Des Moines hospital extends smoke-free workplace to nicotine-free workers

[Mr_Phil]

They were already testing for smoking, they want to test for nicotine, period. This is the second step they've taken. -Magnus

Sheesh! That's scary! The Libertarian part of me thinks its acceptable for an employer to set what conditions they want for employment but it just seems that they are going about this entirely wrongly.

I believe the employer has the absolute right to set conditions of employment. But, I have to wonder what the real deep down reason for this is? I've read about other employers who set off-the-wall conditions to avoid paying for associated healthcare from employer funded insurance pools. Somehow I think this is a bottom line decision rather than any altruistic concerns over employee health.

 

[Vocalek]

I believe the employer has the absolute right to set conditions of employment. But, I have to wonder what the real deep down reason for this is? I've read about other employers who set off-the-wall conditions to avoid paying for associated healthcare from employer funded insurance pools. Somehow I think this is a bottom line decision rather than any altruistic concerns over employee health.

I fail to understand how barring people who use smoke-free nicotine from employment helps the hospital's bottom line.

 

[wrigleyvillain]

I fail to understand how barring people who use smoke-free nicotine from employment helps the hospital's bottom line.

It doesn't. It helps some misguided, high-and-mighty administrator feel better about themselves. Or there could be more to the story at this particular place.

 

[LeAnn]

My employer is also a Healtcare facility and they have just announced that if we use tobacco products after Jan.1 2012 that our health insurance will increase $30 a month and that we come to work smelling of smoke that we will be sent home to change without pay. Now I haven't found out yet if e-cigs will apply to the increase in health insurance, but they have said we will be tested and they said ALL tobacco product which thanks to the FDA e-cigs are now in that catagory, so I am waiting to here if I will have to pay the increase because I vape e-cigs. I think this is defintly discrimination and a violation of my civil rights but ya know if I complain I can kiss my job good-bye! At least I don't have to worry about being sent home for smelling like smoke from a cigarette!

 

[GregH]

Somehow I think this is a bottom line decision rather than any altruistic concerns over employee health.

Call me cynical, but everything any corporation does is strictly with their bottom line as their primary interest. Corporations are in business to make money. To paraphrase an old Dilbert cartoon: "We'd steal your organs in your sleep and sell them if we could get away with it." And yes, hospitals are corporations.

I fail to understand how barring people who use smoke-free nicotine from employment helps the hospital's bottom line.

Two reasons: First, it appears that it's just easier (and therefore cheaper) for them to have a prohibitionist attitude against all nicotine rather than make exceptions for smoke-free nicotine versus smokers. Second, they are, indeed, under the assumption that anyone still actively using Pharma's NRTs will relapse back into smoking soon enough.

 

[Mr_Phil]

I fail to understand how barring people who use smoke-free nicotine from employment helps the hospital's bottom line.

It allows them to exclude coverage based on tobacco use and or components associated with tobacco use. Like I said, I read about a different employer who used this tactic a few years ago when I was an active smoker. They banned anything with nicotine in it. I support their right to do so because I believe that a business owner has the right to run their business into the ground if they wish.

That is not to be mistaken with any idea that I agree with them.

 

[ogredog]

next employment ban-no cookies, or chips, we want to emulate good eating habits blah blah bah and build better robots

 

[MoonRose]

Oh yes, it all comes down to that bottom line. Bet if one were to dig deep enough, you would find that the insurance companies are really behind a lot of these sudden changes for nicotine free work places. And I would also lay odds that they are basing it all on the following reasons as well. They probably think that if they eliminate nicotine use that they will also eliminate how much they have to pay out in healthcare claims.

