Do students in medical school ever smoke?

[Falconclaw]

Just a random question that occurred to me. Would smoking a cigarette on a medical school campus be so frowned upon that nobody does it?

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[sunflower18]

I visited 14 schools, and every single campus was smoke free.

 

[Law2Doc]

Very few med students smoke these days. You will spend so much of your career dealing with the consequences of smoking that it would be foolish and you'll know better. You will need to tell every patient to stop smoking, and won't want to be too much of a hypocrite to boot. Plus, as mentioned, you tend to have to leave the premises to do it. If you are addicted, get the patch or gum and figure out how to quit.

 

[Doug Underhill]

I know of one student at an extremely competitive MD-Ph.D program who smokes. He also drinks heavily and is overweight.

 

[Spinach Dip]

Only the stupid ones.

 

[xffan624]

Just a random question that occurred to me. Would smoking a cigarette on a medical school campus be so frowned upon that nobody does it?

I know one guy that used to, but he said he's been trying to quit. There's probably some out there that only do it when they drink, but in general it's a much more taboo thing than in normal society.

After sitting through second year pathology, I don't know how anyone could NOT be motivated to quit if they hadn't tried already.

 

[Eppur Si Muove]

By now I would think of it as so taboo that most medstudents dont do it but I figure in the future they will all switch to healthier "vaping" so even the ones that do will be able to hide it from those around them.

 

[mimelim]

If you interview at my program, you sign a contract that states that you are tobacco free. This is new as of last year. I am told that the vast majority of residencies on the trail this year had something similar.

 

[625233]

 

[ScrubsMD]

The hospital I work at tests for nicotine in all hospital workers, including the rotating medical students.

 

[Omppu27]

Every campus is smoke free...but at every campus the smokers know where they can hide and sneak their cigarette break in (usually the stairwell of the parking decks from my anecdotal experience).

Lol I see those guys all the time. Or 10 yards across the street from the hospital where it's technically not campus property anymore...

I know one guy that used to, but he said he's been trying to quit. There's probably some out there that only do it when they drink, but in general it's a much more taboo thing than in normal society.

After sitting through second year pathology, I don't know how anyone could NOT be motivated to quit if they hadn't tried already.

"BRAH I ONLY DO IT WHEN I DRINK SO IT'S WHATEVER BRAH"


But yeah, I'm pretty sure most campuses are smoke-free (at least the medical centers are). However, I'll still every so often see the mom driving by with her kids in the car and lighting up while they roll by the cancer center...

 

[JPA178]

If you interview at my program, you sign a contract that states that you are tobacco free. This is new as of last year. I am told that the vast majority of residencies on the trail this year had something similar.

What is the justification? Is it because having nicotine on your clothing or hands could harm some patients with severe respiratory problems?

I just don't see how a hospital or residency program, as an employer, can get away with dictating employees' lifestyle choices - which, while universally considered to be unhealthy, are still perfectly legal. I'm not a smoker, and I do think it's hypocritical for doctors to smoke, but I'm not so sure that it's right for any type of employer to tell employees what they can and cannot do with their own bodies/lifestyle (as long as it's legal). Of course, secondhand smoke does harm others, so most hospital campuses are tobacco free. And it's great for employers to want to help their employees be healthier through programs, incentives, etc. But telling them what to do when they're away from work? I don't know. It's a slippery slope. Would it be right to require doctors who are overweight/obese to lose weight or give up desserts? Because that's an even bigger problem than smoking these days in all patient populations (high rates of DM type II, HTN, etc).

Also, if "tobacco free" includes cigars, I know SO many surgeons and docs who smoke an occasional cigar. Is that not okay anymore?

If it jeopardizes patient safety, that's the only way I can see it being mandatory.

 

[mehc012]

If you interview at my program, you sign a contract that states that you are tobacco free. This is new as of last year. I am told that the vast majority of residencies on the trail this year had something similar.

Yeah, as much as I strongly dislike smoking, this seems out of line. What's next, they'll tell me I have to maintain a certain BMI and can't ride my motorcycle because it puts me at high risk for severe health problems?

 

[Bovary]

I think it's inaccurate to conflate regular, addictive smoking with social smoking. I know a LOT of people who smoke a cigarette when offered, or more often smoke at parties or when out at bars. There's a difference between a pack a day and a pack a month.

Serious question, do you guys not ever go to house parties where there's a permanent, rotating group of folks having a smoke on the patio? And I'm thinking of middle-class, college educated folk, to dispel other images. This of course (as it should be) becomes far more taboo in medical school, but it's not rare among our peers.

 

[mehc012]

I think it's inaccurate to conflate regular, addictive smoking with social smoking. I know a LOT of people who smoke a cigarette when offered, or more often smoke at parties or when out at bars. There's a difference between a pack a day and a pack a month.

Serious question, do you guys not ever go to house parties where there's a permanent, rotating group of folks having a smoke on the patio? And I'm thinking of middle-class, college educated folk, to dispel other images. This of course (as it should be) becomes far more taboo in medical school, but it's not rare among our peers.

Number of parties I've been to where this was true of pot: all of them.
Number of parties I've been to where this was true of tobacco: maybe 2?

But then, at my school almost the only people who smoked regularly were international students, and only a small handful of people smoked socially.

 

[mehc012]

Employers are allowed to set contractual rules for employment. Something can be "perfectly legal" but also against the terms of employment.

I would have an incredibly difficult time acquiescing quietly to that rule, even though it doesn't apply to me. It's just inappropriate. Hire me for how I do my job, tell me I cannot have a single cigarette during the workday due to odor, whatever, but don't tell me which (legal choices) I should make in my life at home.

 

[Bovary]

Number of parties I've been to where this was true of pot: all of them.
Number of parties I've been to where this was true of tobacco: maybe 2?

But then, at my school almost the only people who smoked regularly were international students, and only a small handful of people smoked socially.

You're right, it definitely depends on the crowd ... I went to a liberal arts college which likely has a different culture than other schools.

 

[mehc012]

You're right, it definitely depends on the crowd ... I went to a liberal arts college which likely has a different culture than other schools.

Me too...

We had a couple of things stacked against smoking, though:
No bar scene. I mean, there was one bar, but it was tiny and only seniors could go anyway, so...
Cold as balls in the winter = maybe not worth going outside for a smoke
Athletic - seriously, we were all super into athletics for an LAC. No frats or anything either, so the sports teams drove the social scene...which usually translates to less smoking.

 

[JPA178]

You're right, it definitely depends on the crowd ... I went to a liberal arts college which likely has a different culture than other schools.

Smoking and chewing/dipping are a lot more common in the Midwest and South. Not many of my friends I grew up with smoke, but many of them dip. It's just as bad for you as smoking, but you get mouth cancer instead of lung cancer.

 

[mehc012]

It's rapidly becoming standard operating procedure at major centers. Cleveland clinic and MD Anderson to name a few.

Doesn't mean it's right.
And yeah, I'll probably have to suck it up to get a job, but it's nice to know that I should be anticipating a resentful employer-relationship with little respect shown to employees, because apparently that's becoming standard operating procedure as well.

 

[funkymonkey0987]

I understand the no smoking policy on the campus because it is annoying/disgusting to walk through smoke and gives a bad image for a medical setting, but I think it is overstepping a boundary to make students sign a form saying they wont smoke at all. If the rationale is that it is bad for health I would think there would be anti-obesity rules for the same logic, which would be inappropriate.

I don't smoke, nor am I obese. Just my 2 cents.

 

[Goro]

Even now at RJ Reynolds Tobacco!

It's rapidly becoming standard operating procedure at major centers. Cleveland clinic and MD Anderson to name a few.

 

[DesertSeaDiver]

I know two old-school physicians who smoke and drink rather heavily. It's a dirty secret for sure, but I think most of their co-workers know. They obviously don't smoke on shift or at the clinic but it's clear they're really addicted as they're constantly chewing nicorette gum. They're both former military too, which has a very widespread tobacco culture.

 

[mehc012]

The head of the Cleveland Clinic has publicly said if he could, he would also ban hiring obese patients.

They are a protected group, however, so it's a legal non-starter.

Probably because it's insanely patronizing and discriminatory.
Obesity is unhealthy, no doctors can be fat
Soda is unhealthy, no doctors should drink soda
Smoking is unhealthy, no doctors should smoke, ever
Alcohol is unhealthy, doctors can never drink
Rugby is dangerous, all doctors should only exercise via yoga and jazzercise
Actually, how about you just stick to the diet and exercise plan we've proscribed for you. And no sex unless s/he is brought in for a 10-point screening exam first.

 

[Cyberdyne 101]

I understand the no smoking policy on the campus because it is annoying/disgusting to walk through smoke and gives a bad image for a medical setting, but I think it is overstepping a boundary to make students sign a form saying they wont smoke at all. If the rationale is that it is bad for health I would think there would be anti-obesity rules for the same logic, which would be inappropriate.

I don't smoke, nor am I obese. Just my 2 cents.

I see where you, @mehc012, and others are coming from, but I'm thinking people can push the "no-smoking on campus" boundaries. For example, I once saw a Memorial Sloan Kettering employee (white coat and all) smoking across the street from the building and I was pretty disturbed by that picture.

 

[IgEdoc]

I was a MS2 tagging along a pulmonologist on rounds at the general hospital as part of the Intro to Medicine rotation and we were seeing a hospitalized COPD patient. The attending was lecturing him on smoke cessation and then proceeded to ausculate his lungs. As he leaned over the bed, a pack of cigarettes fell off his shirt pocket onto the patient's lap. The cussing that followed out of the patient's mouth was hysterical.

 

[JPA178]

Probably because it's insanely patronizing and discriminatory.
Obesity is unhealthy, no doctors can be fat
Soda is unhealthy, no doctors should drink soda
Smoking is unhealthy, no doctors should smoke, ever
Alcohol is unhealthy, doctors can never drink
Rugby is dangerous, all doctors should only exercise via yoga and jazzercise
Actually, how about you just stick to the diet and exercise plan we've proscribed for you. And no sex unless s/he is brought in for a 10-point screening exam first.

No motorcycles, no cigars, no bourbon on the rocks after a long week... No gigantic brownie with ice cream for dessert. Doctors apparently can't enjoy some of life's small pleasures anymore.

 

[mehc012]

I see where you, @mehc012, and others are coming from, but I'm thinking people can push the "no-smoking on campus" boundaries. For example, I once a Memorial Sloan Kettering employee (white coat and all) smoking across the street from the building and I was pretty disturbed by that picture.

Then make it 'no smoking during the workday', or even put a smoking area somewhere out of sight for everyone - employee or not - who is smoking. Fill it with pictures of diseased lungs if you wish, but put it away from windows, doors, and air intakes. Most people aren't going to stop just because their family is in the hospital. You can make it so that it is less disruptive to everyone else around without necessarily endorsing the practice.

More to the point, however, just because it is difficult to enforce on campus doesn't make it acceptable to start banning legal activities in employees' home lives. If people are pushing your 'no-smoking at work' rule, then up the penalties if they get spotted, or if they reek of cigarettes. That's an appropriate, pertinent-to-the-issue-at-hand measure. Changing their home lifestyle is not.

 

[Lysinee]

As long as they don't ask about booze, I should be fine. Don't take away my booze.

I was a MS2 tagging along a pulmonologist on rounds at the general hospital as part of the Intro to Medicine rotation and we were seeing a hospitalized COPD patient. The attending was lecturing him on smoke cessation and then proceeded to ausculate his lungs. As he leaned over the bed, a pack of cigarettes fell off his shirt pocket onto the patient's lap. The cussing that followed out of the patient's mouth was hysterical.

The Dr should have done an acting job after getting caught. "I saw another patient smoking and I took his pack. Do you have any cigarettes on you?"

I visited 14 schools, and every single campus was smoke free.

You didn't check the back of the building. There was a Dr smoking right near the ER entrance. He was standing where the cameras can't see him. There are good spots on every campus.

 

[WingedOx]

Two residents in my program have had a lot of trouble quitting. Quit now before your stress level goes through the roof.

/there's quite a bit of pot on the weekends though.

 

[Cyberdyne 101]

Then make it 'no smoking during the workday', or even put a smoking area somewhere out of sight for everyone - employee or not - who is smoking. Fill it with pictures of diseased lungs if you wish, but put it away from windows, doors, and air intakes. Most people aren't going to stop just because their family is in the hospital. You can make it so that it is less disruptive to everyone else around without necessarily endorsing the practice.

