is it fair for an employer to refuse to hire smokers?

by Alison Green on December 3, 2012

A reader writes:

I recently applied to two different hospitals for employment and found that both of them enforced strict anti-smoking policies that included nicotine tests upon hire. One website stated that if you failed the nicotine test, they would provide you with a program to help you quit and then you could reapply. The other stated that it would allow you to reapply again in 6 months.

Although I am not a smoker, I thought that this policy might be borderline invasive of someone’s privacy and choice to smoke. Do you think that this fair? I know that this is a hospital and that you have to take the patient’s health into account, but isn’t this overkill? I am on the fence with this.

Well, from a legal standpoint, there’s no federal law that protects smokers from employment discrimination. However, 29 states and D.C. do have laws that bar discriminating against smokers in hiring, although some have exceptions for nonprofits and the health care industry. And the health care industry seems to be where the trend is strongest — lots of hospitals are implementing the kind of ban you’re talking about. The reasoning among employers who do this is, of course, the impact of smoking on their health care costs, and for some is tied to an institutional mission to promote wellness.

That last part makes sense to me — after all, if you’re a hospital, it might seem as contradictory to hire smokers as it would for PETA be to hire meat-eaters. You want to hire people who are committed to your mission. On the other hand, is the hospital also going to say that they’re not going to hire motorcycle riders or the morbidly obese or people who eat a lot of bacon? I really doubt that the rest of their workers are all paragons of healthy living. Smokers are an easier category to pick on, of course, and as a society we’re much more in agreement that you shouldn’t smoke than that you shouldn’t eat bacon, but there’s a lot of room to poke holes in this whole practice.

In any case, overall, I don’t believe that employers should police your private life — whether it’s what you eat, what you drink, whether you engage in risky sexual behavior, or whether you choose to smoke a joint or a cigarette … both because it’s none of their business and because I don’t think it’s a sound business practice that will help them  hire and retain the best people. After all, if I were running a hospital, I can’t see how I’d justify turning away an amazing doctor or an all-star CFO because of what she chose to do with her body in her time away from work.

What do others think?

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{ 332 comments… read them below or add one }

lilybell December 3, 2012 at 12:10 pm

I think part of the reason for this rule in many health care centers is that people who smoke tend to reek and not notice – many of these employees come in very close contact with patients and it doesn’t send a reassuring message when an employee in a hospital smells of tobacco smoke.

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Julie December 3, 2012 at 12:21 pm

More to the point, depending on your department, you may very well come into contact with patients who have asthma or other respiratory problems. I can tell you, as someone with asthma, that not only can I SMELL smoke on people, I can FEEL it. If someone coming back from a smoke break walks into an elevator with me, it triggers my asthma, even if they are not currently smoking. If the employee is going to be working around patients with pulmonary problems (even if they’re not directly interacting), I can see a smoking ban as totally legit.

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K December 3, 2012 at 12:30 pm

While I understand this is a problem, it seems like the correct way to deal with it is to discipline any employee who causes a problem for patients because they trigger smoke allergies, not to do advance tests for nicotine.

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Julie December 3, 2012 at 12:34 pm

I agree that a pre-hire nicotine test is probably going to far, especially since (as others mentioned) many stop-smoking aids contain nicotine. But I think it’s really important for new hires to know that the reason for the policy, and that they can’t smoke while at work or before coming to work, if they’ll be wearing the same clothes.

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JPT December 3, 2012 at 2:10 pm

OK I just have to ask, also: Who else has had a job where you had to pretend you smoke or you didn’t get breaks? But the smokers *need* breaks because they *need* a cigarette. (This is a result of bad management and not the fault of smokers.) In my first job in fast food I would go outside on a break to read a book. If anyone came out, I had to hide the book and stick a lit cigarette in my mouth or the boss would make me go back in and cover for the smokers who *needed* their breaks. I was 15. (Sorry, kind of a sidebar.)

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Julie December 3, 2012 at 12:47 pm

As an aside, I also do not believe in pre-employment or random drug testing. I know it’s pretty common in the States, and it makes me glad to be a Canadian, where you can only do drug testing for probable cause or for jobs in which drug use would pose a danger for yourself or others. (Ambulance technicians or truck drivers, for example.)

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Soni December 3, 2012 at 1:38 pm

If your smoking triggers an asthma attack or other reaction in a patient that puts their life or their treatment in jeopardy, disciplining you afterwards is hardly meaningful. That may be a reasonable way of handling it outside of a health-care setting, but in a hospital preemptive patient safety takes priority over disciplining those who put patients at risk.

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K December 3, 2012 at 2:09 pm

All kinds of employee misbehavior have permanent consequences. But you make a rule against the behavior, set up consequences, and hope that deters it. It would be completely reasonable for a hospital to refuse to hire someone who had been known to cause an issue with cigarette smoke in a previous job. It’s not reasonable to assume that all smokers are incapable of following smoke-free workplace policies.

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Amanda H December 3, 2012 at 1:43 pm

The head nurse at the allergy and asthma clinic I go to for allergy therapy is a smoker (I can smell it on her clothes). I don’t doubt her abilities as a head nurse, and thankfully my issues are not severe enough for the smell to cause additional problems, but I always found it rather ironic that she works in asthma and allergy.

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OR December 3, 2012 at 2:34 pm

“Third hand smoke” is a relatively new term used to describe the contaminating residue and particulate matter (including carcinogens and heavy metals, like arsenic, lead, and cyanide) that is left on clothes, surfaces, skin, etc that remains long after smoking stops. This particulate matter can be re-exposed into the air and breathed in. Young children are particularly vulnerable, because they can ingest the residue by putting their hands in their mouths after touching contaminated surfaces. To protect patient safety, I think that the medical field should only hire non-smokers AND ensure that they come from smoke-free environments. Healthcare workers come into direct contact with people with compromised immune systems who are much more susceptible to the effects of the residues. They choices they make on their own time can really endanger patients. I would also argue that these workers should stay home when sick for the same reasons.

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fposte December 3, 2012 at 3:18 pm

Well, and that brings up why singling smoking out is somewhat disproportionate: you’re never going to get hospital workers to stay home when they’re sick. But we’ve just dovetailed nicely with Donna Ballman’s most recent post about hospitals that require flu vaccines if you want to stay employed:

http://employeeatty.blogspot.com/2012/11/no-flu-shot-thats-firing.html

(It’s even a little misleading to make that such a focused issue, because that inoculation is usually only one of several required ones.)

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Ariancita December 3, 2012 at 4:01 pm

At the same time, most people who work in hospitals are required to wear scrubs or other professional dress. They’re not typically wearing their regular (aka smoking in off hours) clothes while working (with the exception of some, like doctors).

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AMG December 4, 2012 at 2:15 pm

But they may still have the residue on their hair, skin, etc, even if they hadn’t smoked in that outfit. If I can still smell it under those circumstances, then that residue/matter is still on/around them and everything they touch/own and transfers to their workplace.

And then there are lunch breaks and regular (i.e., smoke breaks) while at work…

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ARS December 5, 2012 at 10:03 pm

But then what if they don’t smoke and live with a smoker? Based on your reasoning, it would be unacceptable for them to have a job in health care because they live with someone who smokes and that residue would also be on their hair and in their clothes. I’m of the opinion that’s it’s none of an employer’s business what I do in my personal life.

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F1nnbar December 3, 2012 at 7:26 pm

Do you have the same reaction when a person who takes the bus to work, and has been diesel belched on as it pulled away, gets onto the elevator with you? At what point are we going to have to ask people to interact from with their own plastic bubbles?

Give me the coal burning, ale swilling, tobacco smoking 1800s.

Criminy.

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JPT December 3, 2012 at 2:05 pm

YES!! I was going to say something like this and then saw someone already had. ;) If you smoke regularly and don’t think you smell bad… well, you do. People notice. I actually get really nauseated around people who smell like smoke and get migraines–not from their smoking, but from their smell without having a cigarette in hand! I don’t think you even need to implement a serious for it, though. I can tell a smoker if I’m sitting a foot or so away. It really comes down to hygiene.

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K December 3, 2012 at 2:10 pm

Except people in this thread have shared stories of people not knowing they smoked until they were told. Everyone is agreeing that it’s a problem when people smell like smoke at a hospital and it’s true that I’m sure some subset of them has no idea they smell like smoke; but that doesn’t mean there aren’t smokers you never identify because they don’t smell like smoke.

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Long Time Admin December 3, 2012 at 2:38 pm

Oh, honey, no smoker has to tell me that they smoke. I start having an allergic reaction immediately. Anyone who is allergic to smoke or has asthma knows when a smoker is near.

Smokers don’t know that they reek – their sense of smell is greatly impared by tobacco.

The rest of us know, though.

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JPT December 3, 2012 at 2:41 pm

Yeah and “reek”/”smell bad” might be a little strong. It’s only a really bad smell to people who have a reaction to it. I’ve gotten migraines, thrown up, and had my throat start to close up from being around smoke and/or people who smell like it. That doesn’t mean I can detect any smoker, but it depends on the proximity to the person.

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Sunday's Child December 3, 2012 at 4:00 pm

I don’t have any kind of “reaction” other than wrinkling my nose and face when I smell cigarette smoke on someone. Just a couple of hours ago, I walked into my office building trailing behind someone who reeked of smoke. She wasn’t smoking at the time and I didn’t see her extinguish or dispose of a cigarette…but I could sure smell it on her as I followed her into the building and then passed her on the way to my office. You don’t have to be allergic or have a reaction to notice the stink. Feel free to smoke on your own time and in your own place, but know that others absolutely can tell and may be turned off by it if you are wearing the same clothes or haven’t showered.

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Jamie December 3, 2012 at 2:47 pm

Maybe that’s true of you – but I’ve nothing but crap from some people at work since they found out I smoke occasionally. These are militant anti-smokers and they could not believe I was “one of them.” I had worked here over 4 years. A couple of people here smoke, the majority do not.

I am not saying no one has been able to smell it on me ever, that’s ridiculous. But to say “the rest of us know, though” – then apparently the people I work with knew about it for over four years and didn’t bother to say anything until a co-worker told them and now have offered me money to quit? That would imply that they knew but didn’t care before, even though other smokers have gotten the same incentives and pressure that I get now?

Granted, I know people who come back in reeking of smoke and – surprise – even smokers hate that. I just found out someone here smokes when she goes out at nights – only when drinking – has for years…no one knew.

I have no doubt some are more sensitive to it than others, it’s the same for all scents offensive or otherwise, but to imply that every non-smoker can out a smoker all the time implies that those of us saying otherwise are liars. I take issue with that.

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K December 3, 2012 at 3:08 pm

I’m not a smoker and, in fact, I can’t always tell when other people smoke. (Sometimes I can, but I’ve certainly later found out people smoked when I’ve never smelled it all on them.)

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fposte December 3, 2012 at 3:19 pm

You’ve just fallen at the confirmation bias hurdle :-). You don’t know about the smoking status of those people who don’t trigger you.

Some smokers do reek, no question. Some of them don’t. Keep in mind also that “smokers” include people who smoke occasionally (the “chippers,” as they’re known, who don’t get addicted) as well as two-pack-a-day folks, too.

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Ask a Manager December 3, 2012 at 2:26 pm

Yeah, by definition you don’t know about smokers you’ve encountered who didn’t smell like smoke or have other tell-tale signs. You only know about the ones who do.

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JPT December 3, 2012 at 2:30 pm

Exactly… I only see it as a problem if it IS a hygiene issue.

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fposte December 3, 2012 at 2:35 pm

Also worth noting that nonsmokers who live/hang with smokers can smell much the same.

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Meg December 3, 2012 at 4:17 pm

My clothes smelled like cigarette smoke growing up because my mom smoked inside. It wasn’t until college did I finally get the smell of cigarettes out of my clothes.

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Anon December 3, 2012 at 4:35 pm

This.

I moved out almost a year ago and I still have many things that smell strongly of smoke. I had to wash every article of clothing when I moved but it still lingers some places. I dread coming home from mom’s because of the smoke all over my jacket and clothing.

All my life people have asked if I was a smoker and people have been rude about it….

Kind of tough to make snap judgements – maybe someone lives with an elderly parent who smokes? So you can’t really tell by age either.

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Rana December 3, 2012 at 9:04 pm

Although… there’s smelling like smoke, and smelling like a heavy smoker. I personally don’t care if people smoke, if I don’t have to breathe their smoke, but I can smell it.

And by it, I mean not just the smoke on one’s clothing. That I can deal with okay (I remember one time coming home from Spain, before the bans were in place, and discovering that even my just-laundered clothing smelled of smoke). But there’s something I think of as “smokers’ BO” where it’s a very particular and pungent sort of body odor/bad breath and not smoke-like at all.

That is a smell that makes me want to barf, no matter how nice the person is, nor how polite they are about keeping the smoke away from me.

(Not all smokers have this smell, but enough do, and I’ve never smelled it on someone who wasn’t a smoker. And, FYI, breath mints and perfume do absolutely nothing to mask it. If anything, they make it worse.)

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Jessica December 4, 2012 at 10:19 am

Concur. Some smokers seem to synthesize the stuff they inhale into pure evil and exude it from their pores. And it really has nothing to do with whether they smoke politely or not.

I recognize migraines, nausea and throat discomfort (fortunately, I don’t have asthma or life threatening allergies) but am I the only one who is rendered nearly unconcious by heavy second hand smoke? A smoky room or a heavily “smoked” room will literally (and yes, I know the difference between literally and figuratively) knocked out if I have to remain for long.

A dear friend used to joke about me always falling asleep on the sofa when visiting. I didn’t know hot to tell them that I was likely nicotine poisoned just from spending time there.

A heavy smoker, not currently engaged in smoking who enters the bus I am on is Russian Roulette with two adverse and one unpleasant outcome, to me.

If I’m lucky, I only gag for the rest of the trip.
If I’m not so lucky, I will need to get off and await the next bus, while discreetly throwing up behind the bus stop.
If I’m unlucky I will get a treatment resistant, debilitating, three-to-seven day migraine that impedes my work and robs me of sleep.

This, of course, means nothing to the average smoker. If I complain they don the Persecution Hat and if I don’t complain, they never know they just ruined a week of my life and think what they are doing is fine.

Nonetheless, I don’t support the idea that employers have anything with your non working time to do.

But I do wish smokers could accept that they do make a choice that puts other people out, somtimes in a really bad way, and that these people are not as rare as the smoker may think.
Sometimes we aren’t telling you because, really – what’s the point? You will never get a smoker to admit that what they are doing hurts other people and they never admit that they stink. In addition to my migraine or somnolence, I would also have to take the inevitable hostility and aggressive self justification from Poor Persecuted Smokers just to invariably find out that they don’t give a sh*t.

Anonymous December 4, 2012 at 12:08 pm

@Rana and @Jessica,

How do you know you can smell all smoker’s BO? Unless you run a test with a wide variety of smokers and nonsmokers to check you accuracy, and then find out afterwards whether or not they are smokers, you cannot know your ability on this.

There are certainly some smokers who you can smell. OK.

But just because you can’t smell someone, does that mean you are sure they don’t smoke. I know a guy who smokes a few every month. By this hospital’s standard he’s a smoker. Could you smell him? I doubt it. But even if you believe you can, how do you know you can? Have you tested it?

Jessica – perhaps you should see a doctor with the symptoms you have. Certainly smoke is not healthy for anyone, but that severe affect on you of even some exposure might be a sign of other problems.

Rana December 4, 2012 at 10:06 pm

Anonymous, I never said that I can smell all smokers’ BO.

Just that some smokers have really bad body odor and breath, of a sort that nonsmokers never have. (Nonsmokers can also be unpleasantly ripe, but it’s a different kind of unpleasant smell.) And that I don’t care for that odor, and that it has nothing to do with the smell of smoke itself.

Rana December 4, 2012 at 10:08 pm

In fact, if you notice my last paragraph in the comment you’re responding to, I specifically made that disclaimer. Please do me the courtesy of actually reading what I say before assuming that I mean something I took special pains not to say. Thank you.

BuffaloNY December 4, 2012 at 1:16 pm

Me too! My friends’ parents all used to think I was a smoker because I reeked so badly thanks to my parents’ indoor smoking. I still cringe when thinking of road trips with the windows rolled up. Yuck.

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Jessica January 8, 2013 at 11:44 am

@anonymous

Condescending and reading challenged much?

Rana already covered your inability to read, so I will just point out that the health issue going on with me is called “migraine”, which you would know if you, as Rana pointed out, actually bothered to read before responding. Migraine has its triggers, of which smoke and smoker’s smell is one. Migraine has not cure at the moment and the treatments don’t always help. Other than that, I am unusually healthy and don’t need snarky health advice. I have no control over when and where smokers decide to light up or how aggressive and condescending they get when they are called out.

It is inconsiderate. It is selfish. No amount of hand waving, or throwing around of red helth concern troll herrings, can change that.

Smokers need to stop deluding themselves. They are engaging in something that hurts other people than themselves.

Oh and anonymous, don’t smoke around your children. Particularly not in the car. You have no idea what that does to them. (Since we are making assumptions and not paying attention.)

Ask a Manager January 8, 2013 at 12:22 pm

Hey Jessica, I totally understand why you’re frustrated here, but please keep it civil — it’s starting to get heated (which, again, I understand, but I ask that people be respectful here).

SarasWhimsy December 5, 2012 at 6:47 pm

I agree with Jamie on this. I’ve had non-smokers, asthmatics, and former smokers in my home, and they can’t tell that I smoke much less smoke in the house. As a smoker, I have a problem with it always being the smokers who are singled out.
My question is for everyone who is being so holier than thou about smokers – like Sunday’s Child saying that a smoker is basically offensive if they smoke outside of their home and/or do not change clothes after smoking. Where is the line? So I smoke in my off time – I can’t even smoke on work property – so I smoke any time other than my working hours. Whose business is that, really?
Ah, it’s okay because people who do not smoke don’t like the smell. Frankly, as someone who’s allergic to cat hair and dander, maybe cat owners shouldn’t be able to work at XYZ company, or what about the ones who wear objectionable perfume? Or who heat up food I don’t like in the microwave?

