Carroll Hospital > Careers at Carroll > Nicotine-Free Hiring Policy

Nicotine-Free Hiring Policy

Key Facts

  • Carroll Hospital was the first hospital in Maryland and one of the first major Baltimore-Metro area employers to institute such a policy. Other health care systems have policies like this one including the Cleveland Clinic, Baylor Health System and WellSpan.
  • Smoking and tobacco use is the leading cause of preventable death in this country.
  • Carroll Hospital’s campuses became smoke- and tobacco-free in 1998.

Frequently Asked Questions about Tobacco Cessation & Nicotine-Free Hiring Policy

Q: What is the effective date of this new policy?
A: Carroll Hospital began screening all candidates for nicotine who have been extended a conditional offer of employment that would begin after January 1, 2015.

Q: Is this policy for all Carroll Hospital affiliates?
A: Yes. This policy applies to potential employees for Carroll Hospital, Carroll Hospice, Carroll Health Group and other hospital affiliates.

Q: How are applicants tested for nicotine?

A: The testing is part of the urine drug screen done at the time of the pre-employment physical. Nicotine test results are on a pass/fail basis.

Q: Will employment applicants know upfront that we will be testing for nicotine?
A: Yes, it will be stated clearly prior to and during the application process.

Q: What will happen to current employees who continue to use tobacco/nicotine?
A: At this time, the new policy does not apply to current employees of Carroll Hospital and its affiliates. The hospital is focusing on a workforce that models a healthier lifestyle for our patients and community. A healthier workforce means better care for our patients as well as setting an example for our communities. We believe this will motivate our patients to make positive lasting changes for their health.

We want to encourage healthy habits, so for the past several years we have supported current employees who want to quit by providing free tobacco cessation programs and resources. A healthy lifestyle is the key to continued well-being, and we know changing one’s lifestyle for the better takes time and real effort. Beginning in January 2014, employees who are on the hospital’s health insurance and who use nicotine have had a bi-weekly surcharge applied to their health care premiums.

Q: What resources or programs do you offer current employees who use tobacco/nicotine?

A: Carroll Hospital offers several free programs and resources for employees who want to quit using tobacco/nicotine. Employees may take advantage of free tobacco cessation products and counseling as well as on-campus events and programs. Employees on the hospital’s health plan also benefit from the Associate Health Navigator, a registered nurse dedicated to connecting employees to health and wellness resources as well as providing education. Employees on the health plan may also receive prescription coverage for tobacco cessation medications. In addition, spouses and dependents of anyone on the health plan may use these resources.

Q: Does this nicotine-free policy apply to employees’ spouses?
A: We are exploring ways to help them become nicotine-free in the future.

Q: Why nicotine use and why not other behaviors or habits?
A: We know that stopping nicotine use has been proven to provide health benefits and decrease the risk of premature death. This is part of our commitment to wellness and preventing disease.

Q: Why did Carroll Hospital make this decision?
A: Not hiring employees who use nicotine is becoming increasingly common, especially in the health care field. Hospitals and health care systems in Florida, Georgia, Maryland, Massachusetts, Missouri, Ohio, Pennsylvania, Tennessee and Texas are among those who have instituted, or plan to institute, such policies.
The use of tobacco and nicotine products is the leading cause of preventable death in this country. As an organization that provides health care, we want to encourage our employees to take better care of their health and set good examples for our patients. It is important that we take care of ourselves so we can lead by example and take care of others.

Q: How will this new policy work?
A: We will have information for interested applicants on our career pages of our website informing them of our nicotine-free hiring policy. Applicants who profess to use nicotine will not have their applications processed. Anyone who receives and accepts a conditional offer of employment for a position at Carroll Hospital, or one of our affiliates, will be tested for nicotine as part of our regular pre-employment testing. Any candidate who tests positive for nicotine will no longer be considered for employment and their conditional job offer will be withdrawn.

Candidates will be provided with free programs and resources to help them become nicotine-free should they choose to do so. For many years, we have conducted pre-employment drug testing for all new hires. In January 2015, nicotine was added to substances looked for in this urine test. This policy also applies to employed physicians.

Q: Is screening for nicotine use legal?
A: Yes. Under federal law, smoking is considered an activity, rather than a medical condition, so it is not protected under the Americans with Disabilities Act. Nicotine users are not a protected class in Maryland.

