Tobacco-free workforces: a growing hospital trend?

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Tobacco users might find it a little more difficult to land a health care job in Maryland this year.

In 2014, three Maryland health systems announced that, starting this year, they will no longer hire people who smoke or use other forms of tobacco. And although the vast majority of hospitals do not include tobacco use among their employment criteria, some people predict such policies will soon become more common.

At Carroll Hospital Center, in Westminster, the no-tobacco hiring policy went into effect on New Year’s Day. At Anne Arundel Medical Center in Annapolis and the University of Maryland Upper Chesapeake Health system, in Harford County, the policy will go into effect July 1.

Current employees at those hospitals will not be affected by the no-tobacco policy, which will require new hires to take a urine test for nicotine — and test negative — before starting work. The health systems could also decide to administer follow-up nicotine tests throughout the individual’s employment.

Screening employees for nicotine is one way for hospitals to improve the overall health of their workforce — which helps reduce health insurance costs — while practicing the anti-tobacco message they preach to their communities.

For those reasons, no-tobacco hiring policies make sense for employers in the health care sector, said Kathleen Hoke, director of the Legal Resource Center for Public Health Policy at the University of Maryland School of Law.

“I do expect to see an increase in the number of facilities that adopt a policy prohibiting tobacco use among new employees,” Hoke said. “And not just hospitals, but the health care sector more broadly —long-term care facilities, assisted living — I’d expect to see growth there.”

Beyond health care, however, Hoke said the policy is unlikely to take root in the private sector. Although she can’t predict which health care employer will be next to announce a no-tobacco hiring policy, Hoke said that smaller employers would probably be more likely to do so than large ones.

For instance, at major hospital systems that employ thousands of people, enforcing the no-tobacco policy might be unrealistic, Hoke said.

“So even though a big health system could potentially see pretty significant cost-savings from having a healthier workforce, to manage a policy like this with an employment base that large would just be incredibly difficult,” she said.

But for the University of Maryland Medical System, hiring policies are set by each individual hospital, according to system spokeswoman Karen Lancaster. Upper Chesapeake Health, which consists of two hospitals, is part of UMMS and is one of the three employers that already implemented the no-tobacco policy.

Lancaster said she doesn’t know of any other UMMS hospitals or facilities that are considering following suit, but she didn’t rule it out.

“As an organization that is charged with helping our communities stay healthy, it is important that the health dangers of smoking be understood, especially by our employees,” Lancaster said. “Each of our hospitals approach this topic in different ways.”

Officials from Johns Hopkins Medicine did not respond Wednesday to inquiries about whether any of its hospitals have considered restricting employees’ tobacco use. But Sharon Kemp, a director in the human resources department, said in a statement that Hopkins “continually reviews policies to ensure current and future employees receive high-quality services.”

A spokeswoman for MedStar Health said she didn’t know if the system has considered adopting a no-tobacco hiring policy, and other MedStar executives were not available for comment Friday.

MedStar and other health systems have already banned the use of tobacco on their campuses, including during employee breaks.

The Maryland Hospital Association supports the decision to not hire tobacco users as one component of a broader anti-tobacco strategy, according to David Simon, a representative for the association. Simon also said a tobacco-free workforce could make some patients more comfortable.

“Patients themselves might be uncomfortable with tobacco odor, so obviously that problem is avoided at hospitals that don’t hire tobacco users,” he said.

Simon said he didn’t know of any specific hospitals that are considering implementing a no-tobacco hiring policy.

“These things are very hospital-specific,” he said. “They’ll factor in how it affects the community, their patients, their hiring process. [Human resources] policies can be pretty complicated, and lots of factors go into determining whether something makes sense for them.”

Despite Hoke’s prediction that more employers will soon stop hiring smokers, at least some hospitals don’t plan to move in that direction any time soon.

John Lazarou, a spokesman for the Greater Baltimore Medical Center, said although GBMC executives are “aware of the growing trend” of not employing tobacco users, the Towson health system doesn’t plan to adopt that policy “at this time.”

“If we do hire someone who smokes, we will help them to quit through our smoking cessation program,” Lazarou said. “As a community hospital, our goal is to help people change their behavior rather than bar them from employment.”