Oh it’s a health issue? Well those who drink in excess of 1 glass of wine 5 out of 7 days a week are more likely to develop liver problems. So, XYZ company will now test for regularly over-consuming alcohol. Don’t forget chocolate! It can cause acne, migraines, and allergic reactions. So we’ll go ahead and test for that too.

Have you heard this poem? http://en.wikipedia.org/wiki/First_they_came… One of the first lines is: First they came for the socialists,
and I didn’t speak out because I wasn’t a socialist. And the last line is: Then they came for me and there was no one left to speak for me.

Well, they’ve come for the smokers. They’ll be coming for your vice next. So let me ask again, where is the line?

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IndyGal December 3, 2012 at 4:14 pm

Thank goodness! It’s nice to see I’m not the only one who blows into a migraine if I even smell a smoker.
I work in a hospital, and we have done everything we can to help our staff quit smoking – including giving a discount on health care premiums to those who don’t smoke. However, I don’t know if we go so far as to not hire smokers, but we should for the reasons mentioned here. People with compromised immune systems should not have a healthcare worker’s personal bad habit affect their health while they are in a place of healing.
Sorry; I have no compassion for smokers. My right to breathe clean air should trump your “right” to pollute it and possibly give me cancer. I don’t create nasty smells and cloudy carcinogenic air around you; don’t do it around me.

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fposte December 3, 2012 at 6:18 pm

How are the immune-compromised more vulnerable to smoke? It’s not an activity relating to an immune response. Not that I think it’s great for patients to be exposed to third-hand smoke; it just seemed an unusual group to use as an example.

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Jamie December 3, 2012 at 6:32 pm

Maybe someone can educate me, but the studies I’ve seen are saying third hand smoke is most dangerous to infants and toddlers because they crawl on surfaces and put things in their mouths.

Even the study posted today said it’s inconclusive at this point what danger this poses to adults.

I totally get second hand smoke – but for example if I only smoke in my car you’d have to lick something I brought in with me for the third hand smoke to kick in – am I wrong? I’m seriously asking, because that’s my understanding. (and seriously, if people are licking my stuff, they’ve got bigger issues than this.)

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fposte December 3, 2012 at 7:19 pm

Right, but that’s not immune compromise, which makes you more vulnerable to *infectious* disease because you can’t marshal antibodies in response. I don’t think smoking is actually a factor there, but thinking about it maybe IndyGal really just meant people who were unwell and used a different phrase.

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TL December 3, 2012 at 11:09 pm

Hmm… If they’re immunocompromised they can also be more susceptible to damage caused by carcinogens like cigarette smoke, though that would be more of a long-term effect.

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Natalie December 4, 2012 at 12:35 pm

I’m not actually sure that’s true. The process by which carcinogens cause cancer isn’t necessarily affected by a weakness in the immune system’s ability to fight microbes. Obviously they are sometimes related, as in the case of AIDS-defining cancers, but I believe that would only be true for cancers that are caused by microbes.

fposte December 4, 2012 at 2:50 pm

Right, that’s what I was thinking too–the immune system is pretty particular in what it defends against (which is what makes it so interesting when something new figures out how to slide past it).

Jaime December 3, 2012 at 9:38 pm

“It really comes down to hygiene.”

It can, but mostly no. If someone smokes in their car or home, then they usually smell really strongly of smoke no matter how clean they are. It’s kind of like cat hair – if the cat sits on the warm laundry, fresh from the dryer, then you’re going to have car hairs on your clothes no matter how often you wash your sweater.

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A Bug! December 3, 2012 at 12:10 pm

Does a nicotine test say conclusively that a person is or is not a smoker? I thought you could get all sorts of stop-smoking aids that contained nicotine in order to keep your cravings in check. Even if it were fair to discriminate against smokers, I don’t think it would be fair to lump the people who are quitting in with the people who are still smoking.

I think it’s fair to give smokers warning that the hospital does not permit smoking by employees anywhere on hospital property and employees’ schedules do not accommodate smoke breaks (are there any laws that require employers to give smokers regular breaks for that purpose?). But this blanket policy seems a bit like throwing the baby out with the bathwater.

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Josh S December 3, 2012 at 12:27 pm

^This. Nicotine exposure =/= Tobacco user.

I’m not a smoker–that is, I don’t smoke cigarettes ever, and only occasionally (as in, once or twice a year at New Years or weddings/birth of child) smoke a cigar. But I have friends who smoke, and I like to go to a bar where people smoke. So I have plenty of secondhand exposure.

I meet the qualifications of a ‘non-smoker’ by the standards of both my life insurance and health insurance policies (hooray for lower premiums!), but I doubt I’d “pass” a medical test that examined hair or whatever for nicotine.

I’m sure that there’s plenty of people who are on the patch/gum/whatever who fall in the same category.

If you’re going to make non-smoking a condition of employment, fine. I don’t like it and I don’t agree, but that’s your prerogative, as stupid as I believe it to be.

But if you’re going to do this, find a test that actually measures smoking/tobacco consumption rather than the myriad other ways you can be exposed to nicotine!

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KayDay December 3, 2012 at 12:39 pm

But I have friends who smoke, and I like to go to a bar where people smoke. So I have plenty of secondhand exposure….I’m sure that there’s plenty of people who are on the patch/gum/whatever who [would not pass a nicotine test].

This is a good point. Even if you’re not a smoker yourself, you could bring smokiness into work if you had been around it–which would be a problem in a hospital (hypothetically, of course. I am assuming that you aren’t actually going into smoke-filled bars immediately prior to entering a hospital). Also, people who have quite but are still using nicotine therapy wouldn’t affect the patients, but also wouldn’t pass a nicotine test. If instead the rule was that employees are not allowed to smell of tobacco smoke during the day, that would catch these things.

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KayDay December 3, 2012 at 12:41 pm

*quit, not quiet.

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Josh S December 3, 2012 at 12:49 pm

What a great rule! “If you/your clothing smells like smoke, you will not be allowed to work, and the time missed will be unpaid.”

See how easy that is? No invasive tests! Protects the patients! Respects the employees!

Sure, this requires a manager with sense and some backbone to enforce it. But it definitely beats a mindless, over-reaching, bureaucratic answer to an issue that is a precursor to the real issue.

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Anonymous December 3, 2012 at 4:46 pm

*picturing the smell police*

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Julie December 3, 2012 at 4:48 pm

Though not necessarily “smell police,” I know of at least one industry where people are sent home if they’re wearing any fragrance: fertility clinics. Apparently the young embryos really don’t like any sort of fragrance (perfume, cologne, scented deodorant, etc.), so anyone entering the lab can’t wear them. If you’re caught wearing any sort of fragrance you’re sent home, at least at some clinics.

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fposte December 3, 2012 at 6:19 pm

Wow, that’s fascinating; I’ve never heard that.

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Anony December 3, 2012 at 11:43 pm

I work at one of these types of places who instituted the “no hiring of tobacco users” rule, and have wondered myself how much 2nd hand smoke would have to be ingested for a non-smoker to fail such a test. And what kind of test is it, a urine, blood or some other wonky test?

I think it’s definitely discriminatory. Just make a rule that employees cannot smell of smoke, cologne, etc. when they are at work.

Anonymous December 3, 2012 at 11:28 pm

It’ll be like every test, the ability to discriminate depends on the blood concentration chosen for the cut-off. Too high a cut-off, and it will miss light smokers and quick metabolizers. Too low and it will pick up people with social and occupational exposure to second-hand smoke. Since it would be counterproductive to exclude a significant proportion of your workforce, it’s probably not set too low.

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Coelura December 3, 2012 at 12:11 pm

Since hospitals are not allowed to have smoking anywhere on their campus by law, I can definitely see where they would want to improve compliance by only hiring non-smokers. If you knowingly hire a smoker, then you are running a higher risk of employment issues later if that employee gets caught smoking on campus.

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fposte December 3, 2012 at 12:50 pm

As far as I know there’s no federal law–that’s why hospitals are enacting bans themselves. I think New York City has this as a municipal law, but in most other places it seems just to be subject to whatever other “public place” limitations exist. In Illinois, for instance, the law forbids smoking inside and within 15 feet of entrances and windows and vents, but it doesn’t forbid it on campuses entirely.

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Coelura December 3, 2012 at 1:54 pm

Good point – I should have been more specific that its a law in Missouri.

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Ariancita December 3, 2012 at 4:54 pm

Just want to point out, while there may not be a law, there are plenty of compliance standards set for by organizations like NQF that rate hospitals and hospital workers based on many factors (quality of care, CAHPS, HCAHPS, etc) and restrict medicare funding and such if the hospital scores are not high enough. I don’t recall if smoking is on any of them, but I could see the logic behind putting a smoking item on the measurement.

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Elizabeth December 3, 2012 at 12:12 pm

We don’t allow the consumption of nicotine on hospital property, in accordance with state regulations for healthcare facilities. We require any employee who is going to consume something containing nicotine to remove themselves from the grounds. If you’re an hourly employee leaving the grounds for personal reasons, you must clock out while you are off of the property.

Clinical personnel are bound by license restrictions to not commit “patient abandonment”, which means that if a patient is in their care, they can’t leave the patient without another licensed provider taking over the care. There is a handoff process required for that, which takes several minutes each time it happens.

Functionally, it means that nurses can’t clock out & go on smoke breaks without creating a problem for their license. We already staff to a patient-to-staff ratio that barely allows for bathroom breaks or getting a meal, and it would be unsafe for patients to have nurses off the floor long enough to go smoke a couple cigarettes.

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Josh S December 3, 2012 at 12:30 pm

All of the above is completely understandable. (Though as a potential patient, I’d love if your facility were staffed a little bit better so the health care personnel could get a good meal, be relieved and refreshed, etc so they’re a bit more pleasant and alert when caring for the patients…but that is neither here nor there…)

But does any of that mean that you won’t hire smokers? What if they are able to work their full shift without a smoke break (except maybe on their lunch)?

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Elizabeth December 3, 2012 at 12:45 pm

We will hire them, and we have them on staff from before when the regulations took effect. They have to commit to not consuming nicotine on hospital property.

Realistically, most smokers in healthcare quit. They can’t get a job in the state that allows them breaks on the property, and they can’t afford to jeopardize their license by abandoning patients.

A physician friend of mine always takes the long way to work and the long way home (by MILES). His wife doesn’t allow him to smoke in the house or garage at home, and he can’t smoke at work. So, he drives around & smokes in his car for 20 minutes before work, at lunch & after work.

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Josh S December 3, 2012 at 12:54 pm

And I think that is an entirely reasonable approach by your health care facility. Thanks for sharing your insight!

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JBowmn December 4, 2012 at 5:03 am

A hospital I used to work out banned smoking from breaks (as well as anywhere on the campus before/after a shift) using the perception that it was the same as banning alcohol consumption during a lunch break.

I was working there when the hospital changed to be smoke-free, and they always said that a big problem was that even when people smoked in their cars, that the smell would transfer to their clothing. So even if you never smoked while wearing your work clothes, by being in a car where you would smoke (while not wearing work clothes) that the transfer of fumes would get onto clothing/hair. At that time, they also said that non-smokers who arrived at work smelling heavily of smoke (i.e. those married to smokers/sharing a vehicle with a smoker) could essentially be fired if there was not a way to resolve the issue. So at the time, the problem identified (beyond smoking on the campus) was strictly “do you smell of tobacco”.

At the time offers were open to employess and employee family members to stop smoking and there were discounts on nicorette and other such products. I no longer work there, but it would make sense to me if they now have a policy where they no longer hire smokers.

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lilybell December 3, 2012 at 12:40 pm

Thank you for the insider report!

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Ellie H. December 3, 2012 at 12:49 pm

Like Josh S suggested, the potential for smoke breaks to be a problem does not necessarily apply to all smokers, though I agree it’s a strong correlation. I’m a smoker and definitely wouldn’t pass any kind of nicotine test, but I am a pretty light smoker and typically don’t smoke during the hours of the work day or even every day.

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KayDay December 3, 2012 at 12:55 pm

Yeah, I worked physically close to one woman who I never assumed was a smoker–until I saw her smoking as she walked home from work one day. But to my knowledge she wasn’t smoking before or during work, and she definitely wasn’t taking smoke breaks throughout the day. She never smelled of smoke.

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Jamie December 3, 2012 at 1:15 pm

I worked here over 4 years before people knew I smoked – someone I had told let the cat out of the bag.

Like Ellie, I don’t smoke every day and I don’t take smoke breaks at work – ever. I do usually have a couple on the way home. I sometimes have a couple on my way in, I have no idea why no one ever smelled it.

I’ve certainly known smokers who abuse the break thing, but I’ve also known a lot of non-smokers who do as well.

I actually don’t have a problem using non-smoking as a hiring criteria in health care – or really anywhere else. But I do resent the implication, and it’s out there a lot, that smokers = slackers who take a ton of breaks and come back in to pollute the office. It’s not always the case.

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Jamie December 3, 2012 at 1:17 pm

I should clarify – I don’t have a problem with using it as a criteria if it will ever impact the workplace…i.e. smell or whatever. What people do on their own time is their business, imo, which applies to a lot of things for me.

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fposte December 3, 2012 at 12:52 pm

Does that mean patches and gum are forbidden as well? (I imagine so from your phraseology, but I wanted to check for sure.)

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Elizabeth December 3, 2012 at 2:05 pm

Yes, it is.

We only allow patches on active patients, not on the staff.

It isn’t our rule; it is something our state department of health instituted several years ago.

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Natalie December 3, 2012 at 5:42 pm

What an odd rule. I wonder what the logic is behind not allowing nicotine replacement.

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Elizabeth December 3, 2012 at 10:24 pm

Patients are effectively captive. It isn’t good to go cold turkey off of nicotine, particularly for a strong addiction. (Nicotine is as addictive as heroin, and detox is almost as difficult.) Slapping a nicotine patch on them is about their safety.

Staff aren’t captive in the facility. Even with having to leave the property, they do have ways of satisfying the addiction that aren’t a patch.

I’m not a smoker; I never have been. Quite literally, my brother & I are the only people I know who haven’t tried smoking tobacco. He’s asthmatic, and I get horrific sinus infections, both as a result of smoking by our parents when we were children. I’ve seen how addictive nicotine is (our father only broke the addiction because he was in the hospital for 2 weeks when I was a kid and was sedated after sinus surgery for most of it). If it were being created for the first time in a lab today, we’d be banning it almost immediately.

I have some sympathy for those who want to quit smoking & can’t. It’s a combination of a highly addictive substance with an ingrained habit that was promoted by society for more than a generation. The totality is incredibly difficult to overcome.

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Mints December 3, 2012 at 5:55 pm

I’d also like to point out that hospitals absolutely can have smell-bans, and this is a possible thing to do.
While people joked about “smell-police,” it’s better to have your manager tell you to change & shower than get thrown up on.
Banning the smell of smoke is entirely possible, and I think reasonable.

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Long Time Admin December 3, 2012 at 12:15 pm

If I’m sick in the hospital, and someone comes into my room reeking of cigarette smoke, I’m going to have an allergic reaction.

My reaction would not be pretty, in any sense of the word.

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-X- December 3, 2012 at 12:48 pm

Do you have this allergy when you’re not sick?

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Laura L December 3, 2012 at 1:56 pm

Probably. Allergies are fairly constant over time. It’s just that if you’re in a hospital, you are probably already sick (unless you’re in the maternity ward or are a relative or visitor), which I think is why LTA added the sick part.

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KayDay December 3, 2012 at 12:19 pm

As someone who was absolutely thrilled when smoking was banned in bars and restaurants, I think this is going to far. I do think it’s fair to ban smoking during the workday and to require that employees not smell of smoke (so no smoking over lunch breaks). But the test should be if there is evidence of smoking while someone is performing their job.

What an employee does on their own time shouldn’t impact their employability. I can think of a few exceptions, but they are all really extreme and wouldn’t apply in the majority of cases (e.g. murder, stealing, owing the mob lots of money, etc.)

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Emilie December 10, 2012 at 6:08 pm

I have to agree with you. I’m also someone who is no fan of smoking, and I think the nicotine tests are a bit to far. I do think it is within the companies right to not allow you breaks to smoke, or allow you to smoke on their property, and ask you to potentially change clothes when you get to work (to prevent third hand smoke), but policing it to this level seems odd to me. I do have to say if they have a smoke free office (and can guarentee that) then it might have a positive effect on their health insurance premiums though. I could see this as a way to lower health care costs to their employees as well.

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Long Time Admin December 3, 2012 at 12:20 pm

And the arguement about not hiring motorcycle riders or obese people to work in a hospital is ridiculous. They are not going to affect the health of patients in the hospital. A smoker, however, will have an adverse affect on patients because tobacco smoke clings to every hair on the smoker, is on every pore of their skin, and in their clothes. For anyone with respiritory ailments, this is very bad news.

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Kit M. December 3, 2012 at 1:16 pm

Those arguments are not ridiculous if you are addressing the following justifications for not hiring smokers:

The reasoning among employers who do this is, of course, the impact of smoking on their health care costs, and for some is tied to an institutional mission to promote wellness.

Which AAM was.

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Not So NewReader December 3, 2012 at 3:21 pm

At one time I had a motorcycle accident. I was out of work for weeks. When I finally returned I was told “You get on a bike again and you are automatically fired.”
I called the labor board “Can they do this?”

YES.

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Anony December 3, 2012 at 11:48 pm

How is that not an invasion of personal privacy??

Am I really going to say this and suggest we need more lawyers on this?

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Not So NewReader December 4, 2012 at 7:05 am

I find it shocking how far an employer can walk into a person’s life and dictate how to live life.

Ironically, if the employer had JUST simply said “Please take care of yourself.” I probably would have chosen on my own to ride the motorcycle less.

Instead, I spent hours trying to figure out if their statement was legal.

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fposte December 4, 2012 at 2:44 pm

There’s no law against that kind of invasion of personal privacy. The at-will doctrine means that absent a law to the contrary, you can fire somebody for anything you please. A lawyer isn’t going to help you on this one–the law just isn’t there.

