Why we won’t hire smokers

Tobacco poses unique risks

Forty percent of all premature deaths are due to forces within our control, such as obesity, sedentary lifestyles and poor dietary choices. One factor, however, rises above all of those — smoking.

Tobacco is addictive, damaging and deadly, causing 450,000 deaths — one in every five — each year in the U.S., often from early heart attacks, chronic lung diseases and cancers.

As a health care institution, whose inherent mission is healing the sick and cultivating a healthier community, does it make sense to support a habit that leads to disease, disability and death? At Cleveland Clinic, we don’t believe so. That’s why we adopted a smoke-free campus in 2005 and why, in 2007, we went further, deciding to no longer hire smokers. Job candidates are told that the offer is subject to a nicotine-free urine test. If a candidate tests positive for nicotine, the offer is rescinded, and he or she is offered a free tobacco-cessation program and may reapply in 90 days.

If that sounds harsh to some, consider that cigarette smoke contains hundreds of chemicals and compounds that are toxic and at least 69 that cause cancer. These chemicals travel throughout the body, wreaking havoc in the form of inflammation, cancer, heart disease, stroke, lung disease and a weakened immune system.

To ignore this would be to undermine our commitment to health and wellness, which includes providing a healthy environment for our employees, visitors and patients. Plus, the policy has not proved to be an overwhelming obstacle for job applicants. Since it was instituted, less than 2% of job offers — about 300 out of 20,000 — have been rescinded due to positive nicotine tests.

At Cleveland Clinic, we have a unique perspective on the burden of chronic disease. We not only treat disease, but we also play a vital role in educating patients and employees about lifestyle choices. It is only right to practice what we preach.

Banning smoking and smokers is a crucial part of that, and part of a broader theme that includes banning transfats, offering free gym memberships, removing sugar-laden drinks from campus vending machines, and rewarding employees who make healthy decisions with lower insurance premiums.

Ultimately, such efforts will allow Cleveland Clinic to be a model of healthy living, as we strive to shift the national focus from providing “sick” care to promoting “health” care.

Dr. Paul Terpeluk is Cleveland Clinic’s medical director of Employee Health Services.