More to the point, however, just because it is difficult to enforce on campus doesn't make it acceptable to start banning legal activities in employees' home lives. If people are pushing your 'no-smoking at work' rule, then up the penalties if they get spotted, or if they reek of cigarettes. That's an appropriate, pertinent-to-the-issue-at-hand measure. Changing their home lifestyle is not.

I agree about the home lifestyle. But I wonder if this has anything to do with achieving perfect on and near campus enforcement, or if it goes beyond that.

 

[Time Table]

When the weed too loud

 

[mimelim]

What is the justification? Is it because having nicotine on your clothing or hands could harm some patients with severe respiratory problems?

I just don't see how a hospital or residency program, as an employer, can get away with dictating employees' lifestyle choices - which, while universally considered to be unhealthy, are still perfectly legal. I'm not a smoker, and I do think it's hypocritical for doctors to smoke, but I'm not so sure that it's right for any type of employer to tell employees what they can and cannot do with their own bodies/lifestyle (as long as it's legal). Of course, secondhand smoke does harm others, so most hospital campuses are tobacco free. And it's great for employers to want to help their employees be healthier through programs, incentives, etc. But telling them what to do when they're away from work? I don't know. It's a slippery slope. Would it be right to require doctors who are overweight/obese to lose weight or give up desserts? Because that's an even bigger problem than smoking these days in all patient populations (high rates of DM type II, HTN, etc).

Also, if "tobacco free" includes cigars, I know SO many surgeons and docs who smoke an occasional cigar. Is that not okay anymore?

If it jeopardizes patient safety, that's the only way I can see it being mandatory.

Yeah, as much as I strongly dislike smoking, this seems out of line. What's next, they'll tell me I have to maintain a certain BMI and can't ride my motorcycle because it puts me at high risk for severe health problems?

For starters, private companies can discriminate against non-protected classes. If they don't like smokers, they don't have to have any other justification to not hire them. That is perfectly legal and acceptable. If you don't like it, then don't apply to our residency program. We have hundreds of qualified applicants and will not miss out on people that this is a sticking point with.

As for the justification, it is expensive to insure people's health. A large part of health insurance coverage is covered by employers, in this case, the hospital. Someone smoking increases the cost of insuring and taking care of that employee. Yes, smoking is a personal choice, but it does impact others. Second hand smoke, smell on clothing, etc are the obvious ones, but it affects the finances of the people insuring you. It is in THEIR interest to decrease those costs and I don't think that it is wrong of them to look out for their own interests.

 

[xffan624]

I think it's hilarious that the hospital where we rotate at has a smokefree campus, but of course at the main entrance is a McDonalds. Health mecca indeed.

 

[mehc012]

As for the justification, it is expensive to insure people's health. A large part of health insurance coverage is covered by employers, in this case, the hospital. Someone smoking increases the cost of insuring and taking care of that employee. Yes, smoking is a personal choice, but it does impact others. Second hand smoke, smell on clothing, etc are the obvious ones, but it affects the finances of the people insuring you. It is in THEIR interest to decrease those costs and I don't think that it is wrong of them to look out for their own interests.

So, then you think that it's OK for them to dictate all of my other risky activities? No motorcycles, doughnuts, skydiving, soda, casual sex, or anything else that's less than the hospital's chosen ideal for healthy behavior? If I do get sick, do they get to decide my entire course of treatment based on their values and cost-benefit assessment? Should we not treat patients with hepatitis and hep C because it's expensive to guarantee the providers' health?

I'm sorry, but arguing that the hospital will choose acceptable lifestyles for its employees because of the financial repercussions due to them providing health insurance is even more demonstration of the inherent ethical problems involved. There has to be a line somewhere. Where do you draw it, if not at "legal activities conducted in their own home when off the clock"?

 

[JPA178]

I think it's hilarious that the hospital where we rotate at has a smokefree campus, but of course at the main entrance is a McDonalds. Health mecca indeed.

I know of one hospital (a university medical center, no less) that has a McDonald's inside the hospital. Maybe we're thinking of the same one. I remember thinking, what? For real?

 

[xffan624]

I know of one hospital (a university medical center, no less) that has a McDonald's inside the hospital. Maybe we're thinking of the same one. I remember thinking, what? For real?

The one I'm referring to is not a university center. So there is definitely more than one.

