Yesterday, Dr. Paul Terpuluk - medical director of the Cleveland Clinic - and I participated in a discussion of nicotine-free hiring policies on Radio Times with Marty Moss-Coane. You can listen to the show here.
For me, two interesting things came out of the discussion.
First, I hadn't realized that the Cleveland Clinic policy denies employment even to ex-smokers who have quit successfully using nicotine replacement therapy. Any nicotine use is grounds for denial of employment, even using NRT or electronic cigarettes. Thus, the policy actually punishes exactly the people who it should be rewarding.
Second, Dr. Terpuluk repeatedly made the point that this is a policy based on principle: that patients shouldn't have to smell a smoker. Without even getting to the appropriateness of that "principle," it struck me that the Cleveland Clinic is not adhering to that principle at all, because it continues to allow smokers to take care of patients. The policy only applies to new hires. If the Cleveland Clinic really was interested in ensuring that its patients didn't have to be taken care of by people who smell like smoke, it would certainly have gotten rid of all its existing smoking employees (or given them a six-month or one-year period to quit smoking).
By the end of the discussion, it was clear to me that this policy has nothing to do with public health and nothing to do with any principle. Instead, it is merely a political action that makes it look like the hospital system is taking a stand when it is doing nothing other than punishing smokers, even those who are trying to quit.