With many US states making legislation to discourage employment to smokers, the smoking population finds it difficult to get an employment. There are many ethical issues involved in this decision.

Just like WHO introduced a “nonsmoker-only” hiring policy in 2008, citing commitment to tobacco control, health care organizations with similar policies have argued that their employees must serve as role models for patients and that only non-smokers can do so. Another argument is that employees must take personal responsibility for actions that impose financial or other burdens on employers or fellow employees. Accordingly, smokers should be responsible for the consequences of their smoking.

Yet it seems highly paradoxical for health care organizations that exist to care for the sick to refuse to employ smokers. Another observation raised against this legislation is that these policies disproportionately and unfairly affect ethnic groups that are already at a disadvantage by high unemployment rates, poor job prospects, and job insecurity. So even though this move might be considered welcome by many, an ethical solution is for employers to have a constructive approach than punishing smokers. In hiring decisions, they should give weightage whether candidates meet the job requirements; then they should provide genuine support to employees who wish to quit smoking. And health care organizations in particular should show compassion for their workers. This approach may even be a win–win economic solution, since employees who feel supported will probably be more focussed and productive than will those who live in fear of repercussions.