No job for smokers

| 26/06/2014

The Heath Services Authority in Grand Cayman recently announced that it will no longer hire smokers. A job applicant must be tobacco-free for six months to qualify for a position here. This decision will surely provepopular. Defending the dirty habit of smoking is now left to fat cat lobbyists, highly paid lawyers with no conscience. I am not in those ranks. Full disclosure: I was a former employee of the university. But, keeping smokers out of the hospital work force unless it protects patients makes me very nervous. Ethically, it is hard to digest. 

HSA is not the first health care institution to go tobacco-free in hiring. The Chrissie Tomlinson did so back in 2007. The HSA board has had such a policy complete with required nicotine testing for more than a year. Hospitals and health systems have all stopped hiring smokers. Lots of companies outside health care are not hiring smokers either, but the big push is in hospitals and health systems. So what is wrong with not hiring those who engage in (or have engaged in) a gross, sickening, bad habit?

In justifying its decision, HSA says smoking and secondhand smoke contribute to 30 premature deaths a year and cost CI $2 million in health care and lost productivity. So, clearly they want to try and make a dent in that bill by barring tobacco users. Employees who smoke cost, on average, CI $3,391 more a year for health care. In addition, smoke breaks during work may be disruptive and subject patients/colleagues to the unpleasant smell of smoke on employees' scrubs and clothing.

So the two big reasons are making a dent in a costly bad lifestyle choice and saving money for the health care system by hiring tobacco-free employees. I am not sure if I buy the smoke break disruption or the smelly clothes arguments. If they are problems, then send the smokers outside to a spot far away from where the patients come in and out, or have them wash their hands and faces, which everyone ought be doing anyway, and only give them the same breaks from work that everyone else gets.

It comes down to a matter of fairness. Why can't the hospital work with people who may want to change their behavior but are having a hard time doing so? There's a little hypocrisy when as a place where you bring people back from sickness to health, your policy seems to reflect little concern for getting health care workers to become healthier. I don't doubt smokers cost us all a lot of money. It is also cheaper not to have to hire them and give them insurance or see them miss work. But the obese, the gamblers, rugby players, skiers, the sedentary, the promiscuous who don't practice safe sex, those who won't wear helmets on motorcycles and bikes, horseback riders, pool owners, all-terrain-vehicle operators, small-plane pilots, sunbathers, scuba divers, and surfers — all of whom cost us money and incur higher than average health care costs — are still on the job.

Picking on the smokers alone is simply not fair. And what message does a no-smokers-are-welcome policy send? We don't want you in our health care system?

Shouldn't doctors and nurses learn to work with those who sin and stray from the dictates of good health? As long as those who have bad habits are not compromising the quality of health care being provided on hospital ground, then let's not exclude smoking nurses, fat physical therapists, and scuba diving pharmacists from work.

What is the best way to get a doctor or nurse who smokes to stop? Make sure they cannot get a job? Oh yeah — that will surely make them kick the habit! Why not hire them, tell them they have to get into anti-smoking programs and pay them a bonus when they stay smoke-free?

Not hiring smokers at hospitals does send a message — but it isn't one that hospitals and health systems ought to be sending.

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  1. Anonymous says:

    Perfect! That cuts out smoke breaks. A time waster. It cuts out the unsightly cigarette butts. It eliminates the need for designated smokingareas around the hospital.  


    Though how how far will we take it? You can barely smoke in public places as it is now. Can't get a job at the hospital. Next the general workforce. Then criminalize it? Isn't decriminalizing marijuana up for discussion. 

    I'm not a smoker and I dislike the smell. But I prefer for people to choose how to live their lives without a heavy hand influencing. 

  2. Anonymous says:

    I would like to know when and where did the HSA made this announcement.

  3. Anonymous says:

    Where does Human Rights fit in this?

  4. Grossly unfair says:

    What about cocaine users, are they testing for these guys too? Or is it because it is considered  illegal we will not test or discriminate these users?

    • Anonymous says:

      But they work super long hours without needing food.

      • Anonymous says:

        They also do great deals on Ipads, TVs, watches, cars and basically all family possessions.

  5. Anonymous says:

    What a load of tosh!  Now we are commenting about cigarette smoke on clothing.  Perhaps we can also ban treatment to patients for wearing cheap perfume or who have had curry for lunch, as the breath is most offensive.

    I love statistical references as it is claimed that it costs $2m in added costs and reduced productivity.  The tobacco tax alone actually makes it a money making proposition.  Several years ago the UK government published a study stating that it cost their economy 9 billion pounds in added health costs and reduced productivity.  That was quickly debunked as the revenue from the sin tax for tobacco there produced over 13 billion pounds.  A true moneymaking opportunity for the government there.

    It is scary to believe that a semi-autonomous agency has the right to make a policy such as this.  After all, the smoker should know better than to smoke but this is a personal decision for the individual.  And as many other commentors here have noted, in our industry here we have a far greater problem with health issues with alcohol and much reduced productivity.  Next thing you know we will be refusing to hire based on religious beliefs (Seventh Day vs. Baptists).

    The whole thing sounds like voodoo management with a good dose of voodoo economics added in.

    • Anonymous says:

      If you're wearing perfume in the hospital, you don't need to be in the hospital.  It's a sick place not a disco club.

  6. Anonymous says:

    Smoking a pack a day could help some of these fattys keep the weight off!

    Just a thought.

    • Anonymous says:

      Cancer does lead to weight loss.  Dramatic weight loss for terminal cases.

  7. Anonymous says:

    Kudos to the Health Services Authority!! I was attended to serval times by nurses from the UK that work there and they both reeked of cigarettee smoke, as they kept going outside to smoke and then come back to check on me. Plus one her breath smelt like a septic and kept talking in my face. So yes, I agree and I am glad to see the years of letter writing to ban smokers as health care providors has come to realty! Great job HAS, now we can all come back and enjoy being helped by persons with a lot less stink!