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Hannah December 3, 2012 at 12:21 pm

I think smoking is different, than say, eating a lot of bacon or riding a motorcycle.

Why? Because people who smoke smell like cigarette smoke and that impacts other people. There are also added issues like smoke breaks and secondhand smoke — even if smoking isn’t allowed in the actual business — it may be allowed 20 feet away from the doorway or whatever that designation is.

Personally, I’m fine with a business (not even just a healthcare facility) not wanting to hire smokers. I don’t want to work in an office where other people reek of cigarette smoke.

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Josh S December 3, 2012 at 12:35 pm

Do people who smoke smell like cigarette smoke after they take a shower? Because there are smokers who like to smoke in the morning and evening and don’t need/crave the smoke break during the day.

Do people who smoke a weekly cigar on Saturday nights smell like smoke when they clock in on Monday morning? Because there are smokers who smoke regularly, but not daily.

Do people who use smokeless tobacco (chewing tobacco, snus, etc) have smoke clinging to every hair and pore? Because there are plenty of people who get their tobacco fix without cigarettes or cigars.

Not everyone who uses tobacco is a chain-smoker who goes through a pack a day. Each of the instances above would have almost zero impact on the person’s ability to work in a health care facility, but would still be caught in a nicotine test. Does this seem like a fair standard?

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-X- December 3, 2012 at 12:49 pm

+1

(I’m not a smoker BTW)

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Hannah December 3, 2012 at 1:53 pm

Life’s not fair. ;)

I don’t care. I don’t want smokers working with me.

Chewing tobacco — also disgusting because I don’t want to see someone spit in front of me or see a “spit jar” kept on someone’s desk.

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A Bug! December 3, 2012 at 2:07 pm

You don’t want to work around someone who smells like smoke. Okay, I can respect that position, even if I don’t agree with it.

But then you say you don’t want to work with smokers, period, which also excludes all the smokers who don’t smell of smoke or have any outwardly-detectable signs of being a smoker while at work. That doesn’t really pass the sniff test; it’s not internally consistent.

I wouldn’t be surprised if you have worked with and respected people in the past who were smokers, it’s just that you didn’t know that you were supposed to find them disgusting because they didn’t tell you they smoked and you had no reason to suspect it.

I suspect your real reason here is “I’m against smoking in principle and I don’t want to work with people whose principles don’t align with mine.” If that’s the case, just be honest and up-front about it rather than casting around for a more socially-acceptable reason that falls apart under scrutiny.

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JPT December 3, 2012 at 2:15 pm

This is an interesting point. Doesn’t a hospital, though, have the right to reject employees who smoke simply because it conflicts with their mission and values, whether or not they smell? From my perspective if you don’t KNOW that they smoke–which is hard to pull off–then it doesn’t really matter. Most smokers do have some kind of scent–their hair, their fingers, etc.–no matter what they do to mask it. If they can pull it off, they deserve the job!

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Jamie December 3, 2012 at 2:32 pm

But if you’re talking about the mission and values part, aside from the effect on patients (which everyone has agreed is valid) then you get into the whole motorcycle, diet, risky sex things as well…because those also go against the mission.

And FWIW, you can’t tell how healthy someone’s eating habits are by looking at them. I’m 5’7″ and when I was younger I weighed between 112 – 119 for years. Who wouldn’t want a healthy co-worker like that? Except that you would not believe what I was doing to maintain that…so it’s absolutely no exaggeration that while I will never see 119 again in this lifetime I am much healthier now – empirically – even though I’m some 20 years older now.

That’s the problem with this – it seems cut and dried to judge one thing: smoking is bad – it’s very simple. But it starts a slippery slope of things that aren’t as simple and that you can’t see on the surface.

It’s just not that cut and dried and you have to weigh privacy issues in this discussion…because if you don’t smoke and you think it doesn’t effect you you’re wrong…because after the smoking it will be something else. And what if it’s something you can’t control?

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JPT December 3, 2012 at 2:38 pm

It’s a tough area, I think, because so many things are risky for your health! Smoking is one of the few that is just as risky to others (but that’s still subjective for others). I really think a nicotine test is going too far; but I wouldn’t hire someone who showed obvious signs of being a smoker. Like you might hire someone overweight, but maybe not if they had donut crumbs all over them. Of course we can come up with a million ridiculous metaphors. I don’t know what statistics say, but I’d guess it’s more effective to offer incentives for not smoking than to block all smokers from working there. I definitely don’t care what people do on their own time, as long as they don’t smell horrible and they don’t do it on the property.

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A Bug! December 3, 2012 at 2:41 pm

But here’s the thing. If a hospital wants to get into that sack of ferrets, they then need to grill applicants about their entire lifestyles. How much do you drink and how often? What kind of food do you eat, how much of it do you eat, and how do you cook it? How much exercise do you get in a week, how much high-intensity and how much low-intensity? Do you consume non-prescription drugs, and how many? Do you drink caffeine? How much? What household cleaners do you use? Do you dye your hair? What do you dye it with? What chemicals do your hobbies expose you to? Do you go to loud concerts? Do you wear ear mufflers when you operate power tools?

The hospital needs to identify what exactly they’re trying to accomplish, because until they do that, they’re not going to be able to accomplish it in a consistent, effective way.

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JPT December 3, 2012 at 2:42 pm

Who says the employer has to be “fair” and ask about all of those things?

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A Bug! December 3, 2012 at 2:54 pm

I’m not really saying anything’s fair or not. I don’t really have a firm position on the smoking issue.

But that doesn’t mean that we shouldn’t be critical of the reasons behind decisions that affect others.

Leaving aside the fact that the nicotine test hurts lots of people who don’t smoke. If the hospital’s ostensive reason for the test is “we don’t want to hire people who don’t embody the principles of healthy living that we endorse”, and the hospital doesn’t give a crap about principles of healthy living such as diet and exercise, then that means the nicotine test is either arbitrary, or motivated by something else that they’re not naming.

And whether it’s legal or not, do you really want hospitals to be running around setting up knee-jerk, arbitrary restrictions on employment? Do you want a hospital to make its decisions on an irrational, politically-motivated basis?

Jamie December 3, 2012 at 3:07 pm

Well, they don’t – to be sure.

But if it’s truly about lifestyle choices in keeping with the mission then if I were to quit smoking and never touch it again, I’d think they’d have just a big a problem if I replaced it with another health averse activity…like having risky sex while base jumping while drinking moonshine.

You know, if it’s about the mission then both should raise red flags. Or just say it’s about making an anti-smoking statement and I’m fine with that, too – but they shouldn’t cloak it in “the mission.”

fposte December 3, 2012 at 2:14 pm

Okay, but would you be all right with making a common habit that somebody thinks is disgusting a reason for an industry not to hire? There are groups of people who think alcohol and caffeine is disgusting; there are definitely people who find anything other than skinniness is disgusting; most people consider nose-picking disgusting. Would you be okay if hospitals limited their hiring accordingly, even if the Taster’s Choice and Kleenex misses happened only at home?

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JPT December 3, 2012 at 2:17 pm

I’d like it if we could attach a fart monitor to prospective employees and if they fart too many times in a 24-hour period, no job!

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Ask a Manager December 3, 2012 at 2:25 pm

And even more problematically, there are people who think gay people / Muslims / Jews / etc. are disgusting and don’t want to work them. It’s not really something that holds up as a reason.

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the gold digger December 3, 2012 at 2:45 pm

I am OK with refusing to hire gum chewers and loud eaters. And hummers. And perfume wearers. I would be very happy with a world run by my rules.

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Jamie December 3, 2012 at 2:50 pm

Throw in a ban on whistlers and I’ll send you my resume.

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JT December 3, 2012 at 6:47 pm

I can’t stand people who jump to conclusions. If I hear someone do that once – just *once* – and I’m done with them.

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Anony December 3, 2012 at 11:52 pm

^ Jamie re: whistlers…you should change your handle to Sheldon :)

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KayDay December 3, 2012 at 3:11 pm

The singers have got to go. I am all for a ban on singers. Sure, some people think they can quit singing, but every time the office gets quite there they go with their Taylor Swift impersonations again!

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Jamie December 3, 2012 at 3:21 pm

I’m in with singers…although I totally read that as “swingers” the first time so I wondered how you would be able to tell…

Definitely time for a new prescription in my glasses…third misread today.

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danr December 3, 2012 at 5:57 pm

Are they wearing ear buds and singing along? It’s amazing how many people do that, and have no singing voice at all.

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Hannah December 3, 2012 at 4:29 pm

If it makes people feel any better, I’m also pro banning perfume.

I SUPPOSE if someone truly, truly did not smell like smoke and I couldn’t detect it, the smoking wouldn’t be a problem.

However, several people have already mentioned that many smokers will swear up and down they don’t smell like smoke, but I can tell.

IIRC, there has also been comments on this blog regarding being disgusted by a spit cup for tobacco chewing left on an employee’s desk.

If someone chewed tobacco, but refrained from doing so at work, I’d have no issues. Chewing doesn’t smell and as long as I don’t have to see spit/etc, I’m fine with you chewing on your personal time.

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Not So NewReader December 3, 2012 at 3:32 pm

This is what I am seeing around me. Even non-smokers are becoming uncomfortable with the laws targeting smokers.
Because once this is all settled, what group of people get targeted next?

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KellyK December 3, 2012 at 4:15 pm

That’s why it has me concerned, for sure. I don’t smoke, but I have to wonder if I’m in one of the groups that’s next.

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JT December 3, 2012 at 6:52 pm

Ditto.

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Not So NewReader December 3, 2012 at 7:53 pm

Jamie noted the militant attitude. We are starting to see more of that and not just with smoking issues.

Ariancita December 3, 2012 at 5:08 pm

Right, I think smoking is a vile and disgusting habit. And it’s an absolute deal breaker when dating someone. But I would have no problem hiring a smoker, as long as they realized they weren’t going to get more breaks than anyone else. And if they arrived to work reeking of smoke, I’d address that in the same way I would any hygiene issue. The principle of not being invasive of other people’s privacy trumps my deep loathing of smoking.

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Rana December 3, 2012 at 9:09 pm

+1

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Kelly December 3, 2012 at 2:41 pm

At both of the local hospitals (both major employers in the area BTW), there is a question in the application asking if you are a smoker. I’m not a smoker and am okay with that question because both offer health insurance to all employees and it’s part of their mission to promote a healthy lifestyle. Like others have bought up, some people who are frequent visitors to health care facilities have severe allergies and smoking is a significant allergy trigger, so it protects the patients and the facility.

Also, having worked in retail, almost all clothing, especially scrubs, absorbs every scent that you either inhale or spray on you. I know most of my clothes probably smells like a combination of Chanel, Prada, and laundry detergent even after washing. Some people might find that combination irritating, but it’s a personal choice and I don’t think that any detergent is completely scent-free.

Returns from smokers are problematic for a couple of reasons. It’s very tough to get the odor out of anything made from fabric (clothing, linens, towels, sheets) and even boxes. Most returns from smokers we have to damage out because the smell rarely comes out. One customer returned over $150 worth of towels because they were the wrong color and I could only get the smell out of a quarter of them. This was after a week, too and it over a $100 loss. I’m not the only one who wishes we had the right to deny a return based upon if it smells like cigarette smoke. The ones who work in clothing see it worse and greater numerical losses. One regular who happens to work for one of the hospitals is a heavy smoker and someone who both buys and returns a lot of stuff. It’s nothing for her to spend ~$500 at a time and return around $300 of that purchase later. Most of that has to be damaged out and sent back. That adds up after a while.

I do think it’s a wee bit hypocritical for a nurse, PA, or doctor who is a smoker to be telling a patient that they need to quit smoking. Same goes for overweight or obese health care professionals suggesting that heavy patients need to lose weight.

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Not So NewReader December 3, 2012 at 3:58 pm

Good point in your last paragraph about doctors, Kelly.
I have known a few doctors that were closet smokers. They would go home at night, draw the shades and light up.
I have known a few doctors who were open about smoking- “I am in no position to tell you this, but for your own benefit, I must say….”

It is always a good idea for a professional to be walking the talk. Would I consider going to a financial adviser with a gambling problem? Hmmm.
Supposes a doctor says to me I need healthier habits. I look at him and see that he is over weight, hasn’t had decent rest in a while, frazzled, etc. What am I supposed to think?
However, if a doctor/other health professional is able to share their experiences getting off of tobacco/caffeine/junk food, I suddenly start to think I am talking to a fellow human being.

It seems to me that if the health care facility were actually interested in keeping health care costs down they would target several issues, not just one. And this can be said of any company. Really, all they can do is encourage good behavior but what the employee does at home is an at-home matter.

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KellyK December 3, 2012 at 4:16 pm

I’m confused here. If items aren’t in their original condition, why are you accepting the return? Is it not being caught until it’s too late, or is it just a trade-off of losing money on the returns to keep customers happy?

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Not So NewReader December 3, 2012 at 8:14 pm

Some places take back anything. I went to an LL Bean tent sale. This is stuff people returned plus damages etc. I bought a sweater for less than half price because it had cologne on it.
The woman at the counter said that people buy things wear them once and then return them. She explained that company policy was to take it back.

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fposte December 3, 2012 at 6:29 pm

I would differ on the overweight thing. When it’s used as an example for hypocrisy in doctors, people tend to use it as if it were the same thing as a doctor who ate unhealthily and didn’t exercise. But it’s not–your overeating can be forty years in the past and still leave you with overweight. It can be more like a doctor who smoked as a teenager but hasn’t since then. The fact is, medical science really doesn’t have a great answer for losing and keeping off weight, nor does any particular program, long-term–success is measured in really small numbers. So it’s not like doctors have some access to a truth that other people don’t and have failed to succeed despite that, any more than a doctor with HIV should be at fault for not curing herself. The successful weight battle is one of prevention, which means that by the time we’re adults we may have already lost it, especially in this era.

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Not So NewReader December 3, 2012 at 8:19 pm

” The fact is, medical science really doesn’t have a great answer for losing and keeping off weight, nor does any particular program, long-term–success is measured in really small numbers.”

Oh how true. I did not lose my extra weight until I got involved in alternative medicine things. It was there that I learned that weight loss is not just about diet and exercise. There is more to it.

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Anony December 3, 2012 at 11:55 pm

^Weight loss/alternative medicine= Might I suggest a sidebar as I am intrigued and want details!

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KellyK December 4, 2012 at 11:12 am

And it gets even more complicated when you consider that a lot of the things that are *recommended* for weight loss (e.g., strict calorie monitoring and tons of exercise) can result in weight gain by screwing up your metabolism unless (and sometimes even *while*) you maintain that super-strict regimen for the rest of your life. *And* the fact that lots of things cause weight gain, not just stuffing your face with donuts on a daily basis. I’d “look” healthier if I went off the meds that have weight gain as a side effect, but I’d actually be a lot less healthy.

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Laura L December 5, 2012 at 8:54 am

Yes and some of those recommendations lead to eating disorders….

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NicoleW December 3, 2012 at 12:32 pm

This seems over-reaching once you get into the nicotine tests. On the other hand, any staff with direct patient contact shouldn’t be coming back from their breaks smelling of smoke. I feel the same way about teachers. There are 1 or 2 staff at my daughter’s after-school program who smoke outside on their breaks and come back in with quite a strong smell.
Is it a feasible policy to just not allow smoking during work hours, including breaks?

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Anonymous December 3, 2012 at 12:37 pm

“…after all, if you’re a hospital, it might seem…”

I want to be a hospital when I grow up!

;)

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Bryce December 3, 2012 at 12:39 pm

Union Pacific Railroad, Scott’s MiracleGro, Alaska Airlines, and Turner Broadcasting are some well-known companies that don’t hire smokers. If I recall, Alaska Airlines makes employees sign an affidavit of non-tobacco use, and some companies do tobacco tests.

The reasons why are too numerous to list here. IMHO, another big reason for not hiring smokers has to do with productivity. Smokers take frequent smoke breaks and get sick more often, for example.

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MentalEngineer December 3, 2012 at 12:45 pm

“On the other hand, is the hospital also going to say that they’re not going to hire motorcycle riders or the morbidly obese or people who eat a lot of bacon?”

This is something of a false equivalence. Unlike smokers, motorcycle riders and bacon eaters bear the brunt of their choices themselves. This is not the case with smoking; unless the employee only ever smokes in their own home or a designated area in the presence of consenting adults, that person is subjecting other people to documented, signficant health risk. That’s what conflicts with a hospital’s mission – they’re bringing someone in whose behavior is self-evidently detrimental to the preservation of public health, not just the individual’s private health.

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-X- December 3, 2012 at 12:52 pm

Driving, at least driving a private car, seems pretty detrimental to public health in a lot of cases. So much pollution, road accidents, contributions to obesity. Is it right to condone that?

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fposte December 3, 2012 at 1:03 pm

Though those activities don’t directly impact the patients, which is I think an important difference.

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-X- December 3, 2012 at 1:26 pm

So fposte, does all smoking impact patients?

A few cigarettes a week at home?

I have a friend who I didn’t know smoked at all till I saw him light up in a bar. He said he smokes at nighttime parties and events – probably a few times a month.

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fposte December 3, 2012 at 1:37 pm

No, but the other examples you have don’t impact patients at all–that’s why it’s different. I’m not arguing for the pre-employment testing here; I’m just pointing out that your argument against it hits an obstacle. I’m also not convinced the literal smell test is as easy to implement as people are claiming, given the struggle people have with on-the-spot information about dress codes (and the reaction people have when being turned away for anything).

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-X- December 3, 2012 at 6:55 pm

My comment that you responded to was merely in response to Mental Engineers claim about mission of not doing things that hurt patients. Car pollution hurts patients. It hurts everyone in the community.

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Soni December 3, 2012 at 1:42 pm

Just as an aside, my husband’s cholesterol levels went down dramatically in the time period during which I gave up vegetarianism and he started eating a lot of bacon and meat that hadn’t previously been in the house (he had been tested prior, and then a test came up few months later after our feast o’pig was initiated). And it continues to go down. His doctor is vastly amused.

