March 18, 2013 | Posted By John Kaplan, PhD

Recently the University of Pennsylvania Health System in Philadelphia announced that it would no longer hire tobacco smokers. This seemed like a smart move for several reasons. There are some pretty obvious benefits for the institution including reductions in employee health care costs, reduced rates of absenteeism due to sick days, fewer employee breaks, and the more minor advantages such as fewer people smelling of smoke. There are similarly benefits to individuals who can be convinced not to smoke by such policies. A longer healthier life spared of the expense and inconvenience of procuring these dangerous and addicting instruments should be reward enough. Thus firms which ban hiring of smokers help advance the cause of providing the twenty some percent of adults who still smoke a reason to quit. Moreover health care organizations seem to be the natural groups to take the lead in instigating this sort of social progress.

This is not a new trend. Turner Broadcasting System banned the hiring of smokers in the 1980s and has maintained this policy since. Similar bans on hiring smokers have been implemented by the Cleveland Clinic, Baylor University’s Hospital and the Geisinger Clinic. It all seems to make so much sense. Nevertheless there has been a reaction. Smokers are not a protected class under federal law. Federal law permits a company to discriminate against smokers. However no less than twenty-nine states , including here in New York State, have laws outlawing bans on the hiring of those who smoke. A list is provided here. This is a testimony to the power of the tobacco lobby.

So you might ask, why is this the subject of a bioethics blog? Because a couple of weeks ago Arthur Caplan , Director of Bioethics at New York University and formerly from Penn wrote on CNNs website an article entitled "Barring smokers from hospital jobs unfair".His central argument is that “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.”

I disagree. Smoking is distinct from all of these in that the certainty of a shorter, less healthy, and more expensive life from a preventable cause is more prevalent than in any of these other cases. As a society we have not chosen to deal with smoking by prohibition because it will simply not work. We therefore need progress to come from the type of action that the University of Pennsylvania Health System has taken here.

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BIOETHICS TODAY is the blog of the Alden March Bioethics Institute, presenting topical and timely commentary on issues, trends, and breaking news in the broad arena of bioethics. BIOETHICS TODAY presents interviews, opinion pieces, and ongoing articles on health care policy, end-of-life decision making, emerging issues in genetics and genomics, procreative liberty and reproductive health, ethics in clinical trials, medicine and the media, distributive justice and health care delivery in developing nations, and the intersection of environmental conservation and bioethics.