Abstract
Background: Increasingly, healthcare and non-healthcare employers prohibit or penalize the use of tobacco products among current and new employees in the United States. Despite this trend, and for a range of different reasons, around half of states currently legally protect employees from being denied positions, or having employment contracts terminated, due to tobacco use. Methods: We undertook a conceptual analysis of legal provisions in all 50 states. Results: We found ethically relevant variations in terms of how tobacco is defined, which employee populations are protected, and to what extent they are protected. Furthermore, the underlying ethical rationales for smoker protection differ, and can be grouped into two main categories: prevention of discrimination and protection of privacy. Conclusion: We critically discuss these rationales and the role of their advocates and argue that enabling equality of opportunity is a more adequate overarching concept for preventing employers from disadvantaging smokers.
Highlights
Smoking causes an estimated 480 000 deaths annually in the United States and 5.7 million deaths globally, making it the most common cause of preventable mortality in the United States and worldwide.[1]
Due to definitional ambiguities relating to the term “tobacco use” and related concepts, it is not clear whether use of electronic cigarettes fall under the laws or not
Smoking can affect workplace productivity and is typically associated with higher healthcare cost. Should these facts play a role when it comes to employment decisions? Should we welcome non-hiring policies as a “tough-love” approach, in which we help smokers who want to quit but find it difficult to help themselves?2,3 In the United States, there is no federal law that would either prohibit employers from not hiring smokers, not one that would permit this in some cases
Summary
Smoking causes an estimated 480 000 deaths annually in the United States and 5.7 million deaths globally, making it the most common cause of preventable mortality in the United States and worldwide.[1] Smoking can affect workplace productivity and is typically associated with higher healthcare cost. Should these facts play a role when it comes to employment decisions?
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