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FreeThinkerTX December 3, 2012 at 7:47 pm

Same thing here in my household. Cutting back on carbs and highly processed food kept my boyfriend from needing medication for high cholesterol and high triglycerides. It’s been two years now of our pork-and-meat-protein fest, and our cholesterol profiles are the envy of folks like my dad, who is convinced that a diet high in whole grains is the way to go. (And while it may be great for some people – everyone’s anatomy and genetic makeup is unique – it certainly isn’t the case for him…. he’s on statins.)

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Wilton Businessman December 3, 2012 at 12:51 pm

whether it’s what you eat, what you drink, whether you engage in risky sexual behavior, or whether you choose to smoke a joint or a cigarette
I was right there with you until I hit “joint”. The difference is the other activities are legal and smoking a joint is not (for now).

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-X- December 3, 2012 at 12:53 pm

Can an employer ask if someone speeds in a car, or even jaywalks, and sign an agreement that if they are caught doing so they’ll be fired?

Legally they can. Do you think that’s right?

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Josh S December 3, 2012 at 12:56 pm

For some states. Colorado, for one, has recently decriminalized possession of marijuana. And many states have legal medical marijuana, which is nearly the same thing.

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Josh S December 3, 2012 at 1:18 pm

Hm, it appears that using the common long-form name (with initials MJ) for the material smoked in a joint can get your comment flagged for moderation. Interesting!

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Ask a Manager December 3, 2012 at 1:34 pm

Yeah, there was some heavy spam for a while using the word :(

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Sunday's Child December 3, 2012 at 4:13 pm

Yes, but even if it’s a legal substance, employers have the right to limit use on the job (or perhap before the job if it affects performance). Alcohol is legal, too, but I can’t have it at work or be under the influence at work. Also, the state can arrest me if I am behaving like I’m under the influence while driving or even just stumbling around in public. Legal to consume, not so legal to display problem behavior as a result of using even legal substances.

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Josh S December 3, 2012 at 11:47 pm

Then punish the resultant behavior, not the consumption.

With alcohol, we arrest/fine/punish people who operate vehicles under the influence and fire/suspend/punish people who come to work drunk. But there’s no calls to ban “drinkers” from the workplace.

Why not do the same thing with tobacco consumption? Let the rule stand as, “You can consume, so long as we never smell it. If someone complains, you have to go home and change, and teh time away will be unpaid.” Punish the resulting “problem behavior,” not the consumption itself.

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Sunday's Child December 4, 2012 at 11:50 pm

Josh S., We make the same argument; employers may have the option/obligation to address a legal behavior when/if it creates a problem in the workplace. And in some cases, employers can limit the legal behavior on their business premises or during working/on-call hours and even away from the premises or outside of the working hours if the behavior could have consequences once someone is on the clock. In some cases, laws make it necessary for employers to address personal behavior, in case that behavior transfers the potential for a problem into the workplace. Do what you want in your personal life, and recognize that some personal behaviors create a greater potential for damage or perhaps only a personal offense.
I find it very interesting and enlightening to read the variety of arguments supporting restrictions or advocating freedoms. I will be curious to see what other cultural shifts will take place around what is considered acceptable “personal” behavior and what becomes unacceptable because of a real or perceived threat to health, safety, public good.

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Ariancita December 3, 2012 at 5:18 pm

It’s not just decriminalized (a lot of states have decriminalized it in certain quantities–which means it’s still illegal, but just the punishment for possession is lessened). It’s legalized. In Washington state too.

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Josh S December 4, 2012 at 11:01 am

Wow! I hadn’t realized that! Colorado & Washington are across the country and I’m not likely to go there (and even less likely to smoke pot)–I heard the news around the election but didn’t pay close enough attention to the details (or the main thrust, even) apparently. Thanks for the clarification!

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Ariancita December 4, 2012 at 11:56 am

We’ll see what will actually happen in practice because it’s still against federal law. But hopefully it sticks. I’m not a pot smoker, but I’m a big believer in its legalization.

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Mike C. December 3, 2012 at 2:03 pm

So you’re cool with the idea of your employer making sure you follow every traffic law when you go driving? Or that you don’t play online poker?

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Kathryn T. December 3, 2012 at 3:26 pm

Washington & Colorado have both made recreational marijuana explictly legal.

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ChristineH December 3, 2012 at 12:51 pm

Interesting topic, and one with no real black-or-white answer. I am definitely in favor of this ban applying to those who are in constant contact with patients–whether it’s inpatient or outpatient–or who are regularly in patient areas as part of their jobs (e.g. janitorial staff–they don’t treat patients, but may clean the rooms), strictly because of the effect this can have on many patients, particularly those with respiratory problems. (wow, run-on sentence, sorry!) At the very least, I’d impose a ban on smoking at ANY time during your workday, including during breaks.

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ChristineH December 3, 2012 at 12:55 pm

Whoops….I should clarify that the not-so-clear answer for me relates to other types of employers. Even in a hospital, I’m sure there are other a couple departments that don’t directly interact with patients (e.g. a development office, medical records, information systems).

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TL December 3, 2012 at 2:19 pm

Unfortunately, you’re still subject to the same rules and basic training and laws even if you have no patient interaction. At least you are in my state.

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Elizabeth December 3, 2012 at 2:20 pm

development office, medical records, information systems

In our facility, all of those departments have some level of interaction with patients.

The development officer is part of the administrative team that meets with newly-admitted patients to assure that they feel they are getting the care they need.

Medical records staff is responsible for filling out birth certificate forms for the state.

We have PC’s in every room, for positive patient identification for medication administration & blood transfusions, as well as for physician use. The information systems staff has to touch almost all of them on a regular basis if the nursing staff report problems. Not being able to scan a critical medication or record vital signs during a transfusion would be a significant problem.

Almost every department in a facility has some patient contact, unless they’ve managed to completely outsource a piece of their operations. The same reason we all get Hep B & MMR vaccines is the same reason that we don’t want employees smelling of smoke or perfume.

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ChristineH December 3, 2012 at 4:04 pm

Ahh okay, that all makes sense. I just assumed those type of departments don’t interact with patients (I’ve volunteered in hospitals, but it’s been a number of years), and we all know what assuming does…. ;) Thank you for clarifying.

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Eric December 3, 2012 at 12:52 pm

I can see preventing people from smoking on the premises or taking additional smoke breaks but telling employees that they can’t smoke at home may be going too far (since cigarettes are legal, after all).

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Anonymous December 3, 2012 at 12:54 pm

Although controversial, I don’t see a problem with this. People choose to smoke despite being educated for decades about how harmful and dangerous it is health-wise. So, if I’m an employer, I sure as heck don’t want to hire someone who is willingly smoking a pack of cancer sticks a day, for which I will be paying the cost because I am contributing to this person’s health insurance premiums. I also don’t want my non-smoking employees to have to inhale this cancer causing smoke, and don’t want to deal with my employees going out for smoke break every few hours. If you want to work somewhere that doesn’t allow smoking…. STOP SMOKING.

One of my father’s coworker’s is dying from throat cancer and he’s never smoked a cigarette a day in his life. My brother is 24 and smokes despite being told since we were 5 that it causes cancer. My aunt smoked, even though her daughter was developing respiratory infections from it and had to use an inhaler as a baby. Sorry to say it, smokers piss me off for their blatant disregard of their own health, and the health of those around them. Now, I understand older generations who didn’t know what they were getting into, but anyone 30 under was raised with the knowledge and chose to disregard it.

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Josh S December 3, 2012 at 1:02 pm

You can accomplish all of your goals without banning smokers from your workplace.

“People choose to smoke despite being educated for decades about how harmful and dangerous it is health-wise.”
People choose to ride motorcycles without helmets, go skydiving, and a variety of other activities where the dangers are significant and well-known, but you don’t ban them from the workplace.

“I will be paying the cost because I am contributing to this person’s health insurance premiums.”
It is entirely possible to pass the cost of higher premiums along to the plan participants who smoke. I was part of such an employer-subsidized health insurance plan, where smokers paid ~$50-75 more per month because of their tobacco consumption.

“I also don’t want my non-smoking employees to have to inhale this cancer causing smoke, and don’t want to deal with my employees going out for smoke break every few hours.”
So prohibit smoking on premises and/or during work hours. None of your other employees will be exposed.

None of those solutions are difficult, and you’re not excluding potentially high-quality employees from your team.

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fposte December 3, 2012 at 1:05 pm

How were smokers identified for this higher premium? Was it self-selecting and thus unreliable, or were they tested–which is one of the things that bothers people about the total prohibition policy?

(I don’t actually have a stand on this, BTW; I’m just thinking about the issue.)

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Josh S December 3, 2012 at 1:20 pm

Self-selecting, but with consequences if discovered to be misreported. (One guy smoked cigars on his breaks EVERY DAY, but put down that he was a non-smoker to get the price break. He was forced to pay the difference in premiums, and was given a written warning.)

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the gold digger December 3, 2012 at 2:54 pm

And if you lie on your life insurance application and you die and your spouse tries to redeem the policy and they find out you lied, your spouse will get a refund of the premiums paid with a polite statement that the policy was obtained under fraudulent premises and was never valid.

Which means your family goes to the poorhouse.

So don’t lie about this stuff.

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Josh S December 3, 2012 at 3:43 pm

Very true. When the wife and I applied for life insurance and they asked on the questionnaire, “Are you a smoker?” I asked for their definition of ‘smoker’ to be sure that my 1-3 cigars each year didn’t qualify me per their definition. Gotta be certain and exact with the fine print folks.

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the gold digger December 4, 2012 at 9:28 am

Unfortunately, my husband’s life insurance policy has a binary standard: either you smoke or you don’t. My husband is a social smoker who might smoke five cigarettes a month. I would like him to quit because that little hobby drives his rate from $16 a month for $250K of insurance to $51. That’s an expensive hobby.

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Anonymous December 4, 2012 at 12:18 pm

Maybe he should smoke more to get the full value out of that higher rate ;-0

Getting Political December 3, 2012 at 1:46 pm

I predict future lawsuits ultimately deciding this isn’t legal. Not sure what basis I have, since it’s legal for life insurance & private health insurance companies to correlate premiums to risk. My employer insurance program charges the same rates for tobacoo users & non-users, but the users have to participate in cessation programs to get the lower rate. I think that might be where every company ends up.

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Mike C. December 3, 2012 at 2:06 pm

I think it’s more likely you’ll see tobacco companies lobby for worker protections at the state level than actual lawsuits.

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Anonymous December 4, 2012 at 12:20 pm

GP – on the logic of it I think you’re right, but in terms of how suits work out we’re seeing more and more power go to government and organizations over individuals and labor in court decisions, so I’m doubtful the lawsuits will succeed.

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TL December 3, 2012 at 11:22 pm

Yes, but my guess is that $50-75 more/month doesn’t actually make up the money spent treating late stage lung cancer, so the cost is still being paid by others. (After 40 years, that’s only about $24000 which isn’t that much in terms of medical bills.)
That’s what insurance is for, though.

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K December 3, 2012 at 1:00 pm

Sadly, I’ve heard many stories of obese people being discriminated against in health care fields as well. I have to say, the moral example argument holds no weight for me. I don’t want my doctor to be someone who can non-hypocritically lecture me on obesity or smoking; I want my doctor to be someone who’s a brilliant physician. (Likewise, I could not care less if my hair dresser has an ugly haircut; my house keeper has a messy house; or my cobbler’s children has awful shoes.)

The other thing to note here is that over the long-run, these policies are going to disproportionately affect certain socioeonomic groups (among which smoking is more prevalent) much more heavily than others. It may be perfectly legal for that to be the case, but it’s something ethical employers should think about.

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Elizabeth December 3, 2012 at 3:20 pm

There was a hospital that instituted a “no obese workers” policy last spring: http://www.texastribune.org/texas-health-resources/health-reform-and-texas/victoria-hospital-wont-hire-very-obese-workers/

I thought I remembered reading a discussion of it here, but since I can’t find it in the archives maybe it was Evil HR Lady or Reddit.

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JB December 3, 2012 at 1:06 pm

I think pre-testing for nicotine goes too far, but I can definitely understand that a hospital wants to keep its building as smoke-free as possible. I am allergic to smoke and asthmatic (fun combination) and when I’m on the elevator with someone who hasn’t changed clothes since they last smoked that does trigger an attack. I’d hate to have that experience if I was already weakened enough to be in the hospital.

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A Bug! December 3, 2012 at 1:53 pm

Right, but a “scent-free” policy would address that problem much more effectively. There are tons of products that emit odors that are dangerous to hospital patients. Strong shampoo or deodorant, perfumes, aromatic foods, campfire smoke. None of these are addressed by refusing to hire smokers.

“Hospital employees are required to maintain a neutral scent with respect to their selves and their clothing. We expect employees to exercise appropriate hygiene and discretion in ensuring that they are not risking patient health by bringing unnecessary odors into the building. Breaches of this policy will be handled on a case-by-case basis and may result in the breaching employee being sent home without pay to address the problem.”

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Jamie December 3, 2012 at 1:56 pm

You make an excellent point, but I totally cracked up at “campfire smoke.”

Just conjured up the image of someone laying down their marshmallow stick, brushing off their pants, and leaving the woods to head in to work at a hospital. Hee.

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Elizabeth West December 3, 2012 at 3:40 pm

“Oh, I had s’mores for breakfast!”

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Natalie December 3, 2012 at 5:57 pm

This has actually (sort of) happened to me. We have a lot of bonfires in the fall, and I have worn my jacket at a Saturday bonfire for several hours, only to notice on Monday that it still *really* smells like bonfire. Especially if it is raining. Ick.

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KarenT December 3, 2012 at 4:48 pm

I do realize the campfire reference was probably a joke, but campfire smoke can’t be compared to cigarette smoke. Unlike cigarette smoke, campfire smoke does not contain formaldehyde, cyanide, arsenic, or lead. Unless of course you were burning something besides firewood!

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A Bug! December 3, 2012 at 5:23 pm

Most of the other things I listed also don’t contain those things, I would hope! Doesn’t change the fact that any strong odors run the risk of triggering respiratory distress in a vulnerable patient.

Which is why a general scent-neutral policy would be more effective than carpet-bombing smokers if protecting patient health is the goal.

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Henning Makholm December 3, 2012 at 5:26 pm

Really? Do you claim that tobacco smoke contains those things in greater proportion than campfire smokes? Where would they come from there? It’s not as if arsenic and lead are deliberately added to cigarettes, as far as I know — are there data saying they are more prevalent in tobacco leaf than in firewood? Formaldehyde and cyanide are chemically simple enough that one would assume them to be produced in about the same measure when burning vegetable matter of any kind. Cyanide requires somewhat anoxic conditions, but seeing how a campfire can flare when you blow on it, there would seem to plenty of that going on there, too.

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KarenT December 3, 2012 at 8:16 pm

I will confess having never done a chemical analysis on a campfire, but yes, many hazardous chemicals are deliberately added to cigarettes. A quick Google search will lead you to some pretty conclusive evidence on that subject. And there have been tons of lawsuits won by complainants showing cigarette companies have deliberately added toxic chemicals (and knew of the effects on health) without disclosing that information.

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Henning Makholm December 4, 2012 at 6:51 am

Do you have data that point to specifically the elements lead and aresenic being added to tobacco products? For what possible purpose?

Do you have data that point to the specific compounds formaldehyde and cyanide (both simple chemicals built from ordinary CHON atoms, which would need to be produced during the combustion rather than added in advance) would be produced in larger amounts when burning tobacco than when burning other vegetable matter?

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Laura L December 3, 2012 at 7:29 pm

That’s true, but smoke is smoke and it’s still damaging to your lungs and can trigger asthma and other respiratory problems.

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fposte December 3, 2012 at 10:03 pm
Laura L December 4, 2012 at 8:32 am

Thank you! I’ve been saying this for years, but even people who are adamantly against cigarette smoking think it’s going too far to say that fireplace or campfire smoke is bad for you!

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JB December 3, 2012 at 5:22 pm

I’ve never heard of a “scent-free” policy before, but I LOVE IT. In my case, it’s true that other scents such as perfume can also trigger attacks, and I wouldn’t want to smell that in the hospital either.

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Can't Say, Small Town December 3, 2012 at 1:09 pm

I disagree with the administrator here because smokers bring their private lives into their work. A different point of view is my father-in-law’s battle with cancer and his respitory therapist being a smoker, carrying a vile smell into the hopsital room when arriving to adminster therapy. I tolerated this once and then met with the nursing supervisor to request a different therapist. The situation was so ridiculously hypocritical that the person destroyed all credibility as a healthcare professional. As an aside, I had a physician who was quite obese. I soon moved to a new practice because I didn’t respect him in his role.

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A Bug! December 3, 2012 at 1:47 pm

Not all smokers carry along with them a Pigpen-style cloud of smells. You’re conflating “people who reek of tobacco smoke” with “smokers generally.”

There are lots of excellent comments in here as to why “anybody with nicotine in their system can look elsewhere for work, we don’t care why it’s there” is a short-sighted, invasive, and ineffective solution to a perceived problem or problems.

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Josh S December 3, 2012 at 1:16 pm

OK. I feel like I need to put out a couple notes of clarification for what is turning into a debate.

1) Tobacco use does NOT necessarily equal smoking cigarettes. There are cigars, chewing tobacco, snus, and other tobacco products. (Cigarettes are, by far, the biggest category by volume and value in the US, but there is a significant market for the other products too.)
2) Those who smoke cigarettes do not necessarily smoke incessantly. Plenty of people smoke occasionally, one-cigarette-per-day, or a few.
3) The nicotine test will return a positive result for any number of things, including second-hand exposure, smoking cessation aids, etc. It doesn’t test for the actual thing desired–does this person put a cigarette to her lips and light it, or not– and IMO fails as a reasonable test to give.
4) There really needs to be a clear definition of “smoker” for these policies. I consider myself a non-smoker — I don’t smoke cigarettes, and smoke appx 1-3 cigars per year. By some definitions, I am a smoker, since I consume tobacco products. By other definitions (like my life insurance and health insurance) I am NOT a smoker. Lumping things into a binary state of smoker/non-smoker is horribly over-simplified.