Side Effects of Nicotine by Body System - for Healthcare Professionals

Cardiovascular
Cardiovascular effects have included increases in heart rate and blood pressure. New ventricular and supraventricular tachycardia, increase in PVC frequency, less supraventricular arrhythmia, less arrhythmia and lower heart rate, new ST segment depression, and an improvement in ST- or T-wave changes have been reported in patients with coronary artery disease given transdermal nicotine for smoking cessation. The average heart rate and incidence of arrhythmias or angina has not been shown to be significantly different from baseline while smoking and during transdermal nicotine therapy in patients with coronary artery disease. In patients with coronary artery disease, nicotine may cause coronary artery vasoconstriction. Myocardial infarction has been rarely associated with the use of nicotine patches. Some of these patients were also smoking (receiving a greater than recommended dose of nicotine) and some may have had underlying coronary artery disease. At least one case of intracerebral hematoma has also been reported.

In patients with coronary artery disease, nicotine may cause coronary artery vasoconstriction. This can be important to patients with ischemic heart disease.

In patients with coronary artery disease given transdermal nicotine for smoking cessation, the following have been reported: new ventricular and supraventricular tachycardia, increase in PVC frequency, less supraventricular arrhythmia, less arrhythmia and lower heart rate, new ST segment depression, and an improvement in ST- or T-wave changes. The average heart rate and incidence of arrhythmias or angina has not been shown to be significantly different from baseline while smoking and during transdermal nicotine therapy in patients with coronary artery disease.

Myocardial infarction has been rarely associated with the use of nicotine patches. Some of these patients were also smoking (receiving a greater than recommended dose of nicotine) and some may have had underlying coronary artery disease.

Respiratory
Respiratory side effects have included bronchospasm in patients with preexisting asthma. It has been associated with the use of nicotine nasal spray and inhaler. Sore throat reported in at least two patients has been associated with the use of the nicotine gums.

Dermatologic
Dermatologic side effects have included itching and local erythema at the patch site in up to half of patients treated. Skin irritation rarely required drug discontinuation. Contact dermatitis due to nicotine or the contents of the nicotine transdermal patch has been reported. Nicotine gum has been associated with increased sweating.

Gastrointestinal
Gastrointestinal side effects have included nausea, dry mouth, dyspepsia, and ........ with the patch and gum formulations in approximately 6% of patients. Use of nicotine gum may also cause hiccups, flatulence, increased salivation, stomatitis, tooth disorder, glossitis, and unpleasant taste. The use of nicotine has been shown to decrease lower esophageal sphincter pressure. Heartburn has been associated with nicotine lozenges in 5% to 5.8% of patients.

Nervous system
Nervous system side effects have been reported in 3% to 12% of patients. These have included lightheadedness, headache, sleep disturbances, abnormal dreams, irritability, dizziness, and tremor. Stroke due to severe cerebral artery vasospasm has been reported in a patient with a recent history of subarachnoid hemorrhage shortly after applying a 10 mg nicotine patch.

Musculoskeletal
Musculoskeletal side effects have rarely included arthralgias and myalgias. Jaw pain has been associated with the use of nicotine gum.

Hematologic
Hematologic side effects have included increases in platelet aggregation and enhanced thrombus formation.

Local
Local side effects have been reported most frequently with the use of nicotine nasal spray. Nicotine inhaler also produced local irritant effects including coughing and rhinitis in 40% of patients.

Endocrine
Endocrine side effects have included hyperinsulinemia and insulin resistance during the long-term use of nicotine gum.

Metabolic
Metabolic side effects including at least one case of hyponatremia and syndrome of inappropriate antidiuretic hormone (SIADH) have been reported.

Ocular
Ocular side effects including vision problems reported in at least two patients have been associated with the use of the nicotine gums.

 

[meems]

ok..so pull up obesity & let me know what health risks are included in that..and how long before they do a body mass index test for employment. It's the insurers that are running this show is my bet.

 

[MoonRose]

These are the side effects for Caffeine. Guess what they are eventually going to go after once they make everyone nicotine free and have eliminated obesity?

Effects of Caffeine by Body System - for Healthcare Professionals

General
In general, consumption of higher doses of caffeine (less than 600 mg/day) has been reported to have lead to caffeinism. Caffeinism is a syndrome characterized by anxiety, restlessness, and sleep disorders (similar to anxiety states). It has also been reported that chronic, heavy caffeine ingestion may be associated with depression. Caffeine may cause anxiety and panic in panic disorder patients and may aggravate premenstrual syndrome (PMS).

