Smokers beware: Puffing away could reduce chances of landing a job, particularly at a hospital or a health care facility.
Methodist Hospital System in Houston this month announcedit will implement a tobacco-free hiring policy on Jan. 1, joining the Texas Medical Center and Memorial Hermann Healthcare System, which have had similar policies since last year and 2010, respectively.
The policies are straightforward. Applicants who smoke or chew tobacco will not be hired. Existing employees are exempt.
A growing number of hospitals and health care institutions have adopted the policies to promote wellness, improve productivity and rein in rising health care costs, but critics say they discriminate and could lead to punitive actions against other personal habits and vices.
"We think this is an invasion of privacy and really overreaching," said DottyGriffith, public education director for the American Civil Liberties Union in Texas. "At what point do you give up your rights and autonomy? Will they not employ those who ride motorcycles and drink alcohol?"
Dr. Marc Boom, president and CEO of Methodist Hospital System, said the policy is about company employees modeling healthy behaviors. More than 13,000 people work at the system's five hospitals.
"This is part of a journey of wellness and making this a great place to work," Boom said. "Employees work here to take of care patients. We can only do that if we're leading by example."
Methodist's online application will warn job seekers that it is a tobacco-free employer and that urine tests will be used to detect nicotine. A job offer will be rescinded if an applicant's results are positive. Free smoking cessation classes will be offered, giving applicants an opportunity to reapply if they have been smoke-free for 90 days.
How many businesses have such policies is difficult to determine because no group or agency is tracking them. Cleveland Clinic in Ohio was the first academic medical center to implement a policy in 2007. The clinic has received numerous inquiries over the past couple of years about its policy, a clinic spokeswoman said.
Lewis Maltby, president of the National Worker Rights Institute, estimates about 4 percent of business had such policies in the 1980s and early 1990s. The trend slowed then regained steam in the past couple of years in the health care and casino industries, he said.
Baylor Healthcare System in Dallas, which sought input from the Cleveland Clinic, implemented its policy in January. Becky Hall, vice president of health and wellness, said the policy was a natural progression. In 2007, the system's hospitals became smoke-free and began offering employees smoking-cessation programs, Hall said.
The primary reason for the policy "is to live by what we actually say," she said. The system has heart disease and cancer centers, and smoking contributes to those illnesses, she said.
Smoking is the leading preventable cause of death and a major contributor to many chronic diseases in the U.S. Smoking causes 443,000 deaths each year and the diseases caused by cigarette smoking result in $96 billion in health care costs, according to the Centers for Disease Control and Prevention.
Boom said cost was also factor in the system's decision. Insurance premiums are higher for smokers than nonsmokers, and all employees have shared the burden, he said.
Whether Baylor has experienced any insurance savings is too early to tell, but Hall assumes it will. Memorial Hermann and Texas Medical Center representatives could not be reached for comment.
Michael Siegel, a public health professor at Boston University, says if cost is a real issue, then employers should get rid of current employees who smoke. He says the policies are simply unethical and a value judgment against smoking.
"It's a form of employment discrimination," Siegel said. "People need to recognize that. They're making a hiring decision based on a group someone belongs to, not his or her qualifications for the job."
Twenty-nine states and the District of Columbia have statutes that ban employment discrimination against smokers, but 21 states, including Texas, do not.
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