I have a (European) friend who is fond of saying, “Yeah, I just quit smoking. In fact, I quit 5 or 6 times every day.”

The debate really ought not to be about classifying people into two groups, but rather on the actions taken and the effects those actions have on results. I don’t care if you’re an occasional smoker, a 3-packs-a-day smoker, or if you chew.

I do care that you’re working and getting things done, and not taking multiple ‘smoke breaks’ through the day that limit your availability and productivity. I do care that you don’t smell like a wet rat trapped in a chimney, which is distracting to clients and co-workers, and may cause health issues for the people nearby.

None of this requires me to know if you’re a smoker in your free time or not. It does require that you don’t smoke at the office, and that you don’t come to work smelling like you smoked a pack during your commute.

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Julie December 3, 2012 at 1:30 pm

+1

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fposte December 3, 2012 at 1:42 pm

I think the fact that there is other tobacco use only matters if you as an employer think that their being able to use, say, snuff is more important than you not having smokers on their staff. I think hospitals who are keen to have no smokers not only wouldn’t be bothered by excluding chawers and snuff-users (cigar smokers are technically smokers already) on the health habit grounds, they’d be quite pleased.

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KarenT December 3, 2012 at 1:45 pm


None of this requires me to know if you’re a smoker in your free time or not. It does require that you don’t smoke at the office, and that you don’t come to work smelling like you smoked a pack during your commute.

I can agree with you in principle, but in practice that gets really messy, really quickly. Most smokers I know would swear that they never smell like smoke, but anyone sensitive to smoke would disagree. Heavy smokers often reek of smoke regardless of when they last showered. I can’t stand being around the smell of cigarette smoke; my asthma and allergies are instantly aggravated and that would go tenfold if I was in the hospital.

I strongly admire a healthcare facilities desicion to keep the entire premesis smoke free (ie., no smoking on breaks or anywhere on the property).

I do, however, think the bloodtest takes it too far.

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Anon December 3, 2012 at 2:26 pm

What about a spouse who smokes? Gets harder and harder to draw a line.

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Joey December 3, 2012 at 3:52 pm

Most employers I know that do this technically ban or provide disincentives for any tobacco use, not just smoking. The justification most employers give is that the rate of tobacco use strongly correlates to unnecessary increases in their healthcare costs and rates. Truthfully, its easy to pick on smokers because its socially acceptable to do it, they’re fairly limited in size, and there aren’t any underlying medical conditions that cause it (unlike obesity). And please don’t argue that stress causes smoking.

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Not So NewReader December 3, 2012 at 4:26 pm

Yeah, THIS. I find it kind of frightening how it is socially acceptable to pick on smokers. In as much as there is a lot to be said about the smoking issue, there is more to be said on the way society reacts to a smoker. Cocaine addicts/drinkers/etc do not get this much attention.
I know plenty of people who work under the influence of drugs and/alcohol.

I see two problems. One is people with addictions. The other is how people react to that person with the habit.

One time, I saw a middle age man, SLAM a younger woman in the back with his fist. Her offense? She was smoking in a non-smoking area. I could not believe what I was seeing. I looked around- there were no signs to indicate no smoking. But he felt he had the right to use his fists on her. I find this alarming that our society has come to this.

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KellyK December 3, 2012 at 4:35 pm

Holy crap. I hope she called the police and he was arrested for assault.

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Jamie December 3, 2012 at 4:43 pm

Well, I bet she came around to his point of view right away – seeing as his fist was such a reasoned argument.

This reminds me, without the violence, of a time when my eldest was about 4-5 and we were in a park at a picnic table and he was eating a happy meal – chicken nuggets. Some woman came up to me and told me that the chicken he was eating had a mommy, how would I feel if someone made nuggets out of my baby.

Holy crap – I don’t remember all conversations from 10+ years ago but I sure remember that.

Oddly enough her approach didn’t win me over to her philosophy…but it did make me extra nervous about being approached in the park.

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KarenT December 3, 2012 at 5:01 pm

I’ve never met your child and I am so angry on his behalf. Way to force your beliefs by upsetting a little kid!

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Natalie December 3, 2012 at 6:02 pm

“And please don’t argue that stress causes smoking.”

This probably wouldn’t be as common of an issue for healthcare workers, but there is quite a bit of research to support the link between smoking and miscellaneous mental illnesses (mainly depression and schizophrenia). A friend of mine works in a psychiatric treatment ward in a hospital, and apparently they have had some difficulty determining what the policy on patient smoking should be and how to best carry out that policy, as they obviously don’t want to just let the patients go outside whenever they want.

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Getting Political December 3, 2012 at 1:37 pm

Obamacare is really ruining things for me.

While I am generally health conscious myself, I’ve historically held the opinion that you can do what you want as long as it doesn’t affect me. So, in the case of the off-duty hospital worker smoking, I wouldn’t care — historically.

But if we’re going to grow the ranks of those covered by taxpayer-funded healthcare, with me being in the half of the citizens who pay taxes, suddenly your private behavior in your home affects me. It’s not just smoking. What you eat, if you wear your seatbelt, and the precautions you take in your intimate relationships all become public health issues to me. I really dislike this, because I think it opens a window for future legislation by the government.

(Assuming the hospital has its own insurance for its employees, I’m not personally affected, but I can take the view of the company and the other employees who do not want their premiums increased due to behaviors of others. And, of course, as the company’s costs go up, so do the costs paid by the patients.)

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Elizabeth December 3, 2012 at 2:12 pm

Obamacare is really ruining things for me.

Most healthcare facilities went smoke-free in the 1980′s as a way to prevent fires in patient care areas and tobacco-free in 2004 to 2007 in comply with state regulations/laws. This has nothing to do with the Affordable Care Act. In point of fact, the ACA has no language related to tobacco consumption.

(Yes, I’ve read it. Yes, it is long & boring. It has a direct impact on my employment. One of the job skills I have is the ability to simplify long, boring government regulations into something the average person who doesn’t have that ability can digest & use. It’s a very useful skill.)

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Julie December 3, 2012 at 2:13 pm

Do you happen to have a write-up of your simplified version, anywhere? I’d love to read through a summary, though not the long & boring original.

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Not So NewReader December 3, 2012 at 4:27 pm

I would be interested, too, Elizabeth.

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Ariancita December 3, 2012 at 2:13 pm

As a tax payer, you pay incredibly for the uninsured every time they show up to the emergency room for all sorts of illness that could have been prevented had they access to health care and preventative care to begin with.

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Anonymous February 7, 2013 at 2:02 pm

Thank you!

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BW December 3, 2012 at 2:34 pm

You realize Obamacare will require people to purchase *private* insurance on their own. It’s not the government giving people healthcare, which is essentially what happens now every time an someone ends up in an ER for medical care and doesn’t pay their bill.

Obamacare does not have a public option for people who do not qualify for Medicaid or Medicare, only programs to allow people easier access to buying *private* insurance and tax credits for some individuals and businesses for purchasing *private* insurance.

That said, even those of us paying for private insurance are affected by anyone else paying for private insurance who is not as healthy. Insurers pass the cost on to everyone. The more healthy people there are in the overall pool paying in and not taking as much out, the more i sets off the increased cost of people who are sick or injured and keeps costs for everyone down overall. That’s the theory behind the mandate portion of the law.

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Mints December 3, 2012 at 5:50 pm

+1
Private insurance mandate just means more people are buying same old insurance. It’s seriously not different.

PS It tends to be young people who are insured because we feel immortal! (just kidding lol)

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Rana December 3, 2012 at 9:35 pm

You know what? I call foul on this. I’ve been self-insuring off and on for the last decade, in several states, and the current quoted premiums for the same care – with the same provider – in this state are exactly in line with those earlier quotes. (Indeed, they are about the same as the quotes I got before ACA passed.)

The difference? Now those policies will actually cover a bunch of things they didn’t cover before, like prenatal care and a bunch of other preventive stuff. And they can’t reject me for a pre-existing condition from ten years ago, as once happened. So, maybe, yeah, it sucks if you’ve never bought insurance and now are facing that decision, but for many of us who’ve been riding this horse for a while, ACA is a blessing.

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Rana December 3, 2012 at 9:47 pm

That was a reply to the original comment. Oops!

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Ariancita December 4, 2012 at 11:57 am

LOL! I was wondering… :)

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Mike C. December 3, 2012 at 3:31 pm

This is nothing to do with the Affordable Care Act.

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Lisa December 3, 2012 at 1:45 pm

I don’t smoke, but I think policing an employee’s actions during their private time goes too far. It would be perfectly reasonable to bar all smoking during business hours for people working at a hospital, and to notify smokers during the hiring process that their employment will be terminated if their use of tobacco products causes a patient to have a negative health consequence such as an asthma attack. Social smokers who smoke one or two cigarettes a few evenings per week are perfectly capable of abstaining during the day and showering thoroughly before coming to work to remove cigarette smell. Heavy smokers would probably be put off by learning that they could be fired on the spot if a smoke smell caused consequences for a patient.

I’m disturbed by the larger trend of “hire the healthiest” to save on insurance, though, ESPECIALLY in the health care industry. People working in health care should be aware that there are many individuals with expensive health conditions who got them through no fault of their own, or even who took stupid risks (like getting lots of sunburns) when younger and would do anything to take those risks back now. It’s a short leap from “no smokers” to “no fat people,” for instance.

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Jamie December 3, 2012 at 1:51 pm

Not to mention that older employees tend to use medical care more often than when they were younger (well, I don’t, but I see it in my 40ish peer group) and that’s a slippery slope if you are trying to make sure you hire people who will only lightly use the insurance.

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K December 3, 2012 at 1:56 pm

Yep, and that cuts across a number of problematic distinctions. How about people from poor families? Chances are they’re going to make heavier use of the company’s dental insurance. Women of childbearing age? Giving birth + maternity leave is expensive. Etc. And yeah, in some cases there are separate federal laws to protect certain groups; but it doesn’t really ethically feel right to me regardless of what criteria you’re using.

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KarenT December 3, 2012 at 2:28 pm

I get your bigger point, but I don’t think those are fair comparisons. Gender and age discrimination are prohibited. Smokers are not a protected class.

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K December 3, 2012 at 2:32 pm

But ethics are different than laws (though as the post noted in some states it is illegal to discriminate against smokers in hiring), and so we can talk about the ethics of making determinations about how much money a potential employee is going to cost the company in benefits separately from the legality of it.

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KarenT December 3, 2012 at 2:39 pm

Fair enough, but it still doesn’t feel the same to me. Smoking is much more a choice than the other things you mention (I know it’s highly addictive and quitting is one the most difficult things you can do). It is easier not to smoke than to not be female, old/young, or poor.

That being said, I really do think the bloodtest takes things too far, and as fposte says below, we don’t want to start the practice of discriminating for non-criminal behaviour.

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fposte December 3, 2012 at 2:05 pm

Yes. I really think that these other arguments weaken the real one: we don’t test to preclude any other non-criminal private-time activity–do we really want to start that practice?

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Ariancita December 3, 2012 at 2:08 pm

Great insights as to the reasoning but funnily enough, it’s a sort of known anecdotal fact around my parts that the most unhealthiest people (lots of smokers, obesity, etc) work/teach in medicine at my university hospital. Shockingly so. But maybe that’s why hospitals and health care settings are trying to reel it in now.

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K December 3, 2012 at 2:13 pm

I would imagine it’s a function of how stressful those professions are. I don’t work in healthcare, but I can only imagine that if I did, I might feel like smoking offered me some blessed relief from the long hours and difficult work!

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Ariancita December 3, 2012 at 3:11 pm

No doubt. I don’t work with patients and I don’t envy those who do. It’s tough work!

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Not So NewReader December 3, 2012 at 4:33 pm

Just the amount of human suffering these people see. That is the number one reason I will not work in health care. The stress of seeing someone suffering… I have see enough of that around me now.
So fine, take away the typical stress relievers- junk food, alcohol, smokes… but give people in the health care industry coping tools to process all that comes at them.

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Pam December 3, 2012 at 2:11 pm

Because hospitals are largely governed by CMS requirements and accrediting agencies (like The Joint Commission, which introduced new smoking-cessation standards earlier this year), I would imagine these hospitals are trying to ensure they meet whatever measures are necessary for reimbursement and accreditation.

Possibly, these drug screenings and cessation programs for prospective employees are one way the hospitals are attesting to some regulatory requirement.

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Ariancita December 3, 2012 at 5:35 pm

Yes. I don’t know if I posted after you or not, but this is exactly what I was alluding to with respect to compliance on hospital measures and medicare funding.

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Hugo December 3, 2012 at 2:16 pm

In my experience, non-smokers are much more productive than smokers. Smokers live to smoke, and their time in between actual smoke breaks is spent thinking about smoking. They are never 100% focused on the job. It won’t be long before smoking is banned in all workplaces, and that will be good for everyone. Productivity will skyrocket and the US economy will eclipse other nations left and right.

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Jamie December 3, 2012 at 2:25 pm

This is patently untrue. I understand there is a bias bordering on hatred for people who smoke, which is certainly the prerogative of the people who hold that opinion…but to condemn the work ethics of millions of people because they have a habit of which you disapprove – I can’t find the logic in that.

And assuming to know what millions of strangers are thinking – that’s really presumptuous.

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Ask a Manager December 3, 2012 at 2:28 pm

Agreed. That seems like a wildly broad stroke to paint millions of people with. I don’t smoke, and I hate smoking. My father died of cancer caused by smoking. But come on — “smokers live to smoke” and are never fully focused on the job? That doesn’t stand up to any scrutiny.

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Not So NewReader December 3, 2012 at 4:35 pm

Yes, it does seem to work into a hatred issue, doesn’t it?
I do recall a study that showed that smokers were actually more productive than non-smokers.

My take away? I think one can find a study somewhere that “proves” almost anything one wants to prove.

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Jamie December 3, 2012 at 4:38 pm

Isn’t that the truth. What’s that old saying, “there are lies, damned lies, and statistics?”

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Not So NewReader December 3, 2012 at 8:02 pm

I took a statistics course for my degree. On the first day, I knew I was in trouble.
The prof walked in and said “There is no such thing as statistics. Numbers can be made to prove anything you would like.”

Oh yeah. I knew I would do well in this course. (NOT)

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KarenT December 3, 2012 at 2:34 pm

Smoking is something I’d generally never defend, and yet I find your comments offensive. I just can’t believe there is any truth to that notion.

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fposte December 3, 2012 at 2:54 pm

There is actually some indication that smoking correlates with higher absenteeism, which is one productivity metric:

http://ehstoday.com/health/ehs_imp_39313

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Julie December 3, 2012 at 3:11 pm

Interesting study, though you probably wouldn’t want to use it for hiring practices. There’s no point in punishing one behavior (smoking) when you really want to punish another (absenteeism). Ah, correlation and causation, my old friends… :)

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Josh S December 3, 2012 at 3:50 pm

Obligatory webcomic: http://xkcd.com/552/

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Anonymous December 3, 2012 at 11:55 pm

If ever a body of evidence has been subjected to the best hostile peer review that money can buy, it’s the evidence for the adverse effects of smoking.

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Jamie December 3, 2012 at 3:17 pm

There was a line in there that caught my attention:

“Smokers More Likely to Struggle with Depression, Anxiety, Asthma”

I can’t speak to the depression or asthma…but I think with the anxiety it’s more of an effect than a cause for many people.

IOW I don’t think smoking causes anxiety, I think it’s a way of self-medicating anxiety for people who would have it anyway…in many cases.

People always wonder why smokers haven’t quit – and it’s a valid point. Non-smokers don’t see what’s in it for smokers, but it’s a really expensive habit these days and if we didn’t get something out of it no one would do it.

I’m not saying that it’s right, or there aren’t other, healthy, ways to meet the same ends but one of the big pay offs is that many of us find it soothing. It’s a stress reducer.

I never smoke at home. I don’t smoke in front of other people, I have never smoked in front of my family. I would never stand outside and have a cigarette with co-workers. The truth is when I’m not stressed I never even want one. I go all weekend and don’t even think about it. It’s some weird way of processing work for me.

I’m glad we can’t smoke at our desks, because if I was able to do it when I was most stressed forget my being a casual smoker.

Anyway, I don’t even know where I’m going with this except that I found the link between smoking an anxiety interesting.

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fposte December 3, 2012 at 3:30 pm

Yeah, the same thought occurred to me on anxiety.

I think smoking is really interesting because it hits so many buttons. It’s class marker, it’s an aesthetic challenge, it’s a minority activity but a large minority, all of which combine to make it a soft target. I’d just as soon it disappeared, and I know my father’s smoking affected my health as well as his. But that’s not the same thing as making it okay to do anything you please to just this one practice.

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KarenT December 3, 2012 at 3:39 pm

I think there has been some fairly conclusive evidence that smoking causes (or at least increases) anxiety. Nicotine causes elevated pulse and other symptoms that increase anxiety. It is true that some smokers use cigarettes to calm anxiety (I, for one, used to smoke during exams when I was in school but never at other times), but that doesn’t mean it is effective. Some alcoholics use alcohol to medicate depression but alcohol actually increases depression.

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Elizabeth West December 3, 2012 at 4:33 pm

Many smokers don’t quit because they are addicted. It’s addictive! I used to smoke and this entire thread is making me want to do it again. That and the tremendously stressful, horrible, awful, life junk I’m going through right now. Yeah, some people definitely use it to self-medicate.

I only smoked outside, except at the company break rooms. I never smoked in my car and when my last company made us go outside, I went. I’m very glad I quit. It’s far too expensive to keep doing it, I can’t skate a two-minute program when I’m huffing and puffing, and I’m much nicer to kiss (even though I was recently dumped, and BOY does that make me want to smoke!!!). But I still want one now and then.

