Memorial Hospital’s decision to stop hiring workers who smoke beginning February 1 can be broadly justified as a symbolic standard for a health-care provider. Yet its challenge to traditional standards of fair treatment for employees and job applicants is a bit more tricky. Ultimately it leads to question of whether employers should attempt to regulate the private, legal, off-premises, life-style behaviors of their employees, and, if so, where to draw the line.
Memorial Hospital’s decision was not based — as many might suppose — on potential savings in health-insurance costs, said Brad Pope, vice president of human resources. Rather, it was intended to reflect the hospital’s commitment to health. (Tobacco use is already forbidden on the entire Memorial campus, and current employees who smoke will not come under the ban.)
“Like it or not, what’s proven is that tobacco is the most preventable cause of death and disability in the United States,” he said. “I think the Chattanooga and surrounding communities should expect this from Memorial.”
Use of tobacco is, indeed, the most readily apparent example of an external, deliberately selected behavior that is devastating to an individual’s health. It also is seen as a risk that individuals should be able to control or quit, however strong the addiction.
People who choose to smoke risk not only their own health; their second-hand smoke also poses a health risks for those around them. Smokers willingly, if negligently, run a high risk of several types of cancer and pulmonary disease, and their higher, tobacco-related, health care costs often falls heavily on insurance costs to the government (through Medicare and Medicaid) or a user’s employer and colleagues, whose insurance premiums bear the cost-sharing burden.