More hospitals are refusing to hire smokers. Not all states allow this, and some anti-tobacco activists are uncomfortable with this trend. "We hope that people will be encouraged to quit smoking and quit using nicotine products and build a healthy life for themselves," said Julie Uehara, spokeswoman for Summa Health System in Akron, Ohio, which implemented a nicotine-free hiring policy in January. No studies show how many hospitals have banned hiring smokers. However, more hospitals have reported instituting such restrictions. For example: * ProMedica, which owns several hospitals in Michigan and Ohio. * St. Francis Medical Center in Cape Girardeau, Mo. * Crittenton Hospital Medical Center in Rochester, Mich. These institutions have been smoke-free for years, and the restrictive policies follow the Cleveland Clinic, which in 2007 became one of the first health care institutions to stop hiring smokers. Though some nonhospital employers have reported saving money on health expenditures as a reason for instituting bans on the hiring smokers, "this was not to reduce costs," said Paul Terpeluk, DO, medical director of Cleveland Clinic's employee health services. "Having health care providers and caregivers model healthy behaviors was really the goal," he said. "We heard from patients who said they did not like nurses to smell like cigarettes. Caregivers are different. They have to meet a higher standard." The policies usually apply only to new hires. Potential hires are informed of the policy at the time of application, with the smoking status assessed by nicotine testing during the pre-employment physical. Applicants whose job offers are rescinded usually can reapply after a certain period. Physician practices interested in instituting such a policy are advised to check their state and local laws, because banning the hiring of smokers is illegal in many jurisdictions. Twenty-nine states and the District of Columbia legally protect smokers. This is done most commonly through laws prohibiting employers from discriminating against employees who smoke outside work hours and off an employer's property. Some states have broader legislation protecting people who engage in lawful activity or use legal products outside the workplace. At the federal level, a spokeswoman for the U.S. Equal Employment Opportunity Commission said such policies were unlikely to run afoul of the Americans With Disabilities Act. Other employment laws may come into play, and testing for nicotine can be carried out only after a job offer has been made. The EEOC has not issued guidance on this subject. "Testing also needs to be consistent for everybody," said Joyce Walker-Jones, an EEOC senior attorney. "Employers could not single out people for testing, but not very much case law has been developed." Some people who work to limit tobacco use question whether refusing to hire smokers is the best way to improve employee wellness and reduce smoking in the community. "I'm a very strong supporter of smoke-free workplaces, but I'm not in favor of not hiring smokers," said Michael Siegel, MD, MPH, a professor at Boston University School of Public Health. "Being unemployed is also a health risk. If [hospitals] really are concerned about the health of the population, they should hire smokers and offer them smoking cessation classes. Denying them employment doesn't help." The full and original article can be found at: