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Some employers are trying to discourage off-duty smoking by increasing health insurance premiums for smokers. Others have gone so far as to terminate or prohibit the hire of workers who smoke, even on their own time.
Now some companies are proposing to fire, suspend, or charge higher insurance premiums to employees who are overweight, have high cholesterol, or participate in risky activities—although about 20 states have laws protecting employees from discrimination based on their lifestyle choices.
DOC News asked:
Have smoking bans gone too far? Should employers have the right to dictate lifestyle decisions?
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I think smoking bans have gone too far if they are trying to tell people what to do in their homes. Certainly in a public place it's appropriate, but when you're at home, you're pretty much free to do whatever you want. As a diabetes educator, I'd certainly hope people stop smoking, though.
Jacqueline A. Carlson, RD, CDE Hospital Diabetes Program Coordinator Jamestown, N.Y.
Our employers are paying our health premiums. We have cardiovascular disease or we have a stroke or heart attack, and a lot of that is related to our smoking. So do they have a right to get involved? Most definitely. Because they risk the rising cost of health care. You're not only looking at the smoker, but secondhand smoke. If you have someone who has family benefits, the entire family is now affected by this. So I am very, very supportive of anything that an employer can do.
If more people went to bans on smoking, and really [showed] a person, OK, not only is it affecting my health, but it's now affecting my work and my paycheck, people might have that additional push to try to quit smoking. I don't see it as an invasion of privacy. I see it more as promoting healthy lifestyles.
You are going to get people who are going to fight it, but I think, ultimately, if you can teach them why we're doing this and how we're going about doing it, it can definitely be helpful for everyone.
Lori Couch, RN, BSN, CDE, CSN School Nurse Bridgeton, N.J.
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I can see why some may be implementing it. If you smoke in a home with small children, and the children develop asthma, and the child now has a chronic condition that he or she had no control over, I can understand why something like this is being enforced in the home because of the potential effects of secondhand smoke. Obesity might be a little bit tougher. Some of it is genetic or a hypothyroid condition that might cause them to be predisposed to obesity. Some of it may not always be in their control, so I don't think that would be appropriate. And you can't control genetics. It's what you're given, so I don't agree with that. Smoking is a choice.
Sophia Kruly, RD, CDN, CDE Diabetes Educator Williamsville, N.Y.
I think a better way is to give incentives if they did not smoke. You can't penalize employees for what they do outside of work.
Kyu Won Kim, MD Family Medicine Getzville, N.Y.
[Employers] should have the right, but I know they won't be able to. I think an employer can enforce a no-smoking restriction as a condition of accepting employment.
John Dulcey, MD Nextgen Healthcare Plymouth Meeting, Penn.
TALK BACK: PUTTING THE SCREWS TO DTC DRUG ADS
Last summer, the Pharmaceutical Research and Manufacturers of America (PhRMA) approved preliminary guiding principles for drugmakers to use with a voluntary advertising code.
The code encourages those in the industry to meet with physicians before starting a new drug campaign, to promote health awareness in drug ads, and to offer information for low-income and uninsured patients. It also suggests age-appropriate targeting of messages, the inclusion of information about a drug's risks and benefits, and making claims only when evidence can support them.
Some critics say that current law already requires most of the guidelines and that stricter enforcement is needed by the Food and Drug Administration (FDA) to halt illegal drug advertising.
Meanwhile, the agency is considering revising rules about how much risk information drug ads must include and whether direct-to-consumer (DTC) ads must be reviewed before running. The FDA planned to convene a public meeting in November with patients, physicians, drugmakers, and others to further discuss DTC advertising requirements.
A September survey of 2,015 U.S. physicians by HRA Research shows more than 80% of doctors support a moratorium on consumer ads for new drugs for a limited period of time. More than 60% of those surveyed say patients ask for advertised drugs, but most of these physicians prescribe the drugs in only 25% or fewer cases.
What do you think? What are the risks and benefits of DTC drug advertising? How could rules that govern the ads be improved?
Send your comments to docnews{at}diabetes.org.
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| DOC News | Diabetes | Diabetes Care | Clinical Diabetes | Diabetes Spectrum |
