E-smokers will NOT be hired at 2 FL hospitals
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I wouldn't say all smokers are self medicating, but I'm pretty sure I was. The only thing that almost worked for me was Zyban and it was great while I was on it, but the minute the therapy stopped, so did my ability to stay away from cigarettes. I even tried to get back on it and the insurance company cut me off. Now I suppose I could have gotten a diagnosis and lived my life on anti-depressants, but tobacco takes care of my needs just fine. I just wish the ?non-profit?"health" associations would have let me know years ago that there were "safer alternatives to smoking".
- Apr 2, 2009
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Except that based upon the published research articles, e-cigarettes deliver virtually undetectable levels of nicotine to users.
As such, blood, urine, and saliva tests that detect cotinine (a biomarker for nicotine exposure) couldn't differentiate between NRT use and e-cigarette use, and may not be able to differentiate between secondhand smoke exposure and e-cigarette usage.
In sum, their policy won't be enforceable.
As such, blood, urine, and saliva tests that detect cotinine (a biomarker for nicotine exposure) couldn't differentiate between NRT use and e-cigarette use, and may not be able to differentiate between secondhand smoke exposure and e-cigarette usage.
In sum, their policy won't be enforceable.
On the first point (NRT and e-cig use), since the policy bans employees from using cigarettes, gum, the patch, and e-cigs, does that even matter?
However, your point about secondhand smoke exposure is interesting.
I e-mailed Ken Mattison (and I encourage others to do so -- ken.mattison@ahss.org). He replied
I replied with the following. I've edited out some personal info about myself.
.
In reference to whether it is legal to not hire based on nicotine usage, it is completely legal. Smoking, or nicotine usage in general is not a protected class. That is cut and dry. Don't work there....
You do look a little blue in your avatar
But seriously, I had been self medicating on Cigs for 30 years, I found e-cigs and have not thought about stopping for a pack since and I am way happier then before I quit analogs.
My thoughts exactly - so no fast food can be ordered into the hospital - they have to adopt healthy in-house cafeteria food - and test fat %? Crap i say - just crap! (Crap is not what I wanted to say but I kept it clean
) 
very smart observation. i guess the only way they can REALLY make sure that all their employees dont test positive for nicotine, is to make sure that they:
dont live with a smoker
dont go to bars/clubs/dancehalls/honkytonks/casinos or any public place where second hand smoke may be encountered
why not just require their employees to live in a bubble?
thank God i am a medical professional working for the feds. i would NEVER work for this company, and would never do any business with them where they would benefit from my health care dollars/medical insurance.
shame on them.
dont live with a smoker
dont go to bars/clubs/dancehalls/honkytonks/casinos or any public place where second hand smoke may be encountered
why not just require their employees to live in a bubble?
thank God i am a medical professional working for the feds. i would NEVER work for this company, and would never do any business with them where they would benefit from my health care dollars/medical insurance.
shame on them.
Placebo, they test for cotinine which is testing for nicotine levels. If the tested CO levels, they could differentiate a smoker from a smokeless user. That would reduce the number of rated "smokers" by the insurance companies, but I would think it would pick up others that may be in risky environments like heavy use of wood burning devices and heavy other pollution.
CO Breath Test Breath tests for CO Carbon monoxide breath testers from Breathe EZ.
CO Breath Test Breath tests for CO Carbon monoxide breath testers from Breathe EZ.
They'll also need to make sure they haven't eaten any potatoes, tomatoes, eggplant, or any other members of the nightshades that contain nicotine!
Here's what I wrote to him (and thanks for all of your efforts and for the information to contact Mr. Mattison):
Dear Mr. Mattison:
First of all, thank you in advance for taking the time to read this message. I'm certain that you have heard from many others regarding the new policy against nicotine use by employees, but I am hopeful that you are still receptive to observing the perspective of others like myself who wish to share our thoughts and experiences with you.
As someone who grew up in a family of smokers and later became one myself by age 15, I understand firsthand the myriad of problems that result from smoking cigarettes. As someone who has successfully quit smoking after numerous failed attempts I also understand how difficult and complex treating this addiction can be. The organizations that lobbied successfully to educate the public about the dangers of smoking and implement strategies to prevent young people from starting and encourage current smokers to quit while protecting the general public from the ill effects of second hand smoke exposure were no doubt motivated by noble intentions from the outset. We have all benefitted from many of the changes that have resulted from these efforts.