 

[JPA178]

For starters, private companies can discriminate against non-protected classes. If they don't like smokers, they don't have to have any other justification to not hire them. That is perfectly legal and acceptable. If you don't like it, then don't apply to our residency program. We have hundreds of qualified applicants and will not miss out on people that this is a sticking point with.

As for the justification, it is expensive to insure people's health. A large part of health insurance coverage is covered by employers, in this case, the hospital. Someone smoking increases the cost of insuring and taking care of that employee. Yes, smoking is a personal choice, but it does impact others. Second hand smoke, smell on clothing, etc are the obvious ones, but it affects the finances of the people insuring you. It is in THEIR interest to decrease those costs and I don't think that it is wrong of them to look out for their own interests.

I understand that entirely. However, I think that organizations would be more successful by providing incentives for employees to make healthy choices and maintaining a tobacco-free campus. I do respect the fact that they are free to discriminate as they please against non-protected classes. You said that the contract specified that new residents have to be "tobacco free" and I just think that's a little excessive. I know that insurance companies believe differently, but you can't honestly tell me that someone who smokes a cigar once in a blue moon represents as great of a financial risk as someone with DM type II or another chronic disease caused by lifestyle factors. I know we're not going to change how these organizations operate as employers, but I tend to side with @mehc012 in that I don't believe in micromanaging people's personal lives.

I recall being at an attending's house one time and the chief resident brought cigars over. I didn't partake, but some of the other people there did. Many people are going to break the new rules.

 

[sundancing]

I saw a sign at Johns Hopkins Hospital is a designated outdoor smoking area that said, "If you must smoke, you may smoke here." I thought it was wonderfully passive-aggressive. It may not exist anymore since they recently made the rules for smoking outdoors even more strict.

 

[mimelim]

So, then you think that it's OK for them to dictate all of my other risky activities? No motorcycles, doughnuts, skydiving, soda, casual sex, or anything else that's less than the hospital's chosen ideal for healthy behavior? If I do get sick, do they get to decide my entire course of treatment based on their values and cost-benefit assessment? Should we not treat patients with hepatitis and hep C because it's expensive to guarantee the providers' health?

I'm sorry, but arguing that the hospital will choose acceptable lifestyles for its employees because of the financial repercussions due to them providing health insurance is even more demonstration of the inherent ethical problems involved. There has to be a line somewhere. Where do you draw it, if not at "legal activities conducted in their own home when off the clock"?

I rock climb. Pretty seriously at that. I have a custom written contract for my disability insurance that covers nuances that I don't think the hospital or the insurance company really understand (compared to me as a climber). Do I wish that the hospital would accept the additional liability for what I choose to do with my free time? Yes, it would save me a lot of money. But, I don't expect them to take on the financial burden of my choices.

Nobody is stopping you from doing what you want to do. Employers are simply saying that they don't want to take financial responsibility for those things. Nobody is forcing you to apply to Cleveland Clinic or our hospital. The point is that what you do on your own time has an impact on other people and it is hardly surprising and certainly hardly unethical for them to look out for their own interests. Tobacco is a much easier target than motorcycles, doughnuts, skydiving, soda, casual sex etc. There is no safe level of smoking. In terms of cardiovascular risk, a cigarette a week is still too much, which is in large part why insurance companies spike premiums for smokers. This is in stark contrast to everything else listed which while a choice CAN be consumed in moderation.

Private firms can be selective how they wish to be for their own benefit as long as they don't discriminate against protected classes. You don't have an inalienable right to smoke or ride a motorcycle. It isn't wrong for an insurance company to charge you more for doing those things, just as it isn't wrong for them to raise my premiums for doing something that increase my risk compared to my colleagues. Forcing someone to pay the penalties of YOUR personal lifestyle is pretty sickening. This isn't a firm telling you what is an acceptable lifestyle. We will still treat you as a patient, even if you decide to do bad things to your body. But, don't expect us to pay for it. You have other options for your employment and are free to seek those out.

 

[mimelim]

I understand that entirely. However, I think that organizations would be more successful by providing incentives for employees to make healthy choices and maintaining a tobacco-free campus. I do respect the fact that they are free to discriminate as they please against non-protected classes. You said that the contract specified that new residents have to be "tobacco free" and I just think that's a little excessive. I know that insurance companies believe differently, but you can't honestly tell me that someone who smokes a cigar once in a blue moon represents as great of a risk as someone with DM type II or another chronic disease caused by lifestyle factors. I know we're not going to change how these organizations operate as employers, but I tend to side with @mehc012 in that I don't believe in micromanaging people's personal lives.

