Sunday, January 31, 2010

No jobs, no health care for smokers

It's a well known fact that tobacco has been the subject of great controversy since Columbus discovered America and took samples of the wicked weed home with him. Moral crusaders, reformers and prohibitionists have been engaged in an undeclared war on smokers and other tobacco users for centuries. The last great battle with anti-smoker fanaticism ended following World War I, about the time Prohibition was imposed in the US.

So, current anti-smoker efforts are not something new. The only thing new is the extremism of the current incarnation of Lucy Payne Gaston's “Anti-Cigarette League of the World” and public acceptance of the blatant discrimination against smokers.

In 2007, a report entitled “Prevalence of Tobacco Use in Tennessee, 1997-2007”, was prepared by the Tennessee Department of Health. It was noted that Tennessee had received plaudits from the ALA (American Lung Association) for passing the Non-Smokers Protection Act prohibiting smoking in most public places and workplaces, for increasing its cigarette tax substantially and for significantly increasing funding for its tobacco control program.

The report continues: “However, even with the expected effects of these interventions, it is apparent that efforts to reduce tobacco use in Tennessee must be ongoing and increased.”

But how do you increase efforts that already include comprehensive, draconian smoking bans, drastic intrusions on the concept of private property and usurious levels of regressive tobacco taxation?

For starters, many private employers are refusing to hire smokers, whether they engage their habit on or off the job. It's a gross encroachment on personal autonomy which is usually justified by the contention that smokers increase health care costs for the employer.

But for Memorial Hospital, in Chattanooga, Tenn., the decision to deny smokers employment is intended to “set an example” in the community and is not based on potential savings in health care costs. And, under the new policy, all job applicants will be tested for nicotine as part of pre-employment drug screening. Any evidence of nicotine use, including traces that may occur from nicotine delivered through smoking cessation products like the patch, nicorette gum or lozenges, will make job applicants ineligible for employment.

This conspicuous intrusion into the personal lives of prospective employees is completely unwarranted, has absolutely no bearing on the suitability of any candidate for any job and is unlikely to have any impact on job performance. But, since the new policy at Memorial is restricted to new hires, it is legal despite its punitive, discriminatory nature.

Current employees at the hospital will not be affected because state law prohibits termination of an employee for engaging in legal activities during non-work hours.

Dr. Michael Siegel, an anti-smoking advocate and professor at Boston University School of Public Health, said the policy is "too invasive" and creates a "slippery slope," even though it's legal.

And, create a slippery slope it does. Should employers really be permitted to check for high blood pressure, high cholestrol or BMI (body mass index) during pre-employment screening? Should they be permitted to deny employment to individuals with these high risk factors for heart disease? Then why single out smokers?

But, this is not the most egreigous example of smoker persecution to come out of Tennessee recently. Earlier this month, state representative Mike Turner introduced legislation in the Tennessee state legislature which would have denied health insurance coverage to all new state employees who smoke or use other tobacco products.

Using the same justification as private employers, Turner claims that: "People who use tobacco products are risking their health and causing more expense to the plan, so this is the attempt to try and hold down some of those costs."

However, Turner announced late in January that he is withdrawing his proposal under the "strong encouragement" of fellow Democratic Rep. John Litz, a tobacco farmer from Morristown.

But, the simple fact that an elected representative could introduce such discriminatory legislation, without fear of social censure or potential political ramifications, is cause for concern. His proposed legislation exemplifies the extremist leanings of the anti-smoker brigade and the unmistakable success of their strategy to denormalize smokers.

For now the discrimination remains smoker specific, although there is considerable evidence that intended future targets include consumers of alcoholic beverages and the overweight and obese. And, the puritans and the health nuts have already signalled their intention to use the same tactics as the anti-smoker brigade in these other areas of “public health”. The slippery slope is no longer theoetical; it is fast becoming a reality.

So, the next time you see a “Help Wanted: Smokers need not apply.” sign, give it some serious thought. Whatever your vice, you just might be the next target.

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