Monday, June 05, 2006

Smokers Should be Banned from College, According to Same Logic Used to Support Workplace Smoker-Free Policies

Friday, I reported that the government of North Korea had imposed a ban on smokers attending college and suggested that we in the U.S. may be just a step away from such an inhumane and discriminatory policy, since we're already seeing widespread discrimination against smokers in employment. Here, I argue that the same justification being used to support these workplace smoker-free policies could even more easily be used to promote policies that preclude young people who smoke from attending college.

There are basically 4 arguments being used by some anti-smoking groups and advocates to support policies by which employers refuse to consider applications from smokers:

1. These policies will save money. They will reduce health care costs for employers.

2. These policies prevent unfairness, because they address the problem of nonsmoking employees having to bear the burden of paying for the increased health care costs incurred by smokers.

3. These policies are justified because employers should be free to make their own decisions regarding their own employment policies.

4. These policies will improve the public's health, because they will encourage smokers to quit. They will create a healthier workforce and ultimately, will save lives.

The Rest of the Story

The exact same justification being used to support employer smoker-free policies could be used (I think perhaps more convincingly) to promote policies by which colleges refuse admission to young people who smoke (as in North Korea, they would be required to quit smoking before being allowed admission to college):

1. Most universities provide health insurance directly for their students. And the larger colleges actually provide health care itself, through university health services. The university's costs to provide this health care are directly related to the amount of illness among the student body. Since smokers are likely to have a greater need for health care, universities could reduce their health care costs by denying admission to smokers.

The effect of this policy of banning smokers on reducing health care costs is even more direct for universities than it is for many employers, because while most employers are merely paying for health insurance contracts, most universities are actually providing the health care themselves. If employers' health insurance plans do not provide differential rates for smokers and nonsmokers, then there may not be any economic savings from banning smokers from employment. But if a university is directly providing health care, then there are direct benefits from a policy of not admitting students who smoke.

2. Since the overall level of health care expenditures drives prices that universities must charge to all their students, denying admission to smokers would prevent nonsmoking students from having to subsidize the cost of increased health care incurred by smokers. This would prevent the current unfairness to nonsmokers. Currently, nonsmokers are shouldering the burden of paying for the increased health care costs of their smoking classmates. The problem could be eliminated if smokers were denied admission to the college.

3. Universities should certainly be free to adopt their own admissions policies. If they wish to make not smoking a criteria for admission to their institution, then they should certainly have that right.

4. Denying admission to smokers would have enormous public health benefits. It would reduce smoking rates by encouraging smokers to quit. This would improve the public's health and save many lives. It would create a healthier student body and ultimately, a healthier public. How could anybody be against a policy that has such enormous public health benefits?

The rest of the story is that the exact justification being used to deny smokers employment could be just as easily (or perhaps more easily) used to deny smokers admission to college.

If anti-smoking groups are truly concerned about protecting the public's health, reducing health care costs, preventing the burden on nonsmokers of reimbursing smokers for increased health care costs incurred, supporting the rights of institutions to set their own admission policies, reducing smoking rates, and saving lives, then surely they should start supporting policies by which universities deny admission to students who smoke.

Interestingly, most (if not all) of us would view such policies as being completely inappropriate, unacceptable, and inhumane, because they are highly discriminatory, unduly intrusive into individual privacy, and most importantly, because they deny individuals a basic right - the right to puruse an education - solely because of a lawful individual behavior choice.

Well I would submit that the right to pursue employment is also a basic right to which all individuals should be entitled. Thus, I find policies that refuse employment to smokers to be just as inappropriate, just as unacceptable, just as inhumane, and just as discriminatory as policies that would deprive smokers of the right to pursue a college education.

If anything, denying the opportunity to pursue an education to young people who smoke is more acceptable than denying the right to apply to work at a company to adults who smoke because it is arguably easier to quit smoking when you are much younger and less addicted.

On further reflection, it's not so clear to me that we are so far away from the policy that has been advanced in North Korea. After all, we in the anti-smoking movement are using the same reasoning to justify employment smoker bans. If we can deny employment to people based on a personal decision to smoke, then we can just as easily justify denying college admission to people based on that lawful personal behavior choice.

I don't want any part of this type of thinking. And I think it's high time that anti-smoking groups and my fellow tobacco control advocates condemn such policies.

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