While perusing the website of a major university-owned hospital system recently, I noticed a banner on the site announcing that they will no longer be hiring tobacco users as of summer 2013.

I was initially surprised to see such an aggressive anti-tobacco campaign and wondered how this health system is able to get away with seemingly discriminatory hiring practices.

When I investigated further, however, I found that nontobacco hiring policies are legal in 21 states. Based on a 1987 federal appeals court ruling, smokers are not considered a “protected class;” therefore, they are not entitled to legal protection under discrimination laws.

Myriad health problems have been associated with smoking. There is clear evidence that smokers are at greater risk for many different types of cancer, cardiovascular disease and stroke, and are more likely to experience upper and lower respiratory infections than their nonsmoking counterparts.

Smoking has also been linked to infertility, preterm birth and low birth weight. Smoking and second-hand smoke exposure contribute to 443,000 premature deaths annually, and result in $193 billion in healthcare costs and lost productivity, according to the CDC. It is common knowledge, even among smokers, that smoking is unhealthy.

Considering all of these factors, I completely understand why a major medical system would make a move not to hire smokers. Limiting tobacco users in a healthcare system ultimately improves the overall health of all employees, while decreasing the system’s health-benefit costs.

Current employees of the healthcare system implementing this hiring policy will not be directly affected, as they will be “grandfathered” in to the new system. But tobacco-using employees will be required to pay higher health insurance premiums, unless they enroll in a smoking cessation program or nicotine-replacement therapy.

I’m very much in support of this new employment policy. I’ve long thought that we as healthcare providers should set a smoke-free example for our patients. Practitioners who reek of smoke are hardly effective when counseling patients on smoking cessation, or other healthy lifestyle choices.

I applaud this healthcare system for taking steps to make changes from within the medical system. I hope more companies and hospitals will follow suit.  

Robyn Carlisle, MSN, CNM, WHNP, works as a full-scope midwife at University Doctors and Kennedy University Hospital in Sewell, N.J.