Nicotine Detection in Blood

[tuold]

A non-smoking pharmacist I know was teaching a smoking cessation class. Nicotine gum was part of the class materials which was made available at some point to the class participants. My friend decided to experience the taste of the gum along with the class so she chewed on a piece for a few minutes.
The next day she reported to a medical lab in order to get blood drawn as part of a new job screening process. A couple of weeks later she received a notice in the mail that nicotine had been detected in her blood sample. As a result, her insurance premiums were going to be jacked up 30% for three months and she would be required to take a smoking cessation class, the very one she had been teaching! Her written protestations were to no avail.
This is what we are up against. I can tell you from my experience, if you have told your doctor you use tobacco of any kind, it is probably noted on your electronic medical record that you have a "Tobacco Disorder". The ramifications of that will probably become more serious as your once private health issues becomes more of a public issue.

 

[drwatson]

But let's make pot legal :crazy:

 

[ravkesef]

I believe the forum rules prohibit political discussion in any form.

 

[taerin]

Talking about Obamacare is generally against forum rules, it gets people too fired up and they attack each other every time. The OP though definitely posted a good subject, it's scary out there!
While my health insurance doesn't care if I smoke or not, I am sure her's did because it was an employer sponsored plan. Anyway this plain sucks, as she never smoked once and a smoking cessation device jacked her rates up and made her take a class, how does someone quit without getting hammered the same way as smokers? Cold turkey I guess... It's just plain sad when cessation devices are lumped in with cigarette smoking.

 

[tuold]

My intention in bringing this up has nothing to do with politics but a lot to do with policy and social issues regarding your personal choice to use tobacco. I think the course we are on is an inevitable one given the lack of engagement by young people in policy issues, especially when it comes to things they feel don't necessarily affect them.
For a lot of us older codgers the world we live in now is a lot different than the one we grew up in. It just so happens that we tobacco users are the ones who come face to face with changes most often, particularly those with regard to freedom and liberty. The older I get, the more squeezed in I feel.
When I first started working I remember smoking cigars during staff meetings. Now, thirty years later there is no smoking anywhere ten feet near the outside of the building!
Also, it used to be your medical records, if you had any, where kept in a folder in a secure room. Now any "authorized" person can access them just like you would a Web Page thanks to the the mandate that all medical records be electronic.
I hope I'm not being too paranoid or pessimistic by bringing this up for discussion. For me, it's all about personal liberty and its rapid disappearance. Watch your legislators. Are they passing laws that leave you more free or less free? Vote accordingly.

 

[ravkesef]

My objection is not to the Original Post, as it is entirely within the purview of our forum, and, quite incidentally, it reflects a point of view with which I wholeheartedly concur. My objection is to the second post which decided to go off on a tangent about Obamacare. Many if us don't like Obamacare, many if us do. But this is not a forum for posting about it, and the forum rules specifically prohibit that, along with tasteless political cartoons of the President of the United States. Again, there are forums for that. This isn't one of them. It's about pipes and tobacco. Hope this helps clarify matters.

By the way-- what are my opinions of Obamacare? I'm not going to say-- but you may PM me and we can discuss it.

 

[brian64]

The next day she reported to a medical lab in order to get blood drawn as part of a new job screening process.

In addition to the issues regarding government and health care, it’s amazing how we have all become accustomed to such practices as this in order to be employed in the corporate world.

 

[chemistfox]

I'm about to have to deal with some insurance changes. Don't know how it will turn out. It's a scam anyway. I'm tempted, really tempted, not to get it. Don't know if they'll care if i smoke.
It begs the question: What about second-hand smoke and nicotine associated with that. I mean, if chewing a piece of gum gets you busted then a night at a smoky bar should too, right???

 

[latbomber]

Oh dear here we go again.... *opens umbrella*

 

[swampmouth]

I'm practicing civil disobedience, ie no insurance. In my experience, permission is needed to draw your blood. Be careful what you sign. The law says you have to be insured, it doesn't say you have to go to the doctor. We are all technically "sick" mentally so watch what you say, or admit to. I was in for a TB test and was grilled about being depressed. Apparently the state required it of the clinicions. Welcome to nationalist socialism. "The needs of the many outwiegh the needs of the few or the one." I, for one, don't mind being part of a dying breed. At least I got to live a little. Smoke em if you've got em.