I recall being at an attending's house one time and the chief resident brought cigars over. I didn't partake, but some of the other people there did. Many people are going to break the new rules.

"but you can't honestly tell me that someone who smokes a cigar once in a blue moon represents as great of a risk as someone with DM type II or another chronic disease caused by lifestyle factors"

First, you aren't even remotely comparing two analogous things. If you compared eating McDonalds once in a while vs. smoking a cigar once in a while, it would be an actual comparison. Nobody decides, "I'm going to choose to be diabetic." One is a lifestyle choice, the other is the end result of thousands of insults (by choice) to the human body, among a miriad of other factors. I am currently at the Southern Association of Vascular Surgeons annual meeting (one of the largest conferences in vascular surgery) and there was a presentation yesterday that specifically stated that peripheral vascular disease was linked to 'any time smokers' with a specific subdivision for people who smoked a cigarette less than once a week. So, yes, as far as cardiovascular health, smoking is much worse than occasionally having a cheese burger or a soda.

I disagree about firms being "more successful" by doing things differently. We have heavy incentives to be healthy, just like at Cleveland Clinic. Just by having a PCP and getting biometric screening, our deductibles drop by over 50%. We don't have to actually improve anything, just do the screening.

I am a registered libertarian. I am a rock climber that pays extra because of it. I believe that people can choose to do what they want to their own bodies and nobody should be telling them what they can and can't do, as long as it isn't affecting other people. However, this does not offend my sensibilities on that front in any way. You can choose to smoke. But, I don't have to pay the price for you to do that. My hospital doesn't have to either. Smoking is easily demonstrated to be hazardous to your health in any amount. Insurance companies recognize this and charge a premium to cover you. Employers should not be required to cover you for this in the same way that you are not required to apply to our residency.

 

[WingedOx]

Honestly, the most cited reason for the medical campus at my school (not sure if the hospital itself was or not) was because people couldn't stop littering the used butts all over our new courtyard.

/and y'all aren't going to win an argument with a vascular surgeon about smoking... I hated my days on that service in med school, but damn if I didn't see what tobacco can do to a vascular system.

 

[mehc012]

I rock climb. Pretty seriously at that. I have a custom written contract for my disability insurance that covers nuances that I don't think the hospital or the insurance company really understand (compared to me as a climber). Do I wish that the hospital would accept the additional liability for what I choose to do with my free time? Yes, it would save me a lot of money. But, I don't expect them to take on the financial burden of my choices.

Nobody is stopping you from doing what you want to do. Employers are simply saying that they don't want to take financial responsibility for those things. Nobody is forcing you to apply to Cleveland Clinic or our hospital. The point is that what you do on your own time has an impact on other people and it is hardly surprising and certainly hardly unethical for them to look out for their own interests. Tobacco is a much easier target than motorcycles, doughnuts, skydiving, soda, casual sex etc. There is no safe level of smoking. In terms of cardiovascular risk, a cigarette a week is still too much, which is in large part why insurance companies spike premiums for smokers. This is in stark contrast to everything else listed which while a choice CAN be consumed in moderation.

Private firms can be selective how they wish to be for their own benefit as long as they don't discriminate against protected classes. You don't have an inalienable right to smoke or ride a motorcycle. It isn't wrong for an insurance company to charge you more for doing those things, just as it isn't wrong for them to raise my premiums for doing something that increase my risk compared to my colleagues. Forcing someone to pay the penalties of YOUR personal lifestyle is pretty sickening. This isn't a firm telling you what is an acceptable lifestyle. We will still treat you as a patient, even if you decide to do bad things to your body. But, don't expect us to pay for it. You have other options for your employment and are free to seek those out.

I didn't say that the insurance company couldn't charge me more. That's a part of their separate business interaction with me.
However, having it as a part of my employment contract is ridiculous. If my employer doesn't want to take financial responsibility for my health, then I suppose they also wouldn't want to hire me if I had a family history of cancer, or diabetes/heart disease, etc. It's understandable that they want to avoid that, but I still think it'd be highly inappropriate if they started hiring only people with no family history of cancer.

