It's not a crime to smoke a cigarette, but some employers refuse to hire people who do it.
Mountain State Health Alliance said this week they will start testing new hires for nicotine. The group's hospitals serve dozens of East Tennessee counties.
If you apply for a job at one of their hospitals or facilities, starting March 1st you have to take a nicotine test. If it's positive, you're not getting the job, but you can reapply in six months.
"As healthcare providers we see everyday the devastating effects that tobacco has and we believe that it's our responsibility to set an example for a healthy workforce and healthy community," said Teresa Hicks, spokesperson for Mountain State Health Alliance.
Summit Medical Group, which employs more than 1,300 people, started the policy two years ago.
"We no longer hire smokers," said Dr. Ed McBride, Summit Medical Group's Medical Director and family physician. "Summit is very proud of this program and I think it is something that we will continue and expand over time."
Dr. McBride said as medical professionals they have to practice what they preach.
"If you are telling your patients to quit smoking, it's a bad example to set if you do smoke," he said. "We also know that folks who smoke have an increased risk for health issues."
Current employees who smoke are not penalized. But Summit offers incentives to help them quit.
"For those who currently smoke but are willing to participate in our tobacco cessation program through health coaching, they see a $75 per month reduction in insurance costs which is $950 per year," Dr. McBride said.
While Dr. McBride credits programs like theirs to a decrease in smoking nationwide, he says the progress has reached a plateau.
"I think we need to do more. So we're looking at expanding our program in order to help more individuals quit smoking," he said. That could mean testing current employees.
Many Knoxville hospitals have taken other steps to reduce smoking, like making their campuses smoke free.
They include UT Medical, Tennova, and Covenant hospitals.