As a licensed professional in the field of addictions, I have witnessed the focus of the anti-smoking movement evolve from anti-cigarettes to anti-tobacco, and now to anti-nicotine. The rationale for this change is based upon the fallacious reasoning that all nicotine containing products pose an equal health risk. It is generally understood that the overwhelming majority of illnesses that result from cigarette usage is caused by the inhalation of the carcinogen containing smoke itself. The combustion of lighted tobacco is specifically essential to the causation of diseases like smoking related lung cancer, emphysema, and COPD. As we know, tobacco cigarettes are well documented to contain hundreds of added chemicals that are cancer causing agents. Although it is a stimulant that effects the body much in the same way that caffeine does, nicotine is not a known cancer causing agent, nor does it cause the aforementioned lung affecting illnesses. The use of nicotine containing products such as nicotine patches, lozenges, and gum as well as the newly popular personal vaporizers (or electronic cigarettes) does not present the same risks to the user or the general public. In fact, many alternative products that address smoking cessation via nicotine replacement are utilized heavily by smokers who are making very serious efforts to quit or to remain abstinent. Unfortunately, no one single method is going to help everyone so it is essential that smokers have access to as many options as possible. Under this new policy, someone who has utilized Wellbutrin or hypnosis will not be penalized in the same way as someone benefitting from nicotine replacement products. Additionally, the electronic cigarette does what no other replacement method does by addressing the deeply ingrained hand to mouth part of the addiction which is indeed the most challenging part for many smokers to move beyond. Of course, the mere imitative motion of puffing on a vaporizer also does not present any health risks.
What is not known by many in the general public is that nicotine itself is a naturally occurring compound (in foods like tomatoes, potatoes, cauliflower, eggplant, and peppers) and that there is reputable documented research that demonstrates it has numerous benefits for memory and other brain functions and has shown to be beneficial when received transdermally to patients with dementia, Parkinson's Disease, and other neurological disorders as well as serious mental illnesses like Schizophrenia. I will gladly provide links to such research, but instead I invite you to do an independent web search so that there is no implication that I am relying on biased sources. For the record, I'm also a licensed therapist working with the geriatric population so I am very invested in the dissemination of current research regarding the treatment of diseases like Alzheimer's and other disorders impacting memory. Therefore, the tendency to demonize nicotine and disregard the potential benefit to many vulnerable citizens is of great concern to me. If there ever was a real life example of the adage throwing the baby out with the bath water, this would be it.
Those in positions of influence have a responsibility to not only address current problems facing our society, but to not inadvertently promote regressive policies that result in another set of damaging consequences. People from all walks of life have been impacted by smoking addiction, and this certainly includes some of our brightest and most capable professionals in addition to average citizens who are motivated to be reliable and dedicated employees regardless of their occupation. Without a doubt, many of these people have served your hospital well and would continue to do so given the opportunity. While it is both admirable and understandable that your facility aspires to present a positive image to the community while encouraging healthy lifestyle habits for its employees, I believe it is counterproductive to assume that any individual that merely has nicotine in his system is engaged in behaviors that compromise these goals. The concept of harm reduction is gaining momentum in the medical community and not without good reason: it relies on factual information about the very real difference in risk posed by the consumption of different nicotine containing products and is focused not on enforcing desired social norms, but saving lives. A major concern of mine as well as of others who share my views is that nicotine use is by far not the most widespread or visible condition that can be targeted in limiting job opportunities for deserving people. Like smokers, overweight or sedentary people are not a protected class and present with a notable increased risk of numerous serious health problems. In fact, overweight people significantly outnumber smokers, not to mention that the use of nicotine is not synonymous with the dangerous act of smoking. We can't help but ponder who will be identified next in the efforts to engineer a healthier society by limiting opportunities to the select few who engage in no potentially risky behaviors whatsoever and excluding those who have made positive changes in an effort to rectify poor choices they made in the past.
Again, I sincerely thank you for giving me the opportunity to share my concerns with you. I welcome any response you may have and will provide any additional requested information that you would find interesting or helpful.
Dear Mr. Mattison:
First of all, thank you in advance for taking the time to read this message. I'm certain that you have heard from many others regarding the new policy against nicotine use by employees, but I am hopeful that you are still receptive to observing the perspective of others like myself who wish to share our thoughts and experiences with you.
As someone who grew up in a family of smokers and later became one myself by age 15, I understand firsthand the myriad of problems that result from smoking cigarettes. As someone who has successfully quit smoking after numerous failed attempts I also understand how difficult and complex treating this addiction can be. The organizations that lobbied successfully to educate the public about the dangers of smoking and implement strategies to prevent young people from starting and encourage current smokers to quit while protecting the general public from the ill effects of second hand smoke exposure were no doubt motivated by noble intentions from the outset. We have all benefitted from many of the changes that have resulted from these efforts.
