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Nursing: You Wanna Know What I Think?

Smokers Need Not Apply: Ban on Hiring Smokers in Hospitals

Published July 8, 2013 8:57 AM by Pat Veitenthal
I wasn't going to touch this. No really, I wasn't. I've written before about my own struggle with nicotine addiction (read: Smoker) so I'm pretty sure my opinion will be less influential because of it. I refer to recent headlines that have noted more hospitals are now refusing to even hire smokers.

This trend has slowly been creeping its way into healthcare systems throughout the country. There are now approximately 60 U.S. hospitals that would not hire me...Even though what I do in my private life, like smoking, is none of their damned business. So if I needed to work at one of these places, and I couldn't (or wouldn't) quit smoking, I'd have to lie to get a job. What a great way to start out on a new job!

The rationale is the amount of productivity in dollars lost by smokers. It's all about the money. Of course it is. It's a little under two grand a year per smoker according to the studies. I have to tell you, this really is a thorn in my side. I can swear to you with a clear conscience that I called out sick WAY less than some of my colleagues who had various chronic health issues. I doubt if their lost productivity was studied, or even an issue.

I wonder how many dollars worth of productivity asthmatics or diabetics lose? Oh, OK you want to make it a about self-inflicted negative impacts? Then let's talk about alcohol use. I wonder how many callouts there are due to alcohol consumption or prescription drug use. Particularly on Monday! Both are just as legal as cigarettes, yet some hospitals are even TESTING employees for nicotine use.

I'm glad I'm retired, but I'm telling you, they'd have to be giving everyone a breath-o-lyzer test at the beginning of each shift before I'd let them test me for nicotine. This is just outrageous to discriminate this way, and you non-smokers should agree! But I'm thinking you won't...

posted by Pat Veitenthal


First - Smokers who smoke 2 or 3 packs a day for 20 or 30 years MIGHT develop complications from smoking.  There are plenty that don't.  The rest will not likely develop complications and most people do NOT smoke that much.  Fools listen to everything the media says (namely those trying to sell quit products).  

Smokers are seriously discriminated against.  It was shown over 10 years ago that being overweight costs companies more money due to diabeties, knee, foot, and back problems etc.  

The only reason the smokers are getting nailed is because they are the minority.  Testing for nicotine is ignorant because people using quit aids would have nicotine in their system yet smoke free so in no proven danger as nicotine has not shown to cause any illnesses.  

Look at the people around you, your family and friends.  If I add up all the money spent on knee, foot, back, diebeties, and cancer NOT related to smoking, those outweigh smoking illness by far.  

Plus, how many hung over people make errors on the job that cost companies a fortune.  Drinking is a much greater concern in my opinion.  How many drinkers harasss people on the job or create a negative atmosphere that results in costly communication problems among employees or even the loss of good employees.  

Just because the insurance companies want an excuse to up the rates for smokers, does not mean they actually do cost the system more than anyone else.  

Matt February 13, 2015 8:14 AM

Ex-smoker here.  I didn't quit because I was forced by a job or school- I quit because my body couldn't take it anymore.  All that aside, the extreme discrimination against smokers has ALWAYS baffled me.  Not smoking in bars and restaurants- okay.  Other people have to breathe that air.  

Then they say- no smoking within 50 feet of the building.  No smoking electronic cigarettes.  Now they aren't hiring smokers??  

Do these "non smokers" have any idea what's in the air they're breathing?  They act as though the air was pure to begin with.  Here's a hint people: air pollution comes from a lot of places even something so simple as your air conditioning.  Your air is NOT pure.

Finally, for the most part- the only people smokers really hurts is themselves (as long as they are doing it responsibly).  Yet alcoholics and prescription drug abusers attend work, drive cars, operate heavy machinery and put everyone else in jeopardy.  

I agree with you 100%.  This is total BS.

Sarah September 20, 2014 8:46 AM

I have made it through day 10 of quitting smoking, but only reason why I did this is not because I couldn't afford it, not because I wanted to at all, not even because my family forced me, but because I was required to quit for my BSN program for College required it.  SCHOOL REQUIRED IT!  Furthermore, it was competitive entry and only 160/300 students were accepted into the program.  So I know what you mean about infringing on your personal liberties and rights.  It down right pissed me off.