 

[mso489]

Partisan politics aside, how do we maintain any concept of privacy in the age of the silicon chip?

Most of us eagerly carry devices that can track us where ever we go and collect information about us

in infinite detail. Like what we said on Forums five minutes ago. And no agency has to decide

to gather the information, it's just there to be abused by big brother, hackers, drug cartels, you

name it/them. No one wants to monitor my boring old phone calls, or emails, or Forum posts,

but they are there and readily available, along with much else. A philosophical question, a huge

policy issue, a technological conundrum, and a vast intellectual challenge. Big brother is watching,

even if he doesn't want to!

 

[rmbittner]

tuold wrote:
"if you have told your doctor you use tobacco of any kind, it is probably noted on your electronic medical record that you have a "Tobacco Disorder". The ramifications of that will probably become more serious as your once private health issues becomes more of a public issue."
You seem to be making some very sweeping generalizations based on nothing more than two "probablys." They aren't even verifiable facts, just two assumptions that have been made, based on an anecdote told by a friend.
Bob

 

[pylorns]

@rmbittner If you are smoking tobacco AND the provider is using an EHR (Electronic Health Record Software System) that is certified then when you tell the provider you smoke - they document it in the system which goes into several sections - one of which is required to meet Meaningful Use standards so the providers can get paid by the government.
Essentially Meaningful Use Stage I says that you have to meet a set of criteria as a doctor - you have to have proper demographics in the patient record, you have to record the patients smoking status in the Patient history, you also should collect family history if there are smokers in the family. Additionally a template and guidelines are given to find out how much is smoked, how many times a day etc. While its generally geared towards cigarettes, there is a place to put in other types of tobacco.
Providers that meet All the stages of Meaningful Use starting from 2011 through 2016 (although its getting extended) Will receive $44,000 from medicare or $63,000 from medicaid. To incentive them to purchase an EHR and then of course follow the criteria set forth in the law.
Furthermore after the initial period providers (doctors) who don't meet the meaningful use standards and who take medicare and medicaid will actually be penalized and receive less reimbursement from the government.

For 2015 and later, Medicare eligible professionals who do not successfully demonstrate meaningful use will have a payment adjustment to their Medicare reimbursement. The payment reduction starts at 1% and increases each year that a Medicare eligible professional does not demonstrate meaningful use, to a maximum of 5%.

If you're more curious you can go here http://www.cms.gov/EHRIncentivePrograms/
Meaningful Use Stage 2 mandates that providers are able to upload to an HIE - essentially uploading your data to a data warehouse where "authorized persons" can access your data.
To sum up:

1. Providers are being paid (and required )to collect your smoking information.

2. Providers are being paid (and required) to upload your PHI (personal health information) to a repository online where others can access.

3. Providers that don't do meaningful use will be penalized for not doing it.
And Yes, I work in the medical industry. And the law actually came from the stimulus package back in 2008/2009.

 

[peter70]

I wonder, why a professional chose to try nicotine gum one day before a scheduled blood analysis. That is like taking a few drags from the bottle, while waiting in the line for a police car control.

 

[taerin]

She probably didn't know that they were testing for nicotine and just assumed it was for real drugs.

 

[tuold]

Even as a pharmacy technician I have to have a blood test yearly since I'm exposed to chemo meds on a daily basis. I assume they are looking for abnormal values from exposure, but now I'm wondering what else they are looking at.
I used to think that as I approach retirement I could adopt the attitude of "to hell with it all". But it looks like I'll be under the microscope until my last breath. Cradle to grave baby!

 

[taerin]

You know the old saying "ignorance is bliss" well it seems most of our country is having lots of bliss at our expense. I feel for ya tuold, you paid all your dues and got cancer, the least they could do is let you spend your final years, decades, or whatever the way you want to without penalty.