Should health organizations add a 'tobacco filter' to their recruitment policies?

Each year, an estimated 5.4 million people die from tobacco usage. This could increase to up to 8 million if current trends continue, according to the World Health Organization. This is why WHO, among other health groups, is boosting its efforts to raise awareness of the health risks associated with tobacco, as well as pushing governments to take measures aimed at discouraging its continued use. These efforts aren’t solely focused externally. A number of health organizations, particularly those engaged in tobacco control activities, have extended their campaigns internally by adopting policies to ensure a smoke-free work premises and offering smoking cessation programs to employees. WHO has even adopted a hard-line policy — the United Nations public health arm won’t hire applicants who smoke or “other tobacco users who do not indicate a willingness to stop smoking,” according to language in its no tobacco recruitment policy. The policy, according to WHO recruitment language, is part of the organization’s commitment to achieving a tobacco-free environment and showing coherence across its work — a stance often heard of health institutions, including those working outside the international development sector. WHO supports staff members who wish to quit smoking through initiatives such as individual counseling, reimbursable pharmaceutical therapy prescriptions and organizing informal in-house group sessions on demand. Counseling sessions are “treated confidentially” and can be done face-to-face or remotely, such as through telephone or Skype, according to Kelvin Khow, technical officer for the Tobacco Free Initiative at the WHO Regional Office for the Western Pacific, where two staff members are trained to provide this support — one based in Manila, Philippines, and another in Phnom Penh, Cambodia. Khow said WHO is “proactive” in encouraging employees to maintain a healthy lifestyle, but that the health aid agency leaves it to staff members to decide when they want to quit, as well as the choice to approach the smoking cessation team for advice and assistance. If they do seek support, the team can help them set up a plan that would allow them to anticipate and prepare for challenges, identify ways to “resist temptation,” receive “positive” support and set a “quit date.” The team would also help evaluate any necessary medications employees may need in the process. No smoking But not all health organizations working in development share the same views, or take the same route, Devex has learned. Action on Smoking & Health, a Washington, D.C.-based public health charity active in campaigning against tobacco use, doesn’t have a policy against hiring tobacco users, although it too strictly forbids smoking on its premises. “Enacting this type of policy is a controversial and complex topic. ASH has not taken a position,” ASH Communications and Project Coordinator Megan Arendt told Devex, although she notes that organizations “should do all they can” to decrease the smoking prevalence among their employees and promote healthy lifestyle. “This is good for the employees and for the employer,” she said. Even if the organization wished to exert more control, however, it would be legally prohibited from doing so. The District of Columbia is among 30 U.S. states that have adopted a law protecting smokers from being subjected to such policy by employers. But even in places where the law would allow it, certain organizations do not see the need to adopt such prohibitive policies. The Stop TB Partnership Secretariat, formerly under WHO and now under the U.N. Office for Project Services in Geneva, has not adopted any such rules in its recruitment policy, according to Sulochana Weerasinghe Roy, head of human resources. “The partnership encourages its staff to maintain a healthy lifestyle [but] the partnership does not believe that by excluding smokers from potential lists of good candidates there will have an impact on the behavior of people or toward nonsmoking in the society,” she told Devex. “The partnership believes it is better to embrace individuals and work together over time to advise them toward a healthy lifestyle.” The Global Fund to Fight AIDS, Tuberculosis and Malaria has also confirmed to Devex that it does not have a “tobacco filter in recruitment.” Even for WHO, the execution of the “recruitment tobacco filter” is tricky. How it determines smokers from nonsmokers, for example, isn’t foolproof, as the organization currently relies on applicants’ honesty in the job application, where they are asked if they smoke or use tobacco products. And if they do, would they continue to do so if employed by the U.N. health agency? Disciplinary action will be taken against an employee found to be smoking if already hired, although no language of specific disciplinary measures is included in the recruitment policy. The same action would be applied to staff members caught continuing to smoke or using tobacco within WHO premises. To Khow’s knowledge, WPRO has not yet taken any such disciplinary actions against an employee found to have breached the policy. “If ever, verbal warnings will be given to remind staff not to smoke within the WHO compound,” he told Devex. This can extend to staff members on field duty, although he confirms WHO does not have any monitoring mechanisms in place for this and largely relies on staff reports or eyewitness accounts, which would then be validated or verified. “Efforts should be taken to encourage a nonsmoking culture in WHO and to have staff themselves doing citizen reporting and encouraging other staff not to smoke while out on the job,” he said. Those advocating for a for no tobacco recruitment policy might argue the economic costs of having smoking employees — higher medical costs and reduced productivity. But there’s another side to the debate: Organizations may be missing out on good talent. Geneva-based Communications Officer Paul Garwood, though, imagines that would be “hard to gauge” on the part of WHO. “If people who smoke cigarettes choose not to apply for a position, then we wouldn’t know if they were interested or not,” he told Devex. “But the key issue here is that WHO has a responsibility, and commitment, to fight tobacco use and to strive to control it on public health grounds.” Whether you’re a seasoned expert or budding development professional — check out more news, analysis and advice online to guide your career and professional development, and subscribe to Doing Good to receive top international development career and recruitment news every week.