Yes, I understand that the difference is a matter of choice...but there's almost always a healthier choice than what you are currently doing. Every single thing that you do is a choice and has an impact on your health. Some of them, like cigarette smoking, are extreme. Some things, like running regularly, are healthier than other options (such as never exercising) but less so than others (some form of low-impact exercise). Everything is a choice, and if we start letting our employers make those choices for us, we open the door to a bizarrely patronizing world where our employer chooses what's best for us or gtfo if you don't like it.

And forcing others to pay the penalties of your lifestyle is pretty much the entire point of insurance in the first place.

 

[mehc012]

Honestly, the most cited reason for the medical campus at my school (not sure if the hospital itself was or not) was because people couldn't stop littering the used butts all over our new courtyard.

/and y'all aren't going to win an argument with a vascular surgeon about smoking... I hated my days on that service in med school, but damn if I didn't see what tobacco can do to a vascular system.

I know what it can do...nobody is arguing that smoking isn't horrible for you. That one anyone would lose every time. I'm just arguing that it's none of my employer's damn business what I do at home on my own time, as long as it's legal.

 

[veryborderlineapplicant]

I know what it can do...nobody is arguing that smoking isn't horrible for you. That one anyone would lose every time. I'm just arguing that it's none of my employer's damn business what I do at home on my own time, as long as it's legal.

Good point, a person shouldn't be limited by their life style choices as long as they don't harm or compromise others. Discriminating against smokers isn't that far-removed from discriminating against people based off of their race, sexuality, the way they look or dress. Also, if they're limiting smokers from smoking on their own time from being parts of programs, they might as well limit people who drink alcohol as well bc alcohol use has just as many consequences if not even more than smoking. That'd at least be a consistent set of rules regardless of what objections you may have.

 

[jqueb29]

By now I would think of it as so taboo that most medstudents dont do it but I figure in the future they will all switch to healthier "vaping" so even the ones that do will be able to hide it from those around them.

Not

What is the justification? Is it because having nicotine on your clothing or hands could harm some patients with severe respiratory problems?

I just don't see how a hospital or residency program, as an employer, can get away with dictating employees' lifestyle choices - which, while universally considered to be unhealthy, are still perfectly legal. I'm not a smoker, and I do think it's hypocritical for doctors to smoke, but I'm not so sure that it's right for any type of employer to tell employees what they can and cannot do with their own bodies/lifestyle (as long as it's legal). Of course, secondhand smoke does harm others, so most hospital campuses are tobacco free. And it's great for employers to want to help their employees be healthier through programs, incentives, etc. But telling them what to do when they're away from work? I don't know. It's a slippery slope. Would it be right to require doctors who are overweight/obese to lose weight or give up desserts? Because that's an even bigger problem than smoking these days in all patient populations (high rates of DM type II, HTN, etc).

Also, if "tobacco free" includes cigars, I know SO many surgeons and docs who smoke an occasional cigar. Is that not okay anymore?

If it jeopardizes patient safety, that's the only way I can see it being mandatory.

"Nicotine on your hands", if it was able to affect patients, would actually likely help respiratory problems long term. Nicotine is a bronchoconstrictor, which is bad for asthmatics (and I believe others with respiratory problems) if this occurs only a few times. But, bronchoconstriction has actually been found to paradoxically be beneficial over the long run for these people. I have nothing else to contribute to this discussion, just wanted to throw in some random medical trivia. Proceed.

 

[mehc012]

Smoking is easily demonstrated to be hazardous to your health in any amount. Insurance companies recognize this and charge a premium to cover you. Employers should not be required to cover you for this in the same way that you are not required to apply to our residency.

Then how about you pay the extra price and that's the end of it? Provide health insurance, but the individual is responsible for paying the additional fees required of smokers. If this is a cost issue, make it a cost issue. Don't make it an employment issue.

 

[mimelim]

I didn't say that the insurance company couldn't charge me more. That's a part of their separate business interaction with me.
However, having it as a part of my employment contract is ridiculous. If my employer doesn't want to take financial responsibility for my health, then I suppose they also wouldn't want to hire me if I had a family history of cancer, or diabetes/heart disease, etc. It's understandable that they want to avoid that, but I still think it'd be highly inappropriate if they started hiring only people with no family history of cancer.

