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Wed Feb 20, 2013, 06:27 AM

Penn Health System to stop hiring smokers

Source: Philadelphia Inquirer

The system, which includes the Hospital of the University of Pennsylvania, said the policy would improve the health of its workforce and reduce the cost of health-care benefits.

A job applicant must be tobacco-free for six months. New employees, including doctors, who are caught lying about their tobacco use may be fired.

Current employees are not subject to the prohibition, but they already pay a higher premium on their health-care benefits if they are tobacco users and are not participating in free antitobacco programs offered by the system.

In 2012, about 11 percent of employees who were part of the system's health-insurance program declared themselves as tobacco users. Their surcharge is $15 every two weeks.


Read more: http://www.philly.com/philly/business/20130220_Penn_Health_System_to_stop_hiring_smokers.html

46 replies, 3556 views

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Arrow 46 replies Author Time Post
Reply Penn Health System to stop hiring smokers (Original post)
onehandle Feb 2013 OP
eridani Feb 2013 #1
cartach Feb 2013 #4
amuse bouche Feb 2013 #9
eridani Feb 2013 #15
amuse bouche Feb 2013 #17
hack89 Feb 2013 #29
hack89 Feb 2013 #30
sweetapogee Feb 2013 #27
onehandle Feb 2013 #16
amuse bouche Feb 2013 #18
eridani Feb 2013 #43
JDPriestly Feb 2013 #23
yardwork Feb 2013 #28
geek tragedy Feb 2013 #34
BigDemVoter Feb 2013 #42
n2doc Feb 2013 #2
IdaBriggs Feb 2013 #10
LisaLynne Feb 2013 #3
eridani Feb 2013 #8
LisaLynne Feb 2013 #12
onehandle Feb 2013 #19
amuse bouche Feb 2013 #26
eridani Feb 2013 #41
beerandjesus Feb 2013 #13
LisaLynne Feb 2013 #14
christx30 Feb 2013 #44
LisaLynne Feb 2013 #46
JDPriestly Feb 2013 #22
LisaLynne Feb 2013 #24
dixiegrrrrl Feb 2013 #39
alarimer Feb 2013 #32
dotymed Feb 2013 #5
Kolesar Feb 2013 #6
RobinA Feb 2013 #7
hughee99 Feb 2013 #21
LisaLynne Feb 2013 #25
Jester Messiah Feb 2013 #11
msanthrope Feb 2013 #36
onehandle Feb 2013 #38
christx30 Feb 2013 #45
Cal Carpenter Feb 2013 #20
davidthegnome Feb 2013 #31
onehandle Feb 2013 #33
davidthegnome Feb 2013 #35
onehandle Feb 2013 #37
dixiegrrrrl Feb 2013 #40

Response to onehandle (Original post)

Wed Feb 20, 2013, 07:14 AM

1. Smokers should be payihg less

They cost the health care system less on a lifetime basis.

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Response to eridani (Reply #1)

Wed Feb 20, 2013, 07:59 AM

4. Czech Republic

had a study done by consulting and engineering firm KPMG a few years back which proved exactly what you say. Needless to say government officials rejected the report because they were looking for the opposite results to support a planned crackdown on smoking which they claimed would cut health care costs drastically. What the report showed was that smokers died earlier and already saved the government a large amount. The overall cost of health care would only increase if you extended smokers' lives. Talk to you later,I'm going outside for a smoke.

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Response to eridani (Reply #1)

Wed Feb 20, 2013, 08:17 AM

9. Smokers' diseases are expensive to treat

COPD, Lung Cancer and Emphysema, just to name a few. Though many more diseases are linked to smoking

The U.S spends more than 100 Billion a year caring for people with smoking related diseases

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Response to amuse bouche (Reply #9)

Wed Feb 20, 2013, 08:51 AM

15. Until the smoker dies, which is a lot sooner than a non-smoker

That's why smokers cost less on a lifetime basis.

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Response to eridani (Reply #15)

Wed Feb 20, 2013, 09:35 AM

17. That seems too simple

And it still doesn't cancel out the fact that treating smoking related diseases is expensive and completely preventable

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Response to eridani (Reply #15)

Wed Feb 20, 2013, 11:53 AM

29. End of life care can be extraordinary expensive

especially when compared to wellness care provided to a generally healthy person.

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Response to eridani (Reply #15)

Wed Feb 20, 2013, 11:55 AM

30. The median age for lung cancer diagnosis is about 70

so it is not killing them off that early. My father was diagnosed at 72 for instance.

