Commentary: Smoke-free versus Smoker-free Workplaces

In searching for solutions to the devastating impact of the tobacco epidemic, it’s easy to understand why some employers are turning to “smoker free” workplaces. After all, smoking is estimated to cost nearly $100 billion in health care costs every year and another $100 billion in lost productivity. Not to mention the more than 400,000 Americans who die every year from tobacco-related disease. So employers might think that refusing to hire smokers and even firing employees who smoke is a good idea. Wouldn’t this kind of “tough love” have the triple benefit of encouraging smokers to quit, modeling positive behavior for others and reducing a company’s health care costs?

A growing number of employers, including some leaders in health care and public health, are buying this argument. But upon sober second thought, “smoker free” workplace policies emerge as a deeply flawed strategy. Refusing employment to smokers is not the answer to the vital public health issue of smoking and tobacco-related disease. Helping smokers quit through work-based cessation programs and smoke-free workplaces is the right way to go.

Consider the following:

Smoking is an extremely addictive behavior and the vast majority of smokers start in their teens. These young people are sold a deadly bill of goods about the wonderful lifestyle of smokers and bombarded with industry marketing that associates smoking with being independent and cool. Let’s not lose sight of the fact that the tobacco companies peddling the sale of these products have been convicted in court of perpetrating a historic 50-plus year fraud on the American people. That’s right – the leading U.S. cigarette companies are racketeers. In the pursuit of profits, they lied about the health effects of smoking and of second hand smoke. They manipulated the nicotine delivery of cigarettes to make them more addictive and then lied about that. They lied when they claimed that “light” and “low tar” cigarettes were less harmful. They lied in denying that they marketed their deadly products to youth. Even in the face of this court decision which went all the way to the U.S. Supreme Court, the tobacco marketing juggernaut shows no sign of abating. In 2008, the most recent year for which figures are available, the tobacco industry spent an eye-popping $29 million every day advertising and promoting their products.

It’s very difficult to stop smoking. The addictiveness of nicotine is comparable to that of heroin. A just-released study from the U.S. Centers for Disease Control and Prevention found that in 2010 nearly 70 percent of smokers said that they wanted to quit and 52 percent tried to quit, but only about  six percent were successful. Many of us are working hard to help smokers quit, and there is much more to be done. But let’s not deny jobs to smokers who can’t beat a powerful addiction.

Smoker free workplace policies disproportionately burden people at lower income and education levels. These days, smoking rates are highest among adults with incomes below the poverty level and among those with a GED diploma or a 9th to 11th grade education. Rates are lowest for adults with graduate degrees. Most of the ad men in “Mad Men” aren’t smoking anymore and haven’t for years. When a hospital decides that it won’t hire smokers, the most likely person to lose out is the orderly or nurse’s aide or janitor. It’s very unlikely to be the highly paid administrator or surgeon– even leaving aside the fact that doctors are typically not even hospital employees and wouldn’t be subject to these policies in the first place.

Smoking is hardly the only cause of additional health care and related costs. Are employers going to stop hiring people they think are too fat? Maybe people who enjoy risky hobbies? What about a sky-divers-free workplace? Whether or not someone smokes outside of the workplace rarely, if ever, has anything to do with whether they can perform a job. We all benefit when job decisions are made on the basis of job-related qualifications and not extraneous considerations.

Rather than refusing to hire smokers, employers can make a real contribution to public health and enhance their bottom line at the same time by taking some proven-effective, common sense steps. They should enforce smoke-free workplaces, including no-smoking zones outside their buildings. Smoke-free workplaces are virtually cost-free and are effective in decreasing cigarette consumption and increasing smoking cessation. Comprehensive cessation programs, which add only a few dollars annually to insurance costs per covered employee (estimated at under $6 in 2006), help smokers quit and achieve both short-term and long-term savings for employers. And among other resources, employers can certainly point employees and applicants who smoke to Legacy’s free and effective web-based cessation program, BecomeAnEx at www.becomeanex.org.

