More hospitals won’t hire smokers. Is it discrimination?

Experts debate implications of tobacco-free hiring

Topics: Health and Wellness, Benefits, Labor Expense, Workforce, Staffing, Recruitment and Retention

January 9, 2012

More U.S. health systems—focused on creating a culture of wellness—are refusing to hire tobacco users, but some worker advocates argue that the policy is discriminatory.

Many organizations say the tobacco-free hiring policies reflect their health-focused missions, having already banned on-campus smoking . For example, Texas-based Baylor Health Care System's tobacco-free hiring policy requires scanning applicants' urine tests for signs of nicotine use. According to USA Today, such hiring policies seek to promote employee wellness and reduce insurance premiums.

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CDC statistics show that smoking or secondhand smoke exposure causes 443,000 premature deaths and results in $193 billion in health costs and lost productivity annually. According to the agency, about 19.3% of U.S. adults smoked in 2011, down from 42.4% in 1965.

Marcy Marshall of Geisinger Health System in Pennsylvania—which will launch a nicotine-free hiring policy next month—says, "We're trying to promote a complete culture of wellness," adding, "We're not denying smokers their right to tobacco products. We're just choosing not to hire them."

However, some members of the health care community say the policies amount to employment discrimination. Michael Siegel, a professor at Boston University's School of Public Health, says tobacco-free hiring practices do little to help smokers quit, noting that they "set a very dangerous precedent."

Although 29 states and the District of Columbia have passed smoker-protection laws, some of the measures exempt not-for-profit groups and health care associations. Chris Kuzynski of the U.S. Equal Employment Opportunity Commission says businesses can refuse to hire nicotine users under federal law because it does not recognize smokers as a protected class (Koch, USA Today, 1/6).

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