The Just Case for 'Get-Tough' Anti-smoking Policies

John Commins, for HealthLeaders Media , August 22, 2011

Nicotine is highly addictive, and many smokers are hooked. To take a Zero Tolerance anti-smoking policy and firing violators without offering them the tools to quit would violate the same healing mission that the hospital is trying to protect. Smokers are not bad people. They are addicts.

At IU Health, for example, employees who violate the on-duty smoking ban are first counseled by a supervisor, given a written warning, and given a written invitation to join the hospital’s Quit For Life smoking cessation program. “If there are repeat offenses, they ultimately could be terminated, but that is just like any other policy,” Ladd says. “Our values are not that we are a mean-spirited organization but we are saying to our employees this isn’t helping our patients. It’s not safe. And you can’t do that to our patients.”

In previous columns I have questioned the right of employers to dictate what employees can do on their own time. And – justified as it may be as a matter of health and economics -- I am still very uneasy with the idea of removing smokers as job candidates. Smoking tobacco is legal. And if banning people for using a legal product is done in the name of controlling health insurance costs, then the slippery slope argument begs the question, what’s next? Bans on pizza and beer after work? Will diabetics be the next class of workers to be banned from the workplace? After all, much of Type 2 diabetes is related to diet, which is a lifestyle choice.


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3 comments on "The Just Case for 'Get-Tough' Anti-smoking Policies"

Paul Deen (8/24/2011 at 11:24 AM)
I understand the dangers of second hand smoke. The article mentioned that if a patient saw someone smoking in scrubs on the hospital campus, a wrong message would be sent. What kind of message is sent when a patient is approached by an obese employee? Does the hospital have the right monitor what these folks eat when they are not working? I would much rather any hospital focus their energy and resources on eliminating staph in their facilities which is killing thousands of patients each year. There are many things a hospital can do to stop killing these people whose only crime is admitting themselves into their facilities. This whole article sounds like our current government...paying a large amount of attention on smaller, big brother issues while they ignore the larger issues.

Joe Tye (8/23/2011 at 10:39 AM)
There is one other more subtle reason for hospitals to not hire smokers. Over the years, the tobacco industry has done everything it can to undermine public appreciation of the real dangers of smoking. They are no longer able to dress up actors in white coats and claim that more doctors smoke their brands and the Tobacco Institute (the mother of all fraud) is now defunct, but that is still their message. Anytime someone sees a hospital worker smoke, it reinforces the tobacco industry message – it can't be that dangerous if hospital people do it. Another reason to not hire smokers is simple marketing. With smoking relegated to the back alleys and fresh air the norm, smoking is increasingly viewed as low class, unprofessional, and downright stupid by a growing proportion of the population. I'm sure I'm not the only one who would entrust the healthcare of my family to a doctor I saw smoking out in the parking lot. Employees who smoke off the job are, pure and simple, bad advertising for the hospitals where they work. One more thought: when Dr. C. Everett Koop called for a smoke-free America back in 1986, everyone wondered what he'd been smoking. Today, we are virtually there. It is a great metaphor for the power of a few dedicated people to change the world, and for the sort of determined toughness that healthcare leaders will need to face the never-ending healthcare crisis in the years to come. Thanks again for your thoughtful comments on a very important issue.

Lance (8/23/2011 at 9:15 AM)
I always find these anti-smoking policies to be such an oxymoron - I am 110% in favor of totally banning smoking anywhere, anyplace and never having tobacco available to anyone. Problem is, our politicians are addicted to the taxes from tobacco sales as much as the smokers are addicted to the nicotine. Therefore, there will always be smokers and the dilema of what to do with them for using a dangerous but LEGAL product.




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