Q: Does this new policy affect current employees who use nicotine products?

A: This new policy does not apply to current employees. In 1998, we committed to being smoke- and tobacco-free on all our campuses, so employees, patients and visitors have not been able to use tobacco or nicotine products on campus. And, since January 2014, employees who are on the hospital’s health insurance and who use nicotine have had a bi-weekly surcharge applied to their health care premiums.

We encourage our staff to take the best possible care of themselves so that they can give the best possible care to our community. For the past several years we have supported current employees who want to quit by providing free tobacco cessation programs and resources.

A healthy lifestyle is the key to continued well-being, and we know changing one’s lifestyle for the better takes time and effort. Since 2006, the hospital has offered health risk assessments to employees as part of the hospital’s wellness program, along with education and resources to improve or maintain one’s health. Associates who take advantage of the health and wellness resources available and take steps to become healthier are eligible for discounts on their health insurance premiums.

Q: What does the new nicotine-free hiring policy mean for people seeking employment with Carroll Hospital or its affiliates?

A: Effective January 1, 2015, Carroll Hospital and its affiliates no longer hires individuals who use nicotine products. Applicants who profess to use nicotine will not have their applications processed. Anyone who is offered and accepts a conditional offer of employment for a position with Carroll Hospital or one of its affiliates will be tested for nicotine during our regular pre-employment testing. Candidates who test positive for nicotine will be eliminated from consideration and conditional job offers will be withdrawn. We encourage candidates who do not pass the nicotine testing to consider taking steps to stop the use of nicotine and reapply for consideration after a period of 90 days. We will supply candidates with free programs and resources should they choose to pursue a nicotine-free lifestyle.

Q: Who is classified as a nicotine user?
A: A nicotine user is any individual who uses nicotine products including, but not limited to, cigarettes, cigars, pipes and chewing tobacco. This policy also applies to e-cigarettes, which are regulated by the Food and Drug Administration as a nicotine product. Use of nicotine patches and nicotine gum also will contribute to a positive test result.

Q: What is a nicotine product?

A: A nicotine product is any type of product that contains or is made or derived from nicotine and intended for human consumption. Products that are chewed, smoked, absorbed, dissolved, inhaled, snorted, sniffed or ingested by any other means are included, as are components, parts or accessories of nicotine products.

Q: What if an applicant only uses nicotine socially?

This policy applies to any applicant regardless of how often they use nicotine products.

Q: How long does nicotine stay in your system?
A: The length of time nicotine stays in someone’s system varies. Some of the variables include length of time a person has been smoking, number of cigarettes smoked, type of cigarette, depth and duration of inhalation, the difference in the way each person’s body breaks down the nicotine, etc. Nicotine can stay in the system up to 30 days or more. It can even take weeks longer until the nicotine is depleted from the fat in the body.

Q: How much do I have to smoke or ingest in order to test positive? 
A: Smoking one cigarette can produce a positive result, depending on when the urine sample is taken.

Q: Does second hand smoke produce a positive result for nicotine use?
A: When testing for nicotine, the lab has built in levels that would take into account the possibility of second hand smoke. Therefore, a positive result will mean the individual who tested positive is a nicotine user.

Q: Does this apply to new physicians?
A: Effective January 1, 2015 any employed physician is subject to the same hiring policy and pre-employment testing as outlined above. New medical staff members who have privileges at the hospital and are not employed by the hospital will sign a pledge that they are nicotine-free.

Q: Does this apply to new volunteers?
A: Yes, volunteers are part of our team that serves our patients. Effective January 1, 2015, new volunteers will sign a pledge that they are nicotine-free.

Q: What if an applicant uses nicotine products now, but wants to quit? Will we hire them?
A: Applicants must be nicotine-free to be considered for hire.

Q: Is there concern that Carroll Hospital will miss out on some talented applicants with this new policy?
A: We understand that this policy has a potential impact on an individual’s choice of employment. So yes, we may miss out on some good people. But not hiring people who use nicotine products is a movement not only in health care, but also with other employers who are looking for ways to build healthier work forces. We have an obligation to set a good example for the communities we serve. By implementing a nicotine-free hiring policy, we will be expecting the same healthy behaviors we encourage of our patients and their family members.