Is employment discrimination against smokers ethical (and should it be legal)?

by Brian Wolfman

At this blog, we have covered issues of employment discrimination. Our posts have mainly concerned employment discrimination on the basis of someone's characteristic or status. But employers sometimes discriminate against prospective or current employees based on behavior, such as whether the prospective or current employee is a tobacco user. Apparently, an increasing number of employers are discriminating against smokers to lower their costs, among other reasons. Is that type of discrimination ethical? Should it be legal?

Those issues are the topic of a debate just published in the New England Journal of Medicine. One  article, entitled "The Ethics of Not Hiring Smokers," by Harald Schmidt, Kristin Voigt, and Ezekiel J. Emanuel, maintains that employer smoker bans are unethical. Here's the opening:

Finding employment is becoming increasingly difficult for smokers.
Twenty-nine U.S. states have passed legislation prohibiting employers
from refusing to hire job candidates because they smoke, but 21 states
have no such restrictions. Many health care organizations, such as the
Cleveland Clinic and Baylor Health Care System, and some large
non–health care employers, including Scotts Miracle-Gro, Union Pacific
Railroad, and Alaska Airlines, now have a policy of not hiring smokers —
a practice opposed by 65% of Americans, according to a 2012 poll by
Harris International. We agree with those polled, believing that
categorically refusing to hire smokers is unethical: it results in a
failure to care for people, places an additional burden on
already-disadvantaged populations, and preempts interventions that more
effectively promote smoking cessation.

The second article, entitled "Conflicts and Compromises in Not Hiring Smokers," by David A. Asch, Ralph W. Muller, and Kevin G. Volpp, takes a different approach. Here are some excerpts:

Tobacco use is responsible for approximately 440,000 deaths in the
United States each year — about one death out of every five. This number
is more than the annual number of deaths caused by HIV infection,
illegal drug use, alcohol use, motor vehicle injuries, suicides, and
murders combined1 and more than the number of American servicemen who died during World War II. A
small but increasing number of employers — including health care
systems such as the Cleveland Clinic, Geisinger, Baylor, and the
University of Pennsylvania Health System — have established policies of
no longer hiring tobacco users. … These policies engender controversy, and we recognize that they risk
creating or perpetuating injustices. One set of concerns arises from the
fact that tobacco use is more concentrated in groups with lower
socioeconomic status. … However, these policies may also save lives, directly and through their
potential effects on social norms, and these same disadvantaged
populations are at greatest risk for smoking-related harms and ensuing
disparities in health. … These policies also increased the stigma against smoking, so although
there's debate over whether stigma can be used as a tool for good,
ultimately these policies almost certainly contributed to the decrease
in the prevalence of smoking, not just the limits on where it occurs.
For example, the Cleveland Clinic moved to a smoke-free campus in 2005
and stopped hiring smokers in 2007. Reportedly, smoking rates decreased
in Cuyahoga County (where the Cleveland Clinic is located) from 20.7% in
2005 to 15% in 2009, whereas the overall rate in the state decreased
only from 22.4% to 20.3%. … Do hospitals' anti-tobacco hiring policies denormalize smoking and
help communities escape tobacco's burden? Critics may argue that these
claims are disingenuous, akin to a human resource director's saying to
tobacco-using applicants, “Believe me, it's for your own good that I'm
not hiring you.” But in the long run, such policies may indeed be for
their own good. We recognize that these hiring practices are
controversial, reflecting a mix of intentions and offering a set of
outcomes that may blend the bad with the good. We know that many
companies will want merely to continue their current level of
anti-tobacco efforts, but given the threats that tobacco presents to our
communities and institutions, we believe it's time to climb another
rung on the ladder.

0 thoughts on “Is employment discrimination against smokers ethical (and should it be legal)?

  1. Brad Farrow says:

    it is illegal it is discrimination why are our courts not investigating this. where are our cigarette companies when we need help like another comment I read the hospital will hire a 350 pound overweight and diabetic person over a smoker they will hire drunks most of them doctors drug attics as you know drugs disappear from hospital shelf daily and then they go against an honest person who smokes I like another commenter never missed a day in 11 years where have my boss who is an overweight person who does not smoke but it is a alcohol miss A’s whenever he wants to you’re all a bunch of hypocrites when the time comes and you have to account for your sins as well as I have to account for mine. I feel my fan of smoking will be far less than your files off 5000 of job seekers that you have not given jobs too will be less than mine

  2. Kevin May says:

    I’m a smoker who works out regularly and I haven’t taken a sick day in 2 years. I can guarantee that the 300 pounder who sits in the office next to me and doesn’t take care of themselves, costs my employer more by being less productive physically and sick for 2 weeks every year. I think we should stop hiring obese people, they are the biggest health care problem, not smokers.

  3. justin says:

    Sooo being adicted to crak or alcohol is a dissability but being adicted to tobaco isnt? and what happens when the liw income people these companys are fireing\not hireing get sick of not being able to get a job… hmmm 5000000 smokers might stand up and fight. Its not right for.companys ti tell to live your life. Prity much if your a smoker and yoy cant quit smokeing get be homless cause no job no money no house.. homless numbers will go up costing the goverment more and more

  4. Ted says:

    This blog elsewhere complains that, because of swipe fees, consumers who pay cash are subsidizing consumers who use credit cards and cost more to serve, and that vendors should be allowed to charge credit-card customers more. How is this any different? Non-smoking employees are subsidizing smoking employees in multiple ways.

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