Why Not All Wellness Programs Are Healthy

U-Haul rental in Kingston, Ont.

Smoking was once considered as American as apple pie. In fact, back when more than a few doctors were willing to recommend them, cigarettes were billed as a healthy alternative to Uncle Sam’s beloved dessert pastry.

“Keep fit—reach for a Lucky instead of a sweet,” advised an old cigarette advertisement featuring film star Al Jolson. “That’s what many men have been doing for years. They know the evidence of prominent athletes whose favorite cigarette is Lucky Strike and who say Luckies do not harm the wind nor impair the physical condition.”

But times change. Indeed, while millions of consumers still smoke, public acceptance of the habit has turned since the days when ads depicting Jolson in blackface assured consumers that cigarettes are “good for you.”

Has smoking lost Its cool Image

As Statista’s Felix Richter recently noted, cigarette sales in the United States dropped to 216.9 billion in 2018, marking the industry’s lowest level in demand since the tracking of cigarette sales was initiated in 1967. This decline occurred despite heavy support from advertising and promotional spending, which jumped from US$1.2 billion in 1980 to US$8.4 billion in 2018.

As Richter put it: “While lighting up a cigarette was once considered a sign of class and sophistication or, at the very least, an act of coolness, smoking seems to have lost some of its spark in recent years.”

Attitudes toward smoking continue to change, especially in the workplace, where “smoke-them-if-you’ve-got-them” policies were extinguished years ago. In 1975, Minnesota became the first U.S. state to restrict smoking in the workplace. In Canada, the first workplace ban was put in place by Ontario in 1994. But today’s smokers are not just being banned from lighting up at work—they are being banned from employment by companies like U-Haul, at least in the United States.

The Arizona-based company, which employs more than 30,000 people across the United States and Canada, recently opened a can of HR worms by announcing it would no longer hire people who smoke cigarettes or use other nicotine products.

In Canada, the Human Rights Act theoretically protects nicotine users from this sort of selective hiring policy, since it outlaws discriminating against job applicants based on race, sex, and disability, and addictions are widely considered a disability. But in 21 U.S. states, companies can decline to hire nicotine users and many of them allow employers to use medical testing to screen them out.

As far as U-Haul sees it, the company’s new restrictive hiring policy is as positive as education-based wellness initiatives. “We are deeply invested in the well-being of our team members,” says a statement issued by the company’s chief of staff in early January. “Nicotine products are addictive and pose a variety of serious health risks. This policy is a responsible step in fostering a culture of wellness at U-Haul, with the goal of helping our team members on their health journey.”

There is no question that well-designed wellness programs can benefit employers and society alike. Following a metadata analysis of global workplace wellness research, a study conducted by the Ivey Business School in partnership with Sun Life concluded in 2016 that wellness programs save 1.5 to 1.7 days of absenteeism in Canada. As Professor Michael Rouse estimated at the time: “If every company in Canada had a wellness program based on this metadata analysis, the savings to the Canadian economy would be $3.6 billion dollars.”

Prior to the establishment of a clear business case for wellness programs, of course, many companies essentially ignored employee health. But as research studies established the potential for significant returns, the “why” question became “when and how.” As Your Workplace magazine noted seven years ago, “The hardest part in creating a wellness program for your company is knowing where to start.” No more. As the U-Haul program demonstrates, the tricky part now appears to be knowing where to stop, especially in the United States—where wellness programs targeting smoking and unhealthy weight levels spread like wildfire amongst large organizations following the passage of the Affordable Care Act.

“I get that there are costs that are connected to smoking, but there may be a cost to keeping smokers out.” – Ivey Business School lecturer Karen MacMillan

U-Haul isn’t the first U.S. employer to attempt to create a healthier workforce by simply deciding not to hire employees who use nicotine. But as the Los Angeles Times pointed out, this extreme kind of wellness policy is still rare and concerning, since it discriminates against people suffering from an addiction. And as Amanda Mull noted in The Atlantic, the addiction in question has become less common in wealthier demographics, which makes U-Haul’s policy appear to mostly ban poor Americans from employment.

Furthermore, as Ivey Business School lecturer Karen MacMillan points out, U-Haul’s new wellness policy itself might prove unhealthy to the company. “I get that there are costs that are connected to smoking,” she says, “but there may be a cost to keeping smokers out.”

MacMillan—a former HR executive—argues that U-Haul’s strict new hiring policy could create a double standard, since it doesn’t apply across the entire organization or to existing employees. “What does U-Haul intend to do with current employees who smoke?” MacMillan asks. “If they remain employed, they could feel unvalued, creating an employee relations issue. And what happens if they hire someone who doesn’t smoke, but then that person starts smoking. Will employee smoking impact success in the organization? Will they put a monitoring program in place?”

In addition to having the potential to negatively impact employee morale, aggressive wellness initiatives can help spawn a culture of deceit, fostering unhealthy attempts to beat the system. In the case of weightloss programs with financial incentives, studies have found that employees often attempt to manipulate results by binge eating and crash dieting.

Monitoring employee health can also be an issue. As noted in “Employers Should Disband Employee Weight Control Programs,” a 2015 article published by The American Journal of Managed Care, “While virtually every wellness program prescribes annual blood draws on all employees to screen for various conditions (and employees forfeit money by refusing to participate), there is no blood-based screen that the US Preventive Services Task Force recommends being done annually on all working-age adults, because overscreening can potentially cause harm through overdiagnosis and overtreatment—and it also increases cost.”

MacMillan advises companies to keep in mind that diversity is a valuable attribute in any organization. And while smoking may have lost its cool, vaping nicotine is popular amongst certain youth groups. As a result, refusing to hire anyone who uses nicotine could limit a company’s access to risk-tolerant or even innovative minds.

Simply put, wellness programs need to be well designed. Providing employees with knowledge, risk management tools, and positive incentives clearly has a role to play in today’s workplace. But refusing to hire people who, for better or worse, use any legal product can clearly do more harm than good. Before following U-Haul’s lead, other companies should consider when it makes sense to get involved in personal lives and when it makes sense to butt out.

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