Smokers charged extra to work in US

SmokerSmokers who work for US department store Macy's are now being surcharged $35 a month for health coverage. The chain joins PepsiCo and Gannett in imposing a charge on employees who like a drag, while some, such as Union Pacific, refuse to hire smokers at all.

Smoking costs the US more than $193bn a year according to the US Center for Disease Control and Prevention, which bases that figure on a combination of medical spending and productivity losses. A smoker is said to be 18% more expensive than a non-smoker for employers.

Health plans

There's now extra pressure on US firms because health legislation passed last year means companies which spend more than average on their health plans will have to pay an additional federal tax from 2018. So employers have to either cut benefits or keep costs down.

Because quit smoking programmes have a higher success rate, 25%, than most other wellbeing schemes, it's here that employers are looking. If employees manage to kick the habit the cost will be deferred. And this is not the only way US companies are trying to get staff to take care of their health.

Staff at Scotts Miracle-Gro cut insurance rates by up to $60 a month for staff who get their weight, cholesterol and blood pressure checked regularly. It says its health premiums have risen by about half the US average since it implemented the policy.

National Health Service

The issue of employee health insurance is highly-charged in the US, which does not have a National Health Service. But the measure has attracted criticism from people who think it means companies are taking too active a role in telling individuals what to do.

In the UK, smoking is estimated to cost the NHS more than £5bn a year according to research by Oxford University's Health Department carried out in 2009. In a time of cuts and austerity, how long will it be before we see more interventionist policies on smoking introduced here?