Two studies have shown that caffeine consumption is associated with a lower serum uric acid level and a lower risk of incident gout.

Gastrointestinal
Gastrointestinal side effects associated with caffeine citrate have included necrotizing enterocolitis in infants. Increased gastric aspirate and gastrointestinal intolerance have been reported rarely with caffeine products.

In clinical trials of caffeine citrate, six cases of necrotizing enterocolitis (3 fatal) were reported among 85 infants exposed to caffeine citrate injection, however, causality has not been established.

Other
In one study of 634 women with fibrocystic breast disease (compared to 1066 women without the disease), the occurrence of fibrocystic breast disease was positively associated with average daily consumption of caffeine. Women who consumed 31 to 250 mg/day of caffeine were reported to have a 1.5 times increase in odds to have the disease. Women who consumed over 500 mg/day of caffeine were reported to have a 2.3 times increase in odds.

Other side effects associated with caffeine consumption have included fibrocystic breast disease in women.

One study has reported that while favorable subjective and performance-enhancing stimulant effects occur at low to intermediate caffeine doses, the unfavorable subjective and somatic effects, as well as performance disruption from high doses of caffeine may intrinsically limit the doses of caffeine used in the general population.

Psychiatric
Psychiatric side effects have included confusion and psychotic symptoms.

Cardiovascular
One study (n=77) reported increased blood pressure following caffeine intake (3.3 mg/kg) of approximately 4.5 mmHg in premenopausal women and 4.1 mmHg in men. Although men and women showed similar responses in blood pressure following consumption of a dietary dose of caffeine the hemodynamic mechanisms facilitating this change are different. Premenopausal women showed an increase in cardiac output whereas men showed increased vascular resistance.

One small study (n=12) reports caffeine to exert an acute unfavorable effect on aortic stiffness in treated hypertensive patients. This effect peaked approximately 60 minutes following administration of caffeine 250 mg orally, lasted a minimum duration of approximately 3 hours, and then decreased gradually.

Cardiovascular side effects associated with caffeine products have rarely included tachycardia, increased left ventricular output, and increased stroke volume.

Endocrine
Several studies report a decrease in insulin sensitivity in individuals following caffeine consumption. The mechanism leading to this effect is unknown but may be related to elevated serum epinephrine levels.

A few studies report a possible decreased risk of type 2 diabetes mellitus in individuals who consume coffee.

Endocrine side effects associated with caffeine products have rarely included alterations in serum glucose such as hypoglycemia and hyperglycemia.

Nervous system
Nervous system side effects associated with caffeine consumption have included central nervous system stimulation such as irritability, restlessness, and jitteriness.

Renal
Renal side effects associated with caffeine consumption have included increased urine flow rate, creatinine clearance, and sodium and calcium excretion.

 

[MoonRose]

ok..so pull up obesity & let me know what health risks are included in that..and how long before they do a body mass index test for employment. It's the insurers that are running this show is my bet.

I don't remember where I read it, but I do recall reading about a company somewhere here in the States that was mandating that it's employees who were overweight to lose that weight. And they were monitoring them by doing BMI's each month. They were being given something like a year to lose X number of pounds, depending on their starting weight.

 

[Thulium]

My employer is also a Healtcare facility and they have just announced that if we use tobacco products after Jan.1 2012 that our health insurance will increase $30 a month and that we come to work smelling of smoke that we will be sent home to change without pay. Now I haven't found out yet if e-cigs will apply to the increase in health insurance, but they have said we will be tested and they said ALL tobacco product which thanks to the FDA e-cigs are now in that catagory, so I am waiting to here if I will have to pay the increase because I vape e-cigs. I think this is defintly discrimination and a violation of my civil rights but ya know if I complain I can kiss my job good-bye! At least I don't have to worry about being sent home for smelling like smoke from a cigarette!