Carl , Student June 30, 2014 8:12 PM

My mom smokes and she wants to apply to gisinger and she loves nursing and she has to take a stupid test for smoking. She would never smoke in front of patients. Or even any where near work.  She really cant stop it helps her stress. See we lost my brothers a while ago and she started nursing beacuase she wants to help people that go through what she did. So thats why people shouldnt care if you smoke. What about heavy drinkers. They dont do tests about that. They dont care if you drink. Do most of you go to a bar with your friends or a club. Please can you all understand. Thankyou for reading this. Raelly thank you

kenzie January 26, 2014 9:01 PM

I see that there are many ways that hospitals can continue to promote a health work environment without crossing the line and invading the rights of American citizens. I personally know someone who was fired on her day off of work because a co-worker saw your smoking on her time off. Because smokers were recently banned from working at this hospital she lost her job of 10 years. I would say to give people the trust factor. If it is the employers goal, to keep the work environment clean, and promote healthy lifestyles; then no, a medical facilitator should not walk into a patient's room smelling like smoke. However, to delegate what this individual can, and cannot do on their time off is in violation of constitutional rights. A necessary way to solve the problem would be to not take action until suspicion sets on. If someone is caught smoking during working hours at a hospital, disciplinary action could be taken. There is no reason that smokers cannot be made aware that smoking during working hours is prohibited. But to take it as far as performing a 6 month drug test to determine nicotine levels is unnecessary and completely invasive. "It comes down to a matter of fairness. Why can't the hospital work with people who may want to change their behavior but are having a hard time doing so? There's a little hypocrisy when as a place where you bring people back from sickness to health, your policy seems to reflect little concern for getting health care workers to become healthier." (Chaplan) I agree completely with this statement found on CNN.com. If hospitals promoted health, instead of banning those who smoke, they would benefit greatly in the long run. Employers making the transition into "non-smoking campuses" can promote their employers to quit smoking, not by banning them altogether. Ban smoking during working hours. Pay for monthly gym memberships, promote healthy food and snacks in your facility, and allow your smoking employees to benefit from free nicotine patches and other ways for them to quit smoking if it is that big of a concern for the employer.

Alisha Smith, Medical - QMAP, TPCC December 8, 2013 11:55 PM
Longmont CO

I have been a nurse for 25 years and have attempted to stop smoking at least 3 times with different medications.  I do not smoke  at my job.  I do feel the government is overly involved  in personal rights -what happened to our constitution? We all know about healthcare costs! A government big enough to give you everything you want is a government big enough to take from you everything you have. ~ Gerald Ford - August 12, 1974

Carol Corey, Trach and Vent - LPN August 5, 2013 10:10 PM
Dingmans Ferry PA

I have taken over many patients who have "fired" their Home Health nurse because she smells of smoke. She smokes constantly & does not care that it bothers non smoking patients or their families. I think if you want to smoke at home where no one cares how you smell, fine. But I think it is incredibly rude & wrong to inflict your odor on sick people.

Angeline, Home Health - RN August 3, 2013 7:16 PM
Los Angeles CA

Again, this is not about a smoke free campus policy, but the refusal to even HIRE smokers...

Pat Vee August 1, 2013 1:51 PM

For years I have heard that Diabetes could prevent a person from getting a job, when in fact many are the most aware of health concerns than the general population. I have to say I was very pleased when hospitals decided to ask for No Smoking at work because of the harm it could cause to all people with respiratory problems, since it was not uncommon for smokers to be standing at the entrance to the building, getting that last smoke before work. I do not smoke, but have asthma and now COPD that Doctors say I have developed from having grown up in a house with a parent smoking 3 packs a day. Early in my nursing career staff were aloud to smoke in a report room 4x6 in size

Mary Krug August 1, 2013 1:04 PM

I personally don't think employers really care that much about their employees because if they did they would fix other more important things about their facility before mandating on butting into peoples personal lives.  Would really like to know some of the big bosses personal lifestyle choices that could serve as subject for ridicule and embarrassment- I bet their not that healthy( like adultery and drug abuse them selves) Its all about the misguided direction of MONEY. I guess they think now that unemployment is better than not hiring smokers- what a sense of ethics these big bosses have. If  people were responsible for purchasing healthcare through a state or national  healthcare exchange like Vermont and Mass. and removed it from the employer's grasp, I wonder how concerned the employer would then be about employee's smoking?? it is a matter of civil liberties and individual freedoms.  Employers need to but out of their employees personal business. Just saying

Karen July 29, 2013 8:49 PM

I am a non-smoker and work as a contract nurse each summer for a drug free hospital. I must agree to a drug screening each year I renew my contract. This year nicotine was added as the hospital extended it's no smoking rules. I feel this is discriminatory since current employees were not required to be screened as a condition for continued employment. I do not receive any health care benefits during my 3 month contract.  So the screening is just an added expense for them. I had to get the screen done within 2 days of the offer or it would be withdrawn. If I was using a nicotine patch or smoking an electronic cigarette I would have tested positive. Drug testing is one thing, but I believe that testing for legal substances or prescribed medication crosses the line. It blurs the line between private health information and hiring. This is a slippery slope where weight or diabetes or risk factors for heart disease or cancer could enter into the hiring decisions. it is not the purview of an employer to discriminate based on health or lifestyle. I think this practice says far more about the employer than any prospective employee. Such policies represent a lack of mutual respect that engenders the animosity between nurses and administration that now starts at hire and runs contrary to most hospitals core value statements.

