Employers do have someconcern about productivity and absenteeism, related to tobacco use,but it's more about the risks of cancer and heart and lungdisease. (Photo: Shutterstock)

When U-Haul recently announced it will no longer hire people whouse nicotine in any form in the 21 states where such hiringpolicies are legal, the Phoenix-based moving company joined a cadreof companies with nicotine-free hiring policies.

U-Haul's announcement isreceiving outsize attention because nicotine-free hiring policiesare more common at high-profilehospitals such as Cleveland Clinic that are especiallyprotective of their healthy image.

Alaska Airlines has one of the oldest nicotine-free hiringpolicies, going back to 1985. But at the time, a big part of thestated reasoning was that the industry isn't conducive to takingsmoke breaks.

Related: Americans smoking less, but diabetes and obesityare increasing

Now, some employers are making the policy change simply citinghealth concerns or health care costs — even the city of Dayton,Ohio, has joinedthe movement.

But the policies are raising concern around labor and medicalethics. HaraldSchmidt, a medical ethicist at the University of Pennsylvania,said targeting smokers disproportionately harms poor people.

"To me, this is more about fair equality of opportunity," hesaid.

Smoking is a behavior, so Schmidt doesn't equate it withdiscriminating on the basis of race, gender or sexual orientation.But he notes that roughly half ofunemployed people smoke. And quitting is hard, because nicotineis highly addictive.

"You're basically posing a double whammy on them," Schmidt said."It's very hard for them to get work, and it's even harder forpeople who are already in a vulnerable situation."

KarenBuesing of the law firm Akerman represents employers and workswith them on smoking policies. She said employers are looking outfor the health of their employees.

Employers do have some concern about productivity andabsenteeism, she said. But it's more about the risks of cancer andheart and lung disease.

"Obviously, there are higher health care costs associated withsmokers. And so many companies would much prefer to have anonsmoking workforce," she said.

The corporate cost per smoker is estimated tobe in the thousands of dollars per year, though some experts havequestioned the accuracy of the figures.

Buesing said discrimination of any kind is so taboo thatemployers in many states don't realize they can reject applicantsfor being smokers. And it's not allowed everywhere: 29 states andthe District of Columbia have various laws that safeguard "off-duty" activity. Many ofthese laws were passed in recent decades specifically to shieldsmokers.

"In that context, you now have protections for smokers," Buesingsaid of the 29 states. "Certainly under federal law, smokers arenot a protected class."

A 2017 Gallup Poll found that morethan half of American smokers feel they're discriminatedagainst for their nicotine habit.

"Even when I was doing temporary work, people would be like,'You're going on break? Are you going to smoke?'" said Carl Carterof Nashville, Tennessee, who is currently on disability benefitsand not working. "I should have the right to do what I want todo."

It's not that he doesn't want to quit. He has tried eight times,most recently on New Year's Day. But the habit is hard to beat.

Labor groups have not fought nicotine-free hiring policies, butEdgar Ndjatou, executive director of the advocacynonprofit Workplace Fairness,calls smoker hiring bans "problematic."

"Someone who uses tobacco could potentially have some form ofdisability," he said, adding that addiction could be protectedunder the Americans with Disabilities Act. "I would argue thatthese types of bans have to be reasoned."

Ndjatou and other critics ask, what's next? Will nicotine-freehiring lead to more policing of worker health?

IT administrator and vaper Scott Bales thinks so.

"I think that it's interesting that they are demonizing one overthe other, and I'll specifically use alcohol," he said on a vapingbreak outside his office in Nashville. "How can you ban onesubstance without banning the other one?"

The American Civil Liberties Union has come out againstnicotine-free hiring, calling it "discrimination." The organizationis critical of other forms of what it calls "lifestylediscrimination."

"Should an employer be able to forbid an employee from goingskiing? or riding a bicycle? or sunbathing on a Saturdayafternoon?" an ACLU legislativebriefing asks. "All of these activities entail a healthrisk."

But companies rejecting smokers point out that tobacco isthe mostpreventable cause of cancer and lung disease. And the employersare the ones who will likely have to pay much of the healthbills.

Still, attorney Buesing doesn't expect the U-Haul announcementto unleash a flood of similar policies. She said rewarding healthybehavior is still seen as the most palatable approach by manyemployers.

U-Haul said its policy will not apply to existing workers. Thecompany employs 30,000 people around the country, with 4,000 at itsheadquarters. U-Haul will screen new hires and require them toconsent to future drug testing for nicotine, though it's unclearhow that would affect workers who use nicotine gum or patches.

"This policy is a responsible step in fostering a culture ofwellness at U-Haul, with the goal of helping our team members ontheir health journey," chief of staff Jessica Lopez said in a press release.

U-Haul declined an interview request.

This story is part of a partnership that includes Nashville Public Radio, NPR and Kaiser HealthNews.

Read more:

• Smoking hurts your job prospects
• Most reject hiring discrimination for smokers,obese
• What should employers do aboute-cigarettes?