LeAnn, I suggest you have a nice talk with your family physician and explain how your vaporizer has helped you. Even if your doctor happens to disapprove of your e-cig and wants to consider you a smoker, you should be able to get a PRESCRIPTION for a nicotine inhaler. Even if you don't actually buy the thing, holding the prescription will give you some protection and a claim to privacy against the discriminatory screening. Bring a copy of one of CASAA's handouts like the Medical InfoGraph or tri-fold brochure: CASAA.org

Hopefully you wont need it, but if you end up needing to "lawyer up" or something, do what you can to protect your right to privacy and freedom from illegal discrimination against people with disabilities that may be treated by nicotine. Even if you don't have a diseases that is treated by nicotine, the ADAA 2008 protects people from discrimination on the basis of a PERCEIVED disability or screenings for medications. For example, you can't be fired because you test positive for seizure medication (as long as you aren't breaking the law or taking it without a prescription), even if you don't actually have the perceived disability. If you actually have a disability* treated by nicotine, your employer is required to make reasonable accommodations which you might use to get permission to vape openly rather than having to "go stealth" or use the vaporless inhalator!

*this is where the prescription comes in handy. You have a right to privacy about health information which means you do not have to divulge any health information to your employer that is not directly relevant to the accommodations you seek.

 

[Crumpet]

Call me a pessimist, but if this is the direction that the most free country in the world (TM) is going in, then the sooner all of our enemies who hate us because of our freedom (TM) blow us off the map the better off we'll all be. But hey, at least we won't be fat or smoking when they do it, right?

 

[Vocalek]

My employer is also a Healtcare facility and they have just announced that if we use tobacco products after Jan.1 2012 that our health insurance will increase $30 a month and that we come to work smelling of smoke that we will be sent home to change without pay. Now I haven't found out yet if e-cigs will apply to the increase in health insurance, but they have said we will be tested and they said ALL tobacco product which thanks to the FDA e-cigs are now in that catagory, so I am waiting to here if I will have to pay the increase because I vape e-cigs. I think this is defintly discrimination and a violation of my civil rights but ya know if I complain I can kiss my job good-bye! At least I don't have to worry about being sent home for smelling like smoke from a cigarette!

Part of the problem is that our government perpetuates the lie that "all tobacco products are equally hazardous." Witness the recent statement about "health fraud" published by FDA on its web site. Health Fraud

So why wouldn't your employer believe that they are saving you from yourself by forbidding the use of all tobacco products. But the truth is that smokeless tobacco products are 99% less hazardous than inhaling smoke. This is proven over and over by studies on smokers who switched to snus compared with smokers who quit all use of tobacco. No higher disease rates, and no difference in life expectency. But as long as the FDA, CDC, WHO, AMA, ACS, ALA, AHA, and other alpabet soup gangs keep repeating the lie, public health will suffer.

 

[Crumpet]

Part of the problem is that our government perpetuates the lie that "all tobacco products are equally hazardous." Witness the recent statement about "health fraud" published by FDA on its web site. Health Fraud

So why wouldn't your employer believe that they are saving you from yourself by forbidding the use of all tobacco products. But the truth is that smokeless tobacco products are 99% less hazardous than inhaling smoke. This is proven over and over by studies on smokers who switched to snus compared with smokers who quit all use of tobacco. No higher disease rates, and no difference in life expectency. But as long as the FDA, CDC, WHO, AMA, ACS, ALA, AHA, and other alpabet soup gangs keep repeating the lie, public health will suffer.

Elaine,

Why can't manufacturers of reduced risk products sue the FDA for making these statements if there are studies that can be cited? I'm sure there's a reason and you would know. I'm really curious.

Thanks.

 

[Thulium]

Elaine,

Why can't manufacturers of reduced risk products sue the FDA for making these statements if there are studies that can be cited? I'm sure there's a reason and you would know. I'm really curious.

Thanks.

