Help Wanted. No Smokers Need Apply: A New Marketplace Podcast

(Photo: Julie Bocchino)

Our latest podcast is called “Help Wanted. No Smokers Need Apply.”  (You can download/subscribe at iTunes, get the RSS feed, listen via the media player above, or read the transcript.)

In many states (21, to be precise), it is perfectly legal for an employer to not hire someone who smokes. This might seem understandable, given that health insurance is often coupled to employment, and since healthcare risks and costs are increasingly pooled. And so: if employers can exclude smokers, should they also be able to weed out junk-food lovers or motorcyclists — or perhaps anyone who wants to have a baby?

That question is the thrust of this podcast, which features a conversation with Zeke Emanuel. He is a Penn medical professor/bioethicist; a former White House healthcare adviser; the author of Healthcare, Guaranteed (and Brothers Emanuel, about growing up with Rahm and Ari); and a coauthor, with Harald Schmidt and Kristin Voigt, of a recent New England Journal of Medical article (previewed on our blog) called “The Ethics of Not Hiring Smokers”:

EMANUEL: I’m a cancer doctor. I find smoking disgusting. I find smoking horrible. I wish that everyone who did it could quit. But I also recognize that it’s not voluntary, that most people start before they’re adults and that it’s incredibly hard to quit once you’ve started.”

Emanuel also appeared in an earlier Freakonomics podcast, “Is the Obesity Epidemic for Real?” In this podcast, he argues that not hiring smokers lies somewhere between discriminatory and unethical. Give us a listen and let us know your thoughts.

Audio Transcript

Kai RYSSDAL: Time now for a little Freakonomics Radio.  It’s that moment every couple of weeks we talk to Stephen Dubner, the co-author of the books and blog of the same name.  It is “the hidden side of everything.”  Dubner, long time, no talk, man!

 

Stephen J. DUBNER: Great to be back, Kai.  Thanks for having me.  I know you trained as a Navy pilot -- I wonder if you ever thought about afterward working as a commercial pilot?  Was that ever a plan?

 

RYSSDAL: No, not really.  That was never my thing.

 

DUBNER: Well, if you had, and if you had interviewed with, let’s say, Alaska Airlines, there’s something you would have needed to know. Here’s airline spokesperson Marianne Lindsey:

 

Marianne LINDSEY:  “In general, there’s a question that’s asked, ‘have you smoked or used tobacco products within the last six months?’  And we go by how the employee responds to that question.  And then, before they’re hired, they have a drug test that they take that detects nicotine use.

 

RYSSDAL: So Alaska Airlines would not hire me, were I a smoker.  Yes?

 

DUBNER: Alaska Airlines would not hire you if you were a smoker.  Now, they’ve had this policy for quite a few years.  And more and more companies now are refusing to hire anyone who uses tobacco -- a lot of healthcare firms, especially, and hospitals.

 

RYSSDAL: This has to be about cutting healthcare costs, right?

 

DUBNER: That’s a primary reason, for sure. Smokers are more expensive than non-smokers, if you’re the company.  By one estimate, about $4,000 a year more in terms of healthcare and lost productivity and so on. But there’s also the idea that you want to make every workplace healthier, which means smoke-free seems to be a good idea there.

 

RYSSDAL: Right, OK.  That makes sense.  Question number two, though, Dubner, is this: Last time I checked, smoking is legal, man.

 

DUBNER: Yes it is.  So, as it turns out, in terms of the legality of hiring smokers: 29 states have passed laws that don’t let companies turn down smokers, but the other 21 states do allow you to do that.  So if I’m a company in New York or North Carolina or California, I cannot reject an employee because he or she smokes. But if I run a company in Pennsylvania or Florida or Alaska, I can. So that’s a pretty severe split – which recently led to a piece in the New England Journal of Medicine about the ethics of not hiring smokers. Here’s one of the authors, Zeke Emanuel, who is a bioethicist and a professor at the University of Pennsylvania.

 

Ezekiel EMANUEL: “I’m a cancer doctor. I find smoking disgusting. I find smoking horrible. I wish that everyone who did it could quit.”

 

DUBNER: All right.  So it’s not hard to think that he’s in favor of not hiring smokers. Right?  But wait, there’s more:

 

EMANUEL: “But I also recognize that it’s not voluntary, that most people start before they’re adults and that it’s incredibly hard to quit once you’ve started.

 

RYSSDAL: OK, wait.  “Not voluntary?”  I mean, Zeke Emanuel is a smart guy and all, but huh?

 

DUBNER: That is really the basis of his argument – which is that most smokers want to quit, but can’t, and to refuse to hire them is therefore discriminatory or at least unethical.

 

RYSSDAL: Does this break down on socioeconomic lines?  Is there a low-income, low-wage worker versus high-wage, high-income person thing?