Smokers are not the enemy. Let’s not treat them as if they are.

Ellen Vargyas, General Counsel, Legacy®

12 Responses to Commentary: Smoke-free versus Smoker-free Workplaces

  1. Elizabeth | December 9, 2011 at 11:40 am

    I agree with this whole-heartedly. As someone who smoked for many years, it is not easy to quit smoking. I agree with smoke-free environments, but people need additional support to quit, and making someone feel ostrasizied and inadequate is not the way to support them and help them to quit their unhealthy habit. The fact of the matter is, until smoking is made illegal, you should not be able to deny a person employment because of what they do in their personal time. Consuming alcohol can also be extremely detrimental to a person’s health and takes people’s lives, and the lives of others, everyday, but we allow that to happen because it is socially acceptable. People in poverty are more likely to smoke so the obvious thing to do is take away their opportunities to get better employment?? That logic is obviously skewed. “Tough love” is not an addiction therapy that has very high success rate. Support, education, counseling, pharmacological therapy… now there’s actually empirical evidence to support these. When people come up with solutions to meet their own needs, instead of the needs of the person who is trying to quit and actually needs the help, odds are they are going to fail and fail miserably.

  2. Gail Chmielewski | December 9, 2011 at 11:47 am

    Good article,liked seeing someone who does not want to punish individuals that with an addiction that are otherwise hardworking people. :)

  3. Lewis Clymore | December 9, 2011 at 1:21 pm

    Well written article. I am a person in long-term recovery from alcohol and other drugs. In my 6th year of recovery my employer promoted and sponsored a quit smoking campaign and I chose to give it a try. After smoking a pack a day for over 18 years (admittedly, with some mixed success in the first 6 months) I was finally was able to stop smoking entirely. We know that level of motivation, readiness, willingness and committment are all vitally important pre-requisits to changing any human behaviour, but programs like these provide opportunity, support and assistance which are equally essential.

  4. smartin | December 9, 2011 at 3:41 pm

    Don’t you think we should send all smokers, and, of course have the government pay the bill, to Dr Hurt’s Mayo Clinic 7 day in patient “Clockwork Orange” program? We can get them hooked on the pharma nicotine replacement and generate a LOT more grant funding?

  5. Nan Davis RPh, CCP | December 9, 2011 at 3:50 pm

    Well said! I was horrified to hear NJ no longer funds free smoke cessation help. I was so glad to find it available when halfway houses began eliminating smoking from grounds.
    NanD (in addiction recovery since 1976)

  6. Elaine Keller | December 9, 2011 at 6:16 pm

    The situation is even worse than the article describes. A growing number of employers are instituting nicotine-free hiring policies. Decades of research shows that smokers who switch to a low-nitrosamine, spit-free type of smokeless tobacco have no higher risks of cancer, lung disease, heart attacks, and strokes than former smokers who quit all use of tobacco/nicotine. This good safety record is being used as evidence that long-term use of NRTs would not be hazardous. Yet these employers (many are hospital systems) are stating that if an applicant tests positive for nicotine–even if the source is a medicinal nicotine product–they will not be hired. There is no justification for this policy. It is discrimination at its worst.

  7. Carol | December 10, 2011 at 3:38 am

    Anti-smokers are the criminals, racketeers, and frauds!!! The anti-smokers commit flagrant scientific fraud by ignoring more than 50 studies which show that human papillomaviruses cause at least 1/4 of non-small cell lung cancers. Smokers and passive smokers are more likely to have been exposed to this virus for socioeconomic reasons. And the anti-smokers’ studies are all based on lifestyle questionnaires, so they’re cynically DESIGNED to blame tobacco for all those extra lung cancers that are really caused by HPV. And they commit the same type of fraud with every disease they blame on tobacco.

    http://www.smokershistory.com/hpvlungc.htm
    http://www.smokershistory.com/SGHDlies.html