I can’t ever casually smoke, because I will start again. It took Chantix to get me off it last time, and there’s no telling what may happen this time. Also, I am praying like crazy to get married and have a baby before it’s too late, so I DO NOT want to smoke again right now. I’m glad to be able to say “No, I don’t smoke” when an employer asks.

If we had a nuclear war and I survived, all bets are off. I’m going to loot the convenience store and smoke like a chimney.

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fposte December 3, 2012 at 3:03 pm

To be clear, that’s a very different statement about productivity from Hugo’s, which seems pretty insupportable. I just thought it was an interesting study. (Of course, there are doubtless other group vs. group differences in absenteeism, too; that’s not an argument for hiring only from one group.)

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KarenT December 3, 2012 at 3:41 pm

Thanks for sharing the study. It is very interesting.

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Laura L December 3, 2012 at 2:40 pm

Also, the US economy probably isn’t going to blow away the economies of any other country any time soon. Regardless of productivity increases (which I doubt are THAT affected by smokers taking breaks).

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KarenT December 3, 2012 at 3:42 pm

Agreed. There are lots and lots of countries with booming economies that have high number of smokers (some South American or Asian countries come to mind).

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Jamie December 3, 2012 at 3:49 pm

Not to mention previous generations in this country where far more people smoked and things were productive as hell.

(Not saying that the smoking caused productivity, because I’m not crazy, just saying the WWII generation for example sure smoked a lot more than we do and they did a thing or two to build industry in this country.)

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Laura L December 3, 2012 at 7:20 pm

Yep, that’s my point!

I bet smoking is not at all related to a country’s productivity. Also, developing countries tend to have faster growing economies than developed countries. Although I think the reverse is true in terms of productivity per worker.

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LL December 3, 2012 at 3:21 pm

Hugo’s comment may seem a bit inflammatory, but he’s got a point. Studies have repeatedly shown that smokers are less productive than non-smokers. Smokers take more breaks and miss more days of work. Their health insurance premiums are quite a bit higher.

Who should shoulder the burden for these costs? The smokers? Or their non-smoking co-workers? It seems like the general consensus is that non-smokers should subsidize these costs to protect the “private life/ personal choices” of the non-smokers.

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LL December 3, 2012 at 3:23 pm

Correction: subsidize these costs to protect the “private life/ personal choices” of the *smokers.*

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fposte December 3, 2012 at 3:33 pm

I think you were right both ways–they’re subsidizing risky behaviors of everybody, not just the smokers. Smokers are just one of the easy catches. As Josh notes, some workplaces have offset this; others may not want to get into the whole can of worms that might open.

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Jamie December 3, 2012 at 3:42 pm

That;s exactly right – it’s easy because smoking really has zero redeeming benefits. So everyone can point, aim, fire because it’s impossible to defend.

Which sounds odd as it may seem like I’ve been defending it, but I’m not…I just want people to separate a bad habit from bad people and co-workers…because not everyone with the habit is guilty of slacking and constant breaks, etc. If a smoker is a lousy co-worker because they reek and are always sick or slacking then off with their heads – but it should be about the problem behavior (stinking, slacking, staying home) than the cause, imo.

But as to what’s next – first it will everyone not within recommended BMI (which is already stickier because some people are skinny by unhealthy means, genetics plays a role, etc.), but then what?

If you are a rock climber maybe that’s awesome because you clearly exercise more than I do since I’m not scaling mountains on the weekend. Or a diver, because swimming is great exercise and fairly indicative of an active lifestyle. On the other hand, my staying home and dangling things in front of my cats won’t cause me to fall off a mountain or be attacked by a giant squid (#1 on my least favorite ways to die).

Hyperbole, sure, but it does get harder to parse out.

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JT December 3, 2012 at 11:34 pm

A few people actually like smoking, so it’s not quite accurate to say it has zero redeeming benefits. Pleasure (for some people) is a benefit.

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Anonymous December 4, 2012 at 2:03 pm

God heavens, nothing fits together better than a cold beer in one hand and a cigarette on the other. That’s why no one would guess I smoke – I don’t drink beer at work either!

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LL December 3, 2012 at 4:59 pm

“they’re subsidizing risky behaviors of everybody, not just the smokers.”

That’s true. But we’ve got to draw the line somewhere. Mountains of scientific evidence show that smokers are less productive and more expensive to employ. Should we ignore all that just because of the slippery slope argument? (Which by the way, is a fallacy. Example: Vietnam.)

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fposte December 3, 2012 at 5:57 pm

Why do we have to draw the line somewhere? Why not have people able to get insurance because they’re human and prone to frailties, not because they won some virtue prize? Or, if you’re going with a pay-by-likely expense approach, are you willing to pay extra if you speed, drink soda, buy fast food, sit more than 40 hours per week, or have a parent who died of cancer? Some people do prefer the strictly individual model wherein the company backing your chances assesses your risk individually; my thoughts is that if that’s what you want, you can opt out of your company insurance and see if being rid of these risky colleagues gets you a better rate. My bet is that it won’t, though–that the sheer scale of a group purchase benefits you even if the people in the group are higher risk than you.

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Natalie December 3, 2012 at 6:08 pm

For that matter, plenty of things that are often thought of as virtuous are not actually the “best choice” from an actuarial standpoint. Moderate drinkers live longer than teetotalers. A woman is less likely to die or suffer long term complications if she has an abortion versus carries a pregnancy to term.

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LL December 3, 2012 at 6:20 pm

I don’t want to conflate the ability to obtain insurance and employer’s right to screen applicants based on smoking. Besides the insurance-related costs, there’s also the issues of lower productivity and increased absenteeism. Co-workers are also “subsidizing” these in the sense that they could be asked to cover for someone who is out of the office due to smoking or its health consequences. So it’s not just about insurance.

And why do we have to draw the line somewhere? To increase productivity, benefit the bottom line, and promote health.

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fposte December 3, 2012 at 6:51 pm

So currently the line is that actual hiring, in most places, doesn’t preclude you based on a common and legal activity you might do at home. You think that American productivity and health would improve if employers *did* consider legal activities people did at home. It’s not as clear to me as it is to you that the argument is logical or that it gets you what you want. For one thing, even if you’re just going for smoking because it’s the low-hanging fruit, that’s 43 million people you’ve just rendered ineligible for hire. That’s close to 20% of the adult population that no longer can contribute to the economy, more than double our current unemployment rate. That’s not going to help the national bottom line a bit, and those freely smoking Chinese are really going to kick our butts now. Plus we don’t even have research that indicates a nonsmoker only facility *is* actually more productive–research on comparative behavior in a mixed workplace does not tell you how a different kind of workplace will behave. So you may be crippling the economy for little productivity gain in the facilities themselves. And that’s without getting into the implications that workplaces will likely seize on about other ways to control their workforce now that the camel’s nose is in the tent.

I think I’ve talked myself into a position on this now :-).

Ask a Manager December 3, 2012 at 8:57 pm

I don’t like this argument that employers are protecting themselves from increased absenteeism and lower productivity. First, I’m not convinced it’s true (it may be for a group as a whole, but that doesn’t mean that it’s true for individual members of that group), but more importantly, it assumes that managers won’t be doing their job — managing. If someone has lower productivity or problematic absenteeism for any reason, not just smoking, I’d expect managers to address that head-on. You don’t ward those things off by making conjectures about who will and won’t have those problems based on the groups they belong to.

Not So NewReader December 4, 2012 at 7:39 am

I am responding to Alison’s post, I hope this comment lines up, there is no reply button on the post.
“I don’t like this argument that employers are protecting themselves from increased absenteeism and lower productivity.”

Bingo. There is no one magic bullet that will decrease absenteeism and increase productivity. There are many aspects to that discussion. To look for that one magic answer is flawed thinking.

Joey December 4, 2012 at 9:42 am

Are you surprised that companies make decisions with the assumption that managers don’t manage? There are lots of companies where the bad outnumber the good (healthcare is notorious for this). Hell, that’s a big reason most policies are put in place.

Not So NewReader December 4, 2012 at 7:26 am

“Why not have people able to get insurance because they’re human and prone to frailties, not because they won some virtue prize? ”

My friend was in insurance for years. He said that in order to get insurance you have to prove how much you do not need it.
He also said that insurance adjusters were taught to resist claims. Throw up whatever hurdle you can in order to deny the claim.

Yes, the size of the insured group does matter. If a person is faced with the choice of two health care plans each from a different company, the plan to choose (if you have to guess) is the plan with the larger group of people. It will probably be the one of lesser expense. Yes, costs are averaged out over the group.

Opting out- roughly speaking from what I am seeing insurance for one individual purchased privately would be about $5000 per year. A family of four would be about $10,000 per year. These are extremely rough numbers, of course. Probably the prices are higher than that.

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KellyK December 3, 2012 at 3:40 pm

I think it’s more that the general consensus is that the only way we won’t end up subsidizing choices we don’t like is if we’re okay with a pretty draconian level of policing of our *own* choices. If “no subsidizing others” is the rule, then everything I ever do becomes everyone else’s business if they can come up with some indirect way it affects them.

Personally, I’d rather cover for a smoking coworker or pay a little more for my insurance than go down the path where anything I do becomes my employer’s business if it might possibly affect my productivity or my insurance premiums. I don’t want to lose my job for:

-playing contact sports
-fostering dogs, particularly a breed that’s been defined as “inherently dangerous”
-being “obese” and not having bariatric surgery
-driving on the DC beltway
-going jogging or walking the dogs at night
-riding roller coasters
-etc. etc. etc.

If an employee’s smoking is making them less productive than they need to be, or causing work-related problems, that’s when it becomes their employer’s business. Even at that, it shouldn’t be the employer’s concern whether the employee fixes the problems by quitting or by another method (e.g., not smoking at work, taking shorter breaks, etc.).

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Jamie December 3, 2012 at 3:58 pm

-fostering dogs, particularly a breed that’s been defined as “inherently dangerous”

I would want to work with you just based on this.

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KellyK December 3, 2012 at 4:26 pm

Aw, thanks. You’re definitely on my preferred list of officemates at Chocolate Teapots, Inc.

But, you know, that’ll work out great for you until about the third time you adopt a dog.

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Jamie December 3, 2012 at 4:33 pm

Seriously, that would be the problem. I’d need to move for extra room and fewer village restrictions.

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Ellie H. December 3, 2012 at 5:04 pm

Yes. There are any number of factors that influence your health. I know how tired it is to give examples like this, but here goes . . . I smoke, yet I’m 25, female, practically vegetarian, work out 6x a week, don’t drive a car, ride my bike and walk everywhere (including to work, up a giant hill, every single morning), don’t engage in any dangerous sports, take vitamins, get enough sleep, etc. I think I’m at least breaking even in terms of being of average health.

In any case, I think it’s really dumb to focus so much on this one issue of “more likely to consume expensive health care and drive everyone’s premiums up” when there are so many other more compelling reasons to hire or not hire a particular individual as an employee! This is to say nothing of the point of view that sucking up health insurance and driving up premiums is not a great way to look at things, but my thoughts on that are too politically motivated than I want to get into here.

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Ellie H. December 3, 2012 at 5:10 pm

If that was unclear . . . I meant to say something like, “the point of view that looking at people’s worth in terms of whether or not they suck up health insurance, etc.”.

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Julie December 3, 2012 at 4:22 pm

Brief note: Productivity =/= time spent at your desk. If the smokers are able to get all their work done while taking more breaks and more days off, there’s no reason to think they’re less productive. They may just be better at managing their time, getting their work done more efficiently, etc. I’ll bet you’re more productive on the last day before vacation; maybe they’re more productive knowing they’ve got a cigarette break coming up.

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KarenT December 3, 2012 at 4:29 pm

In most cases I would agree with you, but for healthcare workers it sounds like they do need to be physically present, just in case.

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Julie December 3, 2012 at 4:37 pm

True. Though the article was about workers in general, not just healthcare workers.

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fposte December 3, 2012 at 6:06 pm

I agree that it’s not the most complete metric, but it’s not irrelevant, either. Most people can’t get more done in 15 days than others do in 20. That’s why it takes most people 20. The odds that lower competence is disproportionately tied to being a nonsmoker aren’t good–it’s likely that competence is pretty evenly distributed between the groups and that therefore being out more days is, in fact, a comparative productivity loss.

Does that tell you anything about what Jamie, or Ellie, or you, or I actually get done as individuals? No, of course not. And since people generally hire as individuals, that’s what to look at. But the less individual and greater scale the hiring, the better chance that following statistics will benefit you. Which has an unfortunate irony in this situation–that would apply to the jobs requiring the least qualifications, which would draw from the group with a proportionately higher number of smokers.

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Ariancita December 3, 2012 at 5:47 pm

There are better and more effective ways of lessening that subsidy than by not hiring/screening out nicotine users. The way to handle it is through public health outreach, fantastic preventative care, personalized community based health care, and education. Cuba is a great example (and yes, I understand they are on a much smaller scale than the U.S., but lessons from there can be transferable elsewhere to some extent). They don’t have the money or access to expensive medicines, machines, therapies. So they focus on preventative care, education, and home visits (which is actually a growing thing in the U.S. now). They have a really low non-communicable disease rate because of this (e.g., diseases caused by lifestyle decisions like heart disease, lung cancer, diabetes, etc), a healthy population, and low health care costs.

I hate smoking. I think it’s entirely vile. But I’m a huge believer in privacy and not having my personal life scrutinized by employers. There are better ways to address subsidies and other costs of public health than through employment based nicotine testing.

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Elizabeth West December 3, 2012 at 4:25 pm

In my experience, nonsmokers are prejudiced against smokers. Nonsmokers live to lecture smokers, and their time at work is spent thinking about how to tell off smokers. They are always 100% focused on making snap judgments about people. It won’t be long before generalizing is banned in all workplaces, and that will be good for everyone. Productivity will skyrocket when people stop wasting time sneering at other people and the US economy will get back to business instead of wasting time on telling everyone how to live their lives.

There, fixed that for you. ;)

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KellyK December 3, 2012 at 4:27 pm

+1

Nice.

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Jamie December 3, 2012 at 4:32 pm

+1 – well put!

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Not So NewReader December 3, 2012 at 4:51 pm

Look at you go, Lady! Nice job.

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Ellie H. December 3, 2012 at 4:54 pm

:)

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JT December 3, 2012 at 6:59 pm

“Smokers live to smoke,”

This is a gross over-generalization.

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susieqpublic December 3, 2012 at 2:34 pm

the residue that smokers bring with them is called third-hand smoke and there are documented health ramifications for people who are exposed to it, especially children and people with health issues. I think hospitals are well within their rights to expect staff to not bring a known toxin into work with them. It’s not just someone else’s lifestyle choice or a health system trying to force healthy behavior from staff, it’s a real health hazard for coworkers and patients.

http://www.mayoclinic.com/health/third-hand-smoke/AN01985

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Elizabeth West December 3, 2012 at 4:38 pm

It sticks to everything, too. Well, that would be second hand, I guess. I live in a house where people apparently used to smoke and I haven’t painted all of it yet. There is definite evidence of it in the bathroom.

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fposte December 3, 2012 at 6:54 pm

Back in the days when you could smoke on airplanes, the nicotine residue would highlight incipient cracks in the fuselage. Not sure that’s something Philip Morris wants to put on the package, though.

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Elizabeth December 3, 2012 at 10:58 pm

My father-in-law was a machinist at Boeing. He was helping to refurbish a jet where the pilot & co-pilot smoked in the cockpit. He had to pull out & clean the instruments. He & the pilot who flew in the plane for maintenance made a pact to quit smoking that day.

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Chaucer December 3, 2012 at 2:47 pm

This is tough. Personally, I fully admit to having a strong dislike of being near someone who is a smoker. I can’t stand the smell of cigarette smoke, and even if they aren’t smoking at that particular moment you can still smell that lingering odor that stays in their clothes. That said, I am engaged in the line of thinking that what people do on their free time is their business and doesn’t necessarily impact their performance in the workplace. However, I can see why it would be imperative to have a restriction on smokers in health care professions. You don’t want patients to be in an environment that could possibly aggravate symptoms or prolong healing.

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KellyK December 3, 2012 at 3:28 pm

My mom has worked as a nursing home nurse for the last 30 years or so, and she’s smoked during that whole time, with multiple attempts to quit. So I’m guessing the “no employees who smoke” trend in healthcare either hasn’t made it to the nursing home universe or hasn’t made it down to the small town where she lives.

Personally, I think an employee’s personal life should be their own business, until and unless it actually affects work. (The health thing is a slippery slope that I think would be much better solved by decoupling health insurance from employment.)

No smoking on the premises or in the clothes you’re going to wear to work? Fine. That has an actual patient care reason behind it.

Doing an invasive test that will also pick up people who are quitting and people who smoke a cigar a month at home, I think that crosses a line.

If the only way to identify someone’s nicotine use is a blood test–not smelling it on them, not seeing them light up, but a blood test–then their nicotine use is, pretty much by definition, not causing any problems.

Also, there is nothing to say that the employee who passed the blood test last week won’t take up smoking tomorrow because of the stress of the new job (or, for real irony, because they’re under major pressure to lose weight), and cause an asthma attack or allergic reaction in a patient.

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CatB (Europe) December 3, 2012 at 3:31 pm

Well, looking at it from the outside: in my country it is illegal to discriminate based on smoking habits when hiring. “Help wanted, non-smokers preferred” would send the hiring person straight to our (equivalent of the) DOL. Same goes for smoking-related questions during interview.

On the other had, smoking is prohibited in all public buildings and you don’t quite see smoking-friendly office buildings (I personally know only two small firms allowing smoking inside). But I do admit that cigarette use is heavy here.

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Anon for this December 3, 2012 at 3:39 pm

This will be an unpopular opinion so I’ll be anonymous. If you smoke in this day and age, when we know what it does to your body, and especially when you are in the health care industry, you are an idiot and I don’t want you taking care of my mother or my husband.

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KellyK December 3, 2012 at 3:44 pm

Or you started smoking long before the risks were well known and have had multiple unsuccessful attempts to quit.

