The Association Between Smoker Protection Laws and Smoking, Employment, and Attempting to Quit Smoking

Globally, workplaces have introduced non-smokers-only hiring policies to avoid hiring people who smoke since they cost thousands of dollars more annually to employ compared to non-smokers. Tobacco industry efforts gave rise to state smoker protection laws in the United States (U.S.), which protect people who smoke from employment discrimination.

This study examined the association between living in a state with a smoker protection law and smoking status among U.S. adults and employment status and attempting to quit smoking in the past 12 months among those who currently smoke.

Cross-sectional, nationally representative data from the 2015 - 2018 Behavioral Risk Factor Surveillance System were analyzed. Participants were U.S. adults who reported being unemployed or employed for wages. Unadjusted and adjusted logistic regression models controlling for race/ethnicity, income, education, health insurance, state, and sex assessed associations between living in a state with a smoker protection law and smoking status (n = 678,203) and employment status and attempting to quit smoking in the past 12 months among people who currently smoke (n = 110,630). Interactions for income were assessed.

Smoker protection laws were not associated with smoking status in the overall sample (OR_adj = 0.99, 95% CI: 0.89, 1.11) or employment among those who smoke (OR_adj = 1.23, 95% CI: 0.92, 1.65). They were associated with a significantly higher odds of being employed (OR_adj = 1.30, 95% CI: 1.06, 1.60) among those who smoke earning <$35,000. They were associated with a significantly lower odds of attempting to quit smoking among people who smoke (OR_adj = 0.80, 95% CI: 0.66, 0.97), especially those earning <$35,000 (OR_adj = 0.71, 95% CI: 0.53, 0.96) and $35,000-<$50,000 (OR_adj. = 0.52, 95% CI: 0.32, 0.84).

While smoker protection laws may promote employment among low-income individuals who smoke, they may reduce quit attempts. Policies should promote evidence-based smoking cessation treatments to support quit attempts among people who smoke.