    And, all their so-called “independent” reports were ring-led by the same guy, Jonathan M. Samet, including the Surgeon General Reports, the EPA report, the IARC report, and the ASHRAE report, and he’s now the chairman of the FDA Committee on Tobacco. He and his politically privileged clique exclude all the REAL scientists from their echo chamber. That’s how they make their reports “unanimous!”

    http://www.smokershistory.com/SGlies.html

    Their phony “smoking cost” claims are based on pretending that costs paid by smokers were paid by non-smokers, that diseases caused by infection were caused by smoking, and that non-smokers’ costs don’t exist at all.

    For the government to commit fraud to deprive us of our liberties is automatically a violation of our Constitutional rights to the equal protection of the laws, just as much as if it purposely threw innocent people in prison. And for the government to spread lies about phony smoking dangers is terrorism, no different from calling in phony bomb threats.

  8. Dwayne | December 10, 2011 at 10:04 am

    I am sorry but people will quit smoking only if they truly want to.Addiction? Bull pucky!!! The addition is all in the head people must truly want to quit.I did every drug known to man and quit with no ones help I also know some people have no will power.
    All I am saying is YOU MUST TRULY WHAT TO QUIT TO QUIT!!!!

  9. Alan Selk | December 11, 2011 at 2:11 am

    The problem with the current approach to tobacco pushed by the medical establishment is it only has 2 choices, to quit or not to quit. It completely ignores the proven approach of harm reduction. Sweden, where low TSNA smokeless tobacco is the dominate form of tobacco use, also has the lowest tobacco related disease in the western world. No surprise there as low TSNA tobacco has essentially none to the smoking related diseases associated with it.

    There is still to many people in the health field who mistakingly think smoking addiction is a bigger issue then the diseases associated with smoking. There are proven was of using tobacco without the diseases associated with smoking. It appears trying to punish tobacco companies is more important then public health.

  10. Fred C | December 12, 2011 at 1:30 pm

    Although I am against punishing smokers, and for jailing tobacco co. bigwigs for their racketeering and fraud. I am astonished by the vehemence of the defenders of the mass murders. Carol what have you been smoking? Those 50 “scientists” were all hired by tobacco companies to create the appearance of doubt about smoking. The numbers published about smoking deaths have already subtracted those HPV figures from the death numbers. This :”science for hire” comes from a completely disreputable lab that cannot get their results published in scientific journals because they are known to come up with whatever result is being paid for. This is the same lab that the oil companies have hired to cast doubt on global warming even though there has never been a single climatologist who doubts it.

  11. Dr. John Gardin | December 20, 2011 at 2:54 pm

    There is much for me to disagree with Ms. Vargyas about in her article. For starters, nicotine is much more addictive than heroin – by a factor of 2-3 times. Getting off heroin is a cakewalk compared to getting off nicotine. A better comparison would be methamphetamine. Bottom line is that nicotine is VERY addictive, and hence the failure of smoking cessation programs in the workplace and just about everywhere else. Yes, smokers say they want to quit, but they are addicted. So, what to do? I have no problem at all hiring and keeping non-smokers. In my book, it’s part of the package of one of the natural negative consequences of smoking – and a key factor in helping smokers decide to, and actually, quit.

  12. Nelson | December 31, 2011 at 4:07 pm

    Let’s not forget that the “smoker-free” term is highly misleading in most cases. The tests frequently used to determine if employees smoke are based on levels of nicotine byproducts in the bloodstream. Such tests do not identify smokers alone, but also those who use any form of nicotine, including smoke cessation products that are key tools in the battle against smoking. The harmful effects of smoking are not caused by nicotine, they’re caused by smoking. There is plenty of evidence that nicotine does little harm and is no burden on the healthcare system. Yet non-smokers who elect to continue use of smoking cessation products to stay smoke-free are vilified right along with smokers.

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