Most of these forms I see require not only nicotine, but also BMI, lipid, BP and fasting blood sugar. No idea what the insurance company/employer does with the info, but patients want us to sign off on the tests.
At one point I was really stressed out and got down to 116 and all I heard from anyone was that I was too thin and what was I trying to accomplish. Sometimes you can’t win.
My D1 cheerfully announced, “hey, I’m not obese anymore” at her pre-college check up. Her BMI had labelled her as obese, simply because she is short and muscular. All gymnasts are obese by that standard too. Numbers by themselves don’t tell the whole truth.
We should not punish folks for the genes they were born with. Poor BMI, blood sugar, cholesterol, etc. can be due to either genetics or bad habits/recklessness towards own health. I am all in favor of people making the right choices, but sometimes one was simply dealt a bad card and not much can be done about it. Not so much with smoking - people don’t pick up their first cigarette because their genes dictated them to. So testing for nicotine is a fair game.
I’m for this. Anything that illuminates the problems with employer based health insurance is fine by me.
On another note, I’d be far more likely to go somewhere that screens out smoking customers. I am very allergic. I’ll get hives just being around smokers… Not even the smoke but the remnants that they carry around.
For me personally I draw the line between choices and genetics. Smoking is a choice. Being genetically predisposed is not.
On the one hand, I know life insurance premiums for smokers are double or more than no-smoking rates and that is based on acutarial info, so there is some basis for that & smoking is easy to target & test. On the other hand people who get the best preferred rate discounts are also paying about half the person who gets standard rates- could be build, could be cholesterol, could be speeding tickets, could be family history, so those risks are also intense.
On the other hand, I hate hate hate the big brother aspect. I love my fitbit, but I don’t care to share it with anyone! Government and work, get out of my private life.
BMI is a bogus number, it cannot possible indicate the true fattiness of everyone the same height. Like the muscular gymnasts, not everyone is built the same. people really are ‘big boned’ or muscular.
Good for them! If someone doesn’t like it- go elsewhere for insurance! Major companies bear a large part of the cost of medical coverage. The employee’s portion (premium and deductibles) does not cover anywhere near the whole expense. Why wouldn’t they check for smoking? It’s the single worst thing you can do for your health, I am a lawyer for a major corporation and this is a big issue. We have a lot of employees in rural areas and a lot of smokers.
I would never hire a smoker, I lose respect for anyone I find out is a smoker, and I don’t want them running up my health care costs. I don’t see a “big brother” problem here at all. If you want the huge benefit that employer provided health coverage gives you, do your part!
I think it is too slippery a slope to head down a path that lets insurance companies pick and choose prices for those they insure. It eventually will come to a point where blondes are charged more because they have light skin. You will be charged more if you ride a bike in urban areas etc. there is no stopping it once it starts.
Before the new law insurance companies were denying newborns coverage because they were treated for jaundice. This is just crazy.
I don’t understand why most people are not truly upset by this.
Because smoking is voluntary, destructive and disgusting. Why should an employer subsidize this habit?
Genetics has more to do with health than habits.
I expect that genetic testing will be required at some point to determine whether or not pregnancy will be covered.
Too bad, since with my genetics/ history, I would have not had pregnancy covered.
It was bad enough that my neighborhood hospital told my Dr, I couldn’t deliver there.
BunsenBurner is completely correct - they test because smoking is expensive to the employer (both from a medical/pharmacy cost standpoint and also from a productivity standpoint) and because the test itself is validated. Also, many employees lie about smoking habits on those health questionnaires, and the blood test for nicotine doesn’t lie.
I used to work for an agency that studied the correlation between healthcare costs and personal habits. The correlation between smoking and employer costs is much stronger than, say, the correlation between diet and employer costs. When/if that correlation with diet is ever proven and validated in multiple studies, my guess is that employers will start punishing/rewarding those habits too. That’s what happens when your healthcare is tied to your employer.
Why should an employer throw money away regarding healthcare costs? Public companies have a duty to the shareholders to run the business profitably and, of course, if the company is successful and growing, it benefits the employees, creates more jobs and helps the economy. I never take my excellent healthcare benefits for granted, and aI fully understand the huge cost to my employer of providing these benefits. Our company is self-funded, by the way.
BMI is a stupid measurement. I am not convinced it is an accurate indicator of health.
My insurance company (not through an employer) offers an option – if you make a wellness visit with your primary care doctor and get some standard bloodwork done, and have height/weight measured, and complete an on-line health improvement training, you get a slightly reduced deductible for the year, and free primary care visits for the next year rather than the $30 copay.
I remember hearing back in the nineties that Aetna and other insurers were charging women more if they were battered. From their POV, it ended up in more ER visits so it was an expensive risk to carry. There was an outcry and they stopped. I think.
As long as we have a system of health care that’s essentially run and partly funded by for-profits (insurance companies/employers) we might as well get used to this kind of intrusion. We’ve allowed ourselves to be taken care of by entities that don’t have us – but rather their profits – in their best interest.
FWIW, I think the reason there hasn’t been more of an outcry is demographic: many young people today don’t smoke (well, at least not nicotine) and they’re healthy, so these tests demanded by their employers don’t phase them very much. And with decline in humanities, they may not even understand the reference to Big Brother 
That’s ridiculous. Encouraging employees not to smoke is not having their best interests in mind? My employer absolutely has the employees’ best interests in mind and offers a very rich benefits package. I wish people would actually know what they were talking about before they comment on some of this stuff.
You want them not to care about profits? Then who is going to yell the loudest when there are layoffs?
Just because we disagree doesn’t mean I don’t know what I’m talking about. If you think your employer is encouraging people not to smoke because he/she/the company has your best interest in mind, good for you. But MOST employers do so because smokers are more expensive to insure. Period.
It is not the decline in humanities… It is the rise of the Facebook generation… 
That said, even in a single-payer system I would want smokers to contribute more. Why should I pay for someone’s choice to endulge in a self-destructing habit that also undermines the health of their spouse, kids, and anyone who lives with them?
It’s both, of course. But stopping smoking is never a bad thing.