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Liz Ryan Headshot

Shame on Humana for Banning Smokers From Employment

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I'd heard about companies pushing their employees to quit smoking, and of course I'd heard about on-site and off-site smoking cessation classes at work forever -- I used to sponsor those classes, when I was a corporate HR person. Until this week, I'd never known an employer to ban smokers from its payroll entirely. Here's the USA Today story that describes the new deal.

It's amazing that hospitals, in particular, would think they've somehow got the moral high ground when it comes to making workplaces more healthy -- such that they could justify installing a policy that says "If you've got nicotine in your system, you can't work here." Hospitals rejecting job-seekers for their unhealthy practices -- now that takes chutzpah! After almost thirty years working in HR, I can tell you that hospitals are known as some of most unhealthy, stressful, dysfunctional and nose-to-the-grindstone workplaces in existence. Turnover rates in hospitals are sky-high. Work-related stress, substance use and abuse are constant items on a hospital HR director's radar screen. So it takes some special combination of tone-deafness, arrogance and piss-poor judgment for a hospital to tell its employees and job applicants, "Quit smoking -- or work somewhere else."

When people in any community (including the population of qualified nurses, doctors, admin staff and others in a hospital's labor pool) have issues that cause them to smoke (as we know they do) is a general clampdown on smokers going to solve anything? Or is the hospital, by banning smokers from its employee roster, playing three-card-monte with the real, systemic health problems it could be tackling?

Years ago, my HR cronies and I would debate Human Resources topics of the day. A big one was pre-employment drug testing. I wasn't a fan. My HR colleagues would say "But you have to keep the drugs out of your plant." I'd ask them "You think that by testing people before they're hired, you're going to keep drugs and other addictions out of your workplace? That's fantasy." One lady told me "We have a manufacturing facility in a town where drug abuse is off the charts -- 70 percent of the adult population." Did the lady think that by running new hires through pre-employment drug testing, she'd somehow keep drugs themselves and the culture of unhealth behind them, out of her company's hair?

When hospitals delude themselves into believing that a pre-employment nicotine test can magically solve the problem of tobacco-related medical issues among its staff members (and the associated insurance costs), one thing is clear: the people at the top of these hospitals know zip-all about health, or about leadership. The irony is crushing -- and appalling. If you work in a hospital, you're going to deal with stressful conditions every day. People who work in hospitals are a subset of people in the hospital's community. Some of them smoke. A health organization's charter is to improve the health of the communities in which it operates, isn't it? Or is the health organization's charter just to make money for shareholders, regardless of the human cost?

If these organizations believe in human health, they can take a closer look at smoking. They can acknowledge that their own physicians smoked, right up through the 70s. They can acknowledge that a drug is a drug and that doctors and health organizations are a huge part of America's dependence on many substances, nicotine among them. They can offer stop-smoking classes, and I hope they do. They can use a carrot, instead of a stick. They can do better than installing shameful, discriminatory employment policies.

A pox on Humana, Geisinger Health System, and other employers whose best stab at a healthier-workplace culture is to implement the policy "If you smoke, you can't work for us." We all know how well lowering the boom works for behavior modification. Truly, if the people at Humana and other smoker-banning health organizations believe that the way to change the state of our national health is to issue edicts and send people for blood tests, do you really want them managing your illnesses and injuries, and those of your family members? I sure wouldn't. You've heard of a bedside manner? This approach is the exact opposite.

Testing is easy. Real change, especially the sticky, tricky kinds of change that involve human frailties and habits, is hard. I wouldn't want my doctor to tell me "Lose 20 lbs. or we're through." So why would I have my next surgery or deliver my next baby in a hospital that manages its team that way?

Discrimination is illegal, and discriminating against smokers is illegal in about half the U.S. states. It should be illegal everywhere. If it were not, why shouldn't employers get all sorts of juicy, intrusive data about us while making hiring decisions? Why not ban people who don't get enough sleep (I'm sure there's a blood test for that) and people who have too many children (kids really run up those doctor bills!) and people who eat too much sugar? Why not DNA test your job-seekers before making offers -- after all, some of them undoubtedly are at risk of terribly expensive diseases!

Why not go all the way to Ceaucescu's Romania, circa mid-80s, and test every employee every month, right in the office? Say, Humana, you've got all kinds of testing equipment around -- you could test every worker for a bunch of things, and if they come up short on some metric or other, hand them a pink slip. It's The Handmaid's Tale without religion -- only the religion of "Your health is your employer's business." That vision of the future of work is no less frightening than the born-again kind.

Shame on Humana, and Geisinger Health Systems and yes, the American Lung Association, and any organization that contorts ethics and morality to believe its employees' daily habits are fair game for its scrutiny. People should be hired based on what they bring to work, not habits they engage in (proudly, regretfully, or with great embarrassment) on their own, after hours. Of all organizations in our lives, we'd look to health professionals to understand the meaning of privacy, and of empathy, and of complex systems. Keeping smokers off the payroll may look like a fix, but it's just another bone-headed, people-hating, thoughtless move toward bringing Big Brother into the workplace. Shame on you, Humana, and any employer who'd believe that an employee's off-work activities is any of its business, at all.