More healthcare employers ban not just smoking, but smokers

Today’s New York Times contains a Page One story on a strange and disquieting trend: U.S. businesses — especially those involved in health care — are increasingly banning not only smoking by employees, but employees who smoke. Among the first of the leading medical institutions to implement the policy was the Cleveland Clinic in Cleveland, Ohio in 2007.

To put the policy into effect, hospitals and clinics have demanded urine tests of workers. In many cases, those who were found to have elevated levels of nicotine byproducts were then dismissed. Laws in 29 states and the District of Columbia prohibit employment discrimination against smokers. But among the states where such discrimination is lawful and where the practice is gaining ground are Florida, Massachusetts, Ohio, Pennsylvania and Texas. One reason for adopting the practice is that smokers have higher health care costs, on average of about $3,391 per employee as compared to non-smokers, according to the article.

While ACSH’s Dr. Gilbert Ross reports that few physicians smoke today, ACSH researcher Susan Ingber says that during her time at Massachusetts General Hospital in Boston, every day on her way to work she passed lines of nurses standing outside smoking. We wonder: will these policies lead to their discharge, and, if so, will this affect patient care?

Dr. Ross notes, “This is clearly a blame-the-victim policy. Employers, especially in health care, should be helping smokers quit, not firing them. And what about quitters on nicotine replacement? Their urine tests will be positive — then what?”

ACSH’s Dr. Elizabeth Whelan asks, “Where do you draw the line? Do you set policies against employees who ride motorcycles? Or those who are obese, or drink more than some arbitrary amount?”