Enhanced Tobacco Control Initiative at Johns Hopkins Health System: Employee Fairness Perception

Shabnum Durrani, Meg Lucik, Richard Safeer

Research output: Contribution to journalReview articlepeer-review


Organizations often fail to establish a clear awareness of what employees consider fair when implementing changes to employee benefits in the workplace. In 2016, the Johns Hopkins Health System (JHHS) enhanced their tobacco control efforts. In addition to enhanced smoking cessation benefits, employees were offered an increased reduction in their insurance premiums if they were nonsmokers. To qualify for the reduction, employees participated in testing rather than relying on self-reporting as had been done in the past. The shift to testing prompted a concern by some senior management at JHHS who did not want employees to feel they were not trusted. As the program unfolded at JHHS, the four-component model of procedural justice was applied to provide a framework for reviewing the implementation of the new voluntary tobacco testing at JHHS from a fairness lens. The purpose of this article is to illustrate the application of the four-component procedural model of justice to the tobacco testing process at JHHS. As approximately 75% of employees participated in the program, the experience at JHHS can be instructive to other employers who are looking to implement changes in their workplaces and how to minimize unintended consequences with their employees.

Original languageEnglish (US)
Pages (from-to)206-213
Number of pages8
JournalHealth promotion practice
Issue number2
StatePublished - Mar 1 2019


  • behavior change
  • cessation
  • tobacco prevention and control
  • workforce development

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Nursing (miscellaneous)


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