If we want to make broad sweeping judgments, odds are that *everyone* has one choice or habit that would cause someone else to define them as a complete idiot who shouldn’t be responsible for the care of a goldfish. But when we’ve fired everybody because nobody’s up to our standards, there won’t be anyone to take care of your mother or your husband.

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KarenT December 3, 2012 at 3:52 pm

There aren’t a lot of people out there who think smoking is a great lifestyle choice.

I do have sympathy for smokers, as I know how hard quitting can be having witnessed my father and some friends try and fail so many times.

Smoking may not be a smart choice, but it is one that people typically make when they are younger or under a lot of stress and then are stuck with the consequences. I know quite a few smokers whose biggest wish is that they had never started.

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Editor December 4, 2012 at 10:33 am

Having dealt with a physician who controlled his weight fastidiously, had limited imagination and no empathy, and was a nonsmoker who was intolerant of all bad habits, I can tell you that I would take a doctor who has struggled with health issues over someone who worships at the altar of fitness.

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Jesicka309 December 3, 2012 at 4:06 pm

First to clarify: I hate smoking, and smokers drive me up the wall. My mother smoked during pregnancy and I’m still angry I didn’t grow past 5 foot 3 like my siblings. My parents quit, as have my grandparents, though my uncle still smokes. Even the Christmas gifts he gives us reek of smoke.
Now my point: it seems like the hospital is doing everything they can to help smokers get work with them, despite their inability to hire them. The six month program is a great idea: rather than saying “we don’t want you because you smoke” they’re saying “we wish we could hire you, but you smoke. Pretty please try to quit, and we will do our best to get you in six months.”
Now, what I don’t agree with is the testing. It’s pretty invasive. But what’s to stop someone who admitted they smoked coming back in six months saying “guess what, I quit! Hire me!” When they haven’t. I don’t agree with it, but I can see why the testing is there, flawed as it is.
But really, smokers, if you’re having trouble getting work, or finding your employers cracking down on smoke breaks, smell etc, maybe it’s time to quit. Seriously, it’s probably the universe telling you it’s time. And do it before you have height challenged children who will be forever bitter that you smoked. :)

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Deedee December 4, 2012 at 8:21 pm

My mom smoked when pregnant with me and I am 5’10″. Kind of glad to not be any bigger than I am…

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kasey December 3, 2012 at 4:11 pm

Ha! I just noticed AAM’s avatar is wearing a cute scarf & hat.

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LCL December 3, 2012 at 4:13 pm

…story as told to me by an old boyfriend.
He was out of work, interviewing for another blue collar job in his line of work. The company was very small, and it was well known in the trade that the owner hated smokers and wouldn’t hire them. Boyfriend smoked but was willing to not smoke at work (in the late 80s the whole militant nonsmoking thing hadn’t taken off in the states).

Boyfriend, smoker, made sure he was in fresh clothes and didn’t smoke the day of the interview. He had what he thought was a very successful interview, until the interviewer finished by asking him “hey, got a smoke?” Of course he reached into his pocket, and of course he didn’t get the job.

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KellyK December 3, 2012 at 4:30 pm

Wow. I’m torn between admiring the sneaky subtle brilliance and rolling my eyes at the snap judgments and the willingness to not hire perfectly good employees because of a personal prejudice.

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Jackie December 3, 2012 at 4:14 pm

A lot of these comments seem to center around smoking and how it’s bad, how it can affect patient care, how it can cost more to the employer, and I think all of those things are valid. (I’m a former smoker AND a public health researcher, so I’m all for health promotion in any and all venues.) However, I actually don’t think that’s the issue. I think a hospital not hiring a smoker is more analogous to a Catholic institution not hiring an avowed Satan-worshiper — you don’t necessarily want people working at your institution who blatantly disregard what the institution stands for. At the moment, smoking is the easiest health behavior (and usually most obvious) thing to go after.

And while I’m at it, here’s a marginally related story: there used to be a surgeon at my old hospital who was total nicotine addict, but couldn’t smoke in the surgical theater (..obviously). So he’d put in a very small wad of chewing tobacco and just swallow the juice. Nicotine’s a hell of a drug.

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Josh S December 3, 2012 at 4:39 pm

I agree that this would be a valid motive, if it held up under scrutiny.

A health care institution that really valued health would (or should) hire more staff so nurses don’t have to work multiple 12 hour shifts. It would be extremely reluctant to hire obese people. It would offer better/healthier food in the cafeteria.

The fact that they focus on tobacco use to the exclusion of other serious, chronic health issues tells me that there’s another reason. Or that it’s a combination of health concern with something else…possibly cultural. I just don’t buy that the reason is “getting on board with the health mission of the institution.”

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fposte December 3, 2012 at 6:14 pm

“A health care institution that really valued health would (or should) hire more staff so nurses don’t have to work multiple 12 hour shifts.” That’s pretty simplistic, though. For one thing, a lot of people in health care *like* those shifts; they like having the intensity/free time balance (and there are definitely hospitals that do 8 hour shifts, too). And honestly, the list of “if they really valued health” goes way, way beyond that anyway.

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Jamie December 3, 2012 at 6:27 pm

“And honestly, the list of “if they really valued health” goes way, way beyond that anyway.”

This is true. And if a company were invested in promoting a culture based on the health of it’s employees it would be interesting to see how things would shake out if the traits that were not so good for the employee were actually benefiting the company.

For example, I have a certain temperament that I channel into my job quite successfully. Any employer would benefit from certain personality traits of mine which aren’t necessarily on the list of “things to be to have a long and healthy life.”

This isn’t unique to me, I know plenty of type A’s (do they still use that term? I don’t know what the kids are calling it today) who are rewarded in the work place for working too much, worrying too much, stressing over the details too much, clenching way too much…I haven’t seen too many people with the laid back zen approach rocketing up the ladder – at least in my field.

If I were to be honest it’s probably not the best thing for my long term health…which I’m willing to sacrifice for quicker short term gain.

It’s just when it comes to smoking it’s easy for the employer to take the side of healthy employees because fewer smokers means less complaints from co-workers, lower premiums, fewer smoke breaks (although – not every smoker takes them.)

If a decidedly unhealthy lifestyle were benefiting the business it’s a lot harder to make that call and I’m not being cynical…it happens every day.

I don’t have a real point – I just find it to be an interesting discussion.

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Josh S December 4, 2012 at 12:01 am

Yeah, I was tired when I wrote that. My whole point was to bring out your last sentence:

“And honestly, the list of “if they really valued health” goes way, way beyond that anyway.”

If they really valued health, the questions/bans wouldn’t be limited to tobacco users.

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Anonymous December 3, 2012 at 4:21 pm

I think it’s less about policing an employee’s off-work habits and more about filtering for company culture. I used to have a company that was big on wellness/wellbeing, and while it wasn’t in the healthcare industry, we did attempt to filter employees for smoking.

Unfortunately, this was outside the US, in a country where most people smoke. So it was impossible to find smoke-free people to hire. We ended up giving up on that, but we certified the office as smoke-free. It was a program with the government where they certified the office environment and people weren’t allowed to smoke in or around the office (like out on the balcony/terrace).

Kind of a compromise: it clarified how we felt as a company about smoking, and ensured that staff smoked less, since they had to go all the way out of the building to do it.

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KarenT December 3, 2012 at 4:35 pm

Are hospitals in the US generally private? I can’t help but wonder if public vs private funding matters here.
I’m Canadian and our hospitals are government-run.

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Judy December 3, 2012 at 5:04 pm

In the US, there are generally3 types of hospitals, non-profit (usually education or religious institutions), profit, and government. In my small (just over 200,000 people) city, there are 2 non-profit hospitals affiliated with religions (one catholic and one protestant). The last town I lived in had a catholic hospital and a county hospital (government). Big cities that have medical schools would have hospitals associated with those schools.

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Montana December 3, 2012 at 4:37 pm

Most of the posts discuss the way smokers smell and how that affects others. My hospital is already tobacco free and I do not give smoke breaks to anyone. Effective in 2013 smokers will pay a higher insurance premium than non-smokers. Why? Smell is an issue but so is heath. As a healthcare institution our mission is health. Smokers are absent more frequently which puts pressure on non-smokers. Smokers are sick more often than non-smokers, which forces the non-smokers to subsidize the smoker’s insurance (hence, the higher premiums for smokers).

And yes, big brother is watching.

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LL December 3, 2012 at 6:01 pm

Does your employee have similar policies for the overweight or obese? My cousin is an overweight ER nurse and she’s shared some concerns that her employer’s wellness incentives may eventually become “unwellness” penalties.

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LL December 3, 2012 at 6:03 pm

Darn, errors all over the place when I type on a touchscreen. Correction: “Does your *employer* have”

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careerservices December 3, 2012 at 5:44 pm

I work to place people in the healthcare field from teh technical college where I work. Honestly, this has been happening in big cities for a few years. We were all fired up when they banned smoking in public places, but now it’s normal, same with NYC banning all sorts of other things for dietary restrictions. Is it discrimination when they ask for certifications and other requirements. The same argument could be given for must have a bachelor’s must have knowledge of x,y, and z. There are plenty of qualified people who are being passed over because tehy don’t have the degrees, but those people suck it up and make the changes to get the job like go back to school. It’s also a part of the application process and everyone is going through the same tests so it isn’t conisdered discrimination, they aren’t choosing a select group of people or only the people who smell like smoke. But honestly, how do you tell someone who has lung or throat cancer to stop smoking if you smell of cigarettes? Believe inthe product you are selling.

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Ask a Manager December 3, 2012 at 9:00 pm

You’re conflating discrimination based on qualifications (good and normal and needed) and not considering applicants based on activities that they might pursue nowhere other than in the privacy of their own homes (no one’s business, in my opinion). I definitely understand your point about how it’s problematic for health care providers who smoke to tell patients to stop smoking (a la my PETA/meat-eater example in the original post), but then wouldn’t that also mean that you shouldn’t have doctors who are overweight, engage in risky recreational activities, eat fatty foods, etc.?

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Bill December 3, 2012 at 5:57 pm

Forget about the smell of smoke. I can’t stand smoker breath. Blecch!!!!!!!

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Rana December 3, 2012 at 9:44 pm

Yes.

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Anon December 3, 2012 at 6:49 pm

It’s worth noting the third hand smoke is there and can set off asthma and respiratory disease even if you can’t smell it. I have asthma which isn’t even that severe but I am very sensitive to cigarette smoke and can often smell it on people who claim they don’t smell. But eI also have to avoid one colleague who smokes, as much as possible during cold weather when my asthma is already exacerbated even though I can’t smell smoke on her I have noticed needing my inhaler after meetings with her. This finally made sense when she mentioned smoking. I can deal with this at work in an office because my asthma is mild, and now that I know I can take my inhaler before meetings which has really made it better for me but I think it would annoy me a lot more in a health care setting and would be worse for those with more severe respiratory complaints.

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TL December 3, 2012 at 11:47 pm

Well, smoking’s an easier target because it’s probably the only legal thing with such a strong correlation between a deadly disease. Other things are quite bad as well, but IIFC, smoking’s the biggest. And while problems caused by obesity, inactivity, ect.. are often caught early, lung cancer’s usually symptomless until it’s too far gone to do much. So that’s why it’s an easy target.

Anyway, while smoking really makes me annoyed/incredulous – it is none of my business and I try to leave it be as long as people don’t smoke around me.

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Jessica December 4, 2012 at 7:12 am

I feel I need to weigh in on this. At time of me writing this there are nearly 300 responses so apologies if I restate something already mentioned.

I have had a peripheral role in a large smoking cessation study. I was not the designer or clinician in this study but I was privy to the protocol and the data acrued. And here’s the thing (that any GP or nurse can tell you)

Firstly: one of the most common cessation methods is nicotine replacement. Therefore taking a nicotine test would be useless as an indicator who smokes and who is in the process of quitting. Therefore outright nicotine tests are not used in cessation studies but instead signal substances and reactive responses are measured as hard endpoints to ensure whether a patient is actually refraining from smoking.

Second: I, a never-even-tried non-smoker, could likely fail such a test. Simply because I commute by public transport.

The signal substances you check for are very responsive and they stay in your body for a long time (I’m simplifying incredibly but I’m trying to not give away too much information.) Therefore it is crucial that patients who volunteer for these tests to keep them on the straight and narrow are honest and aware of their surroundings, because getting a false positive is incredibly easy and you need to be able to discount the falsies by knowing what the patient has done.

First of all, a single puff on someone else’s cigarette, days back, may give a positive. It isn’t false since the patient technically fell off the wagon but it is false because the patient has kept below the agreed/expected grace line.

Waiting for the bus in a crowded shelter where one or two people are smoking on your way to the appointment, may give a false positive as second hand smoke will up your antagonists to the point where it shows up on a test.

Spending a lot of time around smokers, even outdoors, will up your antagonists and keep you on a constant “illegal” level.

Spending a lot of time in a place where a lot of smoking goes on, even if no smoking happens while you are there, will up your antagonists as nicotine is well known to cause “contact buzz”, i.e touching surfaces covered in nicotine will cause you to absorb it through your skin (otherwise, how would the patch work?). So, hypothetically, someone who frequently cleans an office, house or room where lots of smoking goes on will likely have an increase in antagonists unless they use mask and gloves and have no exposed skin, at all times.

There are, today, no useful tests that do not give lots of false positives because of situations that are difficult for most people to avoid. A friend of mine once took over a flat where the previous tennant had been a heavy smoker. The landlord had tried to sanitize but after about a month, the nicotine lodged in the dry wall was literally seeping through the new layers of paint and wall paper, coloring everything yellow and triggering my friend’s asthma. An educated guess says, she would likely have given a positive for antagonists at that point.

And as employers are unlikely to give the same leeway as a cessation study, to explain small increases in antagonists by having a smoking spouse, working in a bar (presumably not in California) or relying on public transport in a rainy city, you will discount a lot of good candidates for very arbitrary reasons. And that’s not even discussing the implications of wanting to control your employee’s free time. I understand that this level of control is somehow acceptable in some parts of the US.

Please note that I, personally, find smoking a filthy habit. I have never met a smoker who does not stink up the entire place even without smoking during office hours, it is lodged in their clothes and their skin and it does actually make me gag, just to sit next to them.

I have a shameless and unreserved loathing for smokers who don’t respect non smoking signs, particularly the pimholes who insist on iffying up bus shelters and indoor cash machine queues, as well as the idiots who seem to believe that train toilets and passageways are magically smoke obliterating. Not to mention the ones who stand outside my living room window and make sure I get the entire benefit of their disgusting habit stuck in my curtains. And my favourite loathing object: the Poser Smoker. The “motherf*ckers” who, in the words of Dr Dre “ain’t smokin’” but are, in fact, “just holdin’ sh*t up”. They stink more than anyone else and their proximity stink other people up, by far, more than any other smoker.

If it isn’t clear. I really, really, really have no sympathy for smokers. None. There are too many of the uncourteous kind. So that the poor minority of smokers who were not brought up by wolves can not rescue smoker reputation, despite all their best efforts.

However, despite this loathing of smokers (And perfume addicts but that’s a different question, even though smokers like to pretend that us smoker haters, asthmatics and smell sensitives somehow disregard the perfumistas. We don’t but you really have no other argument than red herrings and tu quoue, so what are ya gonna do?) I do note condone this type of screening process. By all means, ban smoking during office hours. I have no beef with that.

But people’s free time is not the employers’ to control. It can only be an issue if it impairs actual work performance during working hours.

So while I would wish every single smoker in the world would quit today, I would not refuse them employment. Not even if they stink up the desk next to mine, just by sitting there. (Sure, I’ll complain to my husband when I get home but I’d never make a thing of it.)

—————
TL;DR?

I think smokers stink. However:

There are no tests that are accurate enough to base that decision upon. Too many false positives.

Employers should leave your motherloving free time alone.

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Josh S December 4, 2012 at 11:15 am

This. This! A thousand times, this!

Some of your arguments are what we’ve heard above, but nobody else delves into the detail of testing protocol and weaknesses that you do. Thanks for all your thoughts!

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Anonymous December 4, 2012 at 12:28 pm

+1 Thanks for the super info.

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Jamz Joyz July 17, 2013 at 10:53 pm

Wow. All of that anger towards a habit you don’t have! I mean, I’m a smoker and even -I- think that you’d be a lot healthier if you stopped fantasizing about how much you hate my tobacco use.

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MI Secretary December 4, 2012 at 9:00 am

I tried switching from cigarettes to bacon, but I couldn’t keep it lit.

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GonnaBAWriterNGetOut December 4, 2012 at 9:43 am

LOVE IT!!

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GonnaBAWriterNGetOut December 4, 2012 at 9:41 am

‘In any case, overall, I don’t believe that employers should police your private life — whether it’s what you eat, what you drink, whether you engage in risky sexual behavior, or whether you choose to smoke a joint or a cigarette … both because it’s none of their business and because I don’t think it’s a sound business practice that will help them hire and retain the best people.’
Thank you Alison! The most sane, rational, practical manager’s perspective on what is important in actually, ya know, hiring an employee that I’ve ever heard. It’s a job – not my life.

What I find fascinating in this new wave of emerging restrictive hiring/employment policies is waiting for what is next. Our company now charges an annual tobacco fee for us smokers and I am happy to pay it, rather than be subjected to a program to help me quit something I enjoy doing. Next year, however, employees will be required to have ‘health care counseling’ if their cholesterol is above a certain number or they will lose their match funding health care dollars. Who’s next? Pet owners because the hair they might possibly trail in on their clothing might possibly cause someone in the office to maybe possibly have an allergic reaction? What do you enjoy in your personal life that may be next up on the list for scrutiny? Might want to enjoy it while ya can!

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Not So NewReader December 4, 2012 at 4:03 pm

The thought strikes me here- if we are going to have all these tests and all this counseling… WHEN do we do any WORK???
“Bye, Honey, I am off to counseling now, see you at dinner time!”

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Jessica December 4, 2012 at 11:29 am

Some of my “favourite” smoker fallacies:

“But, but, but AIR POLLUTION! Yeah!”

