While workers’ waistlines remain a prime target in many employer-sponsored wellness initiatives, companies also are deploying aggressive anti-smoking programs in hopes of controlling health care costs, experts say.

Amy McAllister with Provant Heath Solutions noted in a recent Employee Benefit News report that her company has seen a strong uptick in the use of tobacco cessation initiatives.

McAllister said more employers are shifting their wellness programs to include a “total-body” approach, and that means tackling smoking among the workforce.

Provant’s clients are using a mix of “carrot and stick” methods to encourage employees to participate, she said, including higher premiums for workers who refuse to quit.

Although the health benefits of kicking the habit are widely known, employers often overlook some of the legal snags that can occur with a smoking cessation program — especially if it involves tests to make sure workers remain compliant.

“The issue of nicotine testing is complicated not only by the presence of smokers’ rights laws and lifestyle statutes in certain states, which prohibit employer interference in off-duty conduct, but also by questions regarding disability and privacy,” said Julie B. Ross of the law firm Lynn Ross Smith & Gannaway, according to Human Resource Executive Online.

Although no court has ruled that nicotine addiction is a disability, recent amendments of the American with Disabilities Act may make it easier for employees who are fired or penalized for failing a nicotine test to win legal battles with employers, Ross said.

Callan G. Carter, a partner at Fisher & Phillips LLP, noted that communication and test administration can further complicate programs that require testing. These challenges often convince employers to limit their scope of testing programs.

“I find that most employers allow employees to self-certify their tobacco use status and only test an employee for nicotine if the employer has a reason to believe the employee may be using tobacco after they have certified otherwise,” Carter told HREO.

Still, the pressures of health care costs likely will continue to persuade employers to lean on anti-smoking programs and other initiatives that promise to drive down costs. A recent report by Adecco notes that 55 percent of executives rank health care costs as their No. 1 worry — beating wages, taxes and talent retention.

That high concern about health care costs means companies should expect the trend of more smoking cessation programs and tobacco testing to continue, experts say.