Question: No Smoking Allowed-On the Job or Off

In 2012, Pennsylvania's Geisinger Health System adopted a new policy: it would no longer hire smokers. The hospital system had already banned smoking on the job, but this policy went further by saying it would not employ anyone who used tobacco products, even if they indulged their habit only off the job and on their own time. Applicants who had been offered a position would have to take a urine test to screen for nicotine. If they failed, they would be allowed to apply again in six months. Smokers who already worked for Geisinger would not lose their jobs. "We're trying to promote a culture of wellness," said a representative of Geisinger, explaining the hospital system's change of policy. "We're not denying smokers their right to tobacco products.

We're just choosing not to hire them." Geisinger was just the most recent of a large number of health care institutions and insurers-including the Cleveland Clinic in Ohio, Baylor Health Care System in Texas, Humana Inc. in Arizona, and Anna Jacques Hospital in Massachusetts-to ban not just smoking, but smokers. "This is quite a trend. Hospital systems throughout the country are doing this increasingly," said a public health expert. Other employers, while not refusing to hire smokers, had begun charging them more for health insurance. For example, in 2011 Macy's began charging employees who used tobacco products an extra $420 a year. A 2011 survey found than 19 percent of major U.S. employers-including such well-known names as PepsiCo, Safeway, Home Depot, and General Mills-imposed financial penalties on smokers. Some thought this trend would accelerate, since under the health care reform legislation passed in 2010, employers with particularly expensive health plans would be penalized with extra federal taxes. By 2012, most U.S. employers-either acting voluntarily or because they were forced to by local and state antismoking laws-had banned smoking on the job or restricted it to a few separate areas. The health reasons for doing so were compelling. Secondhand smoke-smoke emitted from a lit cigarette, cigar, or pipe, or exhaled by a smoker-caused more than 50,000 nonsmoker deaths in the United States each year, according to medical research.

Nonsmoking employees could be sickened, or even killed, by exposure to others' tobacco smoke at work, particularly in workplaces where smoking was common, such as hotels, bars, and restaurants. Advocates offered several reasons for going further and banning or actively discouraging smoking off the job. Employees who used tobacco products were more expensive. Smokers, on average, cost their employers $1,800 more per year in health care costs, and lost twice as much production time, as nonsmokers. Some employers also gave a noneconomic argument: that they wanted their workers to set a good example. The CEO of the Cleveland Clinic, for example, explained his organization's policy not to hire smokers this way: "If we are to be advocates of healthy living and disease prevention, we need to be role models for our patients, our communities, and each other. In other words, if we are going to talk the talk, we need to walk the walk." For their part, employees who smoked were divided in their reaction to tobacco restrictions or bans. Some smokers welcomed the pressure to quit. A study by researchers at the University of California found that employees who were covered by strong workplace smoking policies were more likely to quit the habit than other smokers.

But others disagreed, calling employment restrictions and higher insurance charges discriminatory and unfair. Some were incensed at what they perceived as a violation of personal rights and freedoms. Some even argued that smoking was, in effect, an addiction to nicotine, and so their right to smoke should be protected under the Americans with Disabilities Act (further described in the following chapter). The National Workrights Institute, a group promoting civil liberties, expressed concern that refusing to hire smokers could lead to other forms of discrimination. The institute's president pointed out, "There is nothing unique about smoking. The number of things we all do privately that have a negative effect on our health is endless. If it's not smoking, it's beer. If it's not beer, it's cheeseburgers." Lawmakers weighed in on both sides of the issue. Many towns and cities, 23 states, the District of Columbia, Puerto Rico, and the Virgin Islands passed antismoking ordinances or laws that banned smoking in enclosed workplaces. But 29 states (sometimes the same ones) also passed laws making job discrimination against smokers illegal. Although these laws did not affect smoking bans or restrictions in the workplace, they did prohibit companies from refusing to hire smokers or from firing employees who continued to smoke. (Pennsylvania, where Geisinger was located, did not have such a law.) Many other countries had historically been more tolerant of smoking, both in the workplace and elsewhere, than the United States. This had begun to change, however. By 2012, 168 countries had signed the World Health Organization's Framework Convention on Tobacco Control. Among other things, the convention called on governments to protect people from workplace exposure to secondhand smoke.

Discussion Questions

1. Should employers have the right to ban or restrict smoking by their employees at the workplace? Why do you think so?

2. Should employers have the right to restrict or ban smoking by their employees off the job, or charge smoking employees more for health insurance? Why do you think so?

3. Should the government regulate smoking at work? If so, what would be the best public policy? Why do you think so?

4. Should multinational firms have a single corporate policy on smoking in the workplace, or vary their policies depending on local laws and norms of behavior in various countries where they do business?