I am generally supportive of anti-smoking legislation and rules. However, I have a feeling that we may be approaching a point where the rights of smokers are being seriously trampled. After all, smokers at work are already relegated to practicing their vice outdoors so second-hand smoke ceases to be a problem for the non-addicted. The Cleveland Clinic has now taken the step of refusing to even hire smokers. The details of this plan are presented in what appears to be a personal message posted on the web from Dr. Delos Cosgrove, Chief Executive Officer and President of the Cleveland Clinic (see: A Message About Smoking). Below is an excerpt from it with boldface emphasis mine:
I suspect that the Cleveland Clinic would not have pursued a hiring policy that bars smokers unless they were convinced that it would withstand a legal challenge. Note that he cites other organizations that have employed a similar policy. I further suspect that legal issues may have been the reason that they decided not to fire existing employees who smoke. To do so would have made the new policy retroactive, which may have been grounds for legal action.
For me, the most interesting point in the rationale for barring smokers as employees is the following statement: We also are committed to taking a lead role in shifting the national focus from "sick" care to "health" care. I strongly believe in this concept and have published a number of previous notes about wellness versus the classic disease model (see: Wellness, Preventive Medicine, and the Classic Disease Model, Moving LISs Toward Greater Support for Preventive and Predictive Medicine, The Relationship Between Predictive and Preventive Medicine, How Predictive/Preventive Medicine Will Change Healthcare Delivery and the IT That Drives It). It's refreshing to see a large health system taking positive steps in this direction.