JERRY, EMERGENCY - R. N., HOSPITAL July 28, 2013 9:59 AM

I believe what you do on your own time is your business. So if you want to smoke when your off work that's your business. However,

I do understand that it is all of our bad habits that are driving the

cost of heathcare up. It's not just the smokers. It's the obese, the alcoholics, the smokers. So where do you draw the line?  I don't smoke, rarely if ever drink, eat right and exercise on a regular basis and I'm tired of paying the price for all your bad habits.

kimberly, medical surgical - registered nurse, memorial hospital July 27, 2013 5:47 PM
jacksonville FL

This is another attack on our individual civil rights.  Many hospitals are now REQUIRING all employees to take a flu shot.  I agree that flu shots and not smoking are good ideas, but when did our personal choices and civil rights become so eroded as to force employees to take immunizations (or lose their jobs), and not to smoke during their own time off premises?  The ACJLU may take this issue on if approached.

Laura Niewenhous, Internal Medicine - NP, Privat Practice July 27, 2013 12:56 PM
Huntingtown MD

Agree with your concerns regarding hospital and many other employers not hiring smokers..lets face it with the increase in healthcare cost it is a way they can save in premiums and pass it to the employees. Do I agree with nicotine testing, no but again the do drug test so why not nicotine. however drug testing should be done more frequently than just before hire, after work related accident or when reasonable suspicion of working while intoxicated (many prospective employees can abstain from their substance of choice long enough to pass the test and once hired they resume its use like nothing) After more than 3 decades in healthcare had opportunity to work with smokes, morbid obese, gay and anything in between and have no problem with any of their live style as long as they carry their workload. No-smokers often complain about smokers taking breaks..but often they were taking snack breaks, personal phone calls, text breaks as often as if not more than smokers going out to smoke. Often many also used employer time/ equipment for personal use as playing computer games..but woo if the smoker took a smoking break. Please do not forget those that are late to work every day 10-15 min with a different excuse and those that you all know will call off sick or "dead" every time they are scheduled for weekend or holiday work. The bottom line here is if you are abusing the use of breaks for what ever reason beyond what is allowed by your employer YOU ARE STEALING from them. I am smoker but choose not to do so during working hours for consideration to all those persons with multiple allergies, but it my choice. If I did chose to take a smoke break I made sure it was as part of my legal lunch break because I hated to fall behind in my work like charting, orders check etc because when it was time to go home I like to leave on time. And No I do not smell like ashtray neither, so if you smoke at least rinse your mouth and use something remove the smoke scent of your clothes before returning to your unit out of consideration and respect to patients and coworkers.

LUZ July 27, 2013 10:01 AM

Remember now, I was addressing the blanket rule of not hiring smokers. Yes, it's an addiction, yes it's could be called a chronic illness. I am NOT addressing a No Smoking Policy on campus or nurses taking smoke breaks. I am addressing whether or not they should have the right to discriminate against me because I smoke. Isn't that what it is? You tell me. Can they just assume I'll cost them lost productivity?

Pat Vee July 26, 2013 7:55 PM

"I can swear to you with a clear conscience that I called out sick WAY less than some of my colleagues who had various chronic health issues. I doubt if their lost productivity was studied, or even an issue."

You DO have a chronic health issue.  Reading all the comments here, it sounds to me as if addiction wins - again.  Addiction is addiction - doesn't matter what you are addicted to, or how many rationalizations you come up with.  I am not judging - I speak from personal experience.

Melissa July 26, 2013 2:51 PM

Big Brother really is watching us!

Karole, Infection Control - RN, Ancora July 26, 2013 2:45 PM
Ancora NJ

I think this is an invasion of privacy. I smoke however I do not smoke during my shift.  I'm offended by all who say "it's my moral obligation to teach people not to smoke." I say I am HUMAN, I am not a robot and I am subject to making mistakes. Just because I strapped on a RN doesn't change that fact. I feel I am more productive than my counterparts, I have seen non smokers sit around and do absoulutely nothing all day. I think it is a matter of jealousy, non-smoker's feel like they are being denied an additional break or something. I say grow up and stay out of people's business. I am appalled that RN's can only be empathetic to patients and not one another.  People make the decision to smoke cigarettes far before they make a career decision, I am not affected by this ban because I don't smoke during work but I also feel like these measures by hospitals take it to far. They are encroaching on my rights as a human being to choose my habits.I am happy you brought up the amount of alcohol related call-ins and chronic condition call ins and fake call-ins from lazy nurses,since I never miss a day of work I pick up over 12 hours of their slack a week. I am fortunate that the hospitals and my fellow RNs aren't my final judge.

