Smokers need not apply. That's the word from Orlando Health, which announced this evening that it will start a tobacco-free hiring policy at seven of its hospitals starting in April.

The move is part of a controversial nationwide trend, in which hospitals are leading the way.

Current Orlando Health employees who smoke will be exempt from the policy, but new hires must not use tobacco in any form, said hospital system spokeswoman Kena Lewis.


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"Our new tobacco-free hiring rule reinforces our culture of prevention and wellness for team members, patients and the Central Florida community," said Christy Pearson, a human resources executive for Orlando Health. "It is our way of leading by example."

Job candidates who get an offer will continue to take a urine test that screens for drugs, but starting April 1, the test will also screen for cotinine, a by-product of nicotine.

The test will detect all tobacco substances, including pipe tobacco, snuff, chew, smokeless tobacco and patches.

"If you're a regular user, it will show up," said Lewis. The cotinine level can determine whether an individual is a primary tobacco user, which would block a hire, or is simply being exposed to second-hand smoke.

If a job candidate gets an offer, then tests positive for tobacco use, the offer will be rescinded. "The message is, if you're interested in working here, don't use tobacco," said Lewis.

The new rule broadens an existing ban that went into effect in 2008 and prohibits smoking on any Orlando Health hospital campus.

Two years ago, Florida Hospital Waterman in Tavares and Florida Hospital Fish Memorial in Orange City implemented a ban on hiring smokers. Florida Hospital Flagler in Palm Coast also has a ban.

Other Florida Hospitals in Central Florida have not started the policy, said Florida Hospital spokeswoman Samantha O'Lenick. However, all ban smoking on their properties.

Orlando hotelier Harris Rosen maintains a no-smoking policy for employees of his seven area hotels. If tobacco tests detect the presence of nicotine, the offense can lead to counseling or even termination.

Critics say the shift from smoke-free to smoker-free workplaces smacks of job discrimination.

In reaction to a similar announcement Wednesday from University of Pennsylvania Health System stating it would not hire tobacco users as of July, Dr. Michael Siegel, professor of public health at the Boston University School of Public Health, wrote a strongly worded blog post.

"Employees should be hired based on their bona fide qualifications for a job, not based on a group to which they happen to belong when that group membership does not relate to a specific job qualification," wrote Siegel.

"Once employment discrimination is justified on the grounds of saving money, then the same reasoning would justify discriminating against obese people, persons who consume alcohol, individuals who do not wear seat belts, persons who talk on their cell phones while driving, motorcyclists, and virtually any other group that an employer does not want to hire."

Nonetheless, employers continue to adopt such rules in an attempt to reduce health-care costs by having a healthier workforce.

Cigarette smoking costs the United States more than $193 billion each year, according to the Centers for Disease Control and Prevention. One in five U.S. deaths is attributed to smoking.

Such policies are taking hold in other hospitals across the country as well as other industries. The Baylor Health Care System in Texas started the ban last year, and the Cleveland Clinic stopped hiring tobacco users in 2007.

However, most states don't allow such hiring bans.