Apr 9, 2013

Employers to Smokers: Don't Bother Applying Here

Going from Smoke-free Workplace to Smoker-Free Workplaces

Are you looking for a job? Here's an important interview tip: do NOT go into your interview smelling like smoke.

Most workplaces are now smoke-free – you can’t smoke in your cube, the bathroom or even inside the building. In fact, many buildings prohibit smoking within 15-25 feet of the doorway.

The latest trend? Smoker-free workplaces. If you smoke (or go into an interview smelling like smoke), you risk not getting hired by companies that are increasingly aware of the healthcare costs of hiring smokers.

Move Up Another Rung?

An article in the March 2013 New England Journal of Medicine entitled “Conflicts and Compromises in Not Hiring Smokers” argue that it’s time we looked at moving up another “rung” on the ladder (see the below chart), from simply creating smoke-free workplaces and offering smoking-cessation and counseling to providing financial incentives or even disincentives such as not hiring smokers.

Proposed ladder of interventions to reduce tobacco use
Source: New England Journal of Medicine
The authors conducted a trial to compare what would happen when employers offered financial incentives for smoking cessation/counseling (rung 5), compared with employers who simply offered smoking cessation/counseling but no incentives (rung 3).

The initial results were dramatic: in the first 12 to 18 months, employees in the incentive group had a quit rate that was approximately three times the quit rate of employees who received no incentives. 

Unfortunately, even employees who received incentives didn’t stick with it; follow-up after 18-months found that only 9 percent were still not smoking. So even with an aggressive system of rewards, 91% of employees who wanted to quit could not.

“We believe that the severe harms of smoking justify moving higher up on the ladder when lower-rung interventions don't achieve essential public health goals,” the authors concluded.

“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.”

Awareness is NOT Enough 

Smoking is responsible for over 400,000 deaths in the U.S. every year (about one in five deaths). That's  more than the combined total from HIV infection, illegal drug use, alcohol use, motor vehicle injuries, suicides, and murders. It's even more than the number of American servicemen who died during World War II. 

Unless you’re living in a cave somewhere, you’re already aware of the fact that smoking kills. And so does secondhand smoke. Yet the current rate of smokers has not dropped very much in the last few years; currently, around 20 percent of Americans (one in five) still smoke. In fact, I’d argue that the rate could be higher, because many women I know who are “social smokers” don’t consider themselves to be “real” smokers.

We've known about smoking's dangers for about 50 years.
Yet in the last decade, the rate of smokers has only dropped from 26 to 24 percent. 
I believe that awareness is not enough. Smoking cessation programs and counseling aren’t enough. We need real solutions and tools to help people who want to quit smoking.

Smokers are not just addicted to nicotine; they’re addicted to the habit. That’s why an e-cigarette starter kit can help. The smoker gets the sensation they’re smoking, but without the 4,000 chemicals and 57 carcinogens in cigarettes. They can still “light up” their e-cigarette battery at work, in their car, when they’re stressed out or just in the mood.

I don’t think it will be long before other employers will join the likes of the Cleveland Clinic*, Geisinger, Baylor, and the University of Pennsylvania Health System in establishing a policy of not hiring people who smoke. These employers are taking a strong stand against a voluntary habit that causes death and disability not only to the smoker herself but to others who are subjected to her secondhand smoke.

And they’re taking action that will reduce healthcare costs and lost productivity by thousands of dollars every year for their employer group. Sure, these policies may be controversial. But in 2013, we've been aware of the dangers of smoking for at least 50 years, and the dangers of secondhand smoke for at least half that time.

Policies such as this could save lives. And they could cause smokers to take action, and join the 21st century and light up the new way with an e-cigarette, without having to take a ciggie break or expose their co-workers to secondhand smoke even as far as 25 feet from the building.

*The smoking rate in Cuyahoga County (where the Cleveland Clinic is located) decreased from 20.7% in 2005 to 15% in 2009, while the overall rate in the state decreased only slightly, from 22.4% to 20.3%.

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