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Response to amuse bouche (Reply #9)

Wed Feb 20, 2013, 11:24 AM

27. can you give an estimate?

How many in the Penn Health System workforce would you say report to work on a daily basis who have COPD or emphysema? Personally I would give the estimate of about 1% just based on my observations of patients with these issues and their likely ability to perform in the healthcare workplace environment.

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Response to eridani (Reply #1)

Wed Feb 20, 2013, 09:28 AM

16. LOL!

Nope.

Smoking is the single most expensive Optional 'habit' there is, healthwise. Period.

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Response to onehandle (Reply #16)

Wed Feb 20, 2013, 09:36 AM

18. I agree

and the excuses are moronic

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Response to onehandle (Reply #16)

Thu Feb 21, 2013, 01:51 AM

43. But it isn't, period.

The costs of treating smoking related diseases are more than offset ON A LIFETIME BASIS, by their earlier deaths. The longer you live, the more you cost the system.

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Response to eridani (Reply #1)

Wed Feb 20, 2013, 10:09 AM

23. Work days lost due to illness are also a cost.

Lower productivity due to illness may also be a consideration.

Also, the lower costs to the health care system are due to the fact that smokers do not live as long as non-smokers statistically speaking. That does not benefit individual employers who may have to cover the health care costs of the employee who dies younger but is unhealthier during his working years.

Medicare covers those who live to 65 and beyond. A lot of smokers don't.

Besides, generally doctors want people to quit smoking because doctors see the suffering that smoking causes. The doctors I know became doctors to stop or at least reduce suffering. The ones I know really want their patients to be healthy. That is why they campaign against smoking. It causes terrible suffering.

Everybody thinks of cancer of the lungs, but smoking is related to a lot of other cancers and bad conditions.

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Response to eridani (Reply #1)

Wed Feb 20, 2013, 11:25 AM

28. They may cost the system less but smokers cost more to insure.

That's what is driving these decisions. Health insurance companies charge more to insure smokers.

If didn't have private health insurance companies running our health care system then we would be able to make better decisions that improved everybody's health, and our costs would be much much lower.

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Response to eridani (Reply #1)

Wed Feb 20, 2013, 12:28 PM

34. Plenty of studies funded by the tobacco industry to back you up. nt

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Response to eridani (Reply #1)

Wed Feb 20, 2013, 06:13 PM

42. I don't necessarily disagree with you on principle. . . .

But smokers DO, in general, cost the heatlh system MORE money in the long run on a lifetime basis, as they generally require more care, and more expensive care, at that. I work in healthcare & see it every day.

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Response to onehandle (Original post)

Wed Feb 20, 2013, 07:38 AM

2. The new discrimination

Next, don't hire the obese. Then, don't hire anyone with an 'alternative' lifestyle into risky sports, then,don't hire anyone with pre-existing conditions,then, don't hire anyone who isn't married..

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Response to n2doc (Reply #2)

Wed Feb 20, 2013, 08:24 AM

10. NPR talked about that this morning: Obese people paying "extra"

for their "lifestyle choices."

http://www.npr.org/blogs/health/2013/02/20/172098418/money-replaces-willpower-in-programs-promoting-weight-loss

Sticking to a diet is a challenge for many people, but starting next year, Americans may have an even bigger, financial incentive to keep their weight in check. The new health care law includes a provision that would allow employers with more than 50 employees to require overweight workers who do not exercise to pay more to cover their insurance costs.

Some employers, inspired in part by the success of shows like "The Biggest Loser," are already designing weight-loss programs that use money to succeed where willpower has failed.

For Peggy Renzi and her colleagues at the Bowie Health Center in Bowie, Md., the war against weight is waged in the emergency room where they work.

The nurses say most of their patients are either overweight or obese. They sometimes require extra-large stretchers or ambulances, as well as extra nurses to haul all that extra girth, Renzi says.

(more at link)

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Response to onehandle (Original post)

Wed Feb 20, 2013, 07:44 AM

3. See, this is why all the employer-based "health care" initiatives worry me.

What I'm talking about are the pushes towards weight limits and whatever. Sure now it's like if you go and do the employer-sponsored health screening you can get a discount on your insurance premiums, but when do they decide to charge you more if your blood pressure is too high? We all agree that smoking is bad and most are fine with punishing smokers, but this sort of thing could be turned against others, eventually, who supposedly cost the employer too much in insurance. Even those who blame those of us who are over-weight as having some moral failing that needs to be punished could see how this could be turned eventually against older workers who may (or may not -- but the perception is there) have more health care costs? What about those who drink? Or do higher-risk sports on the weekends?

