The following guest opinion was prepared by Central District Health Department Executive Director Russ Duke, with small contributions by me. We have submitted it to the local papers for publication but I have not yet seen it appear.
In December 2011 the Central District Health Department (CDHD) announced that it will no longer hire anyone testing positive for nicotine use. The decision was made by the Board of Health because of the irrefutable evidence linking tobacco use with premature death and chronic diseases, but also because it made good business sense. Now Ada County is instituting a similar policy for its new hires.
Since there is no way to differentiate tobacco use from nicotine replacement products, CDHD chose the tougher standard. Ada County will do the same. Nicotine replacement is designed to be a bridge to becoming tobacco-free, not an on-going habit.
The health argument against tobacco is powerful. For those of age, tobacco use is perfectly legal. It is a personal choice, but one with grave consequences. The Centers for Disease Control and Prevention (CDC) says smoking is a primary cause of at least 30% of all cancer deaths, and is responsible for nearly 80% of the deaths from chronic obstructive pulmonary disease (COPD) and for early cardiovascular disease and deaths. For every smoking-related death another 20 people suffer with smoking-related disease. Smokeless tobacco products are really no safer; they are known to cause cancers of the oral cavity.
Clearly tobacco use is linked to higher health care costs. The CDC puts a $3391 annual price tag on each employee who smokes: $1760 in lost productivity and $1623 in excess medical expenditures. An American Cancer Society study of health care utilization showed that employees who smoked had more hospital admissions per 1,000 (124 vs. 76), had a longer average length of stay (6.47 vs. 5.03 days), and made six more visits to health care facilities per year than nonsmoking employees.
We are not only government agencies, but also employers. As such, we are tasked with protecting public health and safety while watching the bottom line. Since employers pay the largest share of the cost of employee health insurance, they (we) have a vested interest in reducing those costs. Every dollar we save on health insurance is a dollar we can use to fund other services to the community, or return to our taxpayers.
Tobacco users are absent from work more often. Smokers miss a little over 6 days of work a year due to sickness (including smoking related acute and chronic conditions) compared to their nonsmoking counterparts, who average just under 4 days of missed work a year.
Tobacco users are less productive. A full time job is considered 2080 hours per year. If a smoker uses just two percent of that time on cigarette breaks, it amounts to about a week of unproductive time away from his job. The more someone smokes, the less productive they are.
Smoke-free policies reduce smoking. When workplaces ban smoking they increase the number of employees who quit smoking altogether. This is followed by improved employee health, greater productivity, less absenteeism and lower costs for health insurance.
You will hear some people comment that the overweight and obese also increase the cost of health care, so why not ban them from being hired? First of all it is illegal. Second, a person’s weight is affected by many variables, some of which are out of their control, like genetics, environment and income. A person doesn’t choose to be overweight, yet everyone using tobacco products is making a conscious choice to do so.
Hiring tobacco-free employees contributes to the bottom line in dozens of ways. But at the end of the day, it also contributes to the health and longevity of our greatest resource, our people.
Director Central District Health Department
Ada County Commissioner