Drug screen now includes screen for nicotine. Is this legal?

Nurses General Nursing

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I was filling out an application for a local hospital and as I was getting ready to submit my application it was in very small print that in addition to other substances to be tested for in a drug screen that they would test for presence of nicotine and if found the candidate would not be hired under any circumstances and the offer would be withdrawn.

I am not a smoker but I was absolutely flabbergasted at this. I know as a nurse and a person being a smoker is bad for your health but so are other things in life that human beings do to their bodies.

My question is this legal ? I mean nicotine is a legal substance for adults to use. This particular hospital system has so many openings for nurses that are never filled perhaps this is why. I know many nurses and doctors, and EMTs that smoke and are great clinicians. I know for years hospital systems have told employees that they cant smoke even in their automobiles on hospital grounds but to do this is just awful in this time of not enough nurses anyway. I am thinking this for health related cost in benefits but this is system wide whether you are benefit eligible or not.. Your thoughts on this are appreciated.

Specializes in ER/ICU/STICU.

Of course it's legal. They can have a mandate that states they won't hire anyone if his/her favorite color is green. This is well within the employers rights and as long as they are not discriminating as defined by the EEOC there isn't too much anyone can do except work somewhere else. The law is not always "fair".

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The point (I believe) of the OP's post is: smoking is legal. drinking is legal. Can the hospital mandate what the employee does when they're not at work. Are they going to check and see if you had a glass of wine after dinner last night? Alcohol causes all kinds of health related diseases and can drain financial resources, are they going to check on that? No one is saying that smokers should be allowed to smoke AT work, but what about after? Tanning isn't good for us either, perhaps we should intervene if someone comes to work looking a bit too tan? Or someone's butt is a little too big, maybe we should check their cholesterol. Someone have a new baby and not breastfeeding? Maybe we should call social services, since we all KNOW breast milk is better. This insanity has got to stop, and sooner rather than later, I hope.

Yes, I agree that hospital's have the right to hire/fire whomever they want. But I think it's just plain wrong, to dictate what people do legally on their own time. I would not work for a company like that. Let the flaming begin!

It has nothing to do with it being legal or harmful to your own body. It has to do with the proven dangers of third hand smoke in a smoker's hair, nails, skin, and clothes. It is proven that there are carcinogens in third hand smoke. It is also been proven that in respiratory patients, it can cause an exacerbation of symptoms. I have only come in to contact with 2 facilites that refused to hire a smoker. One was a asthma/pulmonology clinic and the other was a cancer treatment facility.

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Specializes in Oncology, LTC, Rehabilitation.

Well said! Couldn't agree with u more. Maybe the powers that be will also discriminate against people who eat to much fat in their diet? We know it causes colon cancer, and God forbid, what if an applicant is over weight? Maybe 18 pounds too much is tolerated, but 22 pounds you are too "risky"? We all know how horrible smoking is. But I am not to excited about being told how to live every second of my life how I am to live. Where does it stop? There is a reason that 29 states won't allow nicotine testing. Big brother is indeed watching!

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Specializes in orthopedic/trauma, Informatics, diabetes.

When I was a teacher, they started testing for nicotine for health insurance reasons. if you smoked or were morbidly obese, you had to pay more for health insurance provided by the school system. I have always been under my husband's insurance so it did not affect me. I don't smoke, so it is a moot point. It was amazing though how many teachers had WLS to get their weight and BMIs down.

I think the risk of second hand smoke is so great, they would have to have a test that wasn't so sensitive that it might show up. I swear I would test positive from some of the people I ride the elevator up with! Nasty!

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Specializes in Critical Care; Cardiac; Professional Development.

The above poster is right...this is more for the rising costs of health insurance than it is for the third hand smoke issue.

My last three employers have tested for nicotine. One would withdraw the offer of employment. The other two had a hefty surcharge added to the cost of the employee's health benefit. My most recent now actually has five levels of insurance premium with five different things they look for.... blood pressure, LDL, HDL, smoking status and waist circumference (35 inches or less for women, 40 inches or less for men). If you meet the bar in all five your health insurance premium is impressively low. It goes up from there for each mark you fail to hit. If you are a smoker you have an additional surcharge on top of the increased premium. If you refuse to participate in testing, if you meet no marks or you meet only one, your insurance premium is pretty darn expensive.

I don't mind this. It seems fair to me. Every year you have the chance to improve your benefit level. Given the monthly cost, I find it motivating to improve my standing.

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A patient has the right to not be confronted by a nurse who smells like an ashtray. Fair or not, there it is.

Double standard that happens to bug me is that a patient has the right to refuse care from a nurse who reeks of cigarette smoke but I can't refuse to care for a patient whose visitors stink up the room so bad I risk choking to death from the smell of it. Sure I can request an assignment change but reality is that's usually hard to do and can't always be accommodated so I have to deal with the stank of a roomful of smokers. But I digress.

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This is a growing trend. I understand that smoking is unhealthy but so is eating bacon and donuts for 3 meals a day. Are they screening for that? Illegal and mind altering substances? I get that. But a perfectly legal cigarette that can be purchased at many pharmacies for crying out loud, that's a whole other level of getting into personal choices.

And no, I don't smoke. I do know several nurses, good nurses I would trust with my life, who do.

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This is a growing trend. I understand that smoking is unhealthy but so is eating bacon and donuts for 3 meals a day. Are they screening for that? Illegal and mind altering substances? I get that. But a perfectly legal cigarette that can be purchased at many pharmacies for crying out loud, that's a whole other level of getting into personal choices.

And no, I don't smoke. I do know several nurses, good nurses I would trust with my life, who do.

Some facilities are providing BMI based incentives at least.

I think it depends on why you are screening, I think it is inappropriate to screen for employment purposes in most cases for things like nicotine or BMI but most places doing this seem to be doing it for cost control reasons with health benefits.

I know my employer screens BMI and we get an annual physical. You are not penalized for a poor health status but you do receive hefty financial incentives for improving your health as it would not be right to fine those who smoke or who are obese. No one is fined but those who are healthy pay less lol.

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