I know you can follow things out like this too far, but this just feels really, really wrong and that it's heading to a bad place, a place where employers can control our lives.

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Response to LisaLynne (Reply #3)

Wed Feb 20, 2013, 08:15 AM

8. Fat people, like smokers, cost a lot less on a lifetime basis

In fact, just about anything that's unhealthy saves the system money by shortening lifespans.

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Response to eridani (Reply #8)

Wed Feb 20, 2013, 08:43 AM

12. But the company won't have to pay ...

for the employees who live a long time. They'll force them out when they get a certain age and they are not on their insurance roles anymore.

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Response to eridani (Reply #8)

Wed Feb 20, 2013, 09:37 AM

19. You keep repeating that, yet it's not true.

Lumberjacks are more likely to die young, because they use chainsaws.

Hey! You read it here. Must be true.

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Response to eridani (Reply #8)

Wed Feb 20, 2013, 10:59 AM

26. More bull

A lifetime of treating diabetes and or heart disease is not cheap, even if it's a little shorter

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Response to amuse bouche (Reply #26)

Wed Feb 20, 2013, 05:24 PM

41. Cheaper or not, it still costs less.

I've posted this URL plenty of times. Where are yours?

http://www.nytimes.com/2008/02/05/health/05iht-obese.1.9748884.html

Preventing obesity and smoking can save lives, but it does not save money, according to a new report.
It costs more to care for healthy people who live years longer, according to a Dutch study that counters the common perception that preventing obesity would save governments millions of dollars.

"It was a small surprise," said Pieter van Baal, an economist at the National Institute for Public Health and the Environment in the Netherlands, who led the study. "But it also makes sense. If you live longer, then you cost the health system more."

In a paper published online Monday in the Public Library of Science Medicine journal, Dutch researchers found that the health costs of thin and healthy people in adulthood are more expensive than those of either fat people or smokers.

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Response to LisaLynne (Reply #3)

Wed Feb 20, 2013, 08:43 AM

13. Amen.

And to be clear, I'm generally not persuaded by "slippery slope" arguments. This policy is already odious as it stands.

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Response to beerandjesus (Reply #13)

Wed Feb 20, 2013, 08:51 AM

14. I respect that.

But yeah, as it stands, it's already discriminatory.

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Response to LisaLynne (Reply #14)

Thu Feb 21, 2013, 07:26 AM

44. It's not discriminatory

if it's something that you can control. I can say "I'm not going to hire someone that bashes themselves in the face with an axe every day."
All that person has to do is put down the axe and they are now eligible for hire. All you have to do is stop smoking and you're good. You'll also be healthier, and you'll have more money to spend on other things. Smoking is expensive.

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Response to christx30 (Reply #44)

Thu Feb 21, 2013, 08:39 AM

46. If you look at my other post,

I admitted I should have used another word. However, it's STILL employers trying to control what people do on their own time. And I don't for one minute believe that they really care about the health of their employees. They care about money.

Also, you're setting up something of a straw man to respond to. I never implied nor said that smoking isn't expensive, for everyone.

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Response to LisaLynne (Reply #3)

Wed Feb 20, 2013, 10:03 AM

22. If you have a condition you can't control, you may

have a disability. Smoking and most obesity are lifestyle choices. Some obesity is not a matter of choice. Smoking is always a matter of choice.

Smoking is not a disability, so I think smokers are probably not protected from workplace discrimination. Obesity -- may depend. I don't know how it could be determined whether a person is obese due to diet choices or metabolism. So that is a big question.

High blood pressure is also at least at this time not a choice. But some blood pressure medicines are very cheap.

So, I would prefer a single payer system that just covers everyone for everything, but that isn't what we have. Too bad.

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Response to JDPriestly (Reply #22)

Wed Feb 20, 2013, 10:28 AM

24. I was thinking I should have used a word besides "discrimination", but ...

at the same time, this is about employers trying to control peoples lives, IMHO. Some people do not want to take high blood pressure meds, for example, for many reasons -- some people have too many side-effects such as dizziness. I would not want an employer to be able to fire/not hire that person. I don't think that's right.

