A burning question: Do smokers have to tell employers about habit?

Some employers are trying to get to know their workers a little bit better — and one of the things companies are curious about is whether you are a smoker.

Lots of companies gather and analyze worker information to better design wellness programs in an effort to eventually drive down health-care cost.

Asking employees to fill out a health-risk questionnaire is one of the ways companies compile the information they need. Benefits attorney Edward Leeds says, inevitably, one of the questions is: Are you a smoker?

“In general, you are not going to be required to fill out one of these forms,” said Leeds of the Philadelphia law firm Ballard Spahr. “I’ve not had clients, myself, require that information.”

Answering those questionnaires may be voluntary, but Leeds says many employers offer incentives to sweeten the pot and get workers to participate. He said cost-conscious executives often wonder if they can ask smokers to pay a little more for health care.

It’s tricky.

Leeds said there’s much unresolved tension between supporting employers in their quest to lower health expenses and the interest in protecting workers’ privacy and preventing discrimination

“Those two aims are kind of jarring against each other right now,” he said.

The Health Insurance Portability and Accountability law, or HIPPA, is probably best known for protecting patient privacy, but Leeds said it also prohibits unequal treatment based on illness or disability. The rules apply to how much workers pay for their coverage.

“Under HIPPA, nicotine addiction is considered an adverse health condition,” Leeds said. “That raises the question of whether employers are going to try to distinguish among employees who smoke, whether it’s a choice to smoke or whether it’s a matter of being addicted to nicotine. No employer wants to get into that inquiry.”

Health benefits expert Peggy Schubert, who works for Gallagher Benefit Services, said charging smokers a premium for health insurance is often part of a wider conversation.

“Is it extremely common? No. Not at this point,” Schubert said.

Some of her clients have considered banning cigarettes on campus or offering smoking-cessation classes for free. At the other end of the spectrum is refusing to hire smokers.

“When they go down that path, we say to them: What’s going to happen when you need to hire someone who’s an absolute talent that you need to have for your business, and they smoke?” Schubert said. “You are either all in or all out on that.”

Schubert encourages senior managers to consider all the factors that can make health care expensive. “I think it’s really important to make sure you have the data on what is really driving up costs,” she said.

Employees may ask, “‘If you are starting here with smoking, are you going to do this if I’m overweight? Where does it stop?'” Schubert said. “Employers need to be prepared to answer those questions.”

Estimates vary, but compared with non-smokers, smokers can cost a firm from $1,500 to $2,500 more in health expenses each year.