Will Penn’s Smoker Ban Even Work?

Back in October, the University of Pennsylvania held a massive conference extolling the virtues of the class of drugs known as psychedelics. Finally, I thought, an important institution with a rational approach to drugs. But, alas: wrong again.

This week, the University of Pennsylvania Health System announced it’s going after a drug that’s much less intoxicating: tobacco. Well, more specifically, UPHS is going after smokers themselves, having announced this week that they’ll cease hiring tobacco users (that’s cigars, cigarettes and, yes, chew) starting July 1st this year. And that’s all in an effort to “serve as a model of health for the community,” said UPHS’s Judy L. Scheuler in an interview with NBC. That and reducing health care costs.

Currently employed smokers at Penn Health will not be terminated from their positions come July, but rather must disclose their tobacco use and agree to cessation counseling sessions or nicotine replacement therapy. There’s no urine test (guess that’s a little too intrusive), but anyone caught in a lie could be “disciplined.” Further, spouses of employees who are on UPHS’s health insurance will also be scrutinized; they too must disclose if they are tobacco users. The new policy doesn’t apply to university staff and professors. Apparently, that “model of health” thing is only directed toward health workers. And UPHS employees at facilities in New Jersey are protected from the change by NJ state law.

As a privately owned company, UPHS absolutely has the right to institute an anti-tobacco policy, and in Pennsylvania, smokers aren’t protected under any current anti-discrimination laws. They’re not the first to quit hiring smokers either; Abington Health, Roxborough Memorial, Geisinger Health System and others have done the same.

And according to the CDC, tobacco does contribute some 443,000 deaths a year to our national total, along with $193 billion in health-care costs, so the goal doesn’t seem totally outlandish. However, UPHS is doing all this with virtually no data suggesting that the practice reduces health-care costs, with or without adversely affecting the applicant pool.

The real problem, though, is that banning tobacco use—or, frankly, any other form of drug use—is essentially completely arbitrary so long as the employee is performing. I’m not saying cigarettes aren’t bad for you—they are, and I know that firsthand. But that doesn’t mean that other behaviors aren’t as dangerous or ubiquitous as tobacco use, or that employees aren’t partaking in those acts. At what point does the UPHS health worker who’s a bit obese, or regularly has an extra glass of wine with dinner, or leads a sedentary lifestyle, face sanctions from the employer?

Smoking is not the only thing driving up health-care costs—indeed any actions taken in the privacy of one’s own life can do that. Yup, it’s the old “slippery slope” argument again, and, in seizing on the public perception shift toward filthy smokers, UPHS seems to dutifully be starting down the mountain.

Mitigating that slide could be as simple as charging smokers more fees for their health care, which Penn is doing (not for drinkers, the obese, or the sedentary, though). So why, then, does the Philadelphia area’s largest employer need to ban a set of workers from employment during a recession in a city where as many as four in 10 adults smoke? S’all about perception.

Perhaps this is why Dr. Frank Leone, director of Penn’s Comprehensive Smoking Treatment Program, called the new policy “regressive” in a recent Newsworks interview. We’re essentially removing an entirely viable sector of the workforce from Penn’s application pool on the grounds that, basically, we just don’t like them. The divide between smokers and non-smokers has been coming to a head nationally for years, and now at Penn we have one side removing the other from the equation. All that to force a “none of our employees smoke!” marketing meme.

And what of the employees essentially forced to quit or face termination? So many people are going to lie to Penn’s HR department, and that’s because quitting tobacco is extremely difficult. Not to say that it can’t be done, but it definitely can’t be done at the behest of anyone besides the smoker themselves—to suggest that a job could consistently be the “button” to force longtime smokers to quit is, at best, pretty naïve.

But, beyond all that, it’s important to remember that our employers do not own us—or our spouses—and can only dictate our behavior during work hours—or, least, they should only be able to. We shouldn’t have to worry that what we want to put into our bodies might upset the bosses, especially if that substance is completely legal.

But just try and tell Penn to put that in their pipe and smoke it.