Edited to add that I think why this really gets to me is that, at the risk of sounding cynical, it's NOT that the employers really care about their workers. They care that they are costing them money. I think that's gross. I know we all expect that and it's come to be a good reason to do anything -- if not the only reason -- but I find something about it immoral.

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Response to JDPriestly (Reply #22)

Wed Feb 20, 2013, 01:21 PM

39. Smoking is an addiction, tho.

Even Phillip Morris admitted to adding increased nicotine to cigs to keep the smoker hooked.
So.....
will employers refuse to hire alcohol drinkers?

What about light smokers? Yep, I know people who smoke tobacco 2-3 cigs a week. Don't get how they can do that, but they can.

Fortunately, only about 23% of the pop. smokes now....
but still, slippery slope when employers can decided who is not worth insurance thus not worth hiring.

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Response to LisaLynne (Reply #3)

Wed Feb 20, 2013, 12:12 PM

32. I agree and I hate smoking with a passion.

I see this headed down a very wrong road for the same reasons you do.

With universal heath care, it wouldn't matter. Everyone would be in the same risk pool.

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Response to onehandle (Original post)

Wed Feb 20, 2013, 08:00 AM

5. This has been happening for a while in different companies.

The new paradigm: allow for pre-existing conditions but punish all who refuse to assimilate. Big Brother is watching.

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Response to onehandle (Original post)

Wed Feb 20, 2013, 08:04 AM

6. Cleveland Clinic made smoking cessation classes available to employees, then to the entire county

Cuyahoga County has 1.4 million people.
That was the initiative of CEO Toby Cosgrove.

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Response to onehandle (Original post)

Wed Feb 20, 2013, 08:12 AM

7. Frightening

Next - no overweight, no diabetics, no alcohol (there go most of the doctors they didn't get with the smoking ban). When only the perfect and perfectly healthy can get hired, this should turn around. Doubt I'l live to see it.

I, too, worry about the health surveys from my employer. I've been tempted to lie, but I have not. I have HTN.

Oh, and I forgot to add, no current or history of psychotropics.

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Response to RobinA (Reply #7)

Wed Feb 20, 2013, 09:52 AM

21. They'll have to make sure people aren't lying to them, so I hope people like drug testing, too.

I know not everyone with these health requirements does this now, but the honor system won't last forever, and then it will be up to the employee to prove what they're not doing on their off-time.

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Response to hughee99 (Reply #21)

Wed Feb 20, 2013, 10:31 AM

25. Yeah, I could see that with ...

alcohol and stuff. The honor system is already going away with the health screenings (which my employer does).

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Response to onehandle (Original post)

Wed Feb 20, 2013, 08:41 AM

11. Inappropriate.

What vices people may choose to indulge in in their private lives is their own affair. So long as it doesn't impede their work performance, the employer has no business intruding.

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Response to Jester Messiah (Reply #11)

Wed Feb 20, 2013, 12:42 PM

36. How does smoking not impede healthcare worker performace?

Smoking breaks, smelling like smoke in a hospital setting, bringing smoke and other toxins into a medical setting, litter....

that affects healthcare workder performance.

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Response to msanthrope (Reply #36)

Wed Feb 20, 2013, 01:09 PM

38. Yep. There have been several studies that prove that smokers are less effective workers.

Extra breaks, the mental distraction of cravings, and more sick days.

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Response to msanthrope (Reply #36)

Thu Feb 21, 2013, 07:33 AM

45. I have a co-worker

that smokes heavily on his breaks and lunches. He comes back to his desk and it just reeks for 30 minutes. I'd hate to have a doctor examining my kid with that smell wafting off of him or her.

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Response to onehandle (Original post)

Wed Feb 20, 2013, 09:39 AM

20. Slippery slope

Steep grade.

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Response to onehandle (Original post)

Wed Feb 20, 2013, 12:03 PM

31. Wow.

I'm not sure if it's a State or National tax, but here in Maine at least they're adding another dollar (or more) to the cigarette tax. The issue is that the intent is not really to improve public health or convince people to quit smoking. It's to raise revenue, which is what it usually is. Smokers are an easy target for this because it's an unhealthy habit, it smells bad, these dumb people should just quit, it's always a choice, right? I mean, it's not like it's an addiction that's as difficult to break as alcoholism, heroin, and so on. Of course, in this case, they shouldn't have started to begin with, right?

