2/9/06
By Michael Siegel

A prominent anti-smoking group -- Action on Smoking and Health (ASH) -- is urging cities to ban smokers from employment in order to save on health care costs. In a press release issued today, ASH announced that it was intervening in Melbourne (Florida) to encourage the city to throw job applications from smokers in the trash, regardless of any other individual qualifications they may have for employment with the city of Melbourne.

According to the press release, entitled "Melbourne May Ban Off-the-Job Smoking by Employees; ASH Urges City to Act to Save 25% or More in Smoking-Related Costs," a workplace smoker ban is effective and appropriate because it would save money for the city as well as end "discrimination" against "the overwhelming majority of workers who have wisely chosen not to smoke by forcing them to assume -- directly or indirectly -- the costs of smoking."

The Rest of the Story

I consider February 9, 2006 to be an important date in tobacco control history. It marks the date that the anti-smoking movement officially went on record as supporting bans on smokers in the workplace.

My previous post, in which I suggested that ASH was encouraging employers to fire smokers, was met with some skepticism about whether ASH was actively encouraging such policies or merely trying to educate the public about the legality of doing so. It is now eminently clear that ASH was, and is, actively promoting such policies, and going so far as to intervene in the public policy deliberations of employers: in this case, the city of Melbourne.

While ASH is the only anti-smoking group that is actively promoting these policies, I am aware of no U.S. anti-smoking group that has publicly opposed these policies. Thus, as far as I'm concerned, the anti-smoking movement in the U.S. is officially on record as supporting these policies.

Those who are familiar with my commentaries know that I support workplace smoking bans. But I do not support workplace smoker bans. And there is a huge difference.

The ultimate irony is that ASH calls the fact that nonsmokers may bear increased health care costs because of smokers "discrimination," yet fails to appreciate that the policy it is proposing is actually a form of institutionalized employment discrimination.

Frankly, it is not discrimination (and it is an insult to the term discrimination) to use that term to describe the increased burden of health care costs that fall on nonsmokers. One could just as easily argue that thin people are discriminated against because they bear the costs of treating illnesses among fat people, or that vegetarians are discriminated against because they subsidize the costs of treating people who eat high-fat diets, or that non-bungee-jumpers are discriminated against because they have to subsidize the health care costs of treating bungee jumping injuries.

But it is truly employment discrimination to refuse to consider applications from smokers simply because of the category to which they belong, rather than based on any individual qualifications for employment (which cannot possibly be considered if their applications are immediately thrown in the trash based solely on the fact that they admit smoking off-the-job).

In my workplace, it is indisputably true that the major source of increased health care costs are employees, like myself, who have young children. We are sicker more, especially during the winter, and my co-workers without young children are bearing the burden of our increased illness.

By ASH's reasoning, my co-workers without young children are being discriminated against, and I should be fired. And I guess I should have been fired 4 years ago, when my first child was born. Or maybe they should have asked if I planned to have children when I first applied, and thrown my application in the garbage right then and there. Then all these problems and the "discrimination" it has caused could have been avoided.

It's getting really hard for me to understand what ASH is trying to do. They want smokers to be banned from employment. They want smokers not to be allowed to smoke anywhere but in the privacy of their own homes, and then only if they are not foster parents.

The only thing that makes sense to me in explaining what ASH is doing is that there is a huge amount of underlying hate of smokers, and that ASH apparently feels that smokers need to be punished for their "poor choices."

I challenge ASH to explain why they are not taking the lead in supporting legislation to deprive smokers of medical treatment. Such a move would save an incredible amount of money, would end the terrible discrimination that nonsmokers have to face by subsidizing health care costs for smokers, and would be a huge incentive for smokers to quit smoking and for nonsmokers not to start. It would be an incredibly effective public health intervention that would save lives and money. I don't see how ASH, by its very own reasoning, could possibly justify not supporting such a policy.

The logical endpoint of what ASH (and in the absence of any opposition - the anti-smoking movement) is actively promoting is the creation of second-class status for smokers. They are to become a group that is not capable of obtaining gainful employment and making a living to support themselves and their families.

And you know what? In the long-run, this would only serve to increase socioeconomic disparities in health and to increase smoking. But even if it didn't, it's just plain wrong.

The rest of the story is that a prominent anti-smoking group is actively promoting discrimination against smokers in the workplace, urging cities and employers across the nation to fire existing smoking employees and not to hire any smokers in the future. And the rest of the U.S. anti-smoking groups are sitting around quietly watching this happen.

Even if a single other anti-smoking group in the U.S. condemned these policies, I think it would pretty much bring an end to this nonsense. But most importantly, it would put employers and policy makers on notice that while creating smoke-free workplaces is an important public health goal, creating smoker-free workplaces is unjustified, intrusive, discriminatory, and improper.

2/6/06
By Michael Siegel

 

The city of Melbourne (Florida) is considering adding its name to the growing list of employers who refuse to hire smokers. According to a proposal the City Council is now considering: "Applicants would be asked about tobacco use during pre-employment screening -- and smokers would get dropped from further consideration."

The purpose of the policy is to prevent nonsmoking employees from having to offset the health care costs of smoking employees.

According to the City Manager: "I think it's a good path to explore, and it makes a lot of sense. It is very odd that -- 50 years after the surgeon general said, 'smoking's bad, don't do this, smoking's bad, it's not healthy,' -- that we're still having that conversation."

The Rest of the Story

Interestingly, another Florida city - North Miami - instituted a similar policy in 1990. However, after 13 years of experience with the policy, the city dropped it because officials realized they were having trouble recruiting enough qualified applicants and were turning some otherwise outstanding applicants away: "'We were having difficulty recruiting qualified police officers, and we felt this policy may have prevented some good candidates from applying,' said Rebecca Jones, North Miami director of personnel administration."

And that is precisely why Melbourne's proposed policy is wrong. Because it judges potential applicants based not on their individual qualifications for the job, but on the group to which they belong, it represents employment discrimination.

While it may be true that on a statistical basis, smokers cost an employer more than nonsmokers, on an individual basis this is most certainly not true. The healthiest smoker clearly is going to cost less than the least healthy nonsmoker.

For example, a young (let's say 24-year-old) smoker with normal blood pressure, low cholesterol, a weight of 145 pounds, and clean coronary arteries is going to cost an employer less than a 55 year-old nonsmoker who has a resting blood pressure of 160/100, a cholesterol of 285, a weight of 285 pounds, and two-vessel coronary artery disease due to 45 years of eating too many french fries and tater tots (I can't avoid bringing in those tater tots).

If you're going to try to establish a policy of not making employees pay for the increased health care costs of their fellow employees, then it is irrational to consider only one factor in health. And in fact, among young people, smoking is probably far less of an important consideration in health care costs and lost work days then other factors, including whether or not the applicant has young children at home.

In addition, weight (or body mass index) is a huge determinant of health status and health care costs. Obese employees are 4 times more likely to be hospitalized in a given year than non-obese employees. Eliminating smoking applicants from job consideration while retaining obese applicants seems nonsensical.

This is precisely why employment discrimination is so inappropriate. It precludes individuals from being judged on their individual qualifications, forcing them instead to be judged on group membership.

And if one agrees with the Melbourne City Manager that after 50 years of knowing that smoking is bad for health, it's odd that we're still having this conversation about hiring smokers, then would not one also have to agree that after more than 50 years of knowing that obesity is bad for health, it's odd that we're still having a conversation about hiring obese people?

Unfortunately, this disturbing trend is going to continue until anti-smoking groups speak out against the practice. And it doesn't look like that's going to happen any time soon.