If you smoke and are looking for job at Memorial Health Care System, you might want to hold off on filling out an application. As of Feb. 1, the Chattanooga, Tenn.-based organization -- composed of two acute-care hospitals, home health services, an imaging center, satellite facilities and a physician practice management company -- stopped hiring those who use tobacco or other nicotine products if those substances were detected in the post-offer health screening. The health care system did not respond to requests for comment, but according to its Web site, the step was taken to "further our mission of building healthier communities" (www.memorial.org/about_us_careers.html). Memorial follows in the footsteps of the Cleveland Clinic, which stopped hiring smokers in July 2007. Thousands of other companies have similar rules. Such policies are not legal in all states. Institutions that want to follow suit should check local laws. Memorial's actions elicited mixed responses from some longtime anti-tobacco activists. Those supporting the health system's policy include John F. Banzhaf III, founder, executive director and chief counsel of Action on Smoking and Health, which has long been involved in lawsuits against the tobacco industry. Banzhaf said he came out behind Memorial's move because of estimates that each smoker costs companies an average of an additional $12,000 per year. "Smokers should accept the fact that there is no legal or moral right to smoke and to force others either to put up with their secondhand smoke or the huge costs their smoking imposes on others." But others who also have worked to reduce smoking rates were less sure of Memorial's policy. "This gets into personal freedoms, and I'm very uncomfortable with this," said Alan Blum, MD, professor of family medicine and director of the University of Alabama Center for the Study of Tobacco and Society. "This would be very low on my wish list for what hospitals should be doing. What is it about the person who smokes that makes them less qualified?" The policy does not affect current employees. Also, those whose job offers are withdrawn because they test positive for tobacco byproducts may be able to reapply after six months. According to the Centers for Disease Control and Prevention, 23.1% of adults in Tennessee smoke -- one of the higher rates in the country. The national average is 18.3%. The full and original article can be found here: http://www.ama-assn.org/amednews/2010/02/15/bisf0219.htm