 

DUBNER: Yeah, that’s a great question.  So low-income people are substantially more likely to smoke than high-income people across the board. So, if you’re a low-income smoker and now can’t get a job because you smoke, it’s sort of a double jeopardy. But there’s also the fact that smoking is one of those activities – legal, as you noted, but publicly frowned upon – that seems to open a bigger can of worms in terms of hiring. Here’s Emanuel again:

 

EMANUEL: “Once you’re on this kick, you can say, ‘Look at those Seventh Day Adventists!  They’re the people we really want to employ because those guys -- they don’t smoke, they don’t drink, they eat very healthy, they don’t engage in high-risk sporting activities.’ That just seems to me exactly where we don’t want to be going

 

DUBNER: So Kai, you can imagine a future where nobody wants to hire anybody who does anything at all risky.  Maybe not even risky, but just expensive -- like becoming pregnant and having kids. Because, as we all increasingly share healthcare costs, that means that you increasingly are thinking about what I do because it affects what you’ll pay in insurance and taxes. In the case of smoking, it’s really all about the incentives.  In a tough labor market like ours, will it turn out to be that getting a job is a such a strong incentive that it might help a smoker who has tried everything, but everything else else has failed? I have no idea if that will work, but it will sure be worth keeping an eye on.

 

RYSSDAL: Stephen Dubner.  Freakonomics.com is the web site.  Stephen, we’ll see you in a couple of weeks.

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Comments are moderated and generally will be posted if they are on-topic and not abusive.

 

COMMENTS: 59

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  1. Barman says:

    Smoking, in the privacy of my own room is exercising my choice of freedom. Just like that, if I own a business or I am the recruiter on behalf of a company, hiring specifically the smokers or specifically the non-smokers or taking my hiring decision without caring about smoking habit is my freedom. So I don’t think it’s any way unethical if I don’t hire smokers. After all, given my manpower requirement, for every smoker I turn down, I will hire a non-smoker. So it’s not even like there is a job loss or something. Just that I am taking the best decision for my own business according to my knowledge and belief. Why should someone regulate that? And if all the businesses start similar practice? That will lower the salary expectation of smokers and will give further incentive to hire smokers. So give freedom to the businesses, the system will keep the balance by itself.

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    • Babbo says:

      When you ask why someone should regulate your decision making as a business owner, and specifically mention your knowledge, and particularly “beliefs”, I get the impression that you must be a relative newcomer to the Freakonomics universe? Knowledge is by definition limited, beliefs are at best flawed, and your decisions as a business owner have measurable costs on the world around you. If you discriminate against a definable group of people based on their health when you make hiring decisions, you contribute to a hidden problem of employment and health in your community, and exploring the hidden side of economic calculus is what Freakonomics is all about. Your ideological devotion to freedom is fine, but this is a podcast about data, not ideology.

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      • Al says:

        First, there is no obligation to the “community.” Each individual in their respective location will do what’s in their best self interest in a free and voluntary society. If they feel that their community is failing, they will act in a way to better it. Next, freedom is not an ideology but the natural state of man. Only force, oppression, and propaganda have led you to believe that freedom is some extreme political view. If you want to talk data, just look throughout human history and the empirical evidence shows that more freedom has led to the greatest breakthroughs and achievements for humankind. Lastly, as it relates to this forum, I’d say that truth trumps any kind of subjective topic on any forum. It doesn’t matter who knows what about Freakonomics as long as they speak the truth.

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      • Babbo says:

        @Al:
        The Freakonomics team has spent years and gone to great lengths to bring the hidden side of complicated economic issues like this one to light. We can argue all day about what constitute “the greatest breakthroughs and achievements for humankind”, but don’t you think it serves both of us better to listen a little more and talk a little less, and appreciate the hard work these guys do to comb the data and present rational conclusions to economic problems?

        That being said: “The community” is the marketplace in which businesses perform their services and make their money. Businesses can and do make decisions in their own self-interest which have significant and measurable costs to society and the marketplace as a whole, which is why we have laws (relatively recent ones mind you) forbidding practices like child labor and race/gender discrimination, which in the not-too-distant past were left to the discretion of, and abused by, the collective practices of business owners of the period, at considerable cost to the health and welfare of American families. I can’t recommend strongly enough, brushing up on Chapter 5 of Superfreakonomics, specifically in reference to negative externalities, to better appreciate why freedom and self interest are not the be-all end-all of economic decisionmaking.

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    • ERLW says:

      If you replaced “smoker” with any other subset of society who aren’t (necessarily) breaking the law (e.g. women, Irish, the bald) do you still stand by it? If so, fair enough; you certainly make some good points, and I do agree that somethings in life do not need to be regulated (as customers and potential employees will vote “with their feet”). If however you do not still stand by it, and feel smokers to be different, then surely your argument is to ban smoking, not ban smokers from being hired.

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  2. Brian says:

    Just listened to this podcast, another good one!