As a licensed professional in the field of addictions, I have witnessed the focus of the anti-smoking movement evolve from anti-cigarettes to anti-tobacco, and now to anti-nicotine. The rationale for this change is based upon the fallacious reasoning that all nicotine containing products pose an equal health risk. It is generally understood that the overwhelming majority of illnesses that result from cigarette usage is caused by the inhalation of the carcinogen containing smoke itself. The combustion of lighted tobacco is specifically essential to the causation of diseases like smoking related lung cancer, emphysema, and COPD. As we know, tobacco cigarettes are well documented to contain hundreds of added chemicals that are cancer causing agents. Although it is a stimulant that effects the body much in the same way that caffeine does, nicotine is not a known cancer causing agent, nor does it cause the aforementioned lung affecting illnesses. The use of nicotine containing products such as nicotine patches, lozenges, and gum as well as the newly popular personal vaporizers (or electronic cigarettes) does not present the same risks to the user or the general public. In fact, many alternative products that address smoking cessation via nicotine replacement are utilized heavily by smokers who are making very serious efforts to quit or to remain abstinent. Unfortunately, no one single method is going to help everyone so it is essential that smokers have access to as many options as possible. Under this new policy, someone who has utilized Wellbutrin or hypnosis will not be penalized in the same way as someone benefitting from nicotine replacement products. Additionally, the electronic cigarette does what no other replacement method does by addressing the deeply ingrained hand to mouth part of the addiction which is indeed the most challenging part for many smokers to move beyond. Of course, the mere imitative motion of puffing on a vaporizer also does not present any health risks.
What is not known by many in the general public is that nicotine itself is a naturally occurring compound (in foods like tomatoes, potatoes, cauliflower, eggplant, and peppers) and that there is reputable documented research that demonstrates it has numerous benefits for memory and other brain functions and has shown to be beneficial when received transdermally to patients with dementia, Parkinson's Disease, and other neurological disorders as well as serious mental illnesses like Schizophrenia. I will gladly provide links to such research, but instead I invite you to do an independent web search so that there is no implication that I am relying on biased sources. For the record, I'm also a licensed therapist working with the geriatric population so I am very invested in the dissemination of current research regarding the treatment of diseases like Alzheimer's and other disorders impacting memory. Therefore, the tendency to demonize nicotine and disregard the potential benefit to many vulnerable citizens is of great concern to me. If there ever was a real life example of the adage throwing the baby out with the bath water, this would be it.
Those in positions of influence have a responsibility to not only address current problems facing our society, but to not inadvertently promote regressive policies that result in another set of damaging consequences. People from all walks of life have been impacted by smoking addiction, and this certainly includes some of our brightest and most capable professionals in addition to average citizens who are motivated to be reliable and dedicated employees regardless of their occupation. Without a doubt, many of these people have served your hospital well and would continue to do so given the opportunity. While it is both admirable and understandable that your facility aspires to present a positive image to the community while encouraging healthy lifestyle habits for its employees, I believe it is counterproductive to assume that any individual that merely has nicotine in his system is engaged in behaviors that compromise these goals. The concept of harm reduction is gaining momentum in the medical community and not without good reason: it relies on factual information about the very real difference in risk posed by the consumption of different nicotine containing products and is focused not on enforcing desired social norms, but saving lives. A major concern of mine as well as of others who share my views is that nicotine use is by far not the most widespread or visible condition that can be targeted in limiting job opportunities for deserving people. Like smokers, overweight or sedentary people are not a protected class and present with a notable increased risk of numerous serious health problems. In fact, overweight people significantly outnumber smokers, not to mention that the use of nicotine is not synonymous with the dangerous act of smoking. We can't help but ponder who will be identified next in the efforts to engineer a healthier society by limiting opportunities to the select few who engage in no potentially risky behaviors whatsoever and excluding those who have made positive changes in an effort to rectify poor choices they made in the past.
Again, I sincerely thank you for giving me the opportunity to share my concerns with you. I welcome any response you may have and will provide any additional requested information that you would find interesting or helpful.
