Three Georgia hospital systems have gone one step beyond banning smoking on their campuses.

They won’t hire people who smoke.

The three health systems — Gwinnett Medical Center, DeKalb Medical Center, and Phoebe Putney Health System in Albany — will drop job applicants from their candidate list if a blood test for nicotine comes up positive.

Hospitals’ hiring practices on tobacco use were illuminated in a New York Times story last week.  The article reported that more hospitals and health care businesses are adopting a no-hire policy against smokers.

The Times said that these employment policies — and smoke-free workplace restrictions — have sparked debate over how far employers can intrude into someone’s life to prohibit a practice that is legal.

About 20 percent of American adults are smokers.

Tobacco use is the leading preventable cause of death, according to the Centers for Disease Control and Prevention. Tobacco in the U.S. is responsible for about one in five deaths annually.

Smokers have higher health care costs and lower productivity, and many employers require workers who smoke to pay a surcharge on health insurance premiums.

The Georgia chapter of the American Lung Association also has a policy against hiring smokers. June Deen, the state director of the Lung Association, said she has not heard of an increase in Georgia employers who refuse to hire smokers.

Deen said the Lung Association encourages employers to offer programs and benefits to help smokers quit. Some states have laws prohibiting discrimination against smokers, but Georgia does not, she said.

Dozens of hospital campuses ban smoking

Gwinnett Medical Center adopted its policy in July 2010. A spokeswoman, Andrea Wehrmann, told the Gwinnett Daily Post then: “We are a hospital. We are not a tire company, we’re not a neighborhood bar or restaurant. We’re a medical institution, and most Americans are aware of the health issues related to smoking.”

Gwinnett said this week that since July 1, it has had 25 positive tests for nicotine among job applicants. Gwinnett Medical spokesman Aaron McKevitt said the organization has not faced legal action over the policy.

The hiring policy did not affect Gwinnett Medical employees who smoked at the time of the change. They were offered smoking-cessation programs. Those who quit smoking — and stayed smoke-free for at least 6 months — saved on their health insurance premiums, Gwinnett Medical said.

DeKalb Medical Center went to a nicotine-free hiring policy in November 2009. Spokeswoman Tori Vogt said that since the anti-nicotine hiring practice began, about 2 percent of applicants who were close to getting a job offer have tested positive. Job candidates who test positive for nicotine are offered smoking cessation assistance and are permitted to reapply for open positions after 120 days, Vogt said.

DeKalb Medical campuses have been smoke-free since January.

“Smoking is the leading cause of preventable death in the United States, and secondhand smoke has known health risks,’’ DeKalb Medical said. “As a major provider of health care in the community, we are committed to leading by example and creating a healthy environment for our patients, visitors, employees and volunteers who are on our campus. ‘’

And the website for Phoebe Putney Memorial Hospital states: “Phoebe does not hire individuals, including previous employees, who use tobacco or nicotine in any form.’’

Phoebe said it has followed that policy since January 2008. “We occasionally have positives, but fewer as time goes on,’’ said Phoebe spokeswoman Jackie Ryan. “Applicants know upfront that we test for nicotine.’’

Dozens of hospital campuses in Georgia ban smoking, according to the Georgia Hospital Association. Kevin Bloye, a GHA vice president, said he knew of only Gwinnett Medical, DeKalb Medical and Phoebe Putney that have hiring policies on smoking.

“GHA has not taken a formal position on the national trend toward hospitals choosing not to hire smokers, but we do support the idea that hospitals, as much as any other field, should lead by example when it comes to protecting and improving community health,’’ Bloye said. “Taking a strong stand against smoking — which is proven to have devastating impact on community health — is a natural extension of that role.’’