Yes, I understand that the difference is a matter of choice...but there's almost always a healthier choice than what you are currently doing. Every single thing that you do is a choice and has an impact on your health. Some of them, like cigarette smoking, are extreme. Some things, like running regularly, are healthier than other options (such as never exercising) but less so than others (some form of low-impact exercise). Everything is a choice, and if we start letting our employers make those choices for us, we open the door to a bizarrely patronizing world where our employer chooses what's best for us or gtfo if you don't like it.

And forcing others to pay the penalties of your lifestyle is pretty much the entire point of insurance in the first place.

Smoking is a lifestyle choice. Your family history of various medical conditions is not. If you can't see the difference between the two of those and why firms choose to consider one and not the other, there is a fairly big problem.

Smoking is bad for your health in direct ways that are tangible and undisputed. It is also a lifestyle choice, albeit, once started, highly addictive. Nobody is arguing that a firm should micromanage the details of someone's life outside of work. The point is that while it is your choice if you want to smoke or drink or do anything else in your private time, you are free to do so. But, do not limit OTHERS freedom because of it. If you don't like the policy, then don't work for them and don't support them. That is your right. If you think it is ridiculous to be a part of a contract, then don't work for them.

As previously stated, given my basic political leanings (Libertarian) and my personal preferences (high risk sports), I have every reason to dislike people putting limitations on me. But, nobody is infringing on my rights. This is something that is extremely well supported in science, logic and reasoning. This is not a "slipperly slope" note how both you and JPA keep needing to compare smoking to much larger things, rather than other individual choices that might be policed which are far more analogous. This is not about firms forcing every single healthier choice on their employees. This is a calculated move, based on science/medicine and the economic realities of insuring people based on something that is inherently damaging to your health.

 

[mehc012]

Smoking is a lifestyle choice. Your family history of various medical conditions is not. If you can't see the difference between the two of those and why firms choose to consider one and not the other, there is a fairly big problem.

Smoking is bad for your health in direct ways that are tangible and undisputed. It is also a lifestyle choice, albeit, once started, highly addictive. Nobody is arguing that a firm should micromanage the details of someone's life outside of work. The point is that while it is your choice if you want to smoke or drink or do anything else in your private time, you are free to do so. But, do not limit OTHERS freedom because of it. If you don't like the policy, then don't work for them and don't support them. That is your right. If you think it is ridiculous to be a part of a contract, then don't work for them.

As previously stated, given my basic political leanings (Libertarian) and my personal preferences (high risk sports), I have every reason to dislike people putting limitations on me. But, nobody is infringing on my rights. This is something that is extremely well supported in science, logic and reasoning. This is not a "slipperly slope" note how both you and JPA keep needing to compare smoking to much larger things, rather than other individual choices that might be policed which are far more analogous. This is not about firms forcing every single healthier choice on their employees. This is a calculated move, based on science/medicine and the economic realities of insuring people based on something that is inherently damaging to your health.

I actually acknowledged that the difference was one of choice, but went on to point out that there are a LOT of choices in your day to day life that are directly analogous to this one. How is it not a "slippery slope"? That is exactly the problem here. Eating unhealthy foods, drinking alcohol, maintaining a healthy BMI...those are all very similar lifestyle choices to not smoking, and not at all 'much larger things'. If we are OK with this one 'calculated move', then how do we say the next one is wrong? Where do we draw the line?

They are infringing on your rights (not in the legalese way, but in the 'limiting your personal freedoms' way.) They just don't happen to be targeting any that you personally care about. Yet.

 

[mimelim]

They could probably do this instead. However, there would likely be just as much, if not more uproar about being unfairly taxed for your personal choices (smoking). Given how good of standing hospitals (and other firms are for that matter) are on this, going to the extreme is not all that unexpected. I have no idea what the data is comparing the two methodologies, it likely doesn't exist.

Firms get to pick who they want as employees. You are not entitled to positions or consideration at a particular place. You simply can not be discriminated against for certain things. In the same way it is to a hospital's benefit not to hire lazy or stupid employees, it is to their benefit to not hire smokers. I see no problem with them looking out for their interests. If you disagree or think that they aren't fair, by all means complain, protest or do whatever else you want. But, the effect will likely be the same as the crappy student who thinks that they are being discriminated against because they have a low GPA and MCAT and no medical school accepted them.