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State Any substance containing tobacco leaf including, but not limited to, cigarettes, cigars, pipe tobacco, snuff, chewing tobacco, or dipping tobacco or rolling papers, alternative nicotine products (non-combustible product containing nicotine that is intended for human consumption, whether chewed, absorbed, dissolved or ingested by any other means) and vapor products (non-combustible product containing nicotine that employs a heating element, power source, electronic circuit or other electronic, chemical or mechanical means used to produce vapor from nicotine in a solution, for example e-cigarettes)

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the proposal to use a calculation methodology to account for the impact of improper payments in recalculating expenditures and payment amounts for certain Shared Savings Program financial calculations, upon reopening an ACO's payment determination and issuing a revised initial determination pursuant to 425.315(a) as described in section III.G.7.c of this proposed rule

Smoking significantly exacerbates this risk, with recent evidence showing that cigarette smoking is associated with a 22% increased risk of CVD events in MASLD patients compared to non-smokers (aHR 1.22, 95% CI 1.151.30) [71]

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