- So let me get this straight. You are unhappy that there aren’t more substances giving me acute health issues and pain? Either I should have the same reaction to a completely different substance with a completely different toxicity level and delivery system or I should pretend you aren’t giving me migraines, asthma, nausea, somnolence or whichever way smoke affects me?

Because why? Because it is unfair on you that you make me acutely ill and pollution does not?

I’m sure air pollution is bad for me in the long run and I wish there was something I could do to protect myself from it. However. I don’t spend a tenth of the time in traffic that I spend around smokers (and it is not unusual for a public transport user to have the two combined) and I simply don’t have the same, acute, reaction. Whatever the carcinogens of smog are doing to my future health, they don’t make me immediately, painfully and violently ill. Like you do.

And I do notice when pollution is bad. I can smell ozone when it’s close to the ground. When there is low pressure and a lot of smog stays around in areas of heavy traffic, my eyes start tearing up and sting a bit. And that is not nice but it is not even a twentieth of the immediate discomfort you are causing me. If you have a problem with that then A: why do you want me to have twice the pain? and B: take it up with my body.

“But, but, but… PERFUME! Yeah!”

Okay, let’s just get it out. These are Red Herrings and Tu Quoques, aimed at deflecting attention from what you are doing to me at the moment. There are lots of things we inhale that are bad for us. Droplets of calici virus, for example, rarely lead to fun and games but somehow that’s never where smokers go when they try to deflect. They always go for smog and perfume.

Once again: why do you WANT me to have more discomfort and pain than I already have? Is it your goal in life that I be as miserable as possible – or are you simply too intellectually dishonest to accept that a choice you are making IS hurting other people?

(There’s a special place in hell for people who smoke around children. In the house – or even worse, in the car.)

And second to that? How do you know that I don’t? And how do you know that I don’t complain to the perfumistas as well, when I’m dealing with one of them and not with you, like I’m doing now? What business is it of yours if I had a word with Hans in accounting about his Dracar Noir abuse? I’m not running to him and telling him “Fyi, I just gave Linda in payroll a similar dressing down to the one I had with you but regarding her smoking. I felt it was important that you know this so you don’t feel persecuted because obviously Linda’s business is very much your concern.”

Seriously. There’s a reason they are called fallacies.

In my case, overperfumed people do give me the same migraine your smoke does, plus the teary eyes that smog gives me – and I bring it up to the same extent that I bring smoking up: when it gets unbearable. Does that make you happier? Some people, however, can stand the perfume but not the smoke. Take it up with their bodies.

“It isn’t proven that second hand/third hand smoke is dangerous!”

- Take it up with my body. It isn’t proven to be safe either and studies deal with averages and trends. It certainly doesn’t mean there aren’t people who get genuinely sick when you do it or that there aren’t more of us than you would like to think. After all, with your attitude people are unlikely to come to you with legitimate complaints. Clearly, I have a beef with you that includes giving myself an intentional, debilitating, treatment resistant migraine that will keep me from having any kind of life for the next three to seven days. I hate you _that_ much and I’m REALLY passive aggressive.

I’m a reasonable person. If I’m having this conversation with you, it means you have passed the limits of normal, expected decency with your smoking. You have broken the social contract. It means you either smell so much I get contact buzz or you tend to show little courtesy or respect with when and where you decide to smoke. Maybe you like to clog up busy passage ways or front doors. Maybe you light up in a car with me in it. Maybe you leave butts around. Maybe you smoke in the bathroom instead of finding a designated area so I have to keep it in for the rest of the day.

Yes, I am unusually sensitive to smells. I know who’s been drinking, at all – not even to excess – over the weekend. That doesn’t mean my complaint to you and Hans aren’t valid.

Several of my colleagues eat at their desks. They eat horrible, smelly, microwaved things that I swear consist of reconstituted badger carcas with a side of durian and surströmming-brine. I don’t complain to them. Some of my colleagues are so hungover I can practically say what they last vomited. I don’t complain to them.

Because they are only grossing me out. They aren’t actively making me sick. I curb my reactions to my unusually sensitive nose as part of my end of the social contract.

For example: I often know who’s vegan and who eats a lot of dairy. This is gross, but I usually know _who_ pood if I come into an empty but smelly bathroom. I can tell who has their period.

I never talk about these things. All those behaviours and situations are reasonable. At our office, it is okay to eat at your desk and there are no guidelines to what your food can smell like. Reasonable people doing reasonable things for their life and comfort. I never ever complain about that or let on that I know personal things about them

By the time I complain, I am either in severe pain or the person I’m complaining about is really being unreasonable.

So don’t give me pollution.

By the time I complain, you have been bad and probably for a long time.

So don’t tell me you want me to get sick from air pollution and perfume as well. We are talking about you now, mate.

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Anonymous December 4, 2012 at 12:31 pm

I hope your doctor is able to help you – you have a serious problem.

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Rana December 4, 2012 at 10:19 pm

And if her doctor can’t? What then? She should just keep suffering, silently?

I mean, I like peanut butter, but if someone who works with me is allergic to peanuts, I’m not going to throw a hissy when they politely request that I not bring PBJs in to work, or lecture them on getting allergy shots.

You’re assuming all kinds of things here, about her condition, about what she’s done to address it, what works and what doesn’t, etc. She knows her own body far better than any of us do, given that she lives in it 24-7. Me, I’m inclined to trust people’s expertise in such matters, even if it means rethinking how I’ve been conducting myself.

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Anonymous December 5, 2012 at 5:33 am

“You’re assuming all kinds of things here, about her condition, about what she’s done to address it, what works and what doesn’t, etc. ”

I don’t see what the assumptions are in my statement that she has a serious problem and a wish that a doctor can help.

Also, I don’t think my statement that she has a serious problem should be taken as a lecture or a hissy fit. Sorry if it sounded that way, but I don’t understand what aspects of it are those things. I don’t smoke and never have myself.

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Jessica January 8, 2013 at 12:18 pm

Omg, a DOCTOR! Why ever didn’t I think of that?

Tell me. Out of curiosity.

What do you think “Treatment resistant” means?

Is it –

A: I have tried absolutely nothing and have never seen a doctor in my life. Above all I am receiving no treatment, that can be resisted, whatsoever. THANK YOU FOR SAVING ME!

B: What’s a doctor? What is treatment? Who are you?

C: I had _no_ _idea_ there was a cure for migraine or any other treatment than the octaziljon others that I have tried! What is it. Have you patented it? What are the side effects? (Because most potent migraine treatments have side effects like brain fog, nausea, stomach problems etc. But with your side effect free treatment no one will have to suffer anymore and everyone can smoke everywhere! In fact, I think I will take it up!)

D: You mean you can switch off super smelling? Wait… what about the non super smellers who _still_ get migraines from smoke? It’s almost as if the two conditions aren’t necessarily connected but happen to coincide in one individual. Surely that can’t happen? People never get asthma AND allergies. You get one condition per lifetime, right? No reason to worry about cancer, I have migraines! W00t!

If anyoe else missed the point: the supersmelling isn’t that much of a problem. I’m pointig out that it isn’t about what I like and do not like to smell. I illustrated that by pointing out foul – but inoffensive – smells that I field without complaint every day. Of course, missing the point seems to be anonymous’ MO. Nice Health Concern Trolling Straw Man you built there. What’s next. “But… but… people are FAT and that somehow ifringes my rights… or something. Therefore smoke smells good and makes canaries sing!”

E: Have you talked to someone about your inability to take in written text and form considered opinions. And that passive aggression is very nearly fatal. I think you may have a serious problem. I worry about you. You need to fix that. Is there some treatment or something? What other drugs are you on?

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Jamie December 5, 2012 at 8:05 am

I think the point about co-workers and peanut butter is a good one and if she’s having issues with certain co-workers that should be addressed in some way.

However, the example of people getting on busses causing the same issue…yes, that’s something she and her doctor need to handle. But it is still a legal substance and no reasonable person can expect to control an uncontrolled environment like public spaces because of her extreme sensitivity. Millions of strangers aren’t going to change their legal personal habit because of someone heyve never met.

If anyone had a sensitivity to anything that could trigger a week if incapacitation merely by sitting next to someone on a bus than that’s sever enough that they need to do what they can to protect themselves – you can’t expect the entire world to accommodate that.

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Jessica January 8, 2013 at 12:02 pm

So you make the same ignorant assumption as our condescending friend, anonymous?

Have I said anywhere that I tell the stinko on the bus to get off or to accommodate it? No. But smokers like to pretend they don’t cause anyone else problems or that people can’t smell them when in all likelihood they just have polite friends. They do stink and they do cause inconvenience. They will have to accept that. They will have to accept that they make a choice that they know inconveniences other people, some people quite a bit.

What pisses me off is this pretence that it’s not being selfish. They are being very selfish. There’s no way around that because that isn’t counted in the _amount_ of inconvenience they cause other people. They make a choice to do something that inconveniences and even hurts other people, for their own pleasure. That is the long and the short of it. And it would be a lot less hypocritical if they stopped pretending they don’t.

If only one of them would admit that “Yes. I let my comfort and convenience trump that of everyone else’s when it comes to my smoking. This is something purely selfish that I do and I admit that I don’t care what it does to other people.” Instead of hand waving and donning the persecution hat even at very reasonable requests. (Like: don’t smoke in the car.) They try so hard to make smoking fit into being the considerate person they see themselves as – but it doesn’t.

Forget _what_ it does to whom. Just accept that it is an ego trip.

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zemkat December 5, 2012 at 8:20 am

I actually asked about this during a hiring manager training at work. We were given a big list of things we could not ask about in interviews or use as factors in hiring decisions, and one of those was “smoking status”. I asked about co-workers with allergies/asthma and they said that if the situation arose, those co-workers would be treated as having a disability and receive appropriate accommodation.

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Wubbie December 4, 2012 at 3:20 pm

I am facinated by the idea that people think it is ok to bash smokers in a way they would not for other behaviors.

I’m not a doctor, but I strongly suspect that if you are “blowing into a migraine” simply because you smell smoke on a person, this is more likely a mental issue than physical. I’d be curious to hear from a doctor about this.

I do know that sometimes if I go outside for a smoke, but get distracted by a text or something and neglect to light my cigarrete right away I still see people go into coughing fits as they pass me by. Really? I do really enjoy the sheepish looks when I show them my unlit cigarette on those occasions.

Then there are the people who deliberately come stand near me when I am already there smoking. Then they turn to me and ask me if I can take my smoke somewhere else. NO! I was here smoking. If you want to not be near my smoke, don’t come and stand near me. If you were already there, I would have gone to a different spot with my cig.

But hey, if we’re allowed to do that stuff, here are some of my own complaints:

I am allergic to cats. One of my coworkers has multiple cats. If I spend too much time in her office my eyes get watery. I will be calling HR to request that they no longer hire cat owners.

I despise fish. Occasionally, if someone is eating fish at their desk, the smell bothers me so much I need to step away for a few minutes (usually I go out for a smoke!). I will be calling HR to request that they no longer hire fish eaters.

Then there are the supposed health issues. I challenge anyone to find a single documented case where someone got cancer simply from passing smokers on the street. In cases with DECADES of prolonged exposure (you live with a smoker or worked in an environment that allowed smoking) then there may be an increase in your chance of getting lung cancer. At least it’s been a few years since anyone has said second hand smoke is worse than smoking itself.

If you live in a large city (I’m in NYC) you are more likely to have pulmonary issues from automobile traffic than passing smokers on the sidewalk. Where are the cries to ban car traffic?

There was another time I got yelled at by a mother with a child in a stoller because I was smoking. Meanwhile, I specifically moved about 15 feet away and downwind to minimize exposure. But here’s the kicker. She had the stroller sitting right on the curb 3 feet away from the exhaust pipe of an idling truck. HELLO!!!

I always try my best to be considerate of others when I am smoking. When I am passing a group of people I do what I can to keep my cig from passing directly past someone’s face, and in particular, if I am passing a small child, I stick my arm straight up to keep it as far away from the child as I can.

But get it through your heads. SMOKING IS LEGAL. As such, you have as much of a responsibility to considerately deal with being around smokers as we have to considerately deal with being around you.

I am sure people will be lining up to throw tomatoes at me. That’s fine, I can take it. Just come with FACTS and cite your sources.

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Jamie December 4, 2012 at 3:44 pm

I am sure people will be lining up to throw tomatoes at me.

Let me be the first…back away from the kitty discrimination. If I lose my job because of your vendetta against those of us who share our home with cats and I end up on the street – well, I will find wifi and come on here to give you a piece of my mind! :)

Seriously though, you made a lot of excellent points especially about it being legal. I will concede it’s a very offensive habit to those who don’t enjoy it – absolutely. However, those who truly believe that even if a smoker isn’t smoking around you and isn’t even wearing clothes in which they’ve smoked – but somehow all of their belongings and all they touch are of a health risk to you then I would suggest you work on lobbying to make it illegal. That seems to be the solution.

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Anonymous December 4, 2012 at 8:38 pm

“I do know that sometimes if I go outside for a smoke, but get distracted by a text or something and neglect to light my cigarrete right away I still see people go into coughing fits as they pass me by. Really? I do really enjoy the sheepish looks when I show them my unlit cigarette on those occasions.”

I love this.

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GonnaBAWriterNGetOut December 5, 2012 at 9:56 am

I’m with ya – but please back away from my keekee addiction – those fur heads are savin’ my life in my current living situation! :)
I believe myself to be one of the most considerate smokers on the planet (with the other one being you!) and yet, as hard as I try, there are still those folks who would shoot daggers at me with their eyes, were it actually possible. But then, these are usually the same people who have zero tolerance about lots of things and so I say if the planet will eventually belong to these poor judgemental souls anyway, smoke ‘em if ya gotta ‘em.

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Laura L December 5, 2012 at 8:28 pm

” “blowing into a migraine” simply because you smell smoke on a person, this is more likely a mental issue than physical.”

Migraines are a physical illness, not a mental illness.

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Josh S December 6, 2012 at 4:01 am

This is correct. But they are not (by and large) triggered by the odor of “third-hand” smoke.

So if a person is getting a severe headache because of the smell of smoke lingering on clothing, it is likely that they are not experiencing an actual migraine, but rather some other severe headache…which is more likely to arise from a mental issue rather than physical issue. Which was exactly the point of the GP.

Migraines are awful, as I can attest based on seeing my wife suffer through them. Not all strong headaches are migraines, though people erroneously self-diagnose that all the time.

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Jessica January 8, 2013 at 12:28 pm

Thanks for the condescending aspersion on my mental health.

But no. It’s migraines. Properly diagnosed by proper physicians. If you believe you know more about migraine triggers than migraine specialists, then I say “Publish or gtfo”.

(And FYI, we aren’t talking about “smoke lingering”. We are talking about the kind of person who smokes, constantly, in their home and do not change clothes very often. If you have never come across them I am happy for you but they are out there and they don’t smell nice. I dare say, migraine or not, you would cover your nose if you sat next to them too, unless you are anosmic.

Public transport is like that. At my previous commute, I occasionally ended up next to a lady with a colostomy bag. It did not smell nice but it also did not give me a migraine.

More handwaving and feeble attempts at poisoning the well.

Usually, my response would be: So what? Are people with mental health issues less deserving of consideration. But since you were trying to obfuscate, I still had to point out that no. It’s migraine. Live with it. I have to.

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nyxalinth December 4, 2012 at 5:10 pm

I’m a non-smoker, I’ll only say that the smell does bug me, and I do sneeze/hack if I have to be exposed. On the way to my interview today there were smokers at the bus stop, and even on the bus I could smell the smoke smell. I was worried it would linger on me.

The rest I’m not touching with a ten foot pole, meaning other comments here.

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O'Bunny December 4, 2012 at 11:27 pm

One of the (now defunct) high-tech companies I used to work at had rules that for certain jobs, one could not use people who smoked. In the “clean rooms”, the particulate matter on the smokers’ breath would contaminate the items being worked on.

Yes, there were other things that caused problems, and yes, there were some clean rooms that used external breathers, but if you wanted to work in some of those labs, you had to not smoke and not have smoked for some period of months.

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Al April 19, 2013 at 7:04 pm

Honestly, for any healthcare facility, they shouldn’t hire any smokers. Beyond that, I also believe they should not hire the obese and regulate their current employees to ensure they do not get obese and place them on a plan of exercise and diet with a time frame to get to a healthy status. Being in the healthcare field myself, it shocks me to see so many smokers and obese personnel in the field as we constantly have to give direction to people to live healthier lifestyles. How can you take a person seriously when they are fat and/or smokers. Besides, going through school (and just living life and paying attention to the world), you know that the two things that cause or exacerbate most issues in health are obesity and smoking. So, it doesn’t shock me and I applaud health care facilities that have taken this first step and hope that we take the next step and start hiring only people who only look and act the part of a healthy person and are able to give healthful advice to patients while looking like a true health professional.

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Jamz Joyz July 17, 2013 at 11:24 pm

i work in healthcare on a staff of 30. two or three of us smoke and, coincidentally, we are the -only- staff members who are not obese.

no one at our office takes short breaks for any reason, smoking or otherwise; instead of lunch, i get in my car and drive around and smoke. my coworkers do not know and the patients do not know. if you reek of smoke, you’re doing it wrong.

smoking or not, obese or not, healthy cafeteria food or not, HOSPITALS ARE UNHEALTHY PLACES. despite our best measures, the fact is that people come here because they are sick. honestly, most patients are far too sick and preoccupied to quaff the bouquet of my garments.

in my admittedly limited experience (and this is a complete aside), the coworkers with the most late arrivals/absences/early outs are the ones with children, not the ones with cigarettes. and, yes, this directly affects the patient-to-staff ratio for the entire day, due to the mechanics of the schedule.

i also don’t have a cell phone (and thus am not texting/calling/social networking while with patients – a surprising epidemic in the healthcare industry as of late), nor do i drink alcohol, nor do i use any type of behavior or mood altering medication.

my health (by law, as a matter of fact) is my business. i don’t need your sympathy for partaking in an activity that i really, really like. not any more than you need my sympathy for being really, really angry about an abstract group of people enjoying a cigarette.

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