Health: Get fitter, work harder: As employers 'downsize' on staffing, some are trying to make sure those left are well enough to do the job. Helen Kogan reports

Employees forced to have their lunchtime cigarettes in wind-swept doorways have become an increasingly common sight in city streets. But, according to a recent survey, these smokers should count themselves fortunate. Out of the 731 companies questioned by Reed Personnel Services this summer, 30 per cent say that they would recruit a non-smoker rather than a smoker, given the same qualifications. Smoking, it seems, ruins your health and your job prospects.

It was the sight of the outdoor smokers that inspired Alec Reed, chairman and founder of the Reed employment agencies to organise the survey. The results revealed a measurable social change.

This move to health policies in the workplace is partly due to a growing awareness of the financial drain of sickness absence payments which, according to the CBI, cost British industry pounds 13bn a year.

But another reason for the interest in corporate health programmes is that employers have greater performance expectations of their staff because of 'downsizing'. Employees have to work harder so their health is now seen as an important contributory factor to their ability to maintain the pace.

The Government, too, has become aware of the need to reduce health- care bills through preventive action. The Department of Health has recognised that the workplace gives unique access to the 'well' population. Links have been formed with businesses, resulting in the 'Look After Your Heart Campaign' in the late Eighties and, more recently, workplace alcohol and addiction initiatives.

As a result, many larger companies have begun to consider implementing workplace health programmes covering a range of activities such as fitness classes, give-up smoking sessions and weight counselling.

Those mourning the loss of boozy lunches and fuggy, smoke-filled offices have argued that this is a new puritanism dressed up as an employee benefit. Chris Tame, director of Freedom Organisation for the Right to Enjoy Smoking Tobacco (Forest), says: 'Employers act as if they own their employees. For example, what's to stop them forcing an overweight employee to go jogging to safeguard their job?'

But advocates, backed by some impressive results from early programmes in the United States, point to the benefits.

In the UK, too, companies that actively promote employee health can measure the effect. The Don and Low Group, textile manufacturers based in Tayside, saw a fall in absenteeism of 1.5 per cent among 800 employees between 1986 and 1990 following a health programme. It included subsidised sports arrangements with the local council and a health education programme giving advice on diet, alcohol, drug abuse and stress management. When the cosmetic company Rimmel International launched a repetitive strain injury (RSI) and back awareness programme, it reduced days lost to back injuries from 74 in 1990 to 21 in 1992.

The Wellness Forum was launched in 1992 by a group of companies to promote research and provide information on workplace health programmes. It has 35 members, including Glaxo, Grand Metropolitan, British Telecom, Whitbread and the Post Office. Dr Robert Smith, its chairman, says: 'Health programmes are a positive help to staff but I don't think that there is any evidence that they discriminate against staff who don't want to participate.' But when it comes to using smoking as a test in recruitment, it is down to the individual to choose. 'People who smoke should now accept that they have imposed limitations on themselves in terms of job opportunities,' he says.

Health programmes do not have to go hand in hand with discriminatory policies. Mobil Oil, a Wellness Forum good practice award-winner, has introduced pre-employment assessments and employee health screenings governed by strict rules of confidentiality and sensitivity.

The pre-employment assessment looks at how work practices would exacerbate an applicant's existing health problems. Kate Goodwin, occupational health adviser for Mobil Oil, runs the in-house health promotion programme for employees: 'We don't screen out at all. It has to remain voluntary - you can't police individuals,' she says.

One employee, Paul Lewis, a business analyst, underwent the company health checks and was advised to lose weight. A programme designed by the company's occupational health department over 18 months resulted in a loss of 22lb. 'There was no overt pressure on me to lose the weight but it was suggested that I should take better care of my health,' he says. 'The decision to do something was entirely personal. I'm generally much fitter and it's made a big difference to my lifestyle.'

Other companies may not be so generous. The use of lifestyle factors in recruitment and work practices raises the spectre of management, with little understanding of the complexities of behavioural factors, creating real problems for those least able to make changes.

There is evidence that health choices are affected as much by socio-economic factors as by individual actions. The Black Report in 1980, and Margaret Whitehead's follow-up, The Health Divide, in 1992, established the argument that risky health behaviour is affected by elements out of the individual's control such as food prices, housing conditions and community services.

Whitehead also suggests that tobacco and alcohol help people to cope - small pleasures, she says, 'to make depressing circumstances bearable'. 'In some workplaces, for example,' she says, 'smoking can be the only accepted reason for taking a break.'

(Photograph omitted)