Friday, April 13, 2012

Illinois Senate Passes Bill to Allow Cancer Treatment Centers to Discriminate Against Smokers in Hiring

The Illinois Senate has passed a bill that would allow hospitals that exclusively treat cancer patients to discriminate against smokers and smokeless tobacco users in their hiring by systematically refusing to hire such individuals. Illinois currently has a law that prevents this type of employment discrimination so a law would be needed in order to allow employers to refuse to hire tobacco users.

According to an article in the Daily Herald: "The proposal, from state Sen. Dan Duffy, lets for-profit companies that only treat cancer patients not hire someone because they smoke or use other tobacco products. “That has an impact on people, when they go in (for treatment) and smell that smoke,” the Lake Barrington Republican said. ... “Their sole mission is to cure cancer, not cause cancer,” Duffy said of the Cancer Treatment Centers."

The Rest of the Story

I wasn't aware that seeing a smoker could cause cancer. That's the implication of Senator Duffy's justification for this policy. He argues that the policy is justified because cancer treatment centers should not be "causing" cancer. But in what way does seeing a smoker or smokeless tobacco user "cause" cancer?

Certainly secondhand smoke is a cause of cancer. But the bill does not outlaw secondhand smoke in these cancer treatment centers, it allow for the outlaw of smokers and other tobacco users. The cancer treatment centers already have the authority to ban smoking and other forms of tobacco use in their workplaces. And I bet that most, if not all of them, already do that. But clearly, the presence of a smoker in the workplace does not cause cancer.

Perhaps the argument is that the thirdhand smoke, the smoke exhaled by smokers long after they stop smoking or the smoke that comes off of their clothing, may be a cause of cancer. However, there is absolutely no evidence to support this hypothesis. Moreover, if that were the true motivation for the policy, then why would smokeless tobacco users be included? There is no thirdhand smoke involved.

Another concern of Senator Duffy's is that people going in for treatment will "smell that smoke." But this can be avoided simply by banning smoking in the workplace. That eliminates the smoke.

Perhaps the argument is that patients will smell the residue of smoke particles that have settled on the clothing or skin of smokers. But the workplace has the right to regulate the behavior of employees on the job. The employer can forbid employees from smoking during the work day. And again, that justification wouldn't apply to a ban on smokeless tobacco users.

Clearly, there is something more behind this proposal, beyond merely the desire to protect the health of the patients at these cancer treatment centers. Since smokeless tobacco products are included in the policy, it is apparent that the true motivation is to make a public statement of disapproval of tobacco use. The legislature has every right to make public statements disapproving of tobacco use, but authorizing employment discrimination against tobacco users is not the appropriate way to make that statement.

If the legislature really wants to do something to show its "disapproval" for tobacco use, then why doesn't it allocate a substantial proportion of its Master Settlement Agreement money towards tobacco prevention and treatment, as it was supposed to do in the first place? Discriminating against smokers does not help smokers in any way, nor does it serve to protect the public's health. In contrast, allocating money towards a tobacco prevention and treatment program would both aid smokers and protect the public's health.

In fiscal year 2012, Illinois is spending just $9.5 million on tobacco prevention, making it the 33rd state in the nation in per capita spending for tobacco prevention, with a spending level that is only 6.1% of that recommended by the Centers for Disease Control and Prevention. According to the Campaign for Tobacco-Free Kids: "Illinois’s spending on tobacco prevention amounts to 1.1% of the estimated $856 million in tobacco generated revenue the state collects each year from settlement payments and tobacco taxes."

The rest of the story is that tobacco control efforts have become largely misdirected in recent years. Instead of focusing on the evidence-based interventions that we know will make a difference in reducing smoking and actually improving the public's health, many states are focusing instead on policies designed to discriminate against and punish smokers and other tobacco users, rather than help them. States are diverting billions of dollars in tobacco settlement money away from the original purpose of these funds - which was to prevent tobacco use - and using the money for a wide range of unrelated purposes instead.

If the Illinois legislature really wants to make a statement to the state and the country about the public health burden of smoking, then it ought to put its money where its mouth is and allocate a substantial portion of MSA revenues to tobacco prevention and treatment, rather than devoting its time to allowing employment discrimination against tobacco users.

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