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Tobacco Free Hiring at The University of Texas MD Anderson Cancer Center

Jennifer Cofer1, Krithika Srinivasan, MacKenzie Toliver

  • 1From The University of Texas MD Anderson Cancer Center, Houston, Texas (J.C., K.S., S.V., M.M., E.H.); and Oklahoma State University Health Science Center, School of Osteopathy, Tulsa, Oklahoma (M.T.).

Journal of Occupational and Environmental Medicine
|July 11, 2025
PubMed
Abstract

Insights

MD Anderson Cancer Center

Area of Science:

  • Public Health
  • Healthcare Administration
  • Tobacco Control

Background:

  • A tobacco-free hiring policy was implemented in 2015 at MD Anderson Cancer Center (MDACC) to support its mission to end cancer.
  • Limited evidence exists on the effectiveness of tobacco-free hiring policies.
  • This study evaluates the impact of MDACC's tobacco-free hiring policy.

Purpose of the Study:

  • To assess the effectiveness of a tobacco-free hiring policy.
  • To analyze ethical and organizational considerations of tobacco-free hiring.
  • To determine the impact of tobacco-free hiring on recruitment.

Main Methods:

  • Program outcomes were evaluated.
  • A literature review was conducted.
  • Ethical and organizational considerations were analyzed.

Main Results:

  • Between 2015 and 2024, 41,797 tobacco screenings were conducted pre-hire.
  • Less than 1% (222) of screenings were positive.
  • 29 U.S. states (58%) have laws protecting smokers during hiring.

Conclusions:

  • Tobacco-free hiring policies can be implemented successfully with minimal disruption.
  • A low positivity rate (<1%) indicates feasibility.
  • Such policies may reduce employee tobacco use and protect individuals from secondhand smoke exposure.
Keywords:
health workplaceshospital employeesoccupational health policypre-employmentpublic health policysmokingworkplace health promotion

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