文章基本信息

标题：Ethical Concerns in Tobacco Control Nonsmoker and “Nonnicotine” Hiring Policies: The Implications of Employment Restrictions for Tobacco Control
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作者：Kristin Voigt
期刊名称：American journal of public health
印刷版ISSN：0090-0036
出版年度：2009
卷号：102
期号：11
页码：2013-2018
DOI：10.2105/AJPH.2012.300745
语种：English
出版社：American Public Health Association
摘要：Smoking has been restricted in workplaces for some time. A number of organizations with health promotion or tobacco control goals have taken the further step of implementing employment restrictions. These restrictions apply to smokers and, in some cases, to anyone testing positive on cotinine tests, which also capture users of nicotine-replacement therapy and those exposed to secondhand smoke. Such policies are defended as closely related to broader antismoking goals: first, only nonsmokers can be role models and advocates for tobacco control; second, nonsmoker and “nonnicotine” hiring policies help denormalize tobacco use, thus advancing a central aspect of tobacco control. However, these arguments are problematic: not only can hiring restrictions come into conflict with broader antismoking goals, but they also raise significant problems of their own. RESTRICTIONS ON SMOKING IN the workplace have become common in many parts of the world. More recently, however, a number of organizations have taken the further step of implementing nonsmoker hiring policies that bar tobacco users from employment. Some hospitals have even put in place what they call “nonnicotine hiring policies,” which exclude all job candidates who test positive on cotinine tests, including not only tobacco users but also those who use cessation aids containing nicotine or those who are exposed to secondhand smoke. Although such policies do not violate employment legislation in many US states, 1,2 it does not follow that they are ethically permissible. Such hiring policies curtail, potentially severely, the employment opportunities of smokers and those who are exposed to nicotine for other reasons. They also raise concerns about social justice because smoking is more prevalent among lower socioeconomic groups who are also more vulnerable to unemployment and job insecurity. Although financial considerations are sometimes explicitly mentioned as motivators leading to the adoption of hiring restrictions, 3 hospitals and organizations whose objectives are linked to tobacco control have defended these policies as being crucial to their objectives: excluding job candidates who use tobacco or are exposed to nicotine helps ensure that employees can be role models and advocates in the fight against smoking; furthermore, these policies contribute to antitobacco efforts by further denormalizing tobacco use. If these arguments succeed, we may judge these benefits to outweigh the costs of such policies. However, I argue that these positions are inconsistent with other goals and concerns of the tobacco control community and may in fact run counter to the pursuit of antismoking goals.