Mickalynn, - Registered Nurse July 26, 2013 2:07 PM

Still working fulltime in nursing, beginning my 52nd year 9/13.  Worked ICU for 35 years.  Across the board, smokers are much less productive than nonsmokers.  Do Not Like to work with them for that reason.  No matter what is happening in the ICU, etc. they gotta git that cig. and consistently abuse breaks, lunches.

barbara jonas, Corrections - RNS, McAlpin July 26, 2013 1:20 PM
McAlpin FL

The bottom line is, can you and do you, do your job. The rest is descrimination. Smoker no job, smoke pot OK ( legal now!), over weight no job, drinker no job, caucasian no job ( need diversity), Gay ok the more open the better, Transsexual ok wear what you like , body tatoos ok , no English ok ( need diversity). The point I am trying to make is, society wants to all inclusive on one hand but exclude on the other. Or is it,  if I dont agree with it , its not ok or just let me think about and I will let you know mentality  

fred hopeful, GI - RN , MED July 26, 2013 12:04 PM
Washington DC

I only work with one smoker and I try not to because, fact is, smokers smell bad, they just reek and no patient needs to smell that for 12 hours and they take more breaks so its all about their addiction and not patient care and the patient suffers!!  

Farrah Hungy, RN July 26, 2013 10:47 AM
Orlando FL


B BUTLER July 26, 2013 10:36 AM

I am a 10 year ex-smoker. The worse kind of ex0smoker there is, because it repulses me now. BUT...I have to agree with you here. If it's on your time and you are not taking "smoke breaks" while you are at work, it should not be held against you. I do however think it is a huge problem if you are taking breaks and coming back smelling like an ashtray and offending non-smoking patients and coworkers. And no matter what you do, if you have a cigarette, you DO stink. You can't smell it if you are a smoker, but believe me, everyone else does!

Jessica, RN July 26, 2013 10:34 AM

The "no smoking" rule is not about telling you what you can and can't do on your private time...it's about your health and healthcare costs to you and your employer. Smoking is a risk factor for heart and lung diseases, stroke, hypertension and diabetes, thus increasing the healthcare costs for your employer, which in turn will drive up YOUR healthcare costs in the long run. Ultimately you will have to pay higher premiums if your employer continues to let the employees smoke.

Eva Johnson, Cardiology - ANP-BC, NGMC July 26, 2013 8:18 AM
Gainesville GA

As a "grossly overweight nurse", I am offended by your comment. Just because I am not overweight does not mean I can not do my job or am totally useless in an emergency.  I am sure there are "grossly overweight nurses" out there who sit and do little to nothing but there are also "grossly overweight nurses" out there doing as much as you are. I am in the process of earning my BSN and had a clinical instructor threaten to fail me because of my weight. I had to go to the Dean.  I was nursing circles around her while she was still in High School. And I have worked with several LAZY Skinny nurses in my career, as well as know it all nurses, stupid nurses and great nurses.

Now off that soap box and onto the smoking. As a nonsmoker, I have been abused over the years by the smoker who takes a smoke break every 5 min. What you do in your personal time is you business and as long as you are doing your job, it is not anyone else business. I think it is those who abuse it that are ruining it for everyone,

Brandy, Home Health - LPN, Axton July 26, 2013 6:47 AM
Axton VA

What about the grossly overweight nurses who can't even walk w/out SOB? I find them to be a useless mess! I have worked with several who were unable to do anything but sit at the desk. No help in an emergency at all.  

Lisa Aitala Aitala, RN July 9, 2013 4:30 PM
Briggs TX

A friend of mine gave another POV. Her hospital made flu shots mandatory. She had never taken one in the past, and felt her rights were being infringed upon by stating "either take it or you can't work. " Why is this stuff legal?

Pat Vee July 9, 2013 3:43 PM

I am a non-smoker and I totally agree with you. What I do in my free time is my business. If they say I cant smoke on the job well that's good but then not to hire me just because I smoke is ridiculous in my opinion

Esther, RN July 9, 2013 2:50 PM

Thanks Ed. That's the point...it's not about whether or not we should or shouldn't smoke...it's about an employer telling us what we can or can't do to be employees....

Pat Vee July 8, 2013 9:00 PM

As a good libertarian, an an ex smoker, I agree with you. What you do on your own time is your business alone.

Ed Lawson, , CRNA Prince William Medical Center July 8, 2013 4:58 PM
Manassas VA

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About this Blog

    Pat Veitenthal, BSN, RN
    Occupation: Per diem nursing supervisor and cruise ship nurse
    Setting: Community hospital and cruise ships
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