Under the Americans with Disabilities Act, employers cannot ask if an applicant has ever had cancer or emphysema, Gordon said—but they can legally test for the presence of nicotine, which can indicate a greater likelihood of developing these and other illnesses.
It's not impossible to have a firm anti-smoking policy that doesn't ask employees to take an invasive urine screen.
While Penn Medicine does have a policy against hiring smokers, its employees are on the honor system. "Penn Medicine does not test for cotinine in any applicants," said Michele Fletcher, Vice President of Human Resources-Decision Support at the University of Pennsylvania Health System. However, she added, "Applicants must attest that they are non-tobacco users when applying for a job."
Fletcher says she knows of at least two human resources employees who quit smoking as a result of Penn's smoking ban and the free smoking cessation program they offer. She believes Penn's position on smoking has made employees more aware of the importance of their personal well-being and caused it to become a more healthful organization.