Wednesday, November 02, 2005

On the Need for Protection from Discrimination against Smokers

In response to my post in which I expressed my opposition to policies under which employers refuse to hire smokers or fire existing smokers, I received a number of comments pointing out that work productivity may be lower for smokers (due to smoking breaks, increased absenteeism, decreased retention, premature death, etc.) and suggesting that this provides a justification for the above policies (even under my reasoning) because these factors can directly affect job performance, which I have stated is a valid criterion for making employment decisions.

This argument seems to be a widespread one. A recent article in The Sun Online brings to light the use of this argument to justify hiring policies based on smoking. The article reports on the potential for lost productivity by smoking employees due to the large amount of time spent taking smoking breaks. And it states that in response, many employers are, instead of simply regulating such breaks, refusing to hire smokers as a policy.

I have argued (post 1 post 2 post 3 post 4) that legal, off-the-job behavior that does not directly affect job performance or represent a major inconsistency with an employer's mission should not be a condition for employment. It seems, then, that my argument now fails because a number of anti-smoking advocates have shown that smoking can, in fact, affect job performance (by increasing rates of absenteeism, lowering job retention, requiring frequent smoking breaks which could decrease productivity, etc.) and that smoking is therefore an acceptable criterion upon which to make hiring and firing decisions.

The Rest of The Story

Here is why I think my argument does not fail and more importantly, why I think the above argument represents a very dangerous and unwarranted approach to employment policy (and tobacco control policy).

The reason is called discrimination.

Discrimination is defined as "treatment or consideration of, or making a distinction in favor of or against, a person or thing based on the group, class, or category to which that person or thing belongs rather than on individual merit."

If we as public health practitioners support a policy by which an employer refuses to hire smokers on the grounds that smokers tend to have higher rates of absenteeism, lower productivity, lower rates of retention, and so on, then I believe we are supporting discrimination in the workplace.

Note that I am not talking about discrimination in the legal sense - as long as an employer does not make hiring decisions based on age, sex, race, religion, or sexual orientation, then legal discrimination is not an issue. There is nothing illegal about not hiring smokers (except in a number of states that have enacted laws to specifically forbid this practice). The issue I am addressing here is discrimination in the public policy sense, or in the public health sense.

The reason I believe that a policy of not hiring smokers (based on the premise that smokers tend to have increased absenteeism and lower productivity) represents discrimination is that such a policy precludes the possibility of judging potential employees based on individual merit, and instead, forces individuals to be treated and considered based solely on the group, class, or category to which they belong - in this case, smokers.

I have no problem with the idea that absenteeism, lower productivity, and lower rates of retention are all criteria that are perfectly appropriate to consider in making hiring and firing decisions. But these criteria should be applied, I think, to the individual, not to the group in which that individual is identified.

In other words, each person should be judged as an individual based on their own merits as a potential employee, not judged solely on the basis of the group to which they belong.

It is entirely possible, for example, that a particular job applicant, who happens to smoke, is tremendously productive, very loyal to the company, and the most qualified individual for the position - an individual who would in fact be the most productive possible employee of all applicants for the position. Such a person would not have the opportunity to be considered for the position if the policy being supported by many anti-smoking advocates were in place.

Similarly, it is entirely possible that a particular job applicant who does not smoke is highly unproductive, misses a lot of days of work, is not loyal to the company, and is less qualified and would be less productive than a smoker who was turned down from the job because of the group to which she belongs. But that person could well end up being given the job simply because the more valuable and more worthy job applicant (who happens to be a smoker) was categorically denied the opportunity to even apply for the position.

This is, in fact, the basic reason why discrimination is generally not tolerated in our society. Because it tends to deny equal opportunity to individuals simply because of the category to which they belong, rather than because of actual individual merit.

I certainly don't think that we as public health practitioners, who are supposed to be committed to the principle of social justice (which is one of the central principles of our field), should be supporting a policy that represents discrimination against a particular class of individuals. I myself will certainly not go along with that approach to tobacco control any more.

In fact, I think that this policy is quite dangerous. It promotes the idea that people should in fact be discriminated against based on the class to which they belong, rather than judged as individuals on their own merit. To me, that's a dangerous idea and one that simply doesn't belong in tobacco control any more.

It may well be the case that in the interview process, applicants who are smokers may not fare as well because they have a poorer record of productivity in past positions. Perhaps they will tend to have less favorable job references from previous employers. Fine. That's the way employment decisions should be made. But there is simply no justification that I can see for making a judgment, prior to even considering an individual's application, that a specific person is not qualified or potentially suitable for a job simply because of a category into which that person happens to fall.

I'll be honest here. I have, for many years, been against laws that prohibit discrimination against smokers in the workplace because I simply don't feel that smoking should be elevated to the same status as unmodifiable or very basic individual characteristics such as age, sex, race, or religion. However, the kind of reasoning that I've observed recently among anti-smoking groups and some advocates is scaring me, and I am starting to entertain thoughts that a smoker anti-discrimination policy may in fact be necessary.

Up until a few days ago, my feeling was that simple legislation, such as SB381 in Michigan, which prevents employers from considering as a condition of employment lawful, off-the-job behavior that does not directly impair job performance was an adequate and appropriate way to protect smokers from becoming a second class of citizens which is not deemed worthy of the opportunity to pursue employment.

The problem is that these types of general laws do not prevent employers from discriminating against smokers in making employment decisions in cases where the reason for the discrimination is the perception (correct or not) that smokers tend to have lower levels of job performance. These more general laws provide an exception for behaviors that directly impair job performance and thus allow employers to refuse to hire smokers, so long as the reason for that policy is that smokers' job performance will be impacted negatively by their smoking.

It's honestly not clear to me now that such laws are sufficient, given the widespread discrimination against smokers in the workplace that I have been observing recently and the clearly expressed sentiments of anti-smoking advocates which seem to strongly support these discriminatory policies.

Perhaps most concerning to me, however, is what has happened to compassion for smokers among tobacco control practitioners. The way I view things, smokers are the population that we are supposed to be helping, not hurting. And discriminating against smokers is undoubtedly something which is hurting, not helping them. As a physician who went into tobacco control because I wanted to do something to help the smokers who I treated so often, it is disturbing to me that a whole focus of tobacco control activity in 2005 seems to be the promotion (or at least the support) of employment policies that discriminate against smokers.

If things don't change, I may for the first time find myself supporting legislation that the tobacco companies have long supported. Because discrimination against one group can easily lead to discrimination against the next. And I, for one, do not want to ever be judged based on any group to which I might belong rather than on my individual merit.

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