AWESOME AWESOME LETTER! I dont think ANYONE could have said it any better. Really. p.s. i used to work in addictive diseases unit as an RN. and this RN will NEVER work for that hospital. i'd rather go on welfare, if i had no other choice but to work for this kind of organization.
please keep us updated on any response you get. i would love it if you pm'd me when you do get one, so i dont miss the follow up to this.
thanks for taking the time to write this letter
please keep us updated on any response you get. i would love it if you pm'd me when you do get one, so i dont miss the follow up to this.
thanks for taking the time to write this letter
Given that credible sources are now warning of the dangers of fourth hand smoke (that is, where you come into contact with someone, who has come into contact with someone who had smoked) can anyone be certain that they are not exposed to dangerous, potential fatal levels of nicotine and other tobacco by-products on a daily basis? 
They won't have any staff left
They won't have any staff left
"The fact that somebody would use a device like an electronic cigarette means there is an addiction there," Mattison said.
"...there is an addiction there"
What exactly is that supposed to mean?
People with an addiction are broken and therefore unsuitable for a job?
I got $5 on this guy has his own demons.
At any rate...would this also include employees who are addicted to their job?
How many gallons of coffee and soft drinks are consumed at that facility daily? Addiction?
I own a Harley. I crave the open road. Addiction?
I love my family. I'm compelled to do the best I can for them each and every day. Addiction?
I'm on this forum every evening. Addiction?
"...there is an addiction there"
What exactly is that supposed to mean?
People with an addiction are broken and therefore unsuitable for a job?
I got $5 on this guy has his own demons.
At any rate...would this also include employees who are addicted to their job?
How many gallons of coffee and soft drinks are consumed at that facility daily? Addiction?
I own a Harley. I crave the open road. Addiction?
I love my family. I'm compelled to do the best I can for them each and every day. Addiction?
I'm on this forum every evening. Addiction?
exactly...........and these are the people that you often find in higher level administrative positions making decisions...
may have an MBA but no common sense
may have an MBA but no common sense
JonnyVapΣ;2334363 said:
Not as cut and dried as you might imagine. Someone with a diagnosed illness such as Attention Deficit Disorder is in a protected class. The only FDA-approved medications for treating this come with black box warnings against long term use (as if the disability is only temporary!). It may cause hypertension and is contraindicated in anyone who has hypertension. It is a very controlled substance so you cannot get prescription renewals. You must go back to the doctor and get a new prescription each time you need medication.
The doctor who diagnosed my adult ADD knows that I am self-medicating with nicotine and has no problem with it. I'm fairly sure that if this were to be an employment issue with me, he would be willing to provide documentation. There must be others like me.
I got a reply today! I feel optimistic about this response and am going to compose a thoughtfully worded reply in which I intend to link him to some information on harm reduction and smokeless alternatives. I want to cite as much hard data as possible, including the studies I have about positive effects of nicotine. We have tons of info on CASA but any other recent finds would be welcome. I know there are pleny of people here who are very knowledgeable and articulate and I'm not trying to designate myself some kind of de facto spokesperson. In fact, the more positive (as opposed to snarky) feedback he gets the more of an impact it will have. It made me feel badly when I read that he had gotten some unsavory sounding messages but I intend to address that as well. Namely, that nicotine users have accumulated much frustration after feeling scapegoated and bullied as the anti-smoking lobby continues to move the goalposts every time they have won a battle. I also intend to focus on the concerns about the sincerity of the FDA and the links that anti-smoking groups like the ACS and the Lung Society have to big Pharma. Here is his entire response:
This started out this evening as a reply to ______ but I have included _________ for reasons that I hope will become obvious as you read further.
Dear _________.
Thank you for your thoughtful and well articulated messages. You were able to communicate your passion in a kind, compelling and professional manner. I have heard from just two of you who have utilized a similar, non attacking communication style and I would like to acknowledge my gratitude for the constructive way in which you wrote to me. ______ is a _____ student in New Jersey and I have taken the liberty of copying him and including the e-mail string (at the end) we exchanged on this reply as his suggestions contained some similarities. I am hopeful to take advantage of your interest and experience to explore a compromise. Will address that at the end of my remarks. Have also copied Carrie Fish, Waterman's COO as well as Joe Johnson, the CEO of the sister hospital, Florida Hospital Fish Memorial, as he and I have both wrestled with this issue. Will apologize in advance as combining all the material made this a rather large document.
We have wrestled with this concept for some time. We chose this challenge because the Centers for Disease Control identifies “Tobacco use is the single most preventable cause of disease, disability, and death in the United States.” CDC - Chronic Disease - Tobacco - At A Glance Trying to address the entire negative health continuum (tobacco, inactivity, diet, obesity, etc.) might overwhelm us to inaction and that is unacceptable. There may come a time when society incentivizes the other aspects of this debate and we look forward to helping where appropriate.
