The University of Pennsylvania Health System (UPHS) will stop hiring people who use nicotine at its Pennsylvania locations beginning July 1.
The ban will not apply to the crop of residents who begin this summer, but will be in force for applicants for 2014 residency slots. Last year, there were 1,975 full-time faculty, 769 medical students, 775 PhD students, 1,135 residents and fellows, and 789 post-doctoral candidates working in the nearly 18,000-employee health system.
“Over 50 years of research has proven that tobacco use is the leading preventable cause of death and disease in the U.S., imposing a huge health and financial burden on families and businesses,” the health system stated on its website. “Employees who smoke cost, on average, $3,391 more a year for healthcare. In addition, smoke breaks during work may be disruptive and subject patients/colleagues to the unpleasant smell of smoke on employees’ scrubs and clothing.”
Further, “smoking or second-hand smoke exposure contributes to 443,000 premature deaths annually and results in $193 billion in healthcare costs and lost productivity,” the statement, citing CDC statistics, continued.
The ban applies to new hires, not current employees. However, current employees who use nicotine but are not enrolled in a smoking cessation program will be charged higher health insurance premiums than non-nicotine users, according to the company website and media relations staff.
Employees who take up smoking after they are hired will be offered smoking cessation programs and subject to higher premiums, UPHS said.
Those who use but do not confess to a nicotine habit are subject to discipline or termination if the health system determines that they were not candid in their application.
Faculty and staff at Penn’s facilities in New Jersey are exempt from the ban under a state “lifestyle” statute that prohibits discrimination against smokers, said employment and workplace policy attorney Susan Lessack.
However, New Jersey workers who admit to smoking may be charged the higher health insurance premiums required of Pennsylvania employees, as allowed by law.
“Since 2006, we’ve seen more and more employers adopting policies of not hiring smokers, and I expect that will continue to be the trend with the Affordable Care Act because that act allows employers to impose surcharges of up to 50% of premiums on smokers starting in 2014,” Lessack explained.
Insurance consulting firm Weyco in Lansing, Mich., was one of the first companies to adopt the policy — in 2005, Lessack said. Since then, Kimball Physics in New Hampshire, Cleveland Clinic, Alaska Airlines, and Union Pacific Railroad also have stopped hiring smokers, she added.
Last year, Geisinger Health System in central and northern Pennsylvania adopted the same policy. Geisinger requires a urine test, Cindy Bagwell, vice president of talent acquisition for Geisinger, told MedpageToday.
“It really has had a negligible effect,” Bagwell said. “We’ve had maybe five people who have failed [the test], and we receive over 80,000 applicants for 1,000 jobs. Our applicant pool did not fall off. There was obviously some concern, but we would have seen a shrinking pool of applicants.”
Bagwell said Geisinger has offered employees numerous programs and incentives to quit smoking and improve their health, including providing pedometers, nutrition classes, healthy recipes, healthy food at the Geisinger cafeterias, and banning all smoking on the premises since 2005.
But detractors say the policies are discriminatory and misguided.
“Hiring decisions should be made on a person’s qualifications,” said Michael Siegel, MD, professor of medicine at Boston University, “not on a group to which that person belongs, when that group membership has nothing to do with those qualifications. It sets a dangerous precedent when we engage in employment discrimination.”
Siegel argued that the nonsmoker policy could just as easily be applied to other employees with health conditions that incur expense to employers, such as obesity.
“You can make the same argument for not hiring fat people: The obese are more likely to develop illness and cost more,” Siegel said. “Once you cross that line that it’s ok to discriminate against people because we want to save healthcare costs, it opens the door to discrimination against anyone. I don’t find that argument convincing.”
Health and Human Services secretary Kathleen Sebelius echoed that sentiment, as did Frank Leone, MD, director of the UPHS Comprehensive Smoking Treatment Plan.
“I’d be much more enthusiastic about them providing programs to help employees stop smoking,” Sebelius told the Philadelphia Inquirer on a visit there last week. UPHS does provide such programs.
Leone, quoted on WHYY-FM’s website, NewsWorks, questioned whether “smokers in hiding” would seek help to quit for fear of being outed and terminated.
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Kathleen Struck joined MedPage Today after serving as Managing Editor for EverydayHealth.com, Stars and Stripes and MediaNews Group. She lived and traveled internationally for more than 15 years and has written and edited for publications including, Washington Post, Baltimore Sun, Newsday and Regulatory Affairs Professional Society. At MedPage Today, she reports and edits on general news and information.