Van de nieuwe longkanker gevallen is 50% ex-roker, vergeleken met 35-40% roker (en dus 10-15% nooit-roker). Het risico dat ex-rokers, die tot een jaar eerder stopten, lopen op longkanker is dan ook bijna het dubbele van dat van mensen die nu nog roken (50,7X ipv 26,9X). Zelfs na 15 jaar niet-roken is het risico op longkanker nog steeds 12,6 keer dat van nooit-rokers, dus slechts gehalveerd.
Als je als werkgever rokers wil ontslaan of niet aanneemt om gezondheidskosten te sparen (zoals o.a. de Wereldgezondheidsorganisatie pas aankondigde) kun je volgens Dr. Michael Siegel dus beter alle ex-rokers ontslaan dan rokers. Ook anti-rokenorganisaties die het niet aannemen van rokers propageren zitten dus met het argument van verminderde gezondheidskosten op het verkeerde pad, volgens deze dissidente anti-rokenwetenschapper.
According to a press release issued by Action on Smoking and Health (ASH), a Washington, D.C.-based anti-smoking organization: “firing smokers is an appropriate and very effective way to stop burdening the great majority of employees who wisely chose not to smoke with the enormous unnecessary costs of smoking by their fellow employees.”
The Rest of the Story
According to the Lung Cancer Alliance, “over 60% of new lung cancers are diagnosed in people who never smoked or who managed to quit smoking even decades ago.”
In fact, the majority of lung cancer cases do NOT occur in smokers. They occur in ex-smokers. Approximately 50% of lung cancer cases occur in former smokers, compared to just 35-40% in current smokers. For an employer, hiring a current smoker is statistically less likely to result in incurring high costs for the treatment of lung cancer than hiring a current smoker.
It is quite clear that ex-smokers, even if they quit a long time ago, represent a significant and substantial risk to the employer of having to face the inordinately high costs of medical treatment of these individual employees for lung cancer.
In the CPS-II cohort study, former 1+ pack per day male smokers who quit within the past year actually had the highest observed relative risk of getting lung cancer compared to male never smokers (50.7), even higher than the relative risk for current pack a day smokers (26.9). And the relative risk for lung cancer remained quite high (12.6) for former pack a day smokers who had quit up to 15 years earlier. Even former pack a day or more smokers who quit greater than or equal to 16 years previously had a relative risk of lung cancer of 5.5.
A study of 2,257 HMO members in California found that male former smokers actually had more physician visits than current smokers. And another study found that male former smokers actually lose more days of work to illness than male current smokers. And yet another study reported higher rates of chronic ilness, acute illness, and physician visits, and comparable rates of outpatient visits among former smokers (even those who quit more than one year previously) compared to current smokers.
If it is true that the “great majority of employees” who “wisely chose not to smoke” are being “burdened” with the “enormous unnecessary costs of smoking by their fellow employees,” then it is certainly true as well that these employees are also being burdened with the enormous unnecessary costs of prior smoking by their fellow employees who most unwisely chose to smoke earlier in their lives.
Thus, to avoid burdening never smoking employees with the enormous unnecessary costs of smoking and prior smoking by their fellow employees, it only makes sense to fire both smokers and ex-smokers. I don’t see any way that ASH could rationalize not including ex-smokers, who clearly represent an unfair burden on their employers and fellow employees because of their increased risk of disease. The data simply do not justify making a distinction between these two groups, if the concern is saving health care costs for the employer and not burdening fellow employees with unnecessary costs due to smoking by their fellow employees.