Should Nurses Who Smoke Be Denied A Job?

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Hospitals are banning employees who smokeSmoking in public places is increasingly frowned on. Many colleges, workplaces and even entire towns are declaring themselves smoke free. Now, some companies are taking it a step further, implementing no-hire policies for smokers. Leading this trend are health care employers, like hospitals. So what does this mean for nurses who smoke?

The policies typically include all nicotine products like cigarettes, patches, pipes and e-cigarettes. Candidates are screened as part of the hiring process with a urine test. If there’s nicotine in their system, they won’t be offered the job. In some cases, they’ll be referred to a cessation program, and asked to reapply once they’re smoke-free.

The number of nurses who use nicotine has decreased significantly in recent decades. Only around 7 percent of nurses smoke cigarettes, according to a 2011 study. But for those who do and are thinking of applying for a new job, the hiring bans can be reason to pause.

Smoke-free workplaces

Some big names in health care are putting the new rules in place, like the World Health Organization, the University of Pennsylvania Health System and Baylor Health Care System. Other notable companies are following their lead, like Alaska Airlines and The Scotts Miracle-Gro Company.

The organizations instigating the new policies want to be leaders in creating healthy workforces, and in the case of health care employers, say they’re putting the rules into place to ensure they’re walking the walk when it comes to promoting health. Proponents argue that health care establishments should be role models when it comes to healthy employees. Not hiring smokers gets them closer to that goal.

The cost of smoking

They point to costs, too. Smokers have more health problems that require medical care, increasing employers’ costs and driving up insurance premiums for their co-workers. Smoking is also the leading cause of preventable death in the U.S., according to the Centers for Disease Control and Prevention. And there’s also the cost of decreased productivity for the company. Smokers spend less time on the job because they’re likely to take frequent breaks to smoke.

But not all employers are on board. Those against the new rules, such as Tribune Media Company and United Auto Workers, say they set a scary standard and invade employees’ personal lives. And, they argue smokers are unfairly targeted for high health care costs.

After all, employees who have babies or those with illnesses like cancer also contribute to higher premium costs and missed workdays. Those against the hiring bans also point out that smoking is legal for those over 18 and is a personal choice. Nurses are well-equipped to make informed decisions around smoking, since they see the risks of smoking firsthand.

Nurses who smoke

But by refusing smokers work, the rules may also hurt a population that’s already disadvantaged. A recent article in the New England Journal of Medicine makes the case that not hiring smokers doesn’t help them to become healthier. Instead, it adds to their burden, especially because there’s already a correlation between smoking and lower socio-economic status. Many smokers cite smoking as a source of stress relief, too. For those in stressful professions, like nursing, smoking may be a way to relieve tension.

Laws on smoking in the workplace

Many workplaces already have smoke-free campuses and view the no-hire rule as the logical next step. But is it illegal?

Rejecting a candidate because he or she smokes isn’t against federal law, since the U.S. government doesn’t explicitly protect from discrimination based on smoking status. But it is illegal in 29 states, which have passed legislation that specifically protects smokers in these cases. Still, in the majority of the country, it’s perfectly legal to decide not to hire a nurse because of smoking.

And if the current trend continues, more and more health care employers will choose to hire nonsmokers only, leaving nurses who smoke with few options other than to kick the habit for good.

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