By Peggy McDaniel, BSN, RN

"Smoke break"/by sylvar, via Flickr

Are you a smoker? If so, and you live in Chattanooga, TN, don’t even bother to apply for a job at Memorial Hospital, where being a smoker automatically disqualifies you. To ensure that job applicants are telling the truth, the hospital will subject them to drug tests—for nicotine! This new rule does not apply to current employees, but it does raise some interesting questions. The article notes that such requirements for hire could be a slippery slope on the way to other forms of discrimination. 

As unpopular as this may be, as a fellow health care worker I can see a lot of positives to such a trend. In a previous blog post I discussed nurses as role models for our patients. My focus was on obesity,  but I also mentioned smoking.  

Another recent article, this one in the UK’s Nursing Times, says nursing students in Europe should be encouraged to stop smoking. The article discusses an Italian study reporting that nursing students are twice as likely to be smokers than are members of the general public. Maybe this would be a good policy to promote in the US? The article raises some of the same points I had raised in my earlier post about role modeling and the ways our actions or choices may influence our effectiveness as educators.

In addition to the health benefits in being a nonsmoker, there are also huge cost savings. As with obesity, smoking affects the overall cost of our health care system. The Tennessee health department told the press that an employee who smokes costs the hospital $2500–$4000 more in health care costs a year on average; according to another recent article, “smokers cost the country $96 billion a year in direct health care costs.” (By way of perspective, the article also points out that over time there is actually a societal cost benefit to smoking, since people who smoke die earlier. . . .) 

With the current focus on health care and insurance reform, Memorial’s new hiring policy may become more common around the country. What do you think? Is this good policy or outright discrimination?

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