Star Scientific was the first company to submit an application to the FDA for premarket approval of a reduced risk tobacco product: Ariva BDL and Stonewall BDL are dissolvable tobacco lozenges that have reduced Tobacco Specific Nitrosamine levels below detectable limits (hence BDL). Unfortunately, rather than approving or denying the application, the FDA decided that they didn't think it was a tobacco product because it didn't fit the definition...and then a few days later the FDA announced they would abide by the Injunction forbidding them from regulating non-therapeutic nicotine as drugs rather than tobacco products....but they're still pretending that they haven't been shown any proof that any tobacco products are safer than any other, despite the public domain FACT that evidence has existed since the 60's and 70's showing that EVERY form of smokeless tobacco is associated with at least 95% fewer mortalities than cigarette smoking.

 

[Crumpet]

Star Scientific was the first company to submit an application to the FDA for premarket approval of a reduced risk tobacco product: Ariva BDL and Stonewall BDL are dissolvable tobacco lozenges that have reduced Tobacco Specific Nitrosamine levels below detectable limits (hence BDL). Unfortunately, rather than approving or denying the application, the FDA decided that they didn't think it was a tobacco product because it didn't fit the definition...and then a few days later the FDA announced they would abide by the Injunction forbidding them from regulating non-therapeutic nicotine as drugs rather than tobacco products....but they're still pretending that they haven't been shown any proof that any tobacco products are safer than any other, despite the public domain FACT that evidence has existed since the 60's and 70's showing that EVERY form of smokeless tobacco is associated with at least 95% fewer mortalities than cigarette smoking.

But if the evidence is there, why can they not be forced to take it into consideration via a lawsuit? Seems that would be a good time for companies to present the evidence and prove the FDA is ignoring it.

 

[Vap0rJay]

I don't remember where I read it, but I do recall reading about a company somewhere here in the States that was mandating that it's employees who were overweight to lose that weight. And they were monitoring them by doing BMI's each month. They were being given something like a year to lose X number of pounds, depending on their starting weight.

Just wait till we start playing genetics w/ human embryos, then you wont be able to get a job unless you have had your genetic code re-sequenced to meet specific standards ie the movie Gatica

Of course, employment will be based solely upon what your genetics indicate that you have an aptitude for, your medical insurance based upon your risk of genetic defect, and your loans based upon your genetic life expectancy for abily to repay.

 

[LeAnn]

LeAnn, I suggest you have a nice talk with your family physician and explain how your vaporizer has helped you. Even if your doctor happens to disapprove of your e-cig and wants to consider you a smoker, you should be able to get a PRESCRIPTION for a nicotine inhaler. Even if you don't actually buy the thing, holding the prescription will give you some protection and a claim to privacy against the discriminatory screening. Bring a copy of one of CASAA's handouts like the Medical InfoGraph or tri-fold brochure: CASAA.org

Hopefully you wont need it, but if you end up needing to "lawyer up" or something, do what you can to protect your right to privacy and freedom from illegal discrimination against people with disabilities that may be treated by nicotine. Even if you don't have a diseases that is treated by nicotine, the ADAA 2008 protects people from discrimination on the basis of a PERCEIVED disability or screenings for medications. For example, you can't be fired because you test positive for seizure medication (as long as you aren't breaking the law or taking it without a prescription), even if you don't actually have the perceived disability. If you actually have a disability* treated by nicotine, your employer is required to make reasonable accommodations which you might use to get permission to vape openly rather than having to "go stealth" or use the vaporless inhalator!

*this is where the prescription comes in handy. You have a right to privacy about health information which means you do not have to divulge any health information to your employer that is not directly relevant to the accommodations you seek.

Thanks so much for the advice I am going to fight if they say can't use e-cigs. I have worked for this company for 19 years, have always been an employer in good standing, very, very few sick days and e-cigs have been my only success with being analog free, if they want to raise my insurance I will have to go elsewhere for insurance and I will talk to my doctor about it when I see her in September, I appreciate your help...Thanks again.

 

[jamie]

they are, indeed, under the assumption that anyone still actively using Pharma's NRTs will relapse back into smoking soon enough.

Agreed. I asked an insurance company employee why all NRT users were required to pay smoker rates and that's exactly what I was told - because they'll go back to smoking.

Of course that same insurance company also has a solution to that: join their cessation program and use their recommended NRT products. For which you'll continue to pay smoker rates, because it means you'll go back to smoking.