title: Banning the hiring of tobacco users: where's the fire?
abstract: This commentary addresses the article in this issue by Huddle and colleagues concerning the implementation of policies by the University of Alabama at Birmingham (UAB) School of Medicine and other academic health centers to not hire users of tobacco products. Huddle and colleagues explore the basis for such policies and find that even though institutions may be within their rights to implement such policies, the policies are inconsistent with the societal role of an academic health center as a caregiving institution. They see a potential for discrimination, as contemporary users of tobacco are more likely to have less education and lower incomes than nonusers.The authors of this commentary review the arguments for and against such policies and explore the complexities of the implementation of such a policy by a state institution. They express concern that a state institution has chosen not to hire state residents who use tobacco products, which are legal. The authors also explore the potentially discriminatory aspects of such policies and possible implications of these policies in the context of rights and legal frameworks.The academic medicine community must learn from the experience that will follow from such policies as well as from other state and nonstate institutions that have implemented similar employment policies. Huddle and colleagues have provided a thoughtful contribution to a complex and inevitably continuing discussion.
authors.affiliation: Dr. Samet is Flora L. Thornton Professor and Chair, Department of Preventive Medicine, Keck School of Medicine of USC, and director, Institute for Global Health, University of Southern California (USC), Los Angeles, California. Dr. Wipfli is assistant professor, Department of Preventive Medicine, Keck School of Medicine of USC and USC School of International Relations, Dornsife College of Letters, Arts and Sciences, and associate director, Institute for Global Health, USC, Los Angeles, California. Prof. Gruskin is professor, Department of Preventive Medicine, Keck School of Medicine of USC and USC Gould School of Law, and director, Program on Global Health and Human Rights, Institute for Global Health, USC, Los Angeles, California.
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Samet
authors.forename: Heather L
authors.initials: HL
authors.lastname: Wipfli
authors.forename: Sofia
authors.initials: S
authors.lastname: Gruskin
mesh_terms: D058016:Health Facility Administration; D006801:Humans; D016134:Organizational Policy; D010560:Personnel Selection; D012907:Smoking; D063508:Social Discrimination