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®