The giant University of Pennsylvania Health System and the prestigious Children's Hospital of Philadelphia have joined the ranks of employers who are banning smokers—not just from hospital property but also from their employee rosters.

UPHS said a job applicant must be tobacco-free for six months—and applicants caught lying, including doctors, may be fired. Children's Hospital said it would actually test applicants for nicotine, just as applicants are tested for drug use.

According to a Philadelphia Inquirer story, the ban doesn’t apply to current employees, who must pay a $7.50 per week health insurance surcharge for every insured smoker on a policy.

Such hiring policies have repeatedly been upheld by the courts, except in states that prohibit them.

Still, the ban has sparked another round of debate about workers’ rights and privacy.

“Critics still raise the same stale objections,” says George Washington University law professor John Banzhaf. He supports the policies and has helped to legally defend them.

The Cleveland Clinic and Baylor Health Care System, along with dozens of other companies across the country, have adopted similar policies.

But a Reuters story in Philadelphia last week said the hospitals’ decision “has relit a debate about the wisdom of regulating workers’ behavior away from the workplace.”

“It's not all slopes that are slippery, but this one really is,” Lewis Maltby, a former American Civil Liberties Union lawyer who now runs the National Workrights Institute in Princeton, New Jersey, told Reuters.