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The surcharge may appear as: A separate deduction on a paycheck A higher employee health insurance contribution The loss of a wellness discount A tobacco user or nicotine user premium adjustment A higher cost for covering a spouse or another dependent who uses tobacco Employers commonly determine tobacco status through a questionnaire or self-attestation completed during initial enrollment or annual open enrollment

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I have particular concerns about whether the pharmacy setting is influencing consumer and retailer perceptions around tobacco products in a way thats contributing to these troubling findings.