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How Many Smokers Could Quit If Someone Paid Them $10 Million?


The unexamined life, said Socrates, is not worth living; but sometimes I wonder whether the too-closely examined life is not worth living either, for examination uncovers dilemmas where none existed before.

Two articles in a recent edition of the New England Journal of Medicine ask the question of whether employers should, or have the right to, refuse to employ smokers, as increasing numbers do in the 21 states that permit such discrimination against them.

As is by now no secret, smokers are more likely to suffer from many types of illness than non-smokers, and their health insurance is therefore considerably more expensive than that of non-smokers. They impose costs on their employers which weigh upon all workers, smokers or not. (The authors do not take into account that smokers not only contribute to taxes by their habit but, by dying early, reduce pension costs.)

The authors worry that refusal to hire smokers would be discriminatory against people of lower social class, since it is among the latter that smoking is most prevalent. I am not sure that this is right: the majority of people in all social classes now do not smoke, while people who apply for jobs at any particular level are likely to be of the same social class. Except in the case where there is only one applicant for a job, then, it is likely that there will always be an applicant of any given social class who does not smoke. The discrimination remains against smokers, therefore, and not by proxy against members of lower social class.