What’s in second place?

Smoking is the number one preventable cause of death and disease, everyone seems to say.  How about two and three?  How far can we go in banning?

The University of Pennsylvania Health System (UPHS) will stop hiring people who use nicotine at its Pennsylvania locations beginning July 1 [2014].

The ban will not apply to the crop of residents who begin this summer, but will be in force for applicants for 2014 residency slots. Last year, there were 1,975 full-time faculty, 769 medical students, 775 PhD students, 1,135 residents and fellows, and 789 post-doctoral candidates working in the nearly 18,000-employee health system.

13 thoughts on “What’s in second place?

  1. It’s beginning to sound a lot like Demolition Man out there. Me, I am all for wrestling in green jello. I don’t smoke and very rarely drink; my weight is within 20 lbs of what it was at age 25….and yet, the way the insurance companies are bound, I will surely be labeled “obese” at some point and subjected to some sort of inquisition about what I eat, drink, etc.

  2. Unfortunately, I don’t think the inquisition will just consist in verbal testimony. And I guess in any case, those who want to know can just retrieve our phone calls, etc, and listen for the puffing, sipping, munching, etc.

  3. Yes, eventually they won’t trust just anyone’s ‘say so’. I expect next year, if my husband was not retiring, we would learn that the “suggested” health screening will be required. And at that point, the argument begins: if a patient has a “right” to refuse medical treatment, do so-called “health screenings” comprise treatment that can be refused?

  4. This is a serious issue. I’m a total non-smoker, never have got into it, but since i’m from the generation that went to college where/when even large lecture halls were totally smoke-filled and it was ongoing all during the lectures……..(not to mention the old tradition of the smoking tutorials of oxford…..and the pipe-adorned typical professor-image)…….

    what i’m noticing is that then, i was so used to the smoke (my parents at home, too), my ex-spouse, etc…..i never even noticed it……….whereas now even outdoors i shy away in disgust from a smoker, and the smell bothers me terribly……

    yet, watching the power of that addiction, i think we need to understand that there’s is not too different from the alcoholic, drug-taker or even food-addict, all of whom are risking their health seriously.

    i do assert my right for smoke free spaces i’m in, yet i can’t help feeling compassion and even respect for smokers when they leave the space to take their smoke.

    i don’t think it is morally justified to deny them even that privilege, though restrictions on spaces should be enforced, with respect for the smoker’s personal rights to accept or refuse medical advice from others.

  5. Sadly, it’s not that unlikely that health organizations will also start banning fat people on the basis of high blood pressure being a presumably preventable cause of death… regardless of the actual blood pressure of those fat people, what they eat, and whether high blood pressure runs in the family.

  6. The Ohio State University is banning all tobacco products on campus *that aren’t marketed for cessation*, including cigarettes, chewing tobacco, and electronic cigarettes. Effective in January.

  7. My impression, and I’m certainly open to being shown wrong here, is that these policies are first and foremost about aesthetics. Lots of folks are disgusted by cigarette smoke and hospitals in particular seem to be embarrassed by the lines of (predominantly working-class, predominantly women, predominantly service staff) employees who can often be found smoking on the sidewalks in front of hospitals.

    University administrators also love patting themselves on the back for enacting such policies (even when they are, as anonymous #7 points out, entirely irrational). And they look great in a brochure or on a tour of campus.

  8. Matt, I’m just not sure. There was a time when cigars were considered attractive looking, with wonderful smells.

  9. BTW, I do worry about the addiction side of it; getting tobacco totally off campus might result in a huge hardship for some. And, of course, I worry about what is next on the list. We are learning that lots of factors in obesity are not under an individual’s control. Preventive health measures can easily become discriminatory.

  10. I’m not happy with the ban on nicotine, per se. People should be banning tobacco and tobacco products, since those are addictive and carcinogenic and harm comes from second-hand contact. Nicotine lozenges, patches, e-cigarettes, non-tobacco quitting aids seem like they should be fine. Or at least, if the products are not disruptive or even noticeable or harmful, the ban and any invasion of privacy seem like the wrong thing to do.

    (Admittedly, I like e cigarettes. Never originally smoked, but nicotine itself is not really harmful and I found that it is occasionally great for concentration and stress.)

  11. Whether ridding campus of tobacco counts as a hardship will depend very heavily on the individual campus, its layout and its size. If you’re a disabled person and you have to make quite a trek to an off-campus site to smoke, navigating your way through slick sidewalks in the winter, it’s quite a hardship. If you’re a nondisabled, healthy 30 year old dude, and you only have to walk about 20 feet from your building-at-the-edge-of-campus, it’s no big deal.

  12. Let me suggest that people at least look at the references given in 4. There are sme good distinctions made.

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