Dallas-area Baylor Health Care System is preparing to implement a new hiring policy: a pre-employment nicotine test. Those who fail are ineligible for hire, just like an illegal drug user would be ineligible at many other businesses.

To my limited knowledge, Baylor is the first employer to openly exclude smokers from consideration. Naturally, many smokers are crying discrimination, and they’re absolutely right. But I agree with the policy 100 percent. As stated in the article,

The FDA estimates smoking costs American employers some $200 billion a year in lost productivity and increased medical costs.

Why should a business knowingly hire someone who consistently makes poor health choices that will significantly drive up its healthcare costs?

Discrimination in hiring for certain characteristics such as race, gender, age, and national origin is rightfully illegal. A person doesn’t generally choose his or her status on those characteristics. However, smokers chose to start smoking and choose to continue smoking. Yes, once you’re addicted, it’s a very, very hard habit to break. But people quit every day. Every anti-smoking move that governments and businesses make, such as banning smoking in restaurants and other public buildings or refusing to hire smokers, gives nicotine addicts additional reasons to quit.

I have no visibility to the impact of smoking on healthcare costs at my own company, but I do see some of the operational results within my department. In my office, we work an eight-hour shift with no scheduled breaks. We may leave the desk temporarily to attend to “personal physiological needs”. Some of my colleagues smoke, which means that a few times during each shift, they disappear for a while for a smoke break. When they are gone, the people around them must cover their phones and crew messages. Covering for other people can put us in an awkward legal position, plus it’s just annoying when a smoker expects us to do their job plus our own due to their own poor choices.

To me, refusing to hire smokers is a no-brainer. The more interesting question, as mentioned briefly in the article, is whether an employer can legally refuse to hire people who are overweight. Such a ban would affect a much larger percentage of the population, at least in America, and could be considered illegal discrimination in some cases. After all, obesity can result from multiple factors, including genetics, other health disorders, and lifestyle choices. Some people are overweight despite eating well and exercising.

On a related note, the City of Chicago is starting a wellness program for city employees that includes health screenings, accountability, counseling, and support toward goals such as weight loss. Those who choose not to participate will pay $50/month more for their health insurance.

Banning applicants who smoke and charging overweight people more for health insurance does present a slippery-slope problem. How far do we want to go in rewarding and punishing certain types of behavior? What other risky behaviors can a business or government single out for correction? Use of alcohol? Motorcycle riding? Skydiving? Use of tanning booths? Football? Cycling? Eating at McDonald’s? Unprotected sex? Not getting enough sleep at night? What might seem like a simple issue (to skinny nonsmokers, at least) could get really complicated if you try to take it further.

What are your thoughts? Should employers exclude certain candidates because of their lifestyle choices? If so, which choices form an acceptable basis for discrimination in hiring? If not, what can employers do to mitigate the increased healthcare costs that these employees cause and encourage them to make better choices?