Children's Hospital saying no to new hires who smoke

Arkansas Children's Hospital in Little Rock has a new message for potential employees: Smokers need not apply.

Arkansas Children's Hospital is joining the growing number of medical facilities and businesses in Arkansas and across the nation that are implementing more stringent policies on smoking.

Starting May 1, when its new Tobacco and Nicotine-Free Campus policy goes into effect, the hospital will no longer hire smokers, an email from Andree Trosclair, vice president of human resources, to employees said Monday.

Children's Hospital's new policy is just part of its step toward promoting good health among its employees, Jennifer Holland, director of occupational health for the hospital, said in an interview. She added that the decision is not related to the hospital's health insurance plan for employees.

She did say, however: "We continue to see medical plans [costs] go up every year, which suggests that we're not necessarily getting healthier. Smoking is one of those things we can control."

Holland added that smoking "is not something we want to expose our patients to."

The new policy prohibits all nicotine use: cigarettes, smokeless tobacco, e-cigarettes, and nicotine patches and gum.

Tobacco use is already prohibited on the hospital's campus, but as of May 1, new hires will be required to submit to urine tests for nicotine -- just as they would for illegal drug use -- and their employment is contingent on passing those tests.

If prospective employees fail the nicotine tests, they will be allowed to reapply for a position after 90 days, Holland said.

For current employees, nicotine will be added to the drug-screening program that Children's Hospital already has in place, but positive readings for nicotine will not affect those employees' employment. Instead, the hospital will reach out to them from "an education perspective," Holland said.

The number of smokers among the roughly 4,000 employees at the hospital ranges between 8 percent and 12 percent, she said.

In Arkansas, about 27 percent of adults were cigarette smokers in 2011, and 7 percent used smokeless tobacco, according to the most recent numbers provided by the federal Centers for Disease Control and Prevention in Atlanta.

The policy change from smoke-free to smoker-free workplaces has become increasingly common, especially at health-care institutions. While there are no exact numbers for tracking the changes, those who follow the shift say there's been a dramatic increase in smoker-ban policies in the past five years or so.

There are two main reasons that hospitals and other companies give for banning smokers, said Michael Siegel, professor of community health sciences at Boston University's School of Public Health, who has studied the trend.

One is that it saves the company money because there are higher health-care costs associated with employees who smoke. The second is that the company is "trying to set a good example" for the community.

Siegel, who opposes such polices, is skeptical of both of those reasons.

"I think there's something more going on than just these health- or economic-related motives," he said. "Clearly this is employee discrimination because these decisions are being made on someone being a smoker, not their qualifications."

Siegel added, "Somehow this feeling that hospitals have to set a good example for health -- I think they're misguided. I think that they are forgetting that failing to hire people doesn't set a good example. What sets a good example is ... providing excellent health and wellness programs to employees."

The Cleveland Clinic in Ohio became one of the first hospitals to implement a policy banning smokers in 2007.

"It was part of an ongoing wellness program for Cleveland Clinic employees," said Paul Terpeluk, medical director of employee health at the clinic. "We just felt that smoking was something we didn't want in our new hires.

"Cigarette smoking and tobacco use is considered very unhealthy," he said, adding that employees who work at health-care facilities are supposed "to be healthy people, so it just makes sense that it would happen in the health-care industry."

The policy at the Cleveland Clinic mirrors the one Arkansas Children's Hospital is adopting. The Cleveland company has hired roughly 35,000 new employees since the policy went into effect, and only about 300 people have tested positive for nicotine use, Terpeluk said.

"People got the message that if you want to work at the Cleveland Clinic, you better not smoke," he said.

There are laws in 29 states and the District of Columbia that make smokers a protected class, said Thomas Carr, director of national policy for the American Lung Association, which does not take a position on workplace policies that ban smokers.

"Basically they prevent businesses or employers from not hiring or firing smokers," he said. "Arkansas is not one of those."

Josh Sanford, managing attorney of Sanford Law Firm in Little Rock, an employment law firm, said Arkansas Children's Hospital's new policy is allowed under the law.

"It's obvious they are discriminating against smokers," he said. "However, smoking is not a protected activity. Because it's not protected, discriminating against them is not illegal."

Other hospitals in Arkansas have taken steps or are considering adopting policies on nicotine-free workforces.

Baptist Health Medical Center began hiring nicotine-free employees in January 2013. Job applicants are screened and, if flagged, are not hired. They then face a six-month waiting period before they can again be considered for employment there.

Spokesman Mark Lowan said current employees are not tested, and those who smoke have the option of participating in cessation programs. Nicotine patches or nicotine-gum use are not prohibited.

Baptist has not had a problem filling positions as a result of the policy, he said.

Unity Health, formerly White County Medical Center of Searcy, also has tobacco- and nicotine-free guidelines. According to the company website, "a mandatory drug screen is administered as a part of the health assessment, after the job offer. A positive drug screen will result in the job offer being withdrawn."

CHI St. Vincent is assessing the possibility of nicotine-free campuses and employees, said Tim Osterholm, senior vice president of human resources. Health-care costs and public interaction are among the factors being considered.

"We'll be strongly considering moving that way, but we don't have a specific timeline," Osterholm said. "It's something that has been done other places for a number of years. When you're looking at the wellness of co-workers, those taking care of patients, being nicotine-free is important to consider, and something a lot of folks will be looking at."

Holland, at Children's Hospital, said many employees are asking about how the new policy will affect them and also about participating in the nicotine-cessation program that the hospital offers.

"Which has been good," she said. "It's starting that conversation."

Holland said use of tobacco and nicotine -- just like obesity and stress -- affect employees' ability to work. Also, given their profession, the hospital does not want to expose patients to "third-hand" nicotine residue, she said.

"As health-care workers we know the risk of nicotine and what it actually does to you," she said. The new policy "makes logical sense in that perspective," she said.

Information for this article was contributed by Chris Bahn of the Arkansas Democrat-Gazette.

A Section on 04/01/2015

Reader poll

Do you agree with Arkansas Children's Hospital's plan to no longer hire smokers?

  • Yes; it's key for the health of employees and patients. 55%
  • No; it's discrimination. 41%
  • I have no opinion. 2%
  • Other (please comment) 2%

430 total votes.

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