Many ethical concerns shroud tobacco campaign policies at the institutional levels.
According to McDaniel and Malone (2018) employment ethics tops the tobacco cessation campaign ethics. Tobacco employment campaign strategies are aimed at singling out smokers and second hand smokers from job opportunities, which at the end impair their economic soundness. The campaign dehumanize healthcare providers since a lot of expectation is expected from them ( McDaniel, Malone, 2018). Additionally, it enhances stigmatization among smokers and enhances social and economic gaps due to employment disparities.
Many institutions health institutions are coming up with antismoking employment policies. At the top of the list is the World Health Organizations that has significantly cut his smoking staff. Others include the Cleveland Clinic, Memorial Health Care System in Tennesse, Franciscan Health System in Washington, Baylor Health Care System in Texas, and Geisinger Health System in Pennsylvania that have employed smoking restrictive hiring policies. On the other hand, Idaho Central District Health Department has implemented nicotine test to identify smokers for during hiring and among the staff (Voigt, 2012). While most of these institutions have relied on the nicotine tests, they fail to identify active tobacco use and exposure to nicotine through secondhand smoke, or single out those using cessation aids that contain nicotine. Therefore, many innocent people are implicated.
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Smoking is prevalent in the lower socioeconomic status (SES) groups and less in the higher-SES groups. Therefore, restrictive job policies only favor the latter while harming the lower social economic groups (Borden, Mushlin, Gordon, Leiman, Pardes, 2015). In October 2010, when University Medical Center in El Paso, Texas introduced the policy of not hiring smokers, among the 14 that were affected only 1 nurse was a victim and the rest were support staff (Voigt, 2012). Additionally, when jobs are posted with restriction to nonsmoker or no nicotine candidates, many people will automatically shy away apply, which is a form of job segregation.
Hospitals restriction of positive nicotine tests as role models is considered an ethical dilemma. Their policies are not only targeting smokers, but perceived smokers (those with nicotine stain, smelling cigarette, or with cigarette packs in their pouches), therefore incriminated second hand smokers. The role model policy will bar even non active smokers from gainful employment opportunities. Additionally, all non-smoking community will be less effective in combating smoking campaigns because a task group made up people with experience of the problem are more effective than those who consider themselves holy to deal with smokers.
Role model policies ignore the important aspect that smokers are on the frontline to promote smoking free campaigns. The addictive nature of nicotine makes smokers prisoners of the behavior but they are at the front line to support smoking control policies and the desire to quite (Schmidt, Voigt, Emanuel, 2013). A study conducted in the United Kingdom, showed that 74% of smokers had the urge to quite against the expectation that they were addicts by choice (Voigt, 2012). Smoker-free policies of exclusion; as a result, cannot be justified.
The argument that those in the healthcare fraternity should be non-smokers to act as models is unbelievable. Nurses as caregivers are guided by ethics of care delivery rather than behavioral expectations (Schmidt, Voigt, Emanuel, 2013). In case they are expected to be role model to their patients; therefore, obese nurses will be subjected to scrutiny, similar to the depressed, traumatized, or those that participate on risky sports (Olsen, 2014). These goes against the professional nursing ethics as they attack their personality.
Finally, denormalization of smoking has been associated with negative ethical concerns. At the top, denormalization enhances stigma among smokers. It makes smokes considered, undesirable, abnormal, and not part of the mainstream (Asch, Muller, Volpp, 2013). They counter health promotion strategies against stigmatizations, which also consume a lot of financial input. It is expected that smokers will conceal their behavior rather than seek help. Therefore, antismoking campaigns are riddled many ethical concerns.
References
Asch, D., Muller, R., Volpp, K. (2013). Conflicts and compromises in not hiring smokers. N Engl J Med. 368:1371–1373.
Borden, W., Mushlin, A., Gordon, J., Leiman, J., Pardes, H. (2015). A new conceptual framework for academic health centers. Acad Med. 90:569–573
McDaniel, P.A, & Malone, R. (2018). Health Care Organizations and Policy Leadership: Perspectives on Nonsmoker-Only Hiring Policies. Academic Medicine , Vol. 93, No. 2.
Olsen, D.P. (2014). The ethics of denying smokers employment in health care. Am J Nurs . 114:55–58.
Schmidt, H., Voigt, K., Emanuel, E. (2013). The ethics of not hiring smokers. N Engl J Med . 368:1369–1371
Voigt, K. (2012). Ethical Concerns in Tobacco Control Nonsmoker and “Nonnicotine” Hiring Policies: The Implications of Employment Restrictions for Tobacco Control. American Journal of Public Health 102 (11):2013-8.