The thing is, most smokers aren't going to just quit, cold turkey or otherwise. They're going to try to work more to afford their habit, they're going to sacrifice other things to pay for it as well. I think a lot of people are confused about what an addiction actually is. Smoking begins with a choice, often made at a young, impressionable age. What it becomes in the years that follow is an extreme addiction. The contempt for smokers here is no better than contempt for alcoholics, drug addicts, gambling addicts, or any other sort of addiction.

So now there are going to be limits as to where smokers can work. Hospitals will lead the way with this sort of thing, afterwards it will likely become common with larger corporations, and then down to the privately owned businesses. So, these people, with this expensive addiction who often become ill as a result, will have many fewer options as for where to work. Perhaps, eventually, if enough is taken or lost, they will be forced to cease their habits.

So... has anyone considered the amount of money that will be lost in tax revenue? If we're going to look at it from an entirely practical, financially beneficial point of view, I mean. The sin tax on products like cigarettes must amount to an enormous figure in overall revenue on a yearly basis.

Of course, if smokers become unemployable, many of them, rather than quitting, will apply for federal assistance. So the products will still be bought and sold - the difference is that now the average tax payer is supporting this habit. Until, eventually, perhaps smokers will be denied access to federal aid as well.

What a mess. This issue is not nearly as black and white as some seem to think. Yeah, I'm a smoker, I've quit four or five times over the last fourteen years and I'll likely quit again at some point. It's a damn hard addiction to break though - and I'm not convinced I'll ever be able to break it permanently, despite my best efforts.

I think some need to remember that they're dealing with human beings with an addiction. Not just a bad habit.

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Response to davidthegnome (Reply #31)

Wed Feb 20, 2013, 12:17 PM

33. Most smokers are poor. As the price of smoking rises, and the places you can smoke diminish...

...smoking rates will drop.

Tobacco, like lottery tickets, are a tax on poor people.

The states will have to take up the slack by taxing the rich.

Win-win, imo.

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Response to onehandle (Reply #33)

Wed Feb 20, 2013, 12:29 PM

35. That's what logic would suggest.

Perhaps you're right. I hope you are. I can tell you though, that, as one of those poor smokers, my first thought is to wonder how I'll be able to afford it, rather than a solid decision to quit. I don't know if you've ever had to break the addiction, or a similar one, but I have - and it's really, extraordinarily unpleasant (which is an understatement). Anxiety attacks, greatly increased stress, irritability, in some instances extreme depression and even aggressive and/or violent behavior should be expected.

Smoking rates will inevitably drop as the price goes up and more limits are placed on where you can smoke, I'm just not convinced that the slack will be taken up by taxing the rich. Consider electronic cigarettes, for instance, the tax on those products may go up instead. Perhaps the alcohol tax will become greater to make up the slack. One thing I am convinced of is that the rich, rather than eagerly embracing new taxes, will find another tax for poor people.

Think about facebook, the reported profits and the fact that the company, rather than paying taxes, received tax relief in the amount of over 400 million dollars. The rich will find ways to stay rich and to become richer. The poor, not so much. Get rid of smoking and the sin tax and something equally as devastating to the poor will take it's place.

The solution, I think, lies in compassion, in understanding the addiction and coming up with better ways to treat it - some effort has been made in this regard, but it is not nearly enough. What we need for real change is simply too difficult, too expensive, too work and time intensive for most people to honestly support it - if they aren't smokers to begin with.

Of course, I could be wrong. Maybe this will work out like you think it will. I'm something of a pessimist myself.

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Response to davidthegnome (Reply #35)

Wed Feb 20, 2013, 12:58 PM

37. Hey, I'm a Democrat. I would put billions into a massive stop smoking program...

...hiring ten thousand per average state, and setting up a facility within half an hour of most every American.

But people like Ted Cruz, Michelle Bachmann, and Nicki Haley have a firm grip on the balls of the nation.

Entropy currently dictates the future. If trends are to be believed, their racist, Fox News watching base is going away and the country will Blue these asses out of office.

Then maybe we can be proactive.

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Response to davidthegnome (Reply #31)

Wed Feb 20, 2013, 01:29 PM

40. You are correct. In fact, nicotine is as addictive as cocaine.

From the CDC:
Nicotine Addiction
Nicotine dependence is the most common form of chemical dependence in the United States.
Research suggests that nicotine is as addictive as heroin, cocaine, or alcohol.


http://www.cdc.gov/tobacco/quit_smoking/how_to_quit/you_can_quit/nicotine/

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