    • Anonymous says:

      Based on your experience perhaps we should ban people who eat garlic in their lunch, or indians that eat too much coriander, not to mention those with halitosis.  And no I am not a smoker but i am on their side because obesity is the biggest health problem, not smokers

    • A-nony-mouse says:

      Gee, you must have been attented to by the same smokehouse refugee who last 'served' me while in the casualty department.  I nearly gagged every time they came to check on me.  After shift change, I commented to the new staff member about the stench of the previous staff member.  She said it was a common complaint and most of the patients complained about it.  I know I filed a formal complaint and received a reply stating that a policy was being prepared to deal with it.  That was over 2 years ago.  Better late than never, I always say!  Hooray HSA!!

      As a personal policy, I don't hire smokers and never will. After all they are easy to detect and screen out, just by the smell test!!  My insurance costs went down by 35% as soon as I eliminated the smokers from my payroll in the past.  It just makes economic sense form a productivity standpoint, health care costs and most importantly less sick days per employee.  My average sick days declined by 58% with the elimination of smokers.  All I had to do was require they take ONLY  the same breaks as other staff, and they quickly found other employment.  Problem solved!!.

  8. Anonymous says:

    I always question how smokers can continually be discriminated against when obesity costs more money and kills more people.  I get the "second hand smoke" argument, but really I can't see how one "class" of people can be discriminated against and the other classes of people get a pass.


    Until you ban all bad stuff (smoking, obesity, alcohol, etc) then I feel it is an unfair target.

  9. Anonymous says:

    How the hell did this discussion go from smoking to obesity?

  10. The Janitor says:

    Isn't this a form of discrimination?

    • Anonymous says:

      Not an improper one as it is based on objectively valid criteria.

  11. Anonymous says:

    What about the employees already on staff that smoke ?  Will they get fired ?  They can ban smoking on the premises but I don't see how they can legally refuse to hire someone on the basis of them being a smoker.

  12. Anonymous says:

    Why should they get  $$ to stop!??!? I should get a bonus because I do not smoke then!!

  13. Anonymous says:

    What about workers who drink alcohol? I've had some very memorable nights out with HSA employees who could definitely put the booze away. Are they going to start breathalysing staff when they arrive at work?

    • Anonymous says:

      Great idea about the breathalyser.  Would reduce the headcount efficiently and cheaply.  I knew of a couple of banks that would use that policy from time to time to dump underperforming traders.

    • Anonymous says:

      I personally dislike coffee breathe on people. I feel that people who drink coffee should not work in the public sector.

      • Anonymous says:

        I personally dislike people who cannot spell the word "breath", I feel they should work in Burger King.

        • Anonymous says:

          I personally dislike people who would put down people who work at Burger King!

          OR…..people who would put down anyone who makes a simple spelling error!

          I would rather have someone blow cigarette smoke at me or have coffee "breath"!

  14. Anonymous says:

    In the year 2014, health care workers and medical students should have reviewed sufficient research and evidence to demonstrate comprehension and lead by example. 

  15. Anonymous says:

    Being unable to get a job sounds like a pretty good reason to quit smoking to me

  16. Anonymous says:

    The obese should be treated the same way.  All the same arguments apply.

    • Anonymous says:

      Really? You mean you can die of second hand obesity? Obesity may be due to hormonal imbalances.

      • Anonymous says:

        Clearly the comment of someone who is not exactly slimline themselves. In fact you can have second hand obesity – it's caused by people thinking that because their parents, family, friends, work colleagues, partners or whatever weigh in at the wrong side of 250lbs and need XXXL clothing there's nothing wrong with it. We live, learn and die by example so if you live in a 'plus sized' environment you accept it as normal.      


        • Anonymous says:

          Agreed. If we equate "normal" with average, it's not much of a stretch to say it's normal to be fat. For children and for many adults who are overweight, they are starting to perceive themselves as the new normal. And how often have we heard the comment about a fat child "he's not fat, just big-boned like his father"?

          • Anonymous says:

            Also add to the fat that obese people eat more and eat less healthy foods, which is how they became obese in the first place, and when they eat they will generally feed their children the same thing leading to child obesity.

            • Anonymous says:

              Fat people should be discouraged from having a family.  It is tantamount to child abuse.

        • Anonymous says:

          You would be surprised!

        • Anonymous says:

          That's not 2nd hand obesity, you idiot. No one else can make you fat.

          • Anonymous says:

            A parent can easily make a child fat.  Want to try again with a cogent argument?

      • Anonymous says:

        About 0.01% of the obese population might have a hormonal imbalance, about 70% of the obese population claim to fall within that 0.01%.  But even the "hormonal imbalance" bs does not get over phsyics – matter can neither be ctreated nor destroyed, it can only be cahnged from one form into another.  If you don't take in too many calories you will never get fat.  Seen fat people suffering from a hormonal imbalance in nations with a famine?  Neither did I.

      • Anonymous says:

        Yes!  Watch Chesty Morgan and The Deadly Weapons

    • Anonymous says:

      Nobody can quit being obese cold turkey – many would if it were that easy!  

      • Anonymous says:

        It really is that easy.  Eat less.  Exercise more.  Weight goes. 

        • Anonymous says:

          And drink less. Cutting out high-sugar soft drinks completely and easing off on alcohol makes the weight fall off. I speak from personal experience – I dropped from 180lbs to 150lbs (for me that's a nice healthy BMI of 22) just by that very simple life-style change. 

    • Anonymous says:

      I can't die from second hand obesity but i sure can from second hand smoke

      • Get in my belly says:

        You can too die from second hand obesity…a very large person can fall and drop on you. Ouch!