromises in Not Hiring Smokers. The health system’s announcement that it will no longer hire smokers after July 1 indeed prompted the two articles. This article’s other authors are David Asch and Kevin Volpp, who are both professors at both Penn’s Perelman Medical School and  at the Wharton School of Business.

Right from the start, the second article singles out tobacco use as “the single greatest cause of preventable deaths across the country,” as Hoag Levins writes in LDI Health Economist. In recognition of the limited and minimal effect of “gentler” methods to get people to quit smoking (such as pointing out the numerous ways tobacco can injure one’s health or higher insurance premiums for smokers), the researchers argue that “controversial” measures are in order.

Asch, Volpp and Muller cite the 2007 conceptual “Intervention Ladder” (pdf) proposed by the United Kingdom’s Nuffield Council on Bioethics. This “ladder” contains eight levels that rate health interventions on eight levels, from “Do nothing or simply monitor the current situation” to “Eliminate choice: make tobacco use illegal.” As Levins points out, “in all the years that U.S. health authorities have battled tobacco and tallied up the hundreds of thousands of annual dead, we’ve only partially ascended that ladder.”

Asch, Volpp and Muller indeed take into account that a no hiring of smokers measure would disproportionately affect those from “disadvantaged populations,” but point out that these very individuals are “at the greatest risk of smoking-related harms and ensuing disparities in health.” They also acknowledge that a no smokers ban is potentially coercive and an infringement on civil rights. Their argument is that “behaviors that were once seen as exclusively private often have profound societal effects;” that the benefits for one’s health and financial status are “in the long run… for their own good.”

Yes, it is better not to smoke. Does getting people to quit smoking merit such a paternalistic approach in which people are given no choice — except the choice to have a job or not?

Related Care2 Coverage

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207 comments

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5:22PM PST on Feb 3, 2014

None of anyone's business if you smoke. This is unconstitutional, and that is all.

6:07AM PDT on May 31, 2013

When you smoke you destroy the most fundamental human right of others around you to decide for themselves whether or not to breathe tobacco smoke. You violate the bodies or others. What hypocrisy to compare nonsmokers doing whatever it takes to defend themselves to Nazis when smokers kill 600,000 nonsmokers a year, twice the average death rate of Auschwitz, matching the holocaust concentration camp total of 9,000,000 every 15 years.
Smokers are too addicted to be trusted not to light up where it violates the human rights of those around them to be allowed in places of work. They make too many excuses and rationalizations for their surplus civil rights that they take at the expense of everyone else. The only reason their crimes are legal is the influence of money on the law.
How about "First they came after smokers, then they came after obese people," etc. be written in a more accurate perspective, "First they came after serial killers, then they came after pedophiles, then they came after bullies," so that none of us are safe from society defending the legitimate human rights of all.

12:26PM PDT on Apr 17, 2013

Shouldn't we also go after people who drink alcohol? There are diseases caused by alcohol and enough deaths at the hands of drunk drivers, as well as drunkenness used as an excuse for all kinds of bad behavior. Just saying.

2:35AM PDT on Apr 10, 2013

I'm retired so nobody can tell me to stop smoking.

6:59PM PDT on Apr 9, 2013

This article attacks smokers and we have a lot of people agreeing with the NO hire policy. Another article is about people who are overweight being not hired or being fined. Another article is about how the employers want to decide what your insurance will cover while in their employment. Another article is about a school taking a child's lunch and throwing it away for a small debt. Another is about people from our elderly on down to five year olds being handcuffed and taken to jail. I could go on and one but there should be NO need since the theme is the same throughout. This is about control, the SAME kind of control that led Hitler into war.

They came for the smokers and since you did not smoke you did not help. They came for the overweight but you are skinny so you turned your back on their rights as well. They came for our birth control and legal abortions but again you don't use it so you let it go. They came for our children and out of fear and misinformation you turned your back on our future.

Even here on Care 2 I have noticed that with some ONLY the things they care about are worth fighting for. Today they came after people YOU disagree with but what about tomorrow when they come after YOUR rights, YOUR freedoms, who will stand with YOU???

12:49PM PDT on Apr 9, 2013

I'm all for NOT hiring smokers, especially in healthcare environments. It's a bit odd, don'tcha think, that healthcare workers SMOKE and sometimes work in respiratory therapy (yes, I know a few) ? One local hospital group was supposed to have instituted such a policy...and I hope they succeeded, because those who were being the problems, were visitors who were smoking right outside the ER doors, and staff that were outside the surgical services doors, and the SKANK was getting back inside the hospital, making sensitive people SICK.

In a word, smokers give every appearance of refusing to be responsible with their filthy habit, which is evidenced by far too many spent butts littered all over the sidewalk (compared to "other" litter), therefore, we end up having to make laws that infringe upon the rest of us. Smoke if you want....that's your business. But your "right to smoke" ENDS where another's human NEED to breathe begins. Got that ?

Wanna be a "real man" ? Break that damned sissy filter off and suck that thing all the way down to your toes, like they did in the old days before the Micronite filters were invented. "To a smoker, it's a Kent".

Why our society needs a constant "buzz", I'll never understand.

I like something Boortz said about 20 years ago..."Am I tough on smokers ? You damn right I am. Smokers are, in a word, slobs. They stink. They foul-up every room they walk into, whether or not they have a cigarette lit, because their clothes smell li

8:53AM PDT on Apr 9, 2013

How does this differ from the thread about a church which wants parochial teachers to sign a ''morality'' clause in their contract?

A lot of people claim that the church has the right to do it. Doesn't that apply to this business as well?

Why does religion get ''a pass?"

As someone who watched her husband die an awful death from tobacco-related COPD, I know very well what smoking can do and would never work in a place where smoking is allowed outside the door, etc.

Smoking tobacco is nothing more than slow suicide!

8:59PM PDT on Apr 8, 2013

I am tired of the demonization of cigarettes and smokers. A "smoke screen" has been created to create an "us versus them mentality" and it works because smoking is visible. What about all of the non visible toxins and health threats that are not in plain sight and do as much harm or more? As long as people are concentrating on the smoking villan, all of the other dangers go unnoticed and accepted as not as harmful. Second hand smoke being deemed worse than smoking created a culture of people who believe they can attack smokers at will. No one questions the studies and who pays for them. They just believe it's bad because an anti-smoking campaign pulled them onto the bandwagon not to mention the government money made available for groups to go after.
As for smell, read up on the deleterious effects of room fresheners such as Fabreze.

Smoking is legal. Health choices are personal. You cannot legislate health, intelligence or common sense but people can be polarized if they are convinced their health or safety is at risk. The anti-smoking campaign is a prime example of an experiment in manipulation of the public to try to create laws for everything labeled harmful. More mayor Bloombergs to come.

12:44PM PDT on Apr 8, 2013

I smoke since 53 years.I am healthy as one can be.Nobody ever refusedtohire me because I am a smoker. The worst anti-smokers are the ex-smokers. Live and let live and stop harassing smokers. If you wear clean clothes, wash your hair and smoke outside an office, who is there to judge you ?

12:32PM PDT on Apr 8, 2013

so ,you don't have to hire me if I smoke? I see.so why is it,if I start a business i'm not allowed to allow smokers in?why is it your allowed to discriminate against me,for doing something that is allowed by law ,if you can say I wont hire you or don't have to because you smoke,isn't it your decissionto appy or enter my place? why can't I not hire you because you don't? if I advertise that I have a smoking business,isn't it your decision to enter or apply for work,or not?? you got to love our double standards society.

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Kristina Chew Kristina Chew teaches ancient Greek, Latin and Classics at Saint Peter's University in New Jersey.... more
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