Conflicts and Compromises in Not Hiring Smokers

Some U.S. employers have created controversy by establishing policies of refusing to hire smokers. But such policies may save lives, both directly and through effects on social norms, in a realm where current interventions haven't had sufficient success. Tobacco use is responsible for approximately 440,000 deaths in the United States each year — about one death out of every five. This number is more than the annual number of deaths caused by HIV infection, illegal drug use, alcohol use, motor vehicle injuries, suicides, and murders combined 1 and more than the number of American servicemen who died during World War II. A small but increasing number of employers — including health care systems such as the Cleveland Clinic, Geisinger, Baylor, and the University of Pennsylvania Health System — have established policies of no longer hiring tobacco users. These employers . . .