The economic impact of the use of tobacco provides ample justification to action. And while a business case might be made for taking this direction, the loftier "example" motivation is what is most important to us. What responsibility do we have as healthcare executives to create an environment that promotes wise choices regarding health? One might even say that from a business perspective, this direction is counter intuitive as today, healthcare institutions are compensated for the amount of care we provide, not the ability to improve the health status of a given population. And yet, our faith based, mission compels us to seek ways to honor God by improving the health of the people that He calls us to serve.
This loftier argument is behind the motivation that drove us to be the first hospital in central Florida to adopt a campus free smoking policy back in January, 2007. For a whole year before that date, we communicated the message of education and the motivation behind our decision and we took steps to assist people to consider stopping their use through available resources. Employees were offered discounts on their health insurance premium for making a choice not to smoke. We offered devices like the patch and gum to help make their journey to quit easier. During that time we heard from many who thanked us for helping motivate their choice. Of course we also heard from those who felt that our stand was unkind and motivated only by our desire to impose our values on others. Within a year and a half, most of the hospitals in our region adopted a similar policy.
The natural progression of such a strategy moves us to the steps taken most recently. As we considered the practical aspects of implementing such a policy, the nicotine test presented the simplest, most effective tool to monitor compliance. Your constructive argument makes a compelling case regarding the flaws associated with the use of that test. However, short of abandoning the strategy, which we are unwilling to do, can you think of practical ways that we might compromise to encourage a redemptive strategy for those who are truly trying? Your willingness to share your thoughts and suggestions is greatly appreciated.
With warm regards,
Ken Mattison
This started out this evening as a reply to ______ but I have included _________ for reasons that I hope will become obvious as you read further.
Dear _________.
Thank you for your thoughtful and well articulated messages. You were able to communicate your passion in a kind, compelling and professional manner. I have heard from just two of you who have utilized a similar, non attacking communication style and I would like to acknowledge my gratitude for the constructive way in which you wrote to me. ______ is a _____ student in New Jersey and I have taken the liberty of copying him and including the e-mail string (at the end) we exchanged on this reply as his suggestions contained some similarities. I am hopeful to take advantage of your interest and experience to explore a compromise. Will address that at the end of my remarks. Have also copied Carrie Fish, Waterman's COO as well as Joe Johnson, the CEO of the sister hospital, Florida Hospital Fish Memorial, as he and I have both wrestled with this issue. Will apologize in advance as combining all the material made this a rather large document.
We have wrestled with this concept for some time. We chose this challenge because the Centers for Disease Control identifies “Tobacco use is the single most preventable cause of disease, disability, and death in the United States.” CDC - Chronic Disease - Tobacco - At A Glance Trying to address the entire negative health continuum (tobacco, inactivity, diet, obesity, etc.) might overwhelm us to inaction and that is unacceptable. There may come a time when society incentivizes the other aspects of this debate and we look forward to helping where appropriate.
The economic impact of the use of tobacco provides ample justification to action. And while a business case might be made for taking this direction, the loftier "example" motivation is what is most important to us. What responsibility do we have as healthcare executives to create an environment that promotes wise choices regarding health? One might even say that from a business perspective, this direction is counter intuitive as today, healthcare institutions are compensated for the amount of care we provide, not the ability to improve the health status of a given population. And yet, our faith based, mission compels us to seek ways to honor God by improving the health of the people that He calls us to serve.
This loftier argument is behind the motivation that drove us to be the first hospital in central Florida to adopt a campus free smoking policy back in January, 2007. For a whole year before that date, we communicated the message of education and the motivation behind our decision and we took steps to assist people to consider stopping their use through available resources. Employees were offered discounts on their health insurance premium for making a choice not to smoke. We offered devices like the patch and gum to help make their journey to quit easier. During that time we heard from many who thanked us for helping motivate their choice. Of course we also heard from those who felt that our stand was unkind and motivated only by our desire to impose our values on others. Within a year and a half, most of the hospitals in our region adopted a similar policy.
The natural progression of such a strategy moves us to the steps taken most recently. As we considered the practical aspects of implementing such a policy, the nicotine test presented the simplest, most effective tool to monitor compliance. Your constructive argument makes a compelling case regarding the flaws associated with the use of that test. However, short of abandoning the strategy, which we are unwilling to do, can you think of practical ways that we might compromise to encourage a redemptive strategy for those who are truly trying? Your willingness to share your thoughts and suggestions is greatly appreciated.
With warm regards,
Ken Mattison
OMG!!!!!!!!!!!!!!! That is GREAT! Now I am motivated to write a letter to him myself. Thank you so much for sharing!!!
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