Employment Advice for Job-Seeking Smokers: Quit

When I first read the article in this issue of JAMA Internal Medicine by Prochaska et al,1 I thought: Of course, smokers in the San Francisco Bay area, where smoking is a highly stigmatized behavior, are going to have more trouble than nonsmokers finding employment. In the supermajority world of nonsmokers, who wants a smoker as a coworker? However, Prochaska et al1 helped me to see that their results have a more important meaning. Their adjusted model predicts that if all the participants in these 2 employment development programs who were smokers became nonsmokers, there would be a 24% increase in employment. Therefore, support for smoking cessation, including referral for cessation medications, should be a standard part of employment counseling. For smokers seeking employment, we can add another motivation for quitting to all the health and longevity benefits of cessation: increased likelihood of finding a job. Physicians should advise job seekers who are still smoking to buff up their resume and set a quit date.