Memorial Health Care System in Chattanooga, Tennessee has started testing new hires for tobacco use, along with other standard drug tests. Anyone who tests positive will have their job offer withdrawn.

Current workers aren’t affected by the new policy.

The hospital is making the move to provide a healthier environment for workers and patients — and to save the estimated $3,000 to $4,000 per year in health care costs that smokers ring up.

It’s similar to the policy at a handful of other hospitals, including the Cleveland Clinic.

Some critics say the policy is discriminatory — after all, no one is testing to see how much exercise new hires get or if they indulge in too many between-meal chocolate bars.

But even some workers say the prospect of losing out on a job is good motivation to quit.

A health policy adviser was fired for saying out loud what many medical professionals already think: Alcohol and tobacco are more dangerous than many illegal drugs.

Dr. David Nutt, a respected scientist, was the chair of the U.K.’s Advisory Council on the Misuse of Drugs. This fall, he questioned the nation’s policies for determining which drugs should be restricted. In the course of his speech, he cited the “Mean Harm Scores for 20 Substances,” a well-regarded study which ranked drugs on their addictiveness, harmfulness to the user’s physical health, and threat to society.

The study, which came out about two years ago, unsurprisingly ranks heroin as the top threat, followed closely by cocaine, barbiturates and street methadone. Alcohol holds the fifth place on the list, above tobacco (ranked 9th), and several illegal drugs, including marijuana (11th), LSD (14th) and ecstasy (18th).

Nutt urged policy-makers to give more weight to such science-based rankings when assessing drug laws and regulations.

He was dismissed from his post on the Council the next day.

Science vs. culture?

The sticky truth is that culturally, booze and tobacco are more acceptable than other drugs, despite the fact that other substances, like LSD and pot may be less physically damaging. And politicians or other public figures who are eager to not appear “soft on drugs” may not be interested in hearing scientific research that flies in the face of current social norms.

No reasonable person wants to ban beer based on the study, or to legalize any drug that’s less addictive than cocaine. But to formulate good health policies, researchers have to be able to honestly discuss the results of their research — no matter what the results may be.

How can health practitioners and advisers give good advice if they fear getting flak — or even getting fired — just for mentioning good science that happens to be inconvenient? Share your thoughts in the comments.