If you're a smoker and want a job with Florida healthcare provider, Orlando Health, you're going to be out of luck. Because as of April 2013, the company has said that new hires at seven of its hospitals
must not use tobacco in any form – even in the privacy of their own homes.
The new rule is an expansion of Orlando Health's current drug and alcohol use policy and will apply to all forms of tobacco use. The company says that it will require all individuals who receive a job offer to be screened for cotinine, a by-product of nicotine, as part of the regular drug screening process. The level of cotinine present in the body can determine whether an individual is a primary tobacco user or is being exposed to tobacco through other means, such as second-hand smoke.
Offers of employment will be rescinded for individuals who test positive for "primary user" levels of cotinine. Applicants who fail the cotinine test may re-apply after 180 days.
"Our new tobacco-free hiring rule reinforces our culture of prevention and wellness for team members, patients, and the central Florida community," said Christy Pearson, COO Human Resources, Orlando Health.
"It is our way of leading by example and serving as a community role model for good health behaviors."
Since tobacco remains a perfectly legal substance for adults to purchase and use, such bans are – to say the least – controversial when they mean refusing to hire people who do legal things in their own time. And it is particularly pertinent in a country where so many adults are overweight and employment discrimination against obese candidates is a legal grey area.
In fact, in 29 other American states, such a blanket ban against smokers would be illegal, but Florida is among the 21 states which do not have laws protecting smokers' rights. So too is Pennsylvania, where the University of Pennsylvania Health System announced that as of July 1, it will also stop hiring people who use nicotine, arguing that the policy will save health care costs.
"We think it's our responsibility, as healthcare providers, to help improve local population health by promoting the cessation of all tobacco products," added Christy Pearson.
"Our goal with both these efforts is not to exclude anyone who is qualified and interested in pursuing a career with Orlando Health. It is to promote and encourage the cessation of all tobacco use."
But as Dr Michael Siegel, a professor of public health at the Boston University School of Public Health and a specialist in tobacco control, wrote a recent blog post, such arguments are the thin end of a very dangerous wedge.
"Employees should be hired based on their bona fide qualifications for a job, not based on a group to which they happen to belong when that group membership does not relate to a specific job qualification," he said. "Once employment discrimination is justified on the grounds of saving money, then the same reasoning would justify discriminating against obese people, persons who consume alcohol, individuals who do not wear seat belts, persons who talk on their cell phones while driving, motorcyclists, and virtually any other group that an employer does not want to hire."