    I just wanted to clarify a very key distinction in this whole debate. People seem to conflate the terms tobacco use vs smoker, but they are potentially very different. When my company implemented an insurance fee for smoking the insurance company made it very clear that it was for tobacco use, but the HR employees kept saying the term smoker. A smoker is a habitual user, whereby one could use tobacco products in a responsible manner. For instance, I personally smoke about 5 cigars a year. Basically a number so low that it would probably be impossible to say it has any deleterious health effects. At the very least, the health effects would pale in comparison to something like air pollution. However, I would be considered to be in violation of the policy for use of even 1 tobacco product.

    I’m all for weening smokers (a habitual action) off of their pack or more a day habit, but when you start to regulate ALL tobacco products then that’s a discriminatory action. I’d also like to see in a future episode a comparison of total lifetime health care costs to insurance companies for smokers vs non-smokers. I’ve seen arguments for both sides of the debate and I know where I stand on the issue, but I’d always be curious to hear another take.

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  3. Barman says:

    Seems like my previous post created some confusion. I didn’t try to defend smokers, or to defend those not hiring smokers. I tried to defend the freedom to smoke and the freedom to hire someone based on whatever criteria I want. I think it’s time to appropriately define the word ‘freedom’ here. No matter how much I fight against discrimination, freedom is also important. That’s why I am saying the employer should have his/her freedom to choose people. You smoke in your private time, that’s your affair. But to hire you or not based on whatever criteria I want is my call. I am not telling you to quit smoking, I am telling I can’t hire you and go to someone else. Don’t say that smokers got a right to force managers to hire them to prove that they are not discriminating. Did I make it clear?

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  4. Peter says:

    I think it’s a fantastic idea to exclude candidates who don’t fit your ideal employee in terms of personality and habits. For example, if you’re hiring for a technology firm you may make it a point to not hire people who don’t use smartphones or have wifi in their home.

    If you’re hiring for a fitness gym and you make it a point to not hire people who have little interest in healthy or active habits, even though they work behind a desk, I think that’s okay.

    Let’s take a lesson from the Freakonomics books. Just as the kinds of people who have lots of books in their home have kids who are more likely to enjoy reading I would not want to hire the kinds of people who smoke cigarettes everyday. That kind of person has somewhat of an addictive personality, takes frequent breaks throughout the day to leave the building, in unable to break an obvious bad habit, and is not conscious of their spending habits.

    If someone smokes socially or once in a while then I wouldn’t pay attention to that, but someone who always has a pack of cigarettes on them is not someone I would want to work with.

    All this being said, I would certainly not discriminate because of racial background, gender or ethnicity. In many situations I think discrimination is valid for certain religious beliefs, but since that’s illegal, I would shy away from being openly discriminatory about it.

    Also, since workplaces can administer drug tests, why can’t they discriminate for cigarettes, seems along the same line to me. Asking someone if they are a pothead/alcoholic/chain smoker is out of line, but there’s likely a formal way to do it.

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  5. jane says:

    It would be fine not to hire people we don’t like – if different employers did not like various groups randomly and evenly. So that some positions are not available to smokers, some – to bike riders, and some – to women of childbearing age. Overall, everyone on the market would still have access to the vast majority of positions, if not at one company, than at another.

    Unfortunately, our society has popular stereotypes stigmatizing just certain minority groups – smokers, women, people with tattoos, gays, etc. These groups get disproportionate amount discrimination, and severely limited opportunities because of that. That’s not fair. It takes a government and a legal system to fix that unfairness.

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    • James says:

      Why is it unfair to discriminate on things like smoking & tattoos, that are purely a matter of choice? People choose to do these things, even though they know they are likely to experience discrimination as a consequence.

      So how is this different from the discrimination I experienced in a long-ago job, because I chose not to go drinking after work with the department VP and his clique?

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      • Babbo says:

        @James
        I think that’s a fair question to ask as we have this conversation as a society. I also think, though, that considerations like smoking and obesity (also discussed in the podcast) are a world apart from some other considerations like tattoos or whom you drink with after work, specifically because of their involvement in the new world of health care, which Obama’s Affordable Care Act has turned employers into gatekeepers of. If employers collectively shift their hiring practices to favor of the healthiest people, they effectively bar unhealthy people not only from health care, but from employment as well, imposing even greater external costs on other social institutions than the current health care situation already burdens the country with.

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  6. Evan S says:

    My employer gives us the option to take a test on whether or not we are a smoker. If we are not and pass the test, we get our healthcare costs discounted.
    -ES

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  7. John Dolan-Heitlinger says:

    Just as I don’t think that the government should tell people where they can or cannot work, I don’t think that the government should tell people who they can or cannot hire and for what reasons. The hiring decision should be freely negotiated between the potential employer and the potential employee. If governments chooses to impose discrimination or quota rules on their own hiring processes that is up to those elected to create and approve civil service rules.

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  8. Notjustahatrack says:

    Hire smokers, fat people, the clumsy, etc. and exclude them from your medical plan. They will probably be pretty